E L E C T R O N I C H E A LT H R E C O R D S I N P R I VAT E P R A C T I C E

# H I 2 0 1 # E H R I S S U E S A N D C H A L L E N G E S

Alvina Pauline D. Santiago, MD October 10, 2014

ehrfunding.com

E H R I S S U E S & C H A L L E N G E S

• Question: Aside from cost…

• What are the issues and challenges in implementing an electronic health record in my private practice?

• How would I approach to resolve them?

http://cache.boston.com

M U LT I - S I T E A C C E S S I B I L I T Y

• CHALLENGE 1: How do i make EHR accessible to both clinics without compromising data integrity?

• Fax a pdf copy from clinic 1 to clinic 2

• HIPAA Compliant Cloud storage

• Data Privacy Act of 2012 (Marcelo Solutions Sept 2014)

http://www.razorleaf.com

M U LT I - S I T E A C C E S S I B I L I T Y ( M U I N S O L U T I O N S S E P T 2 0 1 4 )

• Cloud-based platforms

• web-based apps

• cloud-enabled apps

• Data integrity & Confidentiality

• Vendor with high standards for security, availability and storage

• Users personal security practice: handling of passwords and user accounts

• Security awarenesshttps://www.surdoc.com

PA P E R C H A R T S

• Challenge 2: How do i integrate existing paper charts with the new EHR system?

• ScanFully searchable scanned documents

• Use key words or tag words

• Input charts following EHR system as they come

http://swimwest.org.uk cabolabs.com

PA P E R C H A R T S ( M U I N S O L U T I O N S S E P T 2 0 1 4 )

• Scan chart as TIFF or PDF then upload/attach to EMR

• Scan back files up to a certain cut-off date

• Scan back files as patients come for a new visit (only active files get scanned)

http://upload.wikimedia.org

E H R S Y S T E M B A C K - U P

• Challenge 3: What happens if my EHR system crashes?

• Back up Method?

• External Hard Drives under lock and key?

• HIPAA Compliant Cloud storage

• Multiple backup systems

• Oops, I lost your medical records, because of an EHR system error…is not acceptable.

http://salestores.com

E H R B A C K - U P ( M U I N S O L U T I O N S S E P T 2 0 1 4 )

• Onsite backups

• External hard drives

• Offsite backups

• Cloud-based storage

• Data encryption

• Daily backups

• Version control

• Impact same as “Lost paper chart”

softlinkbd.com

http://sys2netsolutions.ca

I S S U E : L E G A L W O E S :

• Are the EHR and notations therein valid legal proof of something that transpired in the physician-patient encounter?

• Dictum: If it is not written it did not happen.

• Solution: print out a hard copy in pdf format and have patients sign the chart.

http://plannedgivingbreakthroughs.com

L E G A L ( M A R C E L O S O L U T I O N S S E P T 2 0 1 4 )

•Relevant laws

•eCommerce Act of 2000

•any electronic communication agreed on by two parties are valid

•Data Privacy Act of 2012

•personal information is not sharable unless with consent or for public health

•Sec 12 (f); 13 (e); 13 (f)

•Sign using public key infrastructure (PKI)

•“A PKI (public key infrastructure) enables users of a basically unsecure public network such as the Internet to securely and privately exchange data and money through the use of a public and a private cryptographic key pair that is obtained and shared through a trusted authority.”-MRouse

http://nurseupdates.com

zaheerspeaks.com