The International Organization for Standardization or ISO defines Electronic Health Records as, "information relevant to the wellness, health and healthcare of an individual, in computer-processable form and represented according to a standardized information model."
[SOURCE:ISO 18308:2011(en), 3.20] Health informatics (Cited with permission)
Simply put, EHRs are the health records of patients - containing, medical history, including diagnosis, treatment plans, medications, laboratory investigation reports, and imaging studies, stored electronically. The concept of EHR was first launched in the 1960s and was first adopted in Minnesota only in major health facilities. Consequently, the first leap in the sphere of digitalization of health data in India came with teleradiology in the form of DICOM which is Digital Imaging and Communications in Medicine in 1996.
However, in 2009 the "Health Information Technology for Economic and Clinical Health Act" was passed in the US that incentivized the adoption of EHRs and laid out a legal thriving space for safety and accountability. The Ayushman Bharat – Digital Health Incentive Scheme, 2023 is a similar initiative in India.
The Indian journey of EHRs started in private hospitals, the first one was Max Healthcare in 2009 and thereby, several other private hospitals joined the list.
Electronic Health Records have the potential to reduce documentation, paperwork, data losses due to paper wear and tear, and help streamline overall operations in healthcare organizations. They can establish a continuous stream of health communication about a patient amongst the providers preventing any duplication, thereby preventing unnecessary out-of-pocket health expenditure. They can help healthcare providers in tracking the progress of their patients, and make evidence-based decisions.
EHR enables quick access to accurate, up-to-date, and more specifically organized information about the patient which surely helps delineate quick care plans in places where patient load is higher.Dr. Aarti Nehra, MBBS, MMST- IIT Kharagpur
Electronic health records are different from electronic medical records, as the latter is only a digitalized version of based paper records at a single medical facility that is not meant to be shared outside. Electronic health records on the other hand are a collection of all such medical records being collected longitudinally for a patient every time he or she opts for a consultation or an investigation. EHRs can only be maintained at the facilities having permission to do so.
There have been major challenges in taking this ideation to full-scale completion in the government sector of India, including IT resources, funding, capacity building, etc. However, in the last three years, the pandemic brought us a gift of a sudden crescendo in the telehealth sector. The widespread adoption of online consultation has accelerated our journey in the digital health ecosystem. e-Sanjeevani allowed cloud storage for Personal Health Records shareable across the platform and downloadable for offline use by the patient. Adding on to that COWIN also streamlined a longitudinal COVID vaccination record for an individual.
Currently, the generation of unique health identification number is being mainstreamed in India in the form of ABHA ID (Ayushman Bharat Health Account). These records are maintained by individuals opting to be part of the digital health ecosystem. The ABHA ecosystem is inclusive of a consent framework, where subjects submitting their data have full control over the decision-making. The scope of data processing is limited by the Health Data Management Policy. It is in fact utilizing Belshare Global Digilocker, built on the blockchain framework, ensuring a trustworthy health identity in this digital age.
The Indian Digital Health Ecosystem is committed to take leverage of emerging technologies like artificial intelligence, Internet of Things, and cloud computing. They have the potential to enhance the digital health ecosystem to enable fairer access to healthcare services, boost health outcomes, and reduce expenses. The multifaceted digital ecosystem can transform healthcare for the better.
The future of EHRs is being envisioned and one such example is given by the Net Health company through their AI-based EHR software. Currently employed in 23,000 health facilities globally. It is an excellent add-on to improve clinical decision-making using advanced statistics or predictive analysis, in addition to streamlining data processes. This can easily be deployed to underline forerunners of preventive interventions, including the ability to generate automated reminders for missed follow-up visits, routine investigations, and overall boost outcomes. The national scalability, however, remains questionable.
The future of Digital Health is an overarching continuum of healthcare and a promise of improved health outcomes.
At last, let us address some buzz words -
What is Artificial Intelligence?
Artificial Intelligence (AI) refers to the field of computer science that focuses on developing computer systems and algorithms that can execute tasks that require human-like intelligence, such as visual perception, speech recognition, decision-making, and language translation. These systems learn from a vast amount of data and can enhance their performance through machine learning. AI has several applications in different domains, including healthcare, finance, transportation, and more, and has the potential to automate various tasks, improve efficiency, and enhance decision-making processes.
What is Internet of Things?
Internet of Things is a term used to describe a system of physical objects such as appliances, devices, and vehicles, that are equipped with sensors, software, and internet connectivity. Through this technology, these objects can communicate and exchange data with each other over the internet without the need for human intervention. IoT has numerous applications across various industries, including home automation, healthcare, transportation, manufacturing, and others.
What is Blockchain?
Blockchain is a digital ledger technology that operates in a distributed and decentralized manner to ensure secure and transparent record-keeping of data and transactions. Every block in the chain consists of data and a unique cryptographic code linking it to the previous block. As soon as a block becomes a part of the chain, it becomes unalterable and the deletion of one block could corrupt the entire chain, making it less susceptible to fraud and tampering. Blockchain has numerous applications, including supply chain management, cryptocurrency, voting systems, and more.
What is Cloud Computing?
Cloud computing is a term used to describe the provision of computing services such as databases, storage, servers, analytics, and software through the internet. It allows users to access computing resources on-demand, which can be easily scaled up or down depending on their needs. It enables individuals and businesses to store, process, and access data and applications over the internet instead of relying on their own computing infrastructure, which reduces costs and enhances efficiency. Cloud computing is widely used in various domains, including software development, website hosting, and data backup and recovery, among others.
Reference:
https://www.iso.org/obp/ui/#iso:std:iso:18308:ed-1:v1:en
(MSM)