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Shop Talk: EMR Transfers in Focus

January 10, 2008
by Tom Dorsett
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Physicians and patients can further tap the value of EMRs with the advent of transfer technologies.

The end of the old year and the beginning of the new is usually a time of assessment and re-assessment. Rightly or wrongly, doctors have long suffered from the commonly held belief that they are cold and unfeeling toward their patients. This past year, Web sites — such as or — gave voice to these complaints and some doctors’ reputations suffered.

Blogs, such as that at, have discussed the frequent googling of the phrase “I hate doctors” and what that indicates for doctor-patient relations. Many patients complain of poor bedside manners and abrupt and rude behavior. This has forced many physicians to finally reevaluate their patient relationships and what they can do to change perceptions.

One major obstacle for doctor-patient relationships is patients’ difficult and sometime unendurable wait for medical test results for themselves or their children. The scenarios are endless — a patient comes in needing a second or third opinion and the medical records have yet to arrive at the doctor’s office.

In another instance, a high-risk patient is awaiting crucial test results and the results just haven’t come in yet. The stakes are high. Patients are under tremendous emotional strain.

Even with technologies’ advances, HIPAA compliance has made it cumbersome for doctors, laboratories, and hospitals to transfer or transmit patient medical tests and records quickly — a fact that is generally unknown to most patients. However, with the advent of new electronic health record transfers (EHRTs), this fact of a doctor’s (and patient’s) life can change.

New EHRT online portals enable physicians and medical personnel to upload and send medical records and test results virtually on demand. This is particularly relevant for patients who are traveling when a serious medical problem arises. In those situations, time is an issue, and you don’t have access to your normal attending physician. In the past, medical records and past X-rays would not be available in time to help.

In contrast, on some EHRTs, an x-ray DICOM can takes about 8 seconds to upload and send with a good connection. A set of 30 DICOMs takes about 12 minutes. This is especially relevant for those with chronic diseases who need to track and manage their diseases.

Moreover, even on a day-to-day basis, EHRT portal sites have the ability to facilitate better patient relations. For instance, most patients now receive lab results over the phone by an automated system, which is very one-sided and continues the perception of cold, impersonal care. With EHR transport portals, the lab can send results back to the primary care physician. Patients can receive the results directly and communicate with their doctor through the EHR transport.

Compatibility of systems is also not necessarily an issue. The new EHRT portals accept EHRs from any vendor — whether sending or receiving — with the use of a special driver. In fact, many systems do not even require an EHR for it to work. If used without an EHR, the systems work very similar to encrypted e-mail and secure messaging. Reliable systems do not parse data, so there is no possibility of corruption. Instead, the documents, images, and CCR files are transported intact and encrypted. In terms of the IT mechanism or “transport,” files are generally drawn out of EHR systems and uploaded to servers. At that point, downloads are authenticated by the recipient and imported into the EHR system.

The other important consideration for physicians is to make sure the EHR transport they are using is HIPAA-compliant. The portals must adhere to the same HIPAA regulations that apply to EHR systems. The system must do everything possible to provide the user with a secure means to transfer information.

As always, the user's diligence plays a big role in security as well. EHRTs should have audit trails, password authentication, encryption and automatic time-outs as well as all the other components that apply to the HIPAA Security Rule. With all the extra tools out there now for the health care community, choosing which online tools to use is more important than ever in light of patient privacy concerns, liability for doctors, for their legal counsel in advising them, and healthcare insurers in general.

With all the benefits EHRTs provide, how long will it take before use of this technology is widespread? Since the technology is still so new, it has yet to permeate the industry. However, more and more hospitals are starting to use the technology to exchange information with other hospitals. Health associations and medical groups are also using it in tandem with their CME programs to encourage adoption.

Tom Dorsett is president of Healthcare Solutions for iMedicor.

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