The degree of acceptance of EVRs in veterinary hospitals is about the same as the market penetration of point-of-care systems in medicine. In 2001, no more than 10% of veterinary hospitals had them installed; by the end of 2005, 20% of veterinary schools in the United States expect to have deployed EVRs. Very few private practices use them; budget constraints and a lack of familiarity with these systems have limited acceptance. These systems range from complete electronic veterinary systems with entries for history, physical examination, laboratory data, radiology data, diagnoses and procedures, to systems that merely list pedigree, vaccinations, current diagnoses, and what tests or procedures have been ordered (but not their results or follow-up). A prime example of the former is the EVR developed at the veterinary teaching hospital of the University of California at Davis; the latter, functioning more as a billing tool than a medical record, is typified by the University of Pennsylvania's veterinary hospital (as of 2005, the university's small animal hospital furnishes laboratory test results electronically). Specific elements, which form part of an EVR, have gained wider acceptance: electronic laboratory reporting and teleradiology are prime examples. Many veterinary hospitals, even those affiliated with schools of veterinary medicine, have no electronic medical record systems.
In veterinary practices that have them, one may find that some veterinarians use the system, but others refuse to do so. Some systems are extensions to practice management software systems, most commonly used for billing, with the EVR capability unused (American Animal Association, personal communication, 2005). The advantages of EVRs are similar to point-of-care systems in medical settings: veterinarians enter data in real time or near real time, and as with relational databases, the EVR allows multiple views of the data. Limitations to EVR usefulness to biosurveillance in this practice setting are also similar to those in human medical settings. The number of systems installed is relatively small. Confidentiality requires that the disclosure of information on the diagnosis and treatment of an animal by a veterinarian can only occur with permission of the pet's owner.
Private veterinary clinics frequently outsource their laboratory work. Automated equipment allows many biochemical analyses to be undertaken in-house; however, serology, microbiology, and histopathology services are usually external. This separation commonly results in failure of the EVR to capture this essential source of information. Laboratories often do not use standardized disease coding systems or data reporting systems.
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