The Dream of EHRs and Their Nightmare-ish Reality

Health Insurance

November 9, 2019

In 2009, the Obama administration dedicated $27 billion to promoting electronic health records (EHRs) among American healthcare providers. Ten years later, plenty of providers have adopted the technology, but neither doctors nor patients are entirely sold on a system that’s rife with problems and can lead to sometimes deadly mistakes. Even former President Obama himself has  expressed regret that the money poured into the initiative hasn’t returned entirely favorable results. Some good has come from electronic health records, yes, but there’s still a long way to go before EHRs can be considered a resounding success for the American healthcare system.

Plenty of Potential

You’ve probably had medical files for as long as you’ve been alive. Perhaps you remember the office staff at your childhood doctor’s office pulling your manila file folder off the shelf when it was time for your appointment. These days, those paper files have been going by the wayside as digital file-keeping has replaced traditional methods.

In fact, in developed countries around the world, medical facilities have been relying on electronic health records for years. At least 90 percent of British doctors use EHR technology. Although American adoption of EHRs has been slower, digital files have become much more widespread over the last decade.

There are good reasons for the shift toward electronic records, not the least of these is the potential streamlining of medical care. With paper records, your specialists don’t have quick or easy access to the files that are at your primary care provider’s office. Electronic systems have the potential to grant doctors quick access to important information about your history, symptoms, tests and treatments. Not only that, but EHRs can give patients access to their files from their home computers or smartphones.

Electronic records can also make billing easier. When data about visits, procedures and treatments are automatically recorded, it should be easy to see what charges are necessary and to double-check for accuracy.

Along with these practical positives, EHRs are promoted as being better for patient wellbeing. Theoretically, a doctor who has more information about your health history can provide better care suggestions. Electronic systems can provide alerts about potential drug interactions and important preventive tests. With a digital system, prescriptions can be electronically delivered to the pharmacy, and the pharmacist need not struggle to interpret a doctor’s handwriting.

On a larger scale, EHRs offer the option to collect widespread patient data. Researchers may be able to use this information to spot trends and discover new treatment options.

Hurdles to EHR Success

Despite their strong potential, EHRs aren’t yet beloved among the American medical community, and patients aren’t entirely on board either.

Have you noticed that during visits with your doctor these days, providers spend much of the time looking down at their tablets or at a computer monitor? That’s because they’re busy entering data into their EHR programs. Doctor-patient engagement can be hampered when a doctor spends the whole appointment clicking on-screen prompts.

To make matters worse, many doctors find their EHR systems cumbersome and hard to use. Often, there are too many screens to click through and too many required inputs. Seemingly endless customization options can make systems hard to navigate.

To top it off, these programs often run slowly – something you might have heard your doctor or a nurse complain about out loud – which causes doctors to fall behind. Providers who, night after night, must spend hours catching up on digital data entry may end up experiencing premature burnout thanks to administrative tasks that should be streamlined with technology, not made worse.

There are plenty of electronic medical systems on the market, so it might seem that a doctor who isn’t satisfied with his current setup could switch to another product. But the high cost of new software can make that hard to do, not to mention the monumental burden of moving an entire practice’s worth of patient data into a new system quickly and securely.

Furthermore, having a gamut of different systems available isn’t necessarily helpful. When various providers use different EHR interfaces, the data may not transfer well from one system to another. It doesn’t usually, in fact.

One of the most disconcerting aspects of EHRs is the potential for dangerous errors. It’s not entirely uncommon for one person’s records to get uploaded to the file of another patient with a similar name. Poor integration between different systems can exacerbate that concern. Human typing errors can lead to further mistakes. When preventable errors mean that medical care does more harm than good, both patients and doctors suffer.

Making Electronic Records Better for Everyone

Frustration with EHRs doesn’t mean that most people want to go back to a paper-based recordkeeping system. It does mean, though, that there’s plenty of room for improvement. With continued refining, electronic records may become something that both medical teams and patients can fully appreciate.

Changes in the platforms themselves need to be the first step. Streamlined interfaces and improved responsiveness would make it easier for doctors to enter information into EHRs. Giving doctors increased control over what information they must input to complete an entry would reduce unnecessary paperwork and free up time for more meaningful patient care.

Regulation changes could help as well. Increased standards for interoperability would improve the transfer of information from one platform to another. Not only could this result in fewer headaches for healthcare workers, but it would also have the potential to improve patient safety by reducing record-related mix-ups.

Although controversial, the adoption of unique patient identifiers — national medical ID numbers for every person — could reduce errors in digital records. If every care provider were to use the same ID code for a patient, the transfer of records from one office to another would face fewer hurdles.

Finally, it must be acknowledged that, at least in part, EHRs are a struggle because they’re designed for use in a complicated system. The American healthcare system is fraught with confusion and a host of problems, largely related to cost and how we – patients, providers, insurers and lawmakers – place value on medical care. EHR platforms are often designed with the bottom line in mind rather than optimal patient care. Barring widespread change, there may be a limit to how successful electronic recordkeeping can be when it’s just one component of a complex and apparently ever-changing healthcare system.