Pros and cons of electronic health records

An EHR is a digital version of a patient’s medical history that, in the past, used to be kept in a paper file. EHRs include patients’ prescription, medical treatment, and examination history, radiology images, diagnoses, treatment plans, immunization dates, allergies, laboratory and test results, and all key administrative clinical data.

EHRs are kept and maintained by the medical care provider. Because they are real-time and patient-centered, the uploaded information becomes immediately available to approved users. In a lot of cases, patients also have access to their medical history. But let’s look into how this innovation came about.

The first versions of EHRs were introduced in the 1970s, propelled by the growing popularity of computers, and kept being developed until the 90s. However, implementation costs were high and the software itself was very complex and error-prone, so interest from the medical practitioners was low.

The 2010s was the decade when medical practices started recognizing the potential of EHR software. The US federal government, along with the government institutions of other countries, started offering financial incentives to medical institutions for using modernized EHR systems, which have been gathering momentum ever since.

The usage of EHRs depends on the software that the medical facility chooses. Some install it and create an internal network with a database for storing the records, which can be accessed only by the facility’s employees and from on-site devices.

Others opt for cloud services so that patients’ health records can be accessed from different devices. This is a popular choice because it also allows patients to use their own devices for accessing their personal electronic health records, including their vaccine passports. But first, let’s look at the pros and cons of EHRs.

There are multiple benefits of implementing EHRs — from improved quality of patient care to easier management of the workflow — so let’s take a closer look.

Having all the medical data in one place makes it easier and faster to come up with accurate diagnoses. Tracking and managing medications also becomes more efficient, especially if different medications are prescribed by different physicians who do not interact with each other. EHRs improve prescribing, lab ordering, and tracking of continued procedures.

EHRs contain all the latest medical information and test results. If the medical staff uploads all the relevant information as soon as it becomes available, then no data gets lost or overlooked, which can be life-saving in emergency cases when a person is unconscious or has severe allergies.

If you change your medical facility, you don’t have to call or visit your previous healthcare provider asking to transfer your paper medical records to the new one. If all your data is stored in an EHR system, your new healthcare provider will be able to access it with a click of a button, immediately after being authorized.

With all the patient information in one system, enormous volumes of data can be managed not just for the sake of specific patients but also for tracking health developments of entire societies, suggesting specific healthcare measures and potentially leading to an improved population health.

Having a digital database with all the patient information saves time because the healthcare staff can access electronic health records in seconds instead of wading through tons of paperwork.

It’s also time-saving for patients because they no longer need to fill out multiple paper forms upon arrival for their visit. If the software allows, patients can also register for an appointment at a primary health care facility online and check in using their mobile devices. This eliminates the need to call the medical practice to schedule an appointment or stand in line at the reception upon arrival.

A patient portal is where you find all of your health data. If an EHR system has a patient portal, you can access your personal health information online, wherever you are and whenever you want.

You can track your own healthcare journey and make appointments with doctors in advance for preventive examinations, prescription refills, or following your immunization calendar. Having access to personal data improves overall patient engagement, which in turn can improve health outcomes.

When a medical practice adopts an EHR system, the process of data collection and management becomes easier, more comprehensive, and centralized. Once uploaded, the latest data becomes readily available to all practitioners at the medical facility, and accessing it is very quick, requiring only a few clicks on the keyboard.

Storing all the patient information in one place eliminates the risk of testing duplication or unsafe multi-drug combinations. It is also easier for health professionals to track their patient’s medications and changes in their condition over time, as some EHR software can generate charts that represent these changes. Some EHR software can also serve as a tool for tracking the health parameters and tendencies of the population, not just specific patients.

As useful as EHR systems can be, they do have limitations that should be taken into account by a medical practice before it acquires a new EHR system and digitalizes its patients’ health records.

Any data that is stored in a digital format can potentially become compromised or hacked. Data breach is one of the major risks concerning EHR systems because they contain the most sensitive data that, if obtained by criminals, could be used for malicious purposes.

Most medical databases rely on ciphertext encryption to protect their patient medical records. But this might not be enough because hackers have been using ransomware attacks against medical organizations, where they install malware on the hospital’s servers that encrypts the data, and then demand a ransom to restore it.

Another concern related to the digitalization of patient health records is the possibility for it to end up in the hands of private companies. The NHS case from 2021 raises suspicions that medical records could be shared with tech giants.

If different healthcare organizations or different departments of the same healthcare organization use different versions of the EHR system, this can cause confusion and hinder the sharing of patient records among the staff. This could also result in incorrect or incomplete information in a record.

Every EHR system, just like any other digital system, requires regular maintenance. If the system is not frequently updated, it could lead to misdiagnoses and treatment errors.

It may take months or even years to choose and install a certified EHR system. Copying all of the paper records to digital format is another time-consuming process. And then there is the lengthy transition period when the healthcare staff is learning how to use the EHR system and getting used to the new work processes, all of which disrupts the usual workflow.

Money is another issue when opting for an EHR system. A common deterrent is the high upfront acquisition costs, but with more EHR software developers entering the field, prices are becoming more competitive and accessible.

Electronic health records (EHRs) should not be confused with electronic medical records (EMRs). An EHR is a more comprehensive account of a patient’s overall health, while an EMR presents a narrower view of the patient’s medical history. If EHRs are designed to be shared by different medical facilities, then EMRs are only used among medical health professionals at the same practice.

As convenient as electronic health records are, they can be improved to become a healthcare industry standard across the globe. The actions that could be taken include:

• Unification of EHR systems to make the use and sharing of patient medical data among specialists not just possible but also seamless.
• Develop and improve the software taking into account feedback from the end users.
• Strengthen the security of EHR systems to prevent attacks and data breaches.
• Have clear personal data protection regulations in place to prevent third parties from using the information to their own benefit.

Taking advantage of health information technology seems like the next logical step for medical practices, but you should carefully consider all the pros and cons of electronic health records before making the leap.