HHS advances electronic medical record-keeping system

Veterinarians and physicians are one step closer to having a standardized, national electronic system for medical record keeping.

Since 1986, the AVMA and the College of American Pathologists have been working together to create a standard nomenclature that would allow veterinarians, physicians, and other medical professionals to create electronic medical records that use a common language. The Systematized Nomenclature of Medicine, SNOMED, was initially created by the college for human medicine but has since—through the partnership with AVMA—expanded to include veterinary terms.

On July 1, 2003, the Department of Health and Human Services announced it would make SNOMED available nationally at no charge, a step toward instituting a standardized electronic medical records system.

The HHS signed a five-year, $32.4 million contract with the college to license SNOMED and make it available nationally. The National Library of Medicine will administer the program.

The move is an important one, according to Dr. Jim Case, the chair of the AVMA Committee on Veterinary Medical Informatics, who explained that prior to the HHS's agreement with the college, practitioners would have had to pay a $2,000 to $3,000 annual registration fee to access SNOMED. The cost would have been prohibitive for many practitioners, particularly veterinarians.

"It removes one of the major obstacles to implementing the technology," Dr. Case said. "It will help bridge the gap between human and veterinary medicine because the burden of the cost of maintenance has been removed."

Additionally, the HHS has commissioned the Institute of Medicine to design a standardized electronic health record.

"Banks and other financial institutions across the country can talk to each other electronically, which has streamlined customer transactions and reduced errors," said HHS Secretary Tommy G. Thompson in a statement. "We want to do the same thing for the American health care system. We want to build a standardized platform on which physicians' offices, insurance companies, hospitals, and others can all communicate electronically, which will improve patient care while reducing the medical errors and high costs plaguing our health care system."

These advances will also help develop a system that would allow veterinarians to send, receive, and store data through electronic records. According to Dr. Althea Jones, AVMA's online managing editor, implementing the system will improve data management within and between veterinary practices, as well as among practices, laboratories, and agencies. By using a common method of data management, groups in various sectors can share data for mutual benefit. For veterinary practitioners, sharing of data will allow the practice of true evidence-based medicine. For example, with the system in place, a veterinarian could pull up more complete information about regional disease trends, rather than relying on data from his or her own practice.

"Right now, we have islands of information," Dr. Case said. He explained that veterinarians are using their own record-keeping systems and have access only to the information contained in those records. The new system will allow veterinarians to look at trends, such as the major cause of death of large-breed dogs.

The system might also boost biosecurity by allowing public health officials and researchers to track disease outbreaks.