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Aspects Considered In Electronic Medical Record

Even if electronic medical records systems wit computerized provider order entry, or CPOE, have existed for more than thirty years, less than ten percent of all hospitals in the United States, as of the year 2006, have fully incorporated electronic medical records into their systems.

In the year 2008, about thirty eight percent of office-based physicians accounted fully or partially using electronic medical records systems for their work processes. However, the same research found that only roughly twenty percent of all physicians reported using a system depicted as functional in minimal value and engaging in orders for prescriptions and examinations, viewing laboratory or imaging results, and clinical notes.

Electronic medical records, like their paper-based counterparts, must be kept in unaltered state and authenticated be their creators. Under data encryption and protection regulations, responsibility for patient records and documents, disregarding the forms they are kept in, is always on the creator and the custodian of the documents.

The tangible medical records are the property of the medical provider or institution that sets them up. This involves films and tracings from diagnostic imaging procedures, such as x-ray, CT scans, PET, MRI imaging, ultrasound, and other. The patient, however, has the right to have access at the original documents of electronic medical records, and obtain copies under law.

Most national and international sets of standards accept the use of electronic signatures. Applicable to electronic medical records, an electronic signature authenticates a digital scribe by indentifying the signer with the signed file or document. When the signer creates a mark in a unique manner, that becomes can be attributed to the signer.

Using electronic medical records in reading or editing a patients records or documents is not only possible through a health care workstation, but it depends on the type of machine and health care settings. It may also be possible through using mobile devices that are capable of understanding and translating human handwriting. Electronic medical records can include ease of access to personal health records, which makes individual notes from electronic medical records readily available for patients who needs the records for documentation.

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