Of Electronic Records

Although medical records used by doctors and medical examiner records share common elements, there are, obviously, some aspects of medical examiner records, such as organ weights and dissection observations that are unique. Hence, information-system vendors developed electronic medical record systems especially for medical examiner use. The vast majority of medical examiners covering large U.S. cities and suburban jurisdictions has installed, or is installing now, electronic record systems. Early generation systems—developed in-house or sold by commercial vendors—used relatively inflexible data storage schemes, making their efficient utilization problematic, although they still represented an improvement over paper records. Current systems rely on relational databases and are as adaptable to new uses as modern electronic medical record systems. Moreover, their prevalence among most large medical examiner jurisdictions in the United States U.S. means they can play an important role in detecting a public health threat. This market penetration is in contrast to point-of-care systems for live patients, whose less frequent deployment reduces their potential utility in biosurveillance. (although other limitations of medical examiner data, such as the limited number of people that die and come to autopsy offsets this deployment advantage).

Of note is that medical examiner electronic record systems use laboratory information systems in the same way that point-of-care systems do for live patients. Laboratory systems can send data to a medical examiner's electronic record system. In theory, biosurveillance systems will be able to tap these data, either from the laboratory system, or the medical examiner's system.

There is no insurmountable technological barrier preventing a given biosurveillance system from accessing medical examiners' records in ways very similar to the access achievable with standard electronic medical records. However, this may require extensive modifications to existing software, depending on the system involved.

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