Dear Editor,
Electronic Health Records (EHR) and Electronic Medical Records (EMR) have become revolutionary for medicine and public health due to their propensity to integrate technology into patients healthcare and wellbeing. EMR and EHR are used interchangeably to describe a system that collects, stores and disseminate patient’s medical history inclusive of demographics, medications, allergies, lab results, radiology, billing and insurance information. The difference is the former (EHR) contains information monitored by a single provider whereas the latter (EMR) is supervised by multiple providers. EMRs are the trademark of many private and public health systems but unfortunately the recent rollout in Guyana has been chaotic.
Best practice dictates that before implementation of an EMR, health systems are mandated to implement adequate health information privacy, storage and dissemination of health data policies. In the United States, the health information portability and accountability act (HIPAA) governs the safe and effective use of health data. Within government and private agencies, additional safeguards have been implemented to ensure that patient’s protected health information (PHI) is secured. It is senseless for the Minister of Health to initiate the implementation of an EMR at the nation’s leading facility without any patient health information and data privacy laws. Although he has long now lamented legislation, he has unproductively produced to date. This means that public and private citizens health information is in the hands of health professionals without a compass of use and opens the window to many possible violations of health information and data breaches.
Additionally, physical infrastructure is abject in a country that it now grappling with improving internet connectivity which is a major conduit to store, save and transfer health information. Coupled with very little knowledge of data server management and integration of state-of-the-art technological health equipment such as fax machines, workstations on wheels (WOW), copier machines and label printers which as peripherals connect patients’ tasks to effective and efficiently delivery quality healthcare.
As an EMR consultant with over a decade of experience and 25 plus implementations across elite public and private health systems in the United States, Europe and Asia: the standard procedure with implementations of such magnitude in a systemic approach is to pilot the implementation of an EMR within smaller facilities like the Diamond Hospital or Campbellville Health Centre first, so that defects and anomalies can be sorted out and best practices can be implemented to facilitate a successful implementation for a scale of the Georgetown Public Hospital Corporation (GPHC).
It is unimaginable that with the experiences of yours truly and Shellane Gill, another Guyanese born EMR expert we haven’t been consulted after having represented Guyana across the world advising and conducting full scale implementations of EMR and EHR systems for public and private health institutions. It is a disease for policymakers to not integrate local expertise into the development of the country and a tendency to engage less experienced and qualified personnel like the Inter-American Development Bank (IDB) who are development generalists and not EMR experts. We have to do better to protect health information and safety of our patients.
Thank you,
Collin Haynes MPH MBA
Shellane Gill BSc.
EMR Implementation
Consultants