EHRs: The good, the bad and the inefficient
Across the various eHealth categories available, electronic health records (EHRs) are the most widely adopted throughout Europe. In 2018, it was reported that 96% of GPs across all EU countries use EHRs in their practice.1 These systems were designed to make it easier for doctors to diagnose and treat their patients.2 With EHRs increasingly becoming the norm, not only in Europe but globally, we must consider the benefits and potential challenges of putting EHRs into practice.
EHRs and usability
An EHR is a digital version of a patient’s medical chart containing vital information that relevant healthcare professionals can access.2 Notably, EHRs should not be confused with electronic medical records (EMRs). Specific EMR software is generally only used within a single office or practice, while EHRs are shared between multiple sites.3
EHRs have various functionalities, many of which have been reported by GPs as being ‘routinely used’.2 Common functionalities include accessing a patient’s medical history, vaccination dates and treatment plans.2 Access to this information can be imperative in many situations. For example, alerts in an EHR can tell care providers if a patient is allergic to any medicines, when the patient is unable to do so.4 This is particularly important in emergency situations, where care providers need to access crucial patient information as quickly as possible. The use of EHRs also make obtaining information, such as previous test results extremely easy, avoiding repeat tests.5
Different to standard methods, EHRs have the potential to pick up worrying symptoms or health-related trends faster.4 These trends are not limited to individuals, they may also appear across wider patient groups.6 For example, through analysis of EHRs, it was found that individuals who have chronic obstructive pulmonary disease (COPD) alongside anxiety or depression were more likely to experience an acute COPD exacerbation than those with other comorbidities, with 27% exacerbating at least once during the first year after their COPD diagnosis.6
Electronic-based health systems, such as EHRs, allow patients to be more independent and involved with their treatment.7 In 2018, Apple launched a new feature for iOS, allowing patients to download their EHR directly onto their phone.7 The feature was introduced to encourage the public to engage with their health by keeping their health information organised and comprehendible.7 Through the use of this, patients may also be reminded about commonly forgotten medical considerations, such as keeping up to date with their vaccinations.7 A global review analysing the effectiveness of patient reminders concluded that such systems were able to increase the number of children and adults receiving any kind of immunisation by up to 20%.8 Innovations within EHRs are constantly being developed and implemented; the ability for a patient to download their EHR onto a smartphone being just one example. In the future, it may also be possible to use dictaphones to help make data input quicker and more efficient for HCPs.9
Potential challenges with EHRs
While there are seemingly a number of benefits afforded by EHRs, the potential challenges must also be considered. Any form of digital technology is vulnerable to security breaches, and unfortunately, EHRs are no different. Indeed, reports of EHR security breaches are increasing every year with over 41 million patient records being breached in 2019 alone.10 In order to combat cybercrime, the EU has budgeted €2 billion for 2021–27. 11 This investment is testament to the reality that cybersecurity remains a significant challenge when handling sensitive data.
Although EHR systems aim to provide more ease for doctors and improved care for patients, at times they seem to have the opposite effect.12 Reports suggest that the poorly-designed interfaces of EHRs may hinder the treatment of patients as more time is spent focusing on the EHR.12 In 2018, it was reported that more than 60% of doctors’ time spent with their patients is actually devoted to interacting with EHRs.12 While, an EU survey in 2018 found that 30% of GPs disagreed with the statement that EHRs allowed for more efficient consultations, and 52% disagreed with EHR usage initiating shorter waitlists.13
In the EU, the use of EHRs poses a unique challenge for interoperability between countries; the ability of a system to work with other systems without the need for additional effort.14 Unfortunately, due to issues surrounding data protection concerns among others, implementing a standardised electronic health system between countries has proven difficult.14 Of course, for this system to be optimally effective, it would require all healthcare professionals to use EHRs as part of their practice. If a healthcare professional is not using EHRs, they may not be able to prescribe certain medications that must be done electronically, for example.15 Therefore, a challenge exists to extend the use of EHRs, while not limiting effective patient management for all. Data input and record format standardisation may provide additional ways to overcome this challenge of interoperability.
Should EHRs become the sole means by which doctors record patient data, any minor errors could have detrimental effects on a patient. Incorrect or incomplete data that is accessed by future healthcare professionals may put patients at risk. In some instances, order entry errors around the dose and administration of medications have the potential to be life-threatening.16
Ultimately, the benefits and drawbacks of EHRs may not be as clear-cut as they originally seem. There is no question that plenty of advantages exist to a universal database where patient information is easily accessed by those who need it. However, the execution of these systems still needs refining for the healthcare world to truly benefit. In an age where society is becoming increasingly dependent on technology, EHRs need to be accessible 100% of the time. Is relying on medical technology going to be costly for the patient? Discover more about digital health and EHRs in our articles on small data vs. big data here and connected data here.
Approval code: RESP-TPE-NP-00341 Date of preparation: October 2022
- ICT and Health. EU e-health adoption study: 96% of doctors use electronic health record. 2019. Available at: https://www.ictandhealth.com/news/eu-e-health-adoption-study-96-of-doctors-use-electronic-health-record/. [Accessed July 2020].
- Health IT. What is an electronic health record (EHR)? Available at: www.healthit.gov/faq/what-electronic-health-record-ehr. [Accessed July 2020].
- Best Electronic Health Record Software of 2020. Available at: https://www.techradar.com/uk/best/best-electronic-health-record-ehr-software. [Accessed July 2020].
- 5 ways electronic health records are boosting patient outcomes. Available at: https://pharmaphorum.com/views-analysis-digital/5-ways-electronic-health-records-are-boosting-patient-outcomes/. [Accessed July 2020].
- SE healthcare. The benefits and challenges of electronic health records. Available at: https://www.sehealthcarequalityconsulting.com/2018/09/18/the-benefits-and-challenges-of-electronic-health-records/. [Accessed July 2020].
- Pikoula M, et al. BMC Medical Informatics and Decision Making 2019; 19 (86).
- Mobi health news. Apple’s EHR feature launched last week: Here’s what that looks like for patients and providers. Available at: https://www.mobihealthnews.com/content/apples-ehr-feature-launched-last-week-heres-what-looks-patients-and-providers. [Accessed July 2020].
- Jacobson Vann, J C and Szilagyi, P. Cochrane Database Syst Rev. 2005 Jul; 2005(3): CD003941.
- Electronic health records: Can the pain shift to value for physicians? Available at: https://www2.deloitte.com/us/en/insights/industry/health-care/ehr-physicians-and-electronic-health-records-survey.html. [Accessed July 2020].
- Breached Patient Records Tripled in 2019 as Malicious Actors Create New Problems for Patients. Available at: https://www.prnewswire.com/news-releases/breached-patient-records-tripled-in-2019-as-malicious-actors-create-new-problems-for-patients-301003328.html. [Accessed July 2020].
- Why The EU Is About To Seize The Global Lead On Cybersecurity Available at: https://www.forbes.com/sites/jodywestby/2019/10/31/why-the-eu-is-about-to-seize-the-global-lead-on-cybersecurity/#62eeafbe2938. [Accessed July 2020].
- Stanford Medicine. White paper: the future of electronic health records. Available at: http://med.stanford.edu/content/dam/sm/ehr/documents/EHR-White-Paper.pdf. [Accessed July 2020].
- European Commission. Benchmarking Deployment of eHealth among General Practitioners (2018). Available at: https://www.ictandhealth.com/wp-content/uploads/2019/08/BenchmarkingDeploymentofeHealthamongGeneralPractitioners2018.pdf. [Accessed July 2020]
- Germaine Shull J. JMIR Med Inform. 2019 Oct-Dec; 7(4): e12712.
- EHR in Practice. Can a modern practice survive without an EHR? Available at: https://www.ehrinpractice.com/modern-practice-ehr.html. [Accessed July 2020]
- 16. PSO Navigator. Wrong-Record, Wrong-Data Errors with Health IT Systems. Available at: https://www.ecri.org/Resources/In_the_News/PSONavigator_Data_Errors_in_Health_IT_Systems.pdf. [Accessed July 2020].
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