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When I began working in the laboratory, my first full-time position was as a lab manager in a pain management practice. The doctor who ran the practice refused to switch to electronic health records because he said, "It is cheaper to pay the fine" than to buy the software needed. This caused a patient care delay when the charts were misfiled or transferred to another office or when they required paperwork for referrals or a copy of their medical records, as everything had to be done by hand. Three years after I left, the practice was raided by the FBI, state police, and the DEA. The agencies arrived with large box trucks to take all the charts to investigate fraud and other state and federal charges.
Last year, I assisted in adopting and developing a new EHR system for the Defense Health Agency. Before the new MHS-Genesis, DHA facilities used CHCS and AHLTA. The problem with CHCS/AHLTA is that visits conducted on-site could be seen by a provider. With most soldiers transferring to a new duty station every 2-3 years, their medical records from one site would not follow them to their next duty station, and treatment off-post would need to be faxed and scanned into the record. MHS-Genesis allows patients' records to follow them throughout their military career. Soon, it will follow them into the veteran's health system, with the VA beginning to adopt the program. The system also allows for communication with providers outside the DHA health system.
With the MHS-Genesis, abnormal laboratory results can be verified with a glance at the patient's medication list or reason for the visit. We can also view a patient's history from one duty station to another, allowing for better continuity of care, including faster, more accurate patient results. However, there are some potential disadvantages as well. Everyone now has access to the patient's EHR, which allows for potential HIPAA and privacy violations. Patients may face discrimination from the data gained from their EHR. While some communication is available with off-post treatment facilities, due to increased safety for national security, many sites cannot communicate directly with the new system due to safety concerns.
References:
Bacon, B., & Yoshida, S. (2008, October 30). Contextual history and visual timeline of Ahlta and Vista/CPRS ... Parsons Institute for Information Mapping.
Jones, S. (2024, June 10). The advantages and disadvantages of sharing patient information. MedTrainer.
Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health Care Information Systems: A practical approach for Health Care Management. Jossey-Bass & Pfeiffer/Wiley.