Electronic Health Record Progress: Looking to the Future of Patient Medical Data

Ever since the Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted, the handling of medical records has been revamped. Instead of relying on written records to access patient data, a new system has been more commonly utilized. Motivated by the incentives offered by HITECH, hospitals have started to embrace electronic health records (EHR). EHR is a unified electronic system that gathers patient health data and makes it available to separate hospital entities, making previously inaccessible information now readily available. The end goal of this transition is efficient healthcare, a reality where the compilation of patient data in a universally connected network improves health outcomes by allowing both patients and physicians access to information medical information. Opponents of EHR claim that the upfront costs of instituting the system are too high, the privacy risks are legitimate, and the transition to digital records requires excessive hassle [1]. Hence, the conversation regarding EHR has become one of the most polarizing in medicine.

The Process

HITECH has promoted movement towards EHR adoption in incremental stages called “Meaningful Use,” financially rewarding healthcare providers who meet these objectives at specific points in time. Stipulations for incentives in Meaningful Use Stage 1 include using EHR for purposes such as e-prescribing, recording demographics, and maintaining active medication lists [2].  Meaningful Use Stage 2 adds other requirements such as providing patient access to online medical record portals and recording electronic notes [3].  This past July, the rules for Meaningful Use Stage 3 were released.  New objectives include conducting security risk analysis to protect patient information, submitting data to clinical data and public health registries, and creating summary of care records for electronic exchange [4].  Additionally, HITECH has provisions that have docked the Medicare payments for physicians who have not incorporated EHR since 2015 [5].

New Doors Opened

Though still only a recent implementation and not yet fully instituted, EHR has opened up possibilities previously not afforded by paper records.  Web portals have made patients more informed about their medical records and give them an avenue of communication with their physicians. The consolidation of patient information has made it less likely that time and money is wasted on duplicate tests, and the automated electronic nature of the system checks for problems with allergies and medications after prescriptions. As a result, the abundance of compiled health data has improved the assessment of public health outcomes.  The clinical perception of EHR further reinforces its benefits [6].  A 2012 National Center of Health Statistics study shows that 94% of providers believe that EHR makes records more readily available and 88% believe that it results in clinical improvements [7].

Concerns to Consider

The opposition to EHR still remains very real.  Leaking of confidential data remains one of the most prominent concerns, yet policymakers have done their due diligence in rectifying this fear.  Security measures such as audit functions showing every individual who has viewed a certain patient’s data are required of every EHR system.  Many hospitals use such tools to enforce zero-tolerance policies for violation of patient privacy.  However, the “one-size fits all” nature of EHR brings up further problems.  Researchers have found a link between computerized physician order entry and medical errors as a result of rudimentary system designs and poor user training [1].

Looking Ahead

Though the concerns regarding EHR should be acknowledged, the benefits far outweigh the negatives.  With the onset of Meaningful Use Stage 3, increasing penalties for sticking to paper records, and the increasingly apparent perks of a unified digital healthcare records system, the capabilities and ubiquity of EHR should continue to expand in the next few years.  Through greater linkage between separate hospital system entities, the previously idealistic vision of continuum care connecting all healthcare facilities now seems more and more an inevitable reality.  The only question that remains is how soon.

References:

  1. Menachemi, Nir, and Taleah H. Collum. “Benefits and Drawbacks of Electronic Health Record Systems.” Risk Management and Healthcare Policy4 (2011): 47-55. US National Library of Medicine. Web.
  2. “Medicare & Medicaid EHR Incentive Program: Meaningful Use Stage 1 Requirements Overview.” gov. Center for Medicare and Medicaid Services, 2010. Web. 29 Sept. 2016.
  3. “Stage 2 Overview Tipsheet.” gov. Center for Medicare and Medicaid Services, Aug. 2012. Web. 29 Sept. 2016.
  4. Scheidlinger, Sophie. “Meaningful Use Stage 3 and 2015 Certification Final Rules Released.” com. Practice Fusion, 30 July 2016. Web. 29 Sept. 2016.
  5. “Are There Penalties for Providers Who Don’t Switch to Electronic Health Records (EHR)?” gov. United States Government, n.d. Web. 29 Sept. 2016.
  6. “Benefits of Electronic Health Records (EHRs).” gov. United States Government, n.d. Web. 29 Sept. 2016.
  7. “National Perceptions of EHR Adoption: Barriers, Impacts, and Federal Policies.” gov. National Center for Health Statistics, 8 Aug. 2012. Web. 29 Sept. 2016.

Image References:

  1. http://static1.squarespace.com/static/53c44895e4b053fc7d14630f/t/549862dbe4b0af001f2f8de9/1419272942428/doctor-at-computer-3.jpg?format=1500w

Nikhil Reddy Yedulla is a sophomore at Wayne State University interested in becoming a physician.

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