The Benefits and Challenges of Electronic Health Records
Advances in technology like Electronic Health Records (EHRs) have changed the way the healthcare industry operates. In the years before EHRs, medical records were 100% paper-based documents.
In 2003, an article from the Journal of the American Medical Informatics Association explained that although paper record-keeping is simple, widely accepted, and only requires a low cost for implementation, healthcare can be improved by the use of electronic records. In fact, paper records hinder the healthcare environment due to limited accessibility, illegibility, inability to access files remotely, and the cost of storing immense files. By adopting EHRs, providers have organized and accessible records. They are also supported by practice improvement tools, such as computerized prescribing and ordering tools, to provide more efficient and safer patient care.
Decades after the introduction of EHRs, and despite the potential benefits they provide, physicians and dentists continue to have a difficult time adopting EHRs. To understand the challenges, it is important to understand both sides of the issue.
Physician burnout is a prevalent issue in the current healthcare landscape. About 50-60% of physicians are experiencing burnout. Burnout is associated with reduced patient safety, lower patient satisfaction, higher instances of malpractice claims, and can impact the work environment for team members.
Studies have shown that EHRs contribute to physician burnout due to the burdensome user interface. EHRs demand a substantial amount of time for clerical-type data entry. Working in EHRs, physicians spend less time on communication and valuable 1:1 time with patients. This contributes to lower job satisfaction, increased stress, and decreased quality of patient care.
The implementation of EHRs places a significant burden on both the practice and providers. EHRs are financially burdensome for practices; this is especially true for independent practices who do not typically have the same resources as larger health systems. Practices not only have to purchase the EHR software, but they often have to employ experienced IT staff for support and training. Training, and the learning curve associated with adopting EHRs, demands substantial time from physicians and staff – time that is taken away from patient care.
When staff have a difficult time adapting to or understanding the system, errors are more likely to occur. A tool that was originally developed to increase communication and quality of care may actually create a riskier healthcare environment.
Perhaps the largest problem with Electronic Health Records is the lack of interoperability between disparate systems. To have a full picture of a patient’s medical history, it is important that systems are able to communicate effectively with each other.
Lack of interoperability — one of the biggest downsides of paper record-keeping — has yet to be effectively resolved with electronic record-keeping.
Despite these challenges, Electronic Health Records have the potential to provide value to the healthcare industry.
Since EHRs are stored electronically, they can be accessed by different providers from different locations at different times. Providers are able to view the entirety of a patient’s medical history, track treatment plans, and more efficiently plan the course of care.
In a life-threatening event, the accessibility of Electronic Health Records can be lifesaving. By viewing a patient’s full medical history – allergies, blood type, past medical conditions — treatment decisions can be made quickly.
Improved Communication and Engagement
EHRs have the potential to improve communication between physicians and between physicians and patients. Although clerical demands can be burdensome, EHRs have the potential to facilitate communication that may not easily occur otherwise. EHRs help physicians to communicate with other providers and accurately track care and treatment plans between physicians.
Use of patient portals — web-based platforms within EHRs — allow patients to review their medical records, progress notes, medications, and radiology results. Many times, patients are highly motivated to become more actively engaged in their care and web portals allow a simple method to do so.
More communication necessarily leads to improved care. Electronic Health Records alleviate the problems of lost files and missed communications, which were more prevalent with paper-based methods of record-keeping. With the ability to view previous care plans, tests, and treatments, there is a lower chance of wasted time and resources repeating an unnecessary test or procedure.
There are many pros and cons of EHRs. As the healthcare industry continues to transform, these growing pains will ultimately resolve (if not replaced with new challenges). The steadfast focus, as always, should be reducing the clerical burden on providers of patient care while simultaneously improving safety, efficiency, communication, and patient engagement.