|Frequently Asked Questions
About Electronic Health Records and Health Information Exchange
An electronic health record is defined as an electronic record of health-related information about an individual that conforms to nationally recognized standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization. In layman’s terms EHRs are computerized versions of patients’ clinical, demographic and administrative data. The records may include treatment histories, medical test reports and images stored in an electronic format. Although they sometimes are referred to as electronic medical records (EMR), EHR is now the preferred term.
What types of information might be stored in an EHR?
Any health record that can be stored on paper can also be stored in an EHR. One benefit of using an EHR is that it’s more comprehensive and flexible than paper files. EHRs enable viewing of results not only in chronological order but also arranged in other ways, such as in charts and graphs, that allow the patient's health care providers to see trends and changes that could affect that person's treatment.
EHRs often allow health care providers to quickly search and review lengthy patient records that may be difficult to sift through when they are on paper, thus improving the quality and quantity of information available to a health care provider, especially in urgent situations.
What are the advantages of EHR?
- Storing health records electronically allows for quicker retrieval of more complete patient information by authorized health care providers.
- Electronic health records make searching, tracking and analyzing information easier. Unlike paper records, they are not bulky, they don’t take up costly space and they don’t require labor-intensive methods to maintain, retrieve and file.
- Electronic health records provide easier access at times of emergency and can be backed up easily to avoid loss during times of disaster (such as floods, fires or tornados) especially when linked into a health information exchange.
- Unlike paper records, electronic records are encrypted and access is restricted so that only authorized individuals can view them. Further, anytime an electronic record is accessed, the information is tracked and audited. When a paper record is accessed, it is very difficult to track who saw the information and whether or not it was authorized.
How secure are electronic health records?
As with paper records, those accessing electronic health records must comply with the federal Health Insurance Portability and Accountability Act (HIPAA) in regard to protecting patient privacy. Unlike paper records, electronic health records can be encrypted so that only authorized individuals can view them.
What is health information exchange (HIE)?
According to www.healthit.gov, health information exchange (HIE) "makes it possible for health care providers to better manage patient care through secure use and sharing of health information." HIE "includes the use of electronic health records (EHRs) instead of paper medical records to maintain personal health information."
What is e-Prescribing and how does it relate to EHR/HIE?
Electronic prescribing, or e-Prescribing, enables eligible health care providers to transmit a prescription electronically to a pharmacy. It also enables health care providers and pharmacies to obtain information about a patient’s eligibility and medication history from drug plans. In many places, e-Prescribing is the first form of EHR/HIE being adopted.
Why share records electronically?
Health care providers need all of your health information to accurately diagnose and treat you. Without EHR/HIE, each of your health care providers may have different portions of your health record. If they can access each other’s records and see more complete health information, they can provide you with better care. Sharing your health information can also help reduce your costs by eliminating unnecessary duplication of tests and procedures.
How would EHR/HIE be useful in an emergency?
When someone needs care in an emergency, that person might be far from home, unable to communicate or unable to remember key information, such as names and doses of prescription drugs. Allowing a health care provider to retrieve the patient’s records quickly and completely speeds the delivery of appropriate care, and avoids unnecessary duplicative testing, medical errors and extra costs.
How would EHR/HIE be useful in a disaster?
During disasters such as floods, tornados and wildfires, paper records can be lost or ruined. Electronic health records, however, can be backed up securely and stored in several locations. That permits their retrieval whenever and wherever necessary for medical treatment.
Why would EHR/HIE lead to less duplicative medical testing and a more efficient system?
When each health care provider involved in a patient’s care has all of that patient’s data readily available, medical tests that have already been performed do not have to be repeated unless new developments warrant them. This allows the health care provider to determine a course of treatment more quickly and accurately.
How would EHR/HIE improve patient safety?
- When any health care provider treating a patient at any time and in any place has access to all a patient’s records, the health care provider can make more informed decisions due to the completeness of the information.
- EHR and HIE systems can automatically alert health care professionals when there are conflicts between prescribed drugs.
- When medical information is stored electronically, problems with illegible handwriting on paper records and prescriptions are eliminated.
- EHRs are much more accurate than many patients’ memories. When an EHR is available through HIE, there is no question what procedures have been performed.
How secure is an HIE?
State-of-the-art systems are employed to secure records to the greatest degree possible and prevent access by unauthorized persons. Any system used must comply with the security provisions of the federal Health Insurance Portability and Accountability Act (HIPAA). In Kansas, specific requirements for security and reporting of security breaches have been established for HIEs certified to operate in the state.
Who has access to my information?
With two limited exceptions, only authorized health care providers and payers who participate in health information exchange through an approved health information organization can access your electronic records through the exchange. To participate in health information exchange, health care providers and payers must agree to specific rules protecting the privacy and security of health information. For example, a participant may access information on a need-to-know basis only for purposes of treatment, payment, and health care operations. The two exceptions are (1) access by authorized state agencies for purposes of mandatory reporting requirements (e.g., reports of suspected child abuse), and (2) Approved Health Information Organization staff and contractors for technical and administrative support. Approved health information organizations are capable of creating audit trails that identify each person who has accessed a particular record and the date and time of such access.
What information will be shared?
All information in the health care provider’s electronic health record may be shared with other participating health care providers. The actual information shared depends on individual health care provider preference and technology, but typically, lab and x-ray results, medication and immunization history, transcribed diagnostic and treatment records, records of allergies and drug reactions, and other transcribed clinical reports are shared with other participating health care providers. Health records before July 1st, 2012 are generally not available unless made available by this particular provider following the provision of this notice.
Why should health information be shared?
Currently, a patient's health information may exist in many different locations. If you have a treatment done at a specialist’s office, for example, your health care provider may not have access to that information. Health care providers can make better decisions about your care when they know your full health history, including lab tests, medication history and allergies - information that could be lifesaving in an emergency. The inability to access your health records also may result in a repeated medical test, which costs time and money.
How is my privacy protected?
As a condition of approval, the Kansas Health Information Exchange (KHIE) requires health information organizations operating in Kansas to maintain the highest level of technical and administrative safeguards to protect your health information from unauthorized disclosures, including encryption, password protection, redundant systems, facility and equipment controls, the ability to track every viewer’s usage of the system, and policies controlling access to information. To participate in health information exchange, health care providers and payers must agree to similar requirements.
How can I prevent my information from being shared?
Under Kansas law, you have the right to restrict access to your health information through health information exchange. To exercise this right, you must complete and submit a "Request for Restrictions on Access" form to the Kansas Health Information Exchange, Inc., (“KHIE”) the oversight agency for health information exchange in this state. The "Request for Restrictions on Access" form is available within the "For Consumers", "Opt Out" tab at www.khie.org. Unless and until you request restrictions in writing, all of your health information will be accessible through health information exchange, including particularly sensitive health information. Current technological limitations prohibit the selective exclusion of such sensitive information. If you do not want this information shared, none of your health information will be available through health information exchange.
Can I ask my doctor to change or delete information in my electronic health record?Yes, you may ask, but your doctor is required to maintain the truthfulness of your health information and, under HIPAA, has the final say over adjusting your electronic health record. You may request to have any mistakes corrected.
What happens if I restrict access?
Through an identification matching system used at the approved Health Information Organization, all of your health records will be blocked from viewing by other health care providers that are part of the network. Your information will still be available on your own health care provider’s electronic health record and may be shared with other health care providers by traditional methods.
Can I restrict part of my health information?
No, you cannot restrict part of your health information. If you choose to restrict your information, none of your information will be available through an approved health information organization (HIO) to providers outside the facility where you are receiving treatment.
If I restrict access, can I revoke the restriction?
Yes. Again, you will need to submit a completed form to KHIE to revoke restrictions of your health records. That form is available on the "For Consumers", "Revoke Opt Out" tab at www.khie.org. Please note that all information collected by your health care provider after your initial restriction of access will be available for sharing between your health care providers.
Can I have access to my electronic health record?
Yes, you are entitled to get copies of your own health information, by law. Access to your personal health information in electronic form will vary among health care providers. If you want copies of your health information, ask your health care provider with whom you have a direct care relationship how you would be able to access or to get copies of your information. You may be able to either access and print your health care information online or request hard copies of your information to be provided to you.