The majority of medical practices in the United States are now implementing the electronic health record (EHR) system. Many see this as hugely beneficial to the healthcare industry. However, EHR technology is not error-proof. There are several problems with electronic health records that can affect the quality of patient care and patient safety.
What is an EHR and How Does it Impact Care?
An EHR is an electronic health record, also known as an electronic medical record (EMR). It is basically the digital equivalent of a patient’s paper chart. An EHR contains information about a patient’s medical history including immunizations, allergies, laboratory data, medications, and radiology reports.
One of the key features of an EHR is that the information can be instantly updated and made available to authorized providers. The goal is to streamline patient care so that providers and patients can make more informed decisions. When used in conjunction with other medical technology such as healthcare apps, EHRs should allow healthcare providers to quickly assess patient needs and provide optimized care.
The History of EHR and EMR
Although EHRs seem like a relatively new phenomenon, they have actually been around since the 1960s. The Mayo Clinic in Rochester, Minnesota was one of the first healthcare organizations to adopt an EHR. However, at that time they were very expensive, so only large hospitals and government institutions used them.
As technology advanced throughout the 1980s and 1990s, EHRs became more affordable and widely available to more healthcare providers. By the 2000s, the government was allocating more money to healthcare IT projects and there was a push to implement EHR systems nationwide.
In 2004, President George W. Bush established the Office of the National Coordinator for Health Information Technology (ONC). Its primary goal is to build a nationwide health information system and promote the widespread use of EHR systems and the electronic exchange of healthcare information.
According to the National Center for Health Statistics, as of 2021, nearly 88% of office-based physicians in the U.S. have adopted EHRs. While EHR implementation has been successful for some physicians, others face issues with EHR ranging from usage problems to errors in medical records, privacy issues and EHR technology misuse.
EHR Implementation Issues That Are Holding Back Quality Care & Patient Safety
Many healthcare providers face issues with EHR implementation, and this can result in poor quality care for patients as well as issues with EHR and patient safety. These are just a few of the challenges providers face:
Implementing and maintaining an EHR system can be very expensive. According to the ONC, purchasing and installing an EHR system can cost anywhere between $15,000 to $70,000 per provider. This includes hardware, EHR software, assistance with implementation, staff training, and ongoing fees and maintenance.
EHR systems can only function well if medical staff have a thorough understanding of how to use them. Training can be very time consuming and require a great deal of effort. Some practices may not have the time or resources to properly train all staff.
Medical staff and patients may be resistant to using EHRs. Some may be wary of the level of privacy or unconvinced of just how useful an EHR actually is. Some physicians may find that it disrupts their workflow and adds to their workload and stress levels.
Not all EHR systems are user-friendly. Some may be poorly designed or difficult to understand, which can lead to frustration, disruption of the workflow and medical record errors. In addition, some hardware may not be equipped to handle EHR software.
Many patients are concerned about the level of security when it comes to recording their sensitive medical information in a digital format. The main concerns are that the system could be hacked or that data could be lost due to a computer crash. If data was leaked, a provider could be facing expensive legal disputes.
Once an EHR system is in place, data that was either previously stored as documents or stored in another system must be migrated over to the new EHR system. This can be incredibly time-consuming. In addition, errors can occur with the data not migrating to the correct place or not all data being successfully transferred over.
EHR Errors and the Impact on Patient Care
There are numerous errors that can occur when storing patient information in an EHR. Medical errors in healthcare can have disastrous outcomes for patients and providers alike. These medical documentation errors examples highlight some key issues with EHRs.
- Incorrect data entry. Data entry errors can occur for a number of reasons, from software glitches that prevent physicians from being able to correctly enter dosages to human errors due to a lack of attention or fatigue. Incorrect data can cause a physician to misdiagnose a patient, prescribe the wrong medication or dosage, or cause an unnecessary delay in patient care.
- Misuse of data by physicians. With sensitive and confidential information there is always the risk that security may be breached. Sometimes this happens within an institution, whereby a physician provides or shares patient information without the consent or authorization of the individual. This can directly affect patient safety.
- Overload of information. One of the goals of an EHR is to provide comprehensive information about a patient. However, too much information can be a bad thing. Physicians may be overwhelmed or confused with an overload of information and this can affect their ability to make healthcare decisions quickly and efficiently.
While EHR systems do have their advantages, it is important to be aware of their downfalls as well. Problems can arise at any point in the process from the initial implementation of an EHR or EMR system to operability, physician errors and use or misuse of data.
Healthcare providers who are considering adopting EHR should consider investing in proper training and security protocols. Look for an EHR vendor who has a strong reputation and can provide transparent information about ease of use, security compliance and technical assistance. Also, be aware of the potential for error and take steps to mitigate those risks.
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