EHR Systems: Definition, Pros and Cons 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. 

What are EHR and EHR Systems?

Briefly answering the question “What is EHR?”, we can say that it is software for a structural way of storing and sharing patient 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 practices where different health professionals can work together in real-time to provide patients with the best care. Also, it enables quick access to services, which will improve waiting lists and diagnosis accuracy using the most advanced EHR measures.

The goal of any EHR 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, costly, 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 wrong. The Office of the National Coordinator of Health Information Technology (ONC) emphasizes the major differences between the two: EMR lacks interoperability, which is a high priority for EHR systems.

Benefits of Electronic Health Records

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 benefits of EHRs.

Benefits of EHRs for Physicians

1. Access to patient information 24/7. EHRs allow health care 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, that 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 7 or how many cases of TB 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. 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.

Benefits of EHR 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 those patients, who have a long medical history in paper format, as EHR contains all the diagnoses in one place. Also, it’s reducing the incidence of medical errors.
5. Monitoring and controlling patients’ own medical records. Thus, patients are more well-informed to make aware decisions about their conditions.
6. Access to records 24/7. This avoids unnecessary calls or 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 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.

EHR Disadvantages

Considering the mentioned advantages of the system, it would be equal 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. It takes time and costs money. Selecting and setting up an EHR system and digitizing all paper 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 competition becomes more 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.

The above problems are not without solutions. 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 a provider or a vendor.

Interoperability — Must-Have of Healthcare

Interoperability is defined by ONS 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, EHR 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 Office of the National Coordinator for Health Information Technology (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, and while evaluating your EHR system, work with your vendor to be sure that the system is incorporating all the leading standards, including FHIR (Fast Healthcare Interoperability Resources) APIs and SMART (Substitutable Medical Applications, Reusable Technologies).

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

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 is 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 are much easier to develop and also cheaper, you need a development team to integrate them one way or another.

You should have build your own system if 1) you have requirements that go beyond what an off-the-shelf solution offers, and 2) you need a customized 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 on a regular basis.

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.

There are many off-the-shelf options and EHR vendors, but most hospitals and practitioners choose to develop their own in order 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 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 for in 2021 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, our experts will 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. In order 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 will need to optimize your EHR system overtime 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 is the most important conclusion? 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 medical practice. If you are 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.