Updated: Aug 6, 2019
What are the major benefits and potential barriers to achieving benefits in an EHR? What steps are important to overcome barriers?
The terms EHR and EMR are most commonly used interchangeably. However, there is a distinct difference between these two terms. Electronic medical records (EMRs) are an electronic version of paper charts in the clinician’s office. While electronic health records (EHRs) include all EMRs purposes and on the top, they focus on the total health of the patient going beyond standard clinical data collected in the physician’s office.
Shorter Consultation Times: Obtaining patients’ records have contributed shorter consultation times because patients were better told during their wait-time compared to if they had not had access to their records already. Besides, online consultations for minor issues can overcome in-house clinic or hospital visits, significantly reducing time on both parts of patients and physicians.
Lowered Costs: Medicare would save over $20 billion a year when patients have a better way to access their medical records. About 88% of Americans believe that access to medical documents online would decrease the needless tests and systems they would have to experience. In turn, it would decrease costs for hospitals, patients and insurance corporations.
Patients are more in control: When patients are more in control of their medical records, they feel more empowered in their health decisions. Web-based programs for tobacco-cessation and diabetes self-management are some ideas that EHRs can be used for public health goals.
Increase physician’s functionality: In adjunct to physicians’ knowledge to give patients extra resources through an integrated EHR, patients forthwith can present physicians with relevant health information of their own.
Assessments and reminders: Online support organizations, health assessments and reminders for regular check-ups are also possible. By initiating the communication channel in both directions, EHRs have the power to transform consumers’ lifestyles and promote healthier habits.
Easy record-keeping: EHRs can support better record-keeping practices and decrease errors. Since EHRs can correlate to multiple different information sources, they can connect an individual’s different medical history into one central place.
Improved patient education: Patient-created means have also been posted on the online web portal from which the EHRs are obtained. Patients, students, and clinicians can study from e
ach other and work together by transferring information to develop both sides of the EHR process.
Lack of time and slow shift: One significant obstacle to achieving a patient-accessible EHR is a gradual shift to digital in the healthcare professionals that are charged with creating the records. Physicians see EHRs negatively because they consume much more time than the former method of physically inscribing notes.
Provider resistance: When patients don’t have access to their medical histories freely, they can’t question about what each record indicates that a doctor has hand-written. However, once this information becomes available to a patient, a new stream of questions may appear. While this may decrease time in the hospital or clinic in the long run, doctors still will require to respond patient emails, a part of their day for which time is not currently factored into.
Computer literacy: Without computer literacy, or access to the Internet, patients won’t be able to view their records even if they exist. For them, it would make no difference whether their EHRs were available online because they may not have the Internet or the skills to navigate an EHR if they do have the Internet.
Funding & IT capabilities: Without sufficient funds, hospitals and other healthcare providers are unable to invest in a suitable ERMS for patient access purposes. Only half of the respondents in the same survey (54.2%) even had an ERMS in place, with hardly any having predominantly electronic records. Funding for more advanced IT options and expertise should be a priority for a successful ERMS implementation.
Interoperability: A lack of interoperability between different EHR systems means that there could be difficulty compiling records from different providers. The lack of cohesion means individual health data will inevitably be lost when switching providers or insurance companies, a fact that could dissuade users from committing to an EHR altogether.
Privacy concerns: Americans suffer that putting this information online will make it more easily accessible to people other than themselves. Eighty percent fear that online access to this information will increase identity theft or fraud, and 90% have concerns about medical information being accessed and used by marketers.
Steps to Overcome these Barriers:
One of the more worrisome challenges is how to make data more reliable and secure. This challenge is one of the primary barriers needed to overcome low levels of participation from the public. The next best option is providing full transparency to the consumer about the possibility of how their information may be used. Consumers need to have the right to opt out of any health information-sharing options that they feel uncomfortable with. The Office of National Coordinator (ONC) has developed a concept of a “Model Notice,” which healthcare companies can use to display security information in terms widely understood by the public.
There exists a need for better-designed EHRs that cater specifically to medical professionals. To enable efficient record creation and maintenance through an ERMS, designers will need to incorporate users into their design and testing process. A collaboration between The ONC, the White House and the Department of Veteran Affairs encourages technology developers to build e-health tools that would increase patient access to personal medical records. This collaboration shows that health and technology professionals alike are becoming aware of the limitations of such systems.
Ongoing patient-led education for medical professionals should be a priority. Online EHR education for medical students should be incorporated into their medical education. Successful implementation of patient accessible EHR requires a strong support system from hospital staff with resources built into the EHR. Online web portals that allow EHR access should be designed as a “one-stop shop” for a patient’s medical history and future, or what.
The EHR model of the future is an intelligent personal health record (iPHR), which is a concept that is still being developed. IPHRs will incorporate web search technology and existing medical information to anticipate patient needs and create individualized plans and resources. One such medical search engine, iMed, uses diagnostic decision trees that are designed by medical professionals that help the user (patient) form queries about their specific symptoms or diseases. Using an extensive algorithm, iMed can search using the diagnostic trees to return related resources for the user.
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