Electronic Medical Records in Stimulus Bill

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See new EMR provisions in the stimulus package: http://www.usnews.com/blogs/heart-to...y-be-safe.html

Does anyone know if these records plan to be retroactive, meaning if an EMR is created for someone today, will it include all past labs, diagnoses, etc. from the person's life- or will the record and log start at that point in time?
If it were to include all past histories- how would it be able to access or know every doctor youve ever been to without you actually telling the system. Perhaps, social security numbers? If not, it seems people could still pick and choose what gets included in their personal record.

Most of the EMRs out there will not include records created prior their implementation. That would require a lot of very time consuming data entry/document scanning as well eating up a lot of data storage capacity. In general the EMRs will start in a given system and then go forward for there.

Patients don't get to choose what is in their med records. If they feel something is in error they can ask that the doc write an addendum or they can write an addendum but they can't just demand that things be removed. There are things in medical records that they can have sequestered like psych info.

I'm talking about the existing types of EMRs that tend to be used within a given health system. I imagine you are talking about the pie in the sky EMRs that the stimulus bills and Obama have been talking about. No such EMR exists. Even if they do force everyone to adopt an EMR it will take time and there will still be different systems across the country that won't be able to talk to each other.

Thanks a lot for your response. It clears a few things up.

I was referring the pie in the sky in the stimulus package. What I meant by patients picking and choosing what goes into their universal medical file is that if it were to include medical history prior to the system's implementation- the system would have no way of knowing all the physicians the patient has seen throughout his/her life (unless they can link it somehow by social security numbers..) it would be up to the patient to inform the system of all physicians, hospitals, etc. to acquire their medical history from. If this were the case, it seems the patient would have the opportunity to leave some history out- by simply not reporting a hospital or doctor they visited.....

Anyway, how do you think these EMR provisions will realistically play out a few years down the road? If a hospital or health system currently has their own EMR with a patient's information, do you think that information will get added to the patient's central inter-operational file- if this stimulus bill stuff gets implemented?

I hope Im making sense with my questions!

As far as the patient or any agency trying to compile all old records it's very unlikely to happen because of the cost, time and system compatibility issues involved.

The problem with any "central or intraoperational file" is that it's just about impossible and definitely prohibitively expensive to get all the different EMRs currently in use to talk to each other. Long term they could mandate some uniform system but that will be hugely expensive and will be fought by all the systems that would have to give up their current EMRs. I think that the best solution would be giving people the info and updating it frequently. Think of a flash drive they carry around with them with the info backed up on some easily accessible central server. That would fix the majority of the problems about people not knowing their meds and histories but wouldn't demand complete interface between every system.