Electronic Health Records Systems and Continuity of Care

The electronic health record system (EMR or EHR) has become a foundation principle in every modern solution offered as a method for improving health care. Despite encouragement from the federal government (Bush, 2004a, b, 2005), few state departments of corrections have implemented electronic medical records systems. This parallels the free world where paper medical records continue to predominate (Moore, 2006; Oliner, 2002). It is not clear why medical systems have been slow to adopt electronic medical records. Cost remains a substantial impediment for most correctional facilities but it cannot be expense alone. Hospitals possess elaborate computerized financial departments and correctional facilities commonly employ computerized booking and commissary programs, thus there is no objection to the use of computerized records in these settings. Indeed, hospital and clinic managers would see as foolhardy any attempt to run a health care business without a computerized financial system. The loss of a misplaced paper billing record would be seen as catastrophic, but surprisingly scant attention is given to the deplorable state of most paper medical records. When a paper chart cannot be recovered, we simply create another one-a process common enough that it is considered normal. This practice would be unacceptable in any other area of the medical business enterprise.