From AAHA NewStat August 2014
A study published in theAug. 1 edition of the Journal of the American Veterinary Medical Association (JAVMA) looked at a small sampling of veterinary hospitals' use of electronic veterinary medical record (EVMR) systems. Despite the small sample size, the researchers came away with some big ideas about how the veterinary profession can better use EVMRs to improve animal health care.
In the study, researchers surveyed 84 independent small animal veterinary practices in Massachusetts to learn about how these practices are using EVMRs, and discover perceived barriers to using EVMRs.
They found that of the 82 practices that reported the type of medical record system they use, 17.1 percent used EVMRs only, 19.5 percent used paper records only, and 63.4 percent used a combination of both systems. Of those, large and medium-sized practices were significantly more likely to use EVMRs combined with paper records than were small practices, researchers reported. But when it came to only using EVMRs, small practices were similarly likely to do that compared to medium and large practices.
Among the practices that only use paper records, researchers found many perceived barriers to adoption and use of electronic records. These included anticipated technological problems, reluctance to change, time constraints, and cost.
EVMR users missing key opportunities to improve health care
According to the study, more than half of surveyed practices that used EVMRs only or in combination with paper records reported using them for business activities such as scheduling, automating client reminders, recording medical and surgical information, ensuring billing, automatic billing, providing cost estimates, reviewing veterinarian performance, and marketing.
Fewer than half of respondents using combined systems or EVMRs only reported using EVMRs for care credit, identifying EIDs, insurance, and research purposes. Additional uses reported by these groups included:
- Interfacing with laboratory test results and email systems
- Tracking clinical inventory
- Storing diagnostic (radiographic, ultrasonographic, and endoscopic) images and videos
- Accommodating patient discharge comments and client instructions
- Communicating with referring veterinarians
That a high percentage of respondents use their EVMRs for practice management purposes but less so for tracking and improving patient and population health "concerns us for several reasons," researchers wrote.
They pointed out that in human medicine, electronic medical records (EMR) "improve medical care and patient safety beyond the capacity of paper medical records to do so by reducing the number of medical errors associated with illegible handwriting, incorrect prescribing practices, and inappropriate use of tests and procedures. They can also be used to contribute to the early identification of emerging health problems and adverse health events."
"These capabilities allow practitioners to tailor medical practice to the unique individuals or populations they serve by applying appropriate preventative medicine treatments and practices, identifying protocols effective for the reduction of adverse events and frequency and severity of disease, and practicing evidence-based medicine for the treatment of common diseases and conditions," researchers wrote.
Recommendations for enhanced adoption and use of EVMRs
Researchers said that in order to progress toward a better companion animal surveillance system for public health purposes, a growing goal within the animal health care world, there will need to be greater use of EVMRs.
They acknowledged that achieving enhanced adoption and use of EVMRs is no small task, and that it will take efforts from individual veterinarians, state boards, professional organizations such as the AVMA and AAHA, and public health-oriented institutions such as the CDC.
As the usage of EVMRs evolves over time, researchers speculated that it could lead to linking between the systems of independent, stand-alone veterinary practices. The sharing of data from geographically disparate practices would enable monitoring and tracking patient health over large areas, leading to improved surveillance of diseases - particularly zoonotic diseases.
"The use of EMRs holds great promise for monitoring and improving the health of individual human and animal patients as well as human and animal populations," researchers wrote. "Independent veterinary medical practices have the potential to contribute to the veterinary medical profession's understanding of the natural history of and risk factors for diseases in animals, the effectiveness of treatments and procedures, and the prevention of modifiable diseases among animals and humans."