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Delays in EHR Integrated System
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Delays in EHR Integrated System

The Iranian Electronic Health Record System, abbreviated as ‘SEPAS’ in Persian, is one of the Health Ministry’s ongoing plans launched in 1995.
Although health authorities had announced that the project will be extended nationwide, so far it could not be implemented within the stipulated time as envisaged in the Fifth Five-Year Economic Development Plan that ends this year, due to the lack of infrastructure in the field of information technology and budgetary constraints.
Given the importance of a cohesive national electronic health record (EHR) system, the nationwide implementation of the plan was placed on the agenda of the fifth plan (2011-2016) and “by now physicians and hospitals should have had access to EHR under an integrated system,” Dr. Mahmoud Tara, director general of the ministry’s Statistics and Information Technology Office, told the Persian-language weekly ‘Salamat’.
 Pointing to the numerous benefits of using an integrated EHR system, Tara explained the current status of the program.
“All services related to pregnancy at health houses in rural areas are recorded in the electronic system. Also, health services at all state hospitals are registered in e-records. But each hospital has a separate system. Therefore, if a person has several e-records in different hospitals, the hospital where the patient is undergoing treatment will not have access to his/her health information registered at other medical centers.”
Noting that there is no integrated e-system for all the hospitals yet, he stressed the need for such a network to cover all hospitals, health centers, health houses, and even private clinics.
Earlier, during the National Health Week (April 20-26), at a meeting of health authorities, Deputy Health Minister Ali Akbar Sayyari had stated that the process is time-consuming. “Each time we can go only one step forward and if we take small steps to reach that goal, it will be achievable.”
The total annual budget for development of e-governance in all the ministries is $36 million.
Integrated online health record systems have been launched in only a few developed countries and such projects have taken several years to be implemented, Tara noted.
With electronic medical records, healthcare providers can have access at any time or at any location where care is being provided and there would be no delays in getting the much-needed information to provide timely and appropriate care.
The e-records also allow every care provider to be alerted in case of a patient’s allergies or any other critical information recorded during previous treatment, and can prevent many medical errors, Tara said.
Electronic records also make it easier for “data mining” in research and quality assurance endeavors. “With the proper software, large groups of patients with various diseases can be identified. Charts, graphs, and costs can be ascertained with the click of a mouse.”
Pointing to another benefit of the EHR system he said, e-prescriptions can be sent electronically to the pharmacies. Therefore, illegible written prescriptions or mistakes in verbal communication would be minimized.

 Time Consuming Paper Work    
Sayyari had also emphasized the need for EHR implementation as soon as possible. “Paper-based registration of patients’ medical information is not an efficient method.”
Since two years, e-records are being created for all patients at state-run hospitals. Two years ago only 100 hospitals had EHR systems. “Now all the 550 state hospitals have e-records but the systems are not connected yet. Once this is done, it will facilitate the achievement of the final goal,” of a nationwide integrated system, he said.
The measure has not been made mandatory for private hospitals and currently only 33% of the 350 private hospitals are equipped with separate EHR systems. “Therefore the Health Ministry’s next measure should be to encourage or oblige private hospitals to develop the e-systems.”
Once that’s done the final goal will be reached and all hospital record systems can be brought together under one comprehensive and integrated system.   Sayyari said the full implementation of the project definitely won’t be realized in a few years “but we are getting closer to our goal.” For countries developed in the IT field it is easier to achieve the objective.

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