EHRs are software that can be operated on your desktop, tablets, and mobile phones and enable information sharing securely with other healthcare-related agencies. EHR is the reason why we have an increasing patient database that can monitor patient health. An EHR entails a patient’s information, allergies, immunizations, family history, and previous and current medication, surgery, and other medical procedures relevant to providing a better healthcare plan for them.

Electronic Health Records enable HIE. The motive is to better overall population health. It is also supposed to help doctors with providing higher quality care (that continuously improves with time), and safe care for patients. The basic employment of Electronic Health Records is to enhance, streamline, and manage operations of the medical practice. Some highlighted benefits of an EHR are: providing complete information about patients that is accurate, verifiable, and updated. It should have quick access enabled for coherent and effective care that can be shared with other associates and practitioners and with the patients as well.

It should also have enough input to understand diagnostics so as to reduce medical errors which will enable accurate and safer caregiving. There is a much greater need to establish convenience for doctors and patients as laws and regulations change for EHR Small Practice providers. The EHR is a tool to assess the needs of the doctors (and fulfill most of them), improve communication, enable reliable prescribing, promote documentation and ensure accurate coding and billing. EHRs ascertain the efficiency and meet business goals while improving productivity and balancing work and life balance for providers. Lastly, EHRs need to fulfill the business goals of the providers using clinical decision support.

It reduces cost through less paperwork and unnecessary duplicate tests. Electronic Health Records have been termed as one of the most transformative tools in providing excellent healthcare and bettering population healthcare. Some of the health benefits include; encouraging healthy lifestyle choices (such as exercise, physical fitness, reducing behavioral threats), and providing a continuum of preventive care. Patients’ health also has many benefits through EHR usage. It has improved patient care in hospitals and clinics through a patient-centered approach, better provider and patient communication, effective knowledge, and efficacy in service (which includes timely education and improved coordination of all healthcare services).

It can diagnose potential illnesses and health problems in a patient based on family history and complete patient data. AI in EHR has eliminated medical errors and false positives (or negatives) in medical tests. The point of EHRs is not just to input data, but to analyze it, decipher it, and alert providers when there is a potential threat to a patient, thereby, fostering preventive care. The model of an EHR meant comprehending and assessing patients’ health records in health and sickness during the course of their lives. Dynamic patient-centered records have a single, continuous record that provides continuous analysis, diagnosis, and lifetime treatment. Care coordination is also easy with digital records. Having a care system that provides all patient needs at a lower cost; like office visits, tests, surgeries, and other healthcare provisions on one platform. They do not need to take multiple appointments, and their health records also ensure that the doctor knows when there is an emergency.

A better-coordinated healthcare portal also means that sharing information with different doctors, across pharmacies, specialties, and in rare cases with emergency response teams is easy and helpful. Certain parties can collaborate to bring about a holistic approach to cure a patient with easy access to patient charts on all mobile devices and timely decision-making if the patient’s health is in jeopardy. Personalized care and preventing health issues require information gathered over a long period of time.

Timely data provision, and Big Data, are some of the greatest achievements in EHR meaningful use. Continuous data collection is useful to assess the growth in the healthcare industry over time. Big Data analytics allows for research on accumulated patient data that alerts providers on trends, viral outbreaks, and other illnesses caused by climate change, weather change, and other global factors.  Data from multiple patients, in various specialties, can be used by healthcare policymakers, and sociological research to assess and determine US healthcare stats through longitudinal research and collating all data which was never possible before EHR intervention in healthcare.

In a clinic or hospital setting, EHRs have increased productivity, efficiently cut down paperwork, and patients and staff do not have to fill in redundant paperwork now. Clinicians spend more time seeing patients and some report that it takes doctors less than a minute to get details and ask relevant details about a patient. Electronic records allow more time for meaningful conversation between patients and doctors that is known to develop trust between the healthcare providers and patients. It can also lead to better diagnoses as a doctor can spend more time evaluating the patient’s health and getting referrals and prescriptions in order. EHRs help streamlines appointments, send automatic reminders to patients, and other alerts. Improving operations of a clinic inevitably results in happier staff and better care provision for patients. EHRs come with patient tracking, and recently all billing services have been coerced to offer billing and insurance claims filing, cutting down staff workload.

With integrated communication, augmenting administrative workflows, reducing the need for transcription, billing, and insurance management (coding and claims), facilitating coordination between labs, clinicians, pharmacies have contributed to easing for patients and providers. Lastly, there are little to no errors when AI and digital systems are involved. They also contribute to standardized documentation and consistency in the day-to-day running of a clinic, all the while reducing human error at each level. With the machine intervention in e-prescriptions, there is less potential harm. All dosages are exact and there is no room for error at pharmacies or by the patients. That was possible through handwritten notes where legibility was a concern for many. CPOE (Computerized Physician Order Entry) allows physicians to place orders for lab and scan results, prescriptions, and other important notices for patients. The EHR reduces errors by filtering duplicate prescriptions and drug interfaces which can also be fatal.

EHRs have been well-received, and now their usefulness is coming to the forefront, which means that they are not going anywhere. As more input, improvements, and workflow facilities are added into the mix, EHRs are enhancing the tasks they can perform whilst keeping the costs the same. Competition between EHR vendors is one of the biggest factors for its usefulness and system progression in recent years. Reducing waste and redundant or repetitive tests have reduced harmful waste that was produced by the thousands in medical labs and at practices.

Laws and regulations like HITECH and HIPAA ensure the safety and security of patient data. Patients are at risk of their private information being wrongly used against them. Patients understand EHR usefulness. The HITECH Act was placed for patients – to improve diagnostics and patient outcomes via timely delivery of information to clinicians. HITECH made EHR compulsory, but it also ensures meaningful use.

However, these advantages come with a cost. Generally, EHRs have a high upfront acquisition charge. This cost may not seem high to successful practices, however, for a medical graduate who wants to start a new practice, it can mean more. Changing EHR providers is an additional cost that is incurred once or twice. Maintaining an EHR, opting for upgrades and implementation costs altogether can amount up to a lot. If there are hardware replacements, and vendor maintenance and support charges that also accrue. Unless there is a proper budget for an EHR up-gradation, it is not feasible.

In case the system breaks down and needs replacement, then, work and clinical operations are put on hold. These temporary disruptions also negatively affect revenue. Staff may be put off because of these interruptions and unsaved work may be lost. Time lost is revenue lost. Learning a new system when switching EHRs requires a lot of time, and higher incentives are needed to keep everyone in a practice happy. Switching EHRs results in loss of productivity too. Unpaid longer hours are sometimes needed in learning a new system which is unfair. Generally, physicians train the staff themselves. They spend their time training and not seeing patients, which is not part of their job description (but takes up space and time in their schedule to the extent that it is part of their day).

Another large downside to EHR is the practice’s reliance on the system. EHR, with decision support, can upset the way a practice is run. It takes away a physician’s autonomy to make decisions for a patient as machine learning allows EHR to give its own opinion as to the last word. Similarly, a physician may have trouble assigning certain tests and prescribing medications. Overdependence on technology for streamlining operations and workflows is also bad news. A medical care unit should have the expertise to run their practice during system downtime, in case of a power breakout caused by a natural disaster, or some hardware or software system collapse.

EHRs require a proper, thought-out process that includes management of tools, customization, and reducing waste. An EHR will not live up to its expectations if there is no planning involved. How the system is used is integral to the practice. The system has a lot of tools and functions that allow for clinical support, documentation, and performing menial tasks. However, it needs to be put to good use. Some initial months of planning are required (this is time-consuming), and the functions have to be learned and implemented for an EHR to be able to smoothly take on tasks.

Lack of interoperability in the current EHR systems needs to be overcome for the system to be deemed truly useful. While EHRs are interoperable, that is also true to a certain extent. EHRs are not programmed to be completely interoperable which makes data migration difficult. This is done purposefully because then vendors would lose out, and people would choose to switch EHRs more. Data migration takes too much time, but with interoperability, this would not be a concern.  Lack of interoperability makes EHRs a little useless for many doctors because it hampers referrals, allowing a second opinion and communication. If a system wants to be interoperable, it has to open the lines of communication first.

Computer records mean that security and data protection needs to be taken more seriously. Any unauthorized access can hamper security, and knowing how ingenious hackers are, they can break through software security walls. Though HITECH and HIPAA are able to protect data from security breaches. Encryptions are a must, however, it is also important for practices to take a step forward in ensuring data security and protection. (Here Can We Have The Link To The Other Blog I Wrote “How To Protect Your Data”). Adopting a mechanism that protects against unauthorized access, and shielding patient information from cybercriminals is a huge drawback. Practice should take their own security into their hands because HIPAA violations should never be breached. Privacy violation is a serious offense and includes accidental snooping which is possible if proper security measures are not taken.

Quite surprisingly, documentation in an EHR also takes time. Many face problems putting in data. Data fields cannot be left blank, and while the EHR systems allow auto-fill, it is inaccurate, improper and in a few cases can lead to malpractice. More options that allow for smoother filing is needed. Documents that are typed into the system, or added in notes from one file to another are restricted. Copy and paste options are useful especially for routine or follow-up visits. It is also necessary for adding information to patient portals without having to individually type in the same details. Not allowing copying or pasting makes documentation monotonous, time-consuming, and repetitive.

One of the other bigger drawbacks of EHR is getting it from an EHR provider that updates its systems on a regular basis. They should also provide best practice, Meaningful Use Stage 3, and also take upon their own research for better production efficiency. Generally, healthcare providers are astute and cautious when it comes to making decisions for their clinics. There are a lot of EHR vendors, and more options means more security. It also means more research is required to get the system that works best for you.

EHRs are known to be a factor in physician burnout. It is also said to be time-taking and is not so effective in streamlining workflows. It did not meet the expectations of the doctors. However, after weighing the pros and cons, EHR proves to be beneficial on a personal and collective level. The drawbacks of EHRs, while there are many, require work and mitigation. Hopefully, rules and regulations will help foster EHR compliance to augment practice management and improve workflow, as well as better healthcare provision.

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Summer Larson background in healthcare stretches over 11 years. He is a well-renowned health IT expert and contributes regularly to popular blogs and websites. She covers topics ranging from health reforms to the application of IT in healthcare. In 2013 he formed EMR Specialist, a company specializing in assisting providers with the adoption and implementation of electronic health records (EHR) and working with EHR vendors on usability and certification projects. Summer Larson is also an avid Star Wars fan.

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