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The first commercial Electronic Health Records system began in 1972, but their use in doctors’ offices is still not universal. Proponents point to a long list of benefits gained by using EHRs, but what are the disadvantages?

What Are Electronic Health Records?

Before we can talk about the benefits and disadvantages of electronic health records (EHRs) we need to first specify what we are talking about.

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An EHR is an electronic version of all health records for a specific patient. This includes all problems and symptoms reported to healthcare workers, medications taken, vital signs, lab tests, x-rays, immunizations, data about the patient’s demographics, diagnoses, etc. It turns out to be quite a lot of data!

EHR Early History and Background

EHRs have been around for a long time. The first commercial electronic health record system started in 1972 and grew out of an earlier adoption of the problem-oriented medical record, pioneered by Dr. Lawrence Weed.

Prior to Dr. Weed, the only records that most medical practitioners kept were related to diagnosis and how the treatment was working. This made it very difficult to impossible for a patient to take his or her medical data to another doctor for a second opinion on the diagnosis.

The problem-oriented medical record changed that by making it possible for another doctor to have access to all of the information the first doctor had.This process worked well, but it also required a lot of data to be stored by all doctors’ offices with the majority of it in paper form. It didn’t take long before someone decided to try storing all of this information on a computer, which was the start of the first EHR system.

Early Benefits and Disadvantages

Early benefits of the EHR system were fairly obvious. The amount of space dedicated to computers and the employees that ran them was roughly 10% of the filing cabinets filled with paper, which reduced commercial rent costs. Data loss went from more than 10% to less than 1%, and retrieval time for information went from a minute all the way down to a few seconds, reducing the number of workers needed as well as increasing the number of patients an office could serve.

Some of the early disadvantages were even more prominent, especially the high cost of obtaining an EHR system. Other disadvantages included the time and expense to train staff on the EHR’s use as well as ongoing maintenance costs. Because of these issues, the use of EHR technology has always been more beneficial at larger offices and hospitals. The costs are just too high for EHR use to be financially feasible at most small offices.

As of 2013, the CDC estimated that only 78% of doctors’ offices employed any kind of EHR system, with the predominant holdouts being offices consisting of three or fewer doctors.

Later Benefits and Disadvantages

As EHR programs became more sophisticated, and with the rise of the internet, the benefits of using these systems grew. Some programs will now alert doctors about critical lab values, point out potential medication errors and interactions, suggest best practice clinical guidelines, point out needed lab results, facilitate communication with the patient, and allow a doctor to access the information remotely. Grouping of health record data has also allowed better medical research to be conducted.Despite these benefits, there are still downsides. The new available technology has increased old concerns and also brought in some new ones. More sophisticated programs cost more to develop, and those costs are passed on to the medical professionals who must pay higher up-front costs for the systems.

These newer programs also require more qualified employees to run, and these professionals also come at a price. Data in electronic format is also susceptible to electronic snooping and hacking. Privacy concerns exist with legitimate uses of data, and many patients are even wary of having data used for large medical studies to group the data for large studies.

Lesson Summary

There are a tremendous number of benefits with electronic health records, because their use lowers the amount of storage space, reduces data loss, and dramatically increases the speed of retrieval and transport of health records.

Newer versions of the software have also started cuing doctors on best clinical practices, appropriate medicines, and even helping facilitate communication with the patient.The downsides of the technology mostly concern costs and data protection. The programs typically have high up-front costs and require more qualified (and expensive) employees to run. Privacy concerns associated with the patients’ data also come about by illegitimate and legitimate means; hacking and sharing of data for research purposes both have concerns.

This is a complicated subject, and one that medical professionals and regulators are keeping close tabs on.

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