Definition, Advantages, and Disadvantages of Electronic Health Records

Electronic health records (EHR) system integration brings the opportunity to switch from a paper-based system to a digitized one. Imagine: no more personal health records written on pages in folders and files that could be in many different locations around the country, instead you’d have modern EHR systems that enable patients and clients to have full access to personal health information. 

However, like any other digital solution, electronic health records are not without their drawbacks. Moreover, their implementation requires additional costs and time from your medical organization. So, how do you know if it’s worth it? Or, could you possibly make do with more universal solutions like Google Sheets to save time and money? Let’s find out right now—below, we’ill consider all the advantages and disadvantages of EHR systems, analyze their types, highlight financial benefits and integration challenges, as well as help you to decide whether you should use a ready-made solution or resort to custom software development.

What Are EHR and EHR Systems?

Before considering all the advantages and disadvantages of electronic health records, let’s briefly answer the question: “What is EHR?” In a nutshell, we can say that it’s software for a structural way of storing and sharing patient medical data. EHRs are digital versions of paper patient cards—real-time and patient-oriented records that make information instantly secure and accessible for users who have authorized them.

This facilitates collaborative working medical practices where different health professionals can work together in real time to provide patients with the best care. Also, it enables quick access to health care services, improving wait lists and diagnosis accuracy using the most advanced EHR measures.

The goal of any electronic health record system is to create a comprehensive, accurate healthcare history for a patient. This is the beginning of a new era of medical record interaction. Digital medical records have become more portable, and patients now rely on the accuracy of their integrated electronic medical records more than ever.

Sharing digital data is quickly becoming the de facto standard because it’s quicker, more cost-effective, and less cumbersome than printing and faxing.

EMR vs. EHR

It’s also worth mentioning electronic medical records (EMR). An EMR is a digital patient record from a single provider or clinic. The EMR system is designed to store medical information locally and is not intended for distribution outside of an individual’s practice.

The terms EMR and EHR are often used interchangeably, but this is fundamentally incorrect. The Office of the National Coordinator of Health Information Technology (ONC) emphasizes the major differences between EMR and EHR: EMR lacks interoperability, which is a high priority for EHR systems.

Advantages and Disadvantages of Electronic Health Records

So, what are the advantages and disadvantages of electronic health records systems?

In general, a full-featured EHR goes beyond basic functions, such as clinical notes and documentation, to include more of your practice’s workflows. With a full-featured EHR, your practice integrates more easily with other members of the medical community, helping to improve care coordination and its quality, increase patient participation in care, improve efficiency, and save costs.

Let’s explore all the advantages and disadvantages of electronic health records, both for physicians and patients.

EHR Advantages

We decided to divide the list of benefits into those that patients receive and those that physicians receive because, ultimately, this determines your individual goals of implementing EHR systems. For example, if you want to improve the quality of patient care, then you should know the benefits for patients, and if your doctors need to optimize their work processes and reduce errors, you should check the block for doctors. Let’s analyze these two blocks in turn.

For Physicians:

1. Access to patient information 24/7. EHRs allow healthcare workers to provide constant access to the right information about patients. While there are still some improvements, the transition from paper—with its hard-to-read medical signatures—to digital format—which can be quickly and easily transferred from office to office—is a technological leap forward. As an example, the system holds what‘s normally in a paper chart—problem lists, ICD-10 codes, medication lists, and test results.
2. Reporting health management. With a searchable EHR database, you can find all the information you need, like how many diabetics have HbA1c before age seven or how many cases of tuberculosis were cured in 2020.
3. Digital records are easy to read. Less risk of misunderstandings or errors in critical areas such as diagnostics and medical orders.
4. Meeting Medicare and Medicaid meaningful use requirements. With a certified EHR system, a physician’s office can access certain incentives issued by the federal government.
5. Improved billing and scheduling operations. When a billing process is integrated with an EHR, it becomes a comprehensive platform. There is no need to enter data manually and repeatedly, and the risk of payment miscalculation is reduced.

For Patients:

1. Order entry. No more prescription padding—all orders are automated using secure electronic prescription technology.
2. Patient support. Patients can receive educational materials from their physicians through the EHR and enter data themselves using online questionnaires and home monitoring devices.
3. Administrative processes. The system helps with practice management and helps avoid treatment delays. Patients can make their own appointments.
4. Easier chronic disease management. EHR saves time and risks for patients who have a long medical history in paper format, as EHR contains all the diagnoses in one place. Also, it reduces the incidence of medical errors.
5. Monitoring and controlling patient records. Monitoring and controlling patients ensures that they are well-informed and can make more informed decisions about their conditions.
6. Access to records 24/7. This avoids unnecessary calls and appointments to clarify information that the patient can easily access electronically on their own.

“The EHR is about quality, safety, and efficiency. It is a great tool for physicians, but cannot ensure these virtues in isolation. Achieving the true benefits of EHR systems requires the transformation of practices, based on quality improvement methodologies, system and team-based care, and evidence-based medicine.”—American Academy of Family Physicians

For healthcare organizations that want to take advantage of this technology and understand how to best utilize other telemedicine capabilities in their work, make sure you choose the right vendor that can manage complex solutions for your patients while saving you time and money. You should also consider the possibility of custom development if you haven’t found a suitable ready-made solution.

EHR Disadvantages

Considering the mentioned advantages of the system, it would be fair to highlight the disadvantages as well. But first, it’s important to mention that many of the drawbacks that have been documented consist of several factors, which, moreover, do not depend on the vendor. For example, loss of productivity and burnout are more likely due to a lack of employee training.

However, other things that fall directly into the category of most notable disadvantages of electronic health records are below:

1. Outdated data. EHRs can get incorrect information if the EHR is not updated immediately when new information, such as when new test results come in. As a result, this can lead to errors in diagnosis or treatment.
2. More time and money. Selecting and setting up an EHR system and digitizing allpaper records can take years. During that time, it’s worth determining your budget and the set of features you need. It also takes time to select and implement the right system for your practice. Then, even after the EHR system is fully set up and operational, it will take time to train your staff in its use. There are also the costs of switching to a completely new medical record system as updates are released, which is not cheap, even at competitive prices. But it’s worth remembering that the more players enter the EHR system market, the more competition becomes pervasive and prices decrease.
3. Inconsistency and inefficiency. As suggested above, maintaining an EHR system requires frequent updates. If your team doesn’t keep up with this, your records can lose their accuracy and, as a result, their value. Find out how to prevent data leaks and high fines when updating EHR. An important part of a strong EHR is the ability to have a team of information technology specialists on hand to address technical issues immediately to minimize interruptions in patient care.

After considering the pros and cons of EHR, we can conclude that the above problems still can be solved. One of the more effective strategies for mitigating these deficiencies is to plan for potential problems early in implementation and closely monitor how the system performs after that.

EHR Integration Challenges

EHRs have the potential to lower costs, improve productivity, and increase patient comfort. At the same time, implementing EHRs is a long and complicated process. Some of the major challenges that EHRs face include interoperability and data privacy.

Quality Issues

Data and knowledge logistics must be supported by EHR. Therefore, related data should not only be accessed on-demand, but also have four dimensions: accuracy, completeness, consistency, and timeliness.

The manner in which data is presented should take into consideration the current clinical context and anticipate users’ needs, thus creating an intelligent ambiance. Thus, the different types of health data such as narrative data, physical examinations, diagnosis, procedures, lab reports, images, and biological signals should be obtained with different methods and corresponding standards.

To ensure high-quality EHR data in healthcare, care managers (nurses) and health information managers must gather, integrate and supervise various pieces of patient information. The accuracy and integrity of data in the EHR must be monitored and verified in accordance with the rules for software as a medical device under the European Medical Device Directive (MDD) or FDA regulations.

Privacy and Security Concerns

Poor design and misuse of an EHR system can lead to what is called EHR-related errors that jeopardize the integrity of information in records, resulting in errors that in turn compromise patient safety and reduce service quality. These unintended consequences can also lead to increased fraud and can have serious legal consequences.

This is why government privacy and security regulations and HIPAA impose restrictions on healthcare systems properly using and disclosing protected health information (PHI). Organizations must take measures to ensure compliance with HIPAA. However, these requirements should not pose serious obstacles to EHR integration where appropriate. To ensure integration with third parties, health systems may need to put in place valid HIPAA business associate agreements (BAAs).

Limitations on Contracts

Some industry players limit integration to contracted restrictions, more accurately described as administrative barriers. According to HIPAA, interoperability laws do not create barriers to integration. On the contrary—these laws encourage interoperability. Generally, any restrictions on integration and data exchange come from healthcare providers or vendors.

Pros and Cons of EHR: Cost Savings and Financial Incentives 

In general, along with electronic health records pros and cons and the potential costs associated with the deployment, there are a number of financial incentives that accompany the implementation of electronic health records. In particular, financial benefits from their use for medical organizations can be achieved in the following directions:

• Reducing time spent on regular work processes. EHR systems are actively used to streamline administrative tasks and thereby reduce paperwork, allowing healthcare professionals to focus more on patient care. This approach, in turn, contributes to more efficient use of the working time of employees of medical institutions.
• Effective revenue cycle management. Such systems also streamline the billing process, improving revenue cycle management in healthcare organizations. This has a positive effect on reducing errors that cause damage to the budgets of these organizations.
• Budget savings by reducing duplication of tests and procedures. EHR systems eliminate the need for duplication of tests and procedures by providing healthcare centers with a centralized repository of patient data. In this way, medical centers can avoid unnecessary costs.
• Full compliance with regulatory requirements and avoiding fines. Among other things, EHR systems help healthcare organizations comply with regulatory requirements and avoid penalties associated with non-compliance. Thus, those organizations that use EHR systems in their work processes may be eligible for government incentives and reimbursements.
• Better data-driven financial decision making. Finally, some advanced EHR systems are capable of generating analytics that can be proactively used to gain valuable financial insights. This enables healthcare organizations to make more informed financial decisions, optimize resource allocation, and identify areas for improvement.

Thus, taking into account the above-described electronic health records pros and cons, we can conclude that with the right approach to choosing specific software, medical organizations can not only improve the quality of patient care but also receive certain financial benefits.

Interoperability—Must-Have of Healthcare

Interoperability is defined by The Office of the National Coordinator for Health Information Technology as, “The ability of a system to exchange electronic health information with and use electronic health information from other systems without special effort on the part of the user.”

With good interoperability, electronic health records software allows users to track the progress of patients across healthcare settings and specialists. This provides a holistic view of patient care and all stakeholders and a consistent view of a patient’s longitudinal health status.

The ONC contributes to improving the quality of patient care, which includes optimization of EHRs and improved data compatibility.

When conducting an electronic health record overview to receive an objective list of advantages and disadvantages of EHR, work with your vendor to be sure that the system is incorporating all the leading standards, including Fast Healthcare Interoperability Resources (FHIRs) APIs, and Substitutable Medical Applications, Reusable Technologies (SMART).

These technologies allow developers to create standardized, easy-to-implement software that makes interacting with EHRs more appealing.

EHR Integration with Other Healthcare Systems

Now, let’s look at the practical side of integrating EHR systems with third-party applications and services, as this requires careful advance planning. In particular, you’ll need to follow these steps to ensure there is no downtime in your business processes or, even worse, loss of some patient records.

• Identify problems solved through integration. First, you’ll need to understand why you need a particular integration. This goal involves defining specific outcomes, such as improving workflow efficiency, eliminating downtime, reducing manual data entry errors, improving patient care, or something else.
• Determine the specific requirements of the software used in your organization. To solve this problem, you’ll likely need to ask your system administrators to help you determine compatibility with the selected EHR system and, if necessary, suggest alternative options that will not cause downtime in your work operations.
• Prepare your data for integration. You will likely need to audit patient data to remove low-quality and duplicate records. It’s also likely that you’ll need to plan an additional step involving data migration or hardware/software upgrade.
• Establish transparent communication with all parties in the integration process. Now you’ll need to establish communication channels between all parties involved, making sure that each of them is well-informed about the goals, conditions, and deadlines for the integration.

Based on the steps above, it becomes clear that special attention needs to be paid to choosing a reliable EHR system supplier. In particular, you’ll have to check the following aspects:

• Recommendations and results obtained through our own research. Do your research to find the right EHR vendors for your healthcare organization. You can also get recommendations from your partners and colleagues—they should also be taken into account.
• Insights obtained after product demonstrations. Schedule product demonstrations with potential EHR suppliers so you can evaluate the system’s effectiveness and usability in practice.
• Available integration options. Visit the websites of your chosen vendors to learn more about how their EHR systems can integrate with third-party software solutions.
• Terms of support and employee training. Make sure that the services of the supplier you choose include training of employees, as well as the provision of prompt technical support for troubleshooting. Also check whether the communication channels offered by the supplier are suitable for you to carry out effective and convenient communication.
• Pricing policy and usage agreements. Finally, check the available pricing models and contract terms. You will also need to make sure that the pricing policy offered by a particular EHR vendor does not include any hidden costs.

If you have successfully completed all the previous preparatory stages, it is time to find out how the process of integrating an EHR system with third-party software solutions works:

• Evaluation of software solutions for which EHR integration is planned. Check whether the solutions you are already using are compatible with the EHR system you have chosen.
• Data preparation. Here it’s assumed that you have already completed the data cleaning stage—now, it will need to be consolidated in such a way as to ensure a seamless transfer to the EHR system.
• Selecting a protocol and standard for integration. Depending on the technical specifics of your IT infrastructure, different standards and integration protocols may be suitable. For example, this could be FHIR, DICOM, or HL7.
• Development of a custom or use of a ready-made API. It’s likely that the EHR system you choose already has ready-made APIs for integration with software solutions that are already used in your healthcare organization. Along with this, in some cases, custom API development is also required.
• Ensuring end-to-end data security. Ensure that technicians adhere to data security and confidentiality measures throughout the entire integration process. For example, if the integration is performed via an API, they will need to obtain an API key or authentication data (this data can be requested directly from the vendor of your EHR system) to ensure a seamless interaction with the system, including patient information, medical records, and laboratory results.
• System stability testing. Once the integration is complete, you’ll have to perform end-to-end testing of the system for potential failures. In particular, load testing, fault tolerance testing, emergency testing, etc., can be useful here. Only after these tests have been successfully passed can you provide access to the EHR system to your employees without worrying that something will go wrong.
• Employee training. Also, don’t forget to provide the employees of your medical organization with all the necessary knowledge that will help them fully and accurately use the EHR system.
• Real-time monitoring. Finally, you’ll need to provide real-time monitoring of the processes that run within your EHR system to prevent it from acting incorrectly if you overlooked some problems during the testing procedure.

Overall, such a meticulous approach to integration should ensure painless implementation of the new system into the existing IT infrastructure and unlock the maximum potential from its use. And, of course, it’s worth noting here that EHR integration is a standard process for the vast majority of medical organizations, since all the advantages and capabilities of such systems are achievable only if they work seamlessly with other software.

Types of EHR Systems

One of the most important tasks when deciding to implement an EHR system is to decide whether to use a ready-made solution or to build a system from scratch. NIX experts believe that a customized solution is always better because it’s tailored to your individual needs and therefore has better, more flexible functionality.

Still, it’s important to talk about both options. Ready-made solutions are third-party modules that you can integrate into your system. They require maintenance, and while they’re much easier to develop and also cheaper, you need a development team to integrate them one way or another.

You should build your own system if 1) you have requirements that go beyond what an off-the-shelf solution offers, 2) the ratio between advantages and disadvantages of EHR systems that are presented in the market is not in favor of the first ones, 3) you need a custom UX. It’s fine if users—including hospital employees—use eight out of ten features built into the system, but what if it’s only four out of ten? Not using the system you bought to its fullest potential is wasting a lot of money upfront. That’s why our experts advise involving your hospital workers in the design of the product because they’re the ones who will end up interacting with it regularly.

You should buy a ready-made EHR solution if 1) you have pretty limited needs, 2) you are okay with cloud hosting—it allows you to run a system quickly with minimal management overhead, but you don’t have absolute security control over your patient data—and 3) you have a certified product already.

It’s also worth noting that there are different ways of representing EHR systems. In particular, we’re talking about the three most common:

• For local hosting. This type of software implies that all patient data is stored on the medical organization’s own servers where it is deployed. At the same time, this suggests that this organization fully assumes all responsibility associated with the purchase of reliable equipment and protection of the internal network infrastructure along the entire network perimeter. This is a rather costly approach to implementing EHR, which, however, is the optimal solution for those medical centers that have very stringent requirements for the security of patient data (beyond the generally accepted ones) and strive for the highest performance of this software from the very beginning of its implementation.
• For remote hosting. This type of software involves transferring data to a third party that specializes in maintaining the stability of EHR systems, as well as their fault tolerance and security. In this case, the medical organization shares the risks associated with the safety of patient data with this party, which can be an excellent solution for those who have just begun their scaling journey.
• Remote ones. This type of software can be roughly divided into three separate subtypes: subsidized—when a relationship with a partner organization is implied, it subsidizes the cost of the EHR (in particular, this could be a hospital), dedicated—when electronic medical records are hosted on local servers of the provider, and cloud-based—when the software provider offers data hosting in the cloud. Note that any of these models must be consistent with local legislation to prevent violation of the rights and freedoms of patients.

In general, there are many off-the-shelf options and EHR vendors, but most hospitals and practitioners, after detailed analysis of the advantages and disadvantages of EHR systems that they found on the market, choose to develop their own to have complete control over them.

Future of EHR — Industry Trends

According to a research report by Global Market Insights, the rate of digital health technology adoption is expected to witness a growth of over 5.5% CAGR from 2019 to 2025. This predictable increase creates the need to integrate the tools below into EHR software, which is increasingly critical for health systems.

It’s estimated that the market of сlinics’ EHR will grow at a short-term rate of 6.3%over the projected period. Expansion of clinical facilities, especially in emerging economies, will soon lead to wider adoption of EHR systems. Joint efforts and initiatives by physicians and others will help to rapidly introduce comprehensive electronic medical records in clinics. Furthermore, the addition of specialized features in clinic EHR, along with other benefits, will increase the segment of clinics in the coming period.

Briefly, five major trends you should watch out are the following:

1. Artificial intelligence and voice recognition combined with EHR
2. Ongoing preparation for 5G networks
3. Emphasis on EHR error mitigation
4. Incorporating blockchain into EHR — NIX blockchain success story
5. Efforts to increase patient participation

“There are a lot of reasons to be optimistic that we will be able to have both high-tech and high-touch medicine”, says Lloyd B. Minor, MD Carl, and Elizabeth Naumann Dean Stanford University School of Medicine.

Cost of Implementing EHR

Of course, if you want an estimate for your specific system, besides analyzing the advantages and disadvantages of electronic health records systems on your own, you can also ask our experts to advise you, taking into account all the necessary needs of your case. Much depends on the functionality you would like to have in your app. The more features there are, the more expensive your EHR system will be and the longer it will take to develop.

You should keep in mind that the software development budget and the overall cost of implementing electronic health records aren’t the same things. Those who plan hospital capital budgeting need to keep this in mind. Usually, apart from EHR development, the final EHR system cost includes many expenses, such as:

• Hardware. For the entire team to have access to the EHR system, the organization will need desktops, laptops, tablets, and other hardware. Depending on the technology stack being used, investments will also need to be accessed either locally or via cloud storage, as the EHR software handles large volumes of data.
• Predictive maintenance. At 100%, you’ll need to optimize your EHR system over time to keep it running smoothly. These costs are usually added to the costs of electronic medical records.
• End-user training. To minimize employee stress and facilitate technology adoption, budget planning and cost estimates at medical facilities should take training into account. Efficiency directly depends on this. Invest in adequate EHR training when onboarding physicians and bring them up to speed when incremental changes are made.

Conclusion

What’s the most important conclusion after checking all the advantages and disadvantages of electronic health records? It’s possible to reinsure all the complexities if you think about them initially. Don’t be intimidated if there’s something you don’t know or have doubts about — our experts can help you figure out exactly what your challenges are.

The key is to follow the rules and have all the necessary licenses if you own a medical practice. If you’re an investor, your project must be compliant with GDPR, HIPAA, and/or other regulations.

There are two ways that you can develop an EHR system. The first is to build a custom EHR system from scratch and have it include all the internal communications, analysis, and tracking that you need. The second is to buy ready-made EHR systems, but in this case, be sure that the functionality of your EHR system will be sufficient for your needs. Therefore, first, analyze all advantages and disadvantages of EHR systems among off-the-shelf ones, and then, if the optimal choice isn’t found, consider addressing this issue by resorting to custom software development.