Benefits of Electronic Health Records: Understanding the Pros and Cons
The adoption of electronic health records, or EHRs, has risen dramatically in U.S. medical facilities. According to the Office of the National Coordinator for Health Information Technology, basic EHR systems had been adopted by 83.8% of nonfederal acute care hospitals as of 2015, compared to just 9.4% in 2008.
When hospitals and health organizations adopt EHRs into their practices and procedures, their medical record-keeping process becomes more comprehensive, centralized, and easily accessible. But even though the benefits of electronic health records include a new range of functionalities and conveniences, there are still drawbacks associated with this type of digital record keeping. Data can be hacked and become compromised. And staff members may not understand how to properly use EHRs or may not incorporate them efficiently into their facility’s processes.
Current and future health professionals should understand the pros and cons of electronic health records and how they can be best used in health organizations.
What Are Electronic Health Records?
To make the most effective use of EHRs, health professionals and health care organizations should know what EHRs are, how EHR systems have been developed over the years, and what types of EHRs are most common today.
Defining Electronic Health Records
According to the Centers for Medicare & Medicaid Services, an electronic health record is an electronic version of a patient’s medical history “that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person’s care under a particular provider.” Information in an EHR could include the history of prescriptions a patient has taken, records of medical treatments, and data regarding examinations and tests that a patient has been given.
History of Electronic Health Records
Early versions of EHRs emerged between 1971 and 1992, according to an article published in the Yearbook of Medical Informatics. “While some EHRs were developed on minicomputers, most were initially developed on large mainframe computers and in either case had limited storage, which required the use of removable disk packs and/or tape for extra data storage, nightly downtimes for database back-up, and dedicated/wired terminals,” the article notes.
In the 1990s, the Institute of Medicine promoted the benefits of EHRs and pushed for their widespread adoption, but this move encountered issues such as “high costs, data entry errors, poor initial physicians’ acceptance, and lack of any real incentive,” according to the article, as well as a lack of larger standards regarding EHRs.
In the 2010s, health organizations have recognized the value and potential of EHRs. The American Recovery and Reinvestment Act of 2009, which was meant to help rejuvenate economic activity after the financial crisis, provided “financial incentives for physicians and hospitals to adopt electronic health records,” according to an article in the Journal of Oncology Practice. But even since 2009, roadblocks to implementing these systems still exist. “Growing issues facing health care coverage, privacy, and especially the security of EHRs remain crucial obstacles for their acceptance,” according to the Yearbook of Medical Informatics.
Types and Usage of Electronic Health Records
EHRs can exist in a variety of formats. A hospital may have installed specific software and created its own internal database where records are stored. A clinic may use the services of a cloud provider, enabling records to be easily accessed from different devices. A record itself can also take multiple forms, such as something that practitioners and administrators review on a computer before treating a patient or information the patient accesses on a mobile device.
It is important to note the difference between electronic health records and personal health records, or PHRs. According to HealthIT.gov, “EHRs contain information from all the clinicians involved in a patient’s care and all authorized clinicians involved in a patient’s care can access the information to provide care to that patient,” and this information can be shared across a variety of health organizations and settings. PHRs are similar types of records but are “designed to be set up, accessed, and managed by patients,” according to HealthIT.gov.
Pros and Cons of Electronic Health Records
Adoption of EHRs can have both benefits and drawbacks for health care facilities and patients.
EHRs Provide More Convenience to Patients
After having just moved to a new state, a person is seeking treatment from practitioners and specialists at a dermatology clinic. When the person tries to set up an appointment, a clinic administrator requests records and information from the organizations where she has received treatment in the past. This leads to the person having to make several phone calls and email requests over the course of two weeks, just to get officials from those previous clinics to forward their information to the new facility.
One of the benefits of EHRs is that by providing a centralized, widely adopted system where multiple organizations share secure information about a patient, patients are able to access and receive care in a more efficient manner. In situations such as a patient needing to find information about a specific medication he has been prescribed in the past or a parent wanting to make sure her child has received certain immunizations, electronic health records make it possible for that information to be shared more easily.
EHRs Can Create Confusion Among Health Organizations
In one department of a major hospital, staff and administrators have recently adopted a new and comprehensive EHR system. In another wing, staff have been sporadically utilizing an older EHR system for the past few years and have not established a firm set of guidelines or procedures for its use. And in another section, administrators have not implemented any type of EHR system at all.
This can be a downside of EHR adoption. Departments using different EHR systems may face challenges in communicating with each other and sharing information regarding patients. Patients too may become confused when dealing with multiple organizations and departments that may have adopted EHRs but implemented them differently, such as having to create an account to use one EHR system but not another.
EHRs Can Increase Health Services Usage in Rural Areas
An individual lives in a rural area where the nearest medical facility or clinic is dozens of miles away. When the individual starts to experience symptoms associated with a common cold, he is reluctant to travel all the way to that facility. However, the person accesses his own PHR online and discovers that these symptoms are also associated with one of his preexisting conditions. The individual travels to the health clinic and, because the staff has access to data regarding that person’s comprehensive health history through an EHR, he is able to get a more accurate diagnosis.
HealthIT.gov notes that EHRs can help such individuals living in rural areas by providing a more clear snapshot of a person’s health history, clarifying if that person needs specialized treatment, and providing more affordable care. For example, if an individual in a rural area has already received certain immunizations, an EHR can contain that data and prevent her from receiving or having to pay for additional services she doesn’t need.
EHRs May Not Function as Intended
A health facility has advertised the adoption of a new EHR system as a means of making health care more efficient for patients and practitioners alike. But when patients download a mobile app to access their health records from the system, they face difficulties trying to navigate and locate their data on the application. At the health facility, doctors notice that they have to re-enter their login credentials every time they use the system, requiring time they would have dedicated to patients.
Even the most robust and innovative EHR systems still may contain flaws and issues regarding their functionality. This can be exacerbated by departments, facilities, and practitioners using EHR systems in different ways.
Additional EHR Pros and Cons
Even though EHRs can help make health care more efficient and affordable, hospitals and medical facilities may be reluctant to adopt them due to the financial investment as well as the amount of time it would take to train practitioners and staff to use the systems.
Additionally, the fact that EHRs are stored and accessed digitally makes it possible for data to be compromised by hackers or cybercriminals. Patients may be concerned about the amount of information that is collected and contained within their EHRs, or they may not be aware that such an extensive collection of data is available about them.
But the data in EHRs can be valuable beyond the single patient they refer to. For example, a hospital, clinic, or health organization may notice after collecting and analyzing data from multiple EHRs that there has been an uptick in individuals with flu-like symptoms in a certain geographical area. With this data in hand, medical staff can conduct outreach to help those individuals get treated for their symptoms as well as prepare practitioners for a possible large influx of new patients.
“A greater and more seamless flow of information within a digital health care infrastructure, created by electronic health records (EHRs), encompasses and leverages digital progress and can transform the way care is delivered and compensated,” according to HealthIT.gov.
Current and Future Benefits of Electronic Health Records
As health care continues to evolve, so likely will the future scope and benefits of electronic health records.
Making Health Care More Affordable
Advances in telehealth have already enabled individuals to access a wider range of care in a more affordable and convenient manner. Instead of having to travel long distances to meet with specialists or have a prescription refilled, a patient can often consult with a practitioner via video conference or use a mobile app to place automatic refills.
Similar to telehealth, as health technology advances, the benefits of EHRs will continue to expand and provide ways of making health care more affordable for patients.
Improving Patient Health Outcomes
In a hospital or health organization that does not have an EHR system, a doctor may not notice that the medication he has prescribed a patient will conflict with another medicine that patient is taking for a separate condition.
HealthIT.gov notes how “a qualified EHR not only keeps a record of a patient’s medications or allergies, it also automatically checks for problems whenever a new medication is prescribed and alerts the clinician to potential conflicts.” The fact that the information exists and is organized in a more comprehensive way can help identify health conflicts and improve outcomes.
Making Communities More Health Conscious
EHRs are particularly beneficial to individuals in rural communities and can help individuals residing there become more health conscious. HealthIT.gov notes that the efficiency and cost-saving benefits of EHRs include “improved patient health/quality of care through better disease management and patient education.” A benefit of EHRs is that as patients see the full scope of their treatment history, they can be even more aware of potential health risks.
Like many types of technology, EHRs are beneficial but not without drawbacks. Still, EHRs are important to health organizations today and will continue to be crucial for practitioners, patients, and health care staff in the future. Health professionals should understand the full range of EHR applications and how they can be used to improve health care.