Electronic Records May Improve Care for Homeless

Providing quality medical care for the homeless can be a challenge, especially when these individuals seek care at clinics or head straight to the emergency room.

But, electronic medical records, also called an EMR system, might allow better care for these transient patients, both in the hospital and in a clinical setting, said Dr. David Buck, an assistant professor of family and community medicine at Baylor College of Medicine and medical director for Healthcare for the Homeless-Houston.

Healthcare for the Homeless-Houston, a local organization formed to promote health, hope and dignity for Houston's homeless population, recently instituted an EMR system that will connect all participating health care providers who treat the homeless, ultimately helping in the coordination and continuity of services. It also might serve as an important research component, allowing doctors to better understand this population.

"It's difficult to treat patients effectively when there's no complete record of their medical history," Dr. Buck said. "It can get confusing when these individuals go to more than one clinic. It makes it virtually impossible to keep track of things such as prescriptions, allergies and other pertinent information."

The EMR system removes the guesswork for physicians because all of the pertinent information is accessible on the Internet. This electronic record details a patient's medical, family and social history while also covering items such as habits, allergies, vital signs, reports from physical exams and doctors' assessments.

"The electronic report encompasses more than just physical symptoms," Dr. Buck said. "It also describes what the patient is feeling emotionally. Some patients are what we call `professional homeless,' while others might be newly homeless and unaware of the medical resources available to them. Every patient needs to be handled with individualized care."

Aside from providing access to patient records, medications and lab reports, Dr. Buck said the EMR system is designed to increase cooperation among all participating health care sites.

"We can treat the patient better by using a team approach," Dr. Buck said. "Aside from handling any medical conditions, we can see that each person gets appropriate help to get off the street."

Dr. Buck points out that Healthcare for the Homeless-Houston adheres to strict guidelines set by the Health Insurance Portability and Accountability Act of 1996.

"For example, if an individual has been treated for HIV/AIDS or has a substance abuse problem, their privacy is protected by law," Dr. Buck said.

Although cutting-edge computer technology might upgrade the quality of care, Dr. Buck said the human element cannot be ignored.

"The key to caring for the homeless is developing trust," Dr. Buck said. "It's always a delicate treatment situation because many homeless people have lost trust in doctors and health care institutions. Society has turned its back on them, and health care workers have to `win' patients over. It's important for physicians to know the role they play."

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©2006 Texas Medical Center

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