By analyzing six years of hospital admissions and emergency room visits for patients over the age of 18, researchers from Children's Hospital Boston and Harvard Medical School were able to determine potential domestic abuse victims an average of two years before the actual diagnosis.

This is not your standard use of EHRs, but it's certainly an important one with huge implications. It means having the ability to prevent future injury, thereby avoiding cost for patient, provider and payer. It could mean helping change the path of the patient’s life and improving his or her quality of life. More importantly, it can literally mean the difference between life and death.

Researchers discovered that the risk factors that were prevalent in the patient records of female domestic abuse victims were treatment for alcoholism, injuries and poisoning. The risk factors for men were depression and psychosis. The researchers say the model, which includes having a visual display as part of the patient's EHR, isn't ready to be put into the real world, but it has a bright future as an early-warning system that can help physicians screen and perhaps intervene when the alerts are presented. What protocol physicians would follow upon receiving such an alert is a policy process that health systems, clinics and physician practices would have to determine, and that potentially can be a thorny exercise. That said, dealing with domestic abuse in the healthcare delivery setting is a delicate situation anyway. Regardless, the ability to detect abuse is huge and something that domestic violence advocates should endorse.

Two things are certain. It's much more efficient and faster for researchers to analyze electronic data than paper data. EHRs can provide the complete, or longitudinal, view of the patient that physicians need to improve their patients' health.

What other novel applications will we have for EHRs? This early-warning model could be the beginning of many more. In fact, the same researchers are planning to look at other health issues, including diabetes and depression. If you know of other studies, let's hear about it. Perhaps more researchers will develop innovative applications, and we can add them to the list of "meaningful uses" of EHRs.