As Minnesota’s health commissioner, I work to improve the health of all Minnesotans. As a physician, I’m dedicated to providing the best care possible to patients. Secure electronic health records help achieve both goals by enhancing the safety, effectiveness, and efficiency of our health care system. With that in mind, I have been concerned to see some recent pushback on Minnesota’s requirement that all health care providers use electronic health records (EHR) by 2015.
Minnesota’s law on electronic health records was enacted in 2008 by a bipartisan majority and signed by Republican Gov. Tim Pawlenty. Instead of imposing penalties or fines on doctors and nurses, the law created a collaborative effort to meet its goals.
Today, small and large clinics and hospitals have succeeded under this approach: 93 percent of Minnesota’s clinics and 99 percent of Minnesota’s hospitals have adopted EHRs and see their value. When surveyed, 95 percent of Minnesota’s clinics said EHR technology enhances patient care and 92 percent said EHRs alerted them to potential medication errors. Four Minnesota hospitals reported that over six months, using EHRs helped them collectively avoid 560 duplicate procedures.
All patients stand to benefit
These are important benefits at a time of increasing specialization and demand for team-based health care. Minnesotans will see additional benefits in settings such as nursing homes and mental health clinics. All Minnesota patients, whether they visit a small clinic, need mental health treatment, or receive care from multiple providers, stand to benefit from EHRs and the improved care coordination they make possible.
This coordination is very important for patients facing multiple health challenges. Evidence shows EHRs can prevent patients from falling through the cracks as they get care for different conditions from different providers. Given that Americans with major mental illness die 14 to 32 years earlier than the general population, due greatly to a lack of coordinated medical care, the American Psychological Association has noted that, “Health information technology is the bedrock of any effort to coordinate and integrate care.”
The benefits of EHRs are not disputed, but there are four myths I would like to address.
Myth 1: Patients lose control over their mental health records such as therapy notes.
Fact: Minnesota has one of the strongest privacy laws in the country. Patients must consent before their information can be shared with another provider, and there is a standard consent form any patient can use to specify with whom their data are shared, what types of data are shared, and for what purposes. For psychotherapy notes or chemical dependency information, an additional level of consent is required. The form is available online [PDF]. State law requires all providers to accept this form and respect patients’ wishes about how their data are shared.
Myth 2: Private information is stored online where anyone can access it.
Fact: EHRs do not make patient data accessible online or to every provider. EHRs are secure systems that exist within health care systems. Communication between these systems happens using secure, encrypted methods, and only after patient consent. Significant penalties exist for inappropriate releases of private medical information.
Myth 3: The government is creating a database of electronic health records.
Fact: Not true. Clinical data are in separate private systems belonging to providers, which communicate with each other via encrypted, secure messages, and only with patient consent.
Myth 4: Any clinician in the state can access anybody’s electronic record.
Fact: EHRs allow health care organizations to limit access only to employees who need the information to provide care. The systems also track who is accessing the records. In comparison, paper records do not provide this level of protection because anyone with access can view them without leaving a trace.
Minnesota’s approach to electronic health records strikes a responsible balance of patient privacy protection with key system improvements. The technology offers a strong public health benefit, and processes are in place to prevent problems. Minnesota’s EHR law sets our state on a sound course leading to better care coordination and service; this benefits all of us.
Dr. Ed Ehlinger is the Minnesota Commissioner of Health.
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