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Teresa Cascio Masters of Public Health candidate, Department of Health Policy, School of Public Health and Health Services, George Washington University, Washington, D.C.
Jane Thorpe Associate Research Professor, School of Public Health and Health Services, and Director, Healthcare Corporate Compliance Program, College of Professional Studies, George Washington University, Washington, ...
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Electronic health record (EHR), computer- and telecommunication-based system capable of housing and sharing patient health information, including data on patient history, medications, test results, and demographics.
The technical infrastructure of electronic health records (EHRs) varies according to the needs of the health care provider or other entity using the system and the provider’s chosen EHR technology platform. In general, EHRs operate over a high-speed Internet connection and therefore require computer hardware and specialized software. When properly deployed, EHRs allow health care providers to avoid duplicative testing, reduce medical errors, and facilitate patient decision making, which may ultimately improve care quality and patient safety and possibly decrease health care costs.
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Health care providers throughout the world have worked to implement EHRs. However, costs and interoperability problems, which limit providers’ ability to access and share patient information, as well as concerns about the privacy and security of patient and provider information, have impeded progress and limited EHR effectiveness (
The Health Information Technology for Economic and Clinical Health (HITECH) Act is the primary financial driving force for EHR implementation in the United States. Passed in 2009 as part of the American Recovery and Reinvestment Act, the HITECH Act creates financial incentives for providers participating in federal and state government health care programs (i.e., Medicare and Medicaid) that implement and demonstrate “meaningful use” of EHRs. Those providers may demonstrate meaningful use by meeting certain objectives established by the Centers for Medicare & Medicaid Services (CMS). Objectives include maintaining an active medication list and having the capacity to exchange “key clinical information.” In order to help providers adopt sufficient EHR infrastructures, the Office of the National Coordinator for Health Information Technology (ONC) maintains a list of EHR products certified as capable of meeting the meaningful use criteria. In the second decade of the 21st century, however, even with the support of the federal and state governments, only a small percentage of physicians had access to EHRs in their offices, and most hospitals lacked a basic EHR platform.
EHRs have been implemented with varying success in countries throughout the world. For example, the U.K. government launched a program in 2002 to support the use of EHR systems in the National Health Service (NHS), with the goal of having an EHR for all patients by 2010. By that time, however, only 20 percent of providers had begun to use EHR systems, and, as a result, in 2011 the program underwent reconceptualization. U.K. health officials subsequently developed a framework to determine how to more effectively use data and technology to improve health care, with the eventual aim of giving citizens online access to their personal health records.
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Implementation met with relative success in New Zealand, where general practitioners began developing health information technology (HIT), including EHRs, in the 1980s, leading to widespread physician group and practice investment in the 1990s. New Zealand’s health care system has since made extensive use of EHRs to store patient information, including test results, medication lists, and clinical notes. The country’s health care providers actively exchange patient information and have worked to expand patient access to personal EHRs.
By the 2010s only several highly industrialized countries had made significant progress toward adopting EHRs; less-developed countries, particularly in Africa, lagged behind.
While policymakers around the world believe that full-scale use of EHRs could decrease health care costs, substantial up-front implementation expenses place considerable pressure on public and private budgets. This was especially true in the early 2000s, when health care budgets were strained by global economic downturn and demand for EHR implementation increased considerably. CMS estimated that the U.S. EHR Incentive Program would cost $14.6 billion for the period 2014 through 2019. This estimate did not include government expenses or expenses sustained by participating providers.
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Numerous privacy and security concerns accompany the increased use of EHRs. Breach of an EHR could result in, for example, identity theft, fraud, or the public dissemination of an individual’s health information as well as the release of sensitive information about health care providers. Governments have tried to alleviate those concerns through patient privacy, security, and access laws, examples of which include the U.S. Health Insurance Portability and Accountability Act (HIPAA) of 1996 and Sweden’s Patient Data Act of 2008.
Because the gains of EHR implementation hinge on interoperability, the inability of EHR systems to interact and communicate across care settings and providers can substantially hinder the success of EHRs. For example, a hospital’s EHR system will not be fully effective in reducing duplicative testing or preventing medication errors if it cannot communicate with the EHR system used in a nearby primary care practice. The issue of interoperability is evident particularly in Sweden, where providers implemented incompatible EHR systems at the regional level and were forced to reconfigure their systems. The European Union was working toward interoperability among all member countries.Electronic health records software with prioritized task donuts, patient cards & physician dashboard to unify all roles of your practice to improve clinical care while creating a more personal experience with patients.
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EHR / EMR software is a computer system that helps healthcare providers manage patient medical records and automate clinical workflows. EHR systems allow providers to:
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While the terms EHR (electronic health records) and EMR (electronic medical records) are often used interchangeably, they have slightly different meanings. The primary difference is that EHR puts forth the notion of interoperability, or interfacing with other medical systems to create a comprehensive view of a patient’s clinical information. To learn more about the difference, check out our article, EHR vs. EMR
Electronic medical records represent a huge improvement over the paper-based methods of the past, and open the door to a new world of functionality for healthcare providers. As opposed to first generation EHRs that simply digitized and stored medical records, modern EHR systems act as virtual assistants that organize and prioritize practice workflow. As EHR technology continues to evolve, providers will be able to connect with patients in more meaningful ways and continuously provide better care.
Another benefit of modern EHR systems is seamless integration with practice management software. This integration eliminates time and errors caused by copying-and-pasting between software systems, reduces the amount of missed follow-up appointments, and speeds up reimbursement.
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The cumulative result of these benefits is a medical practice that runs more efficiently, allowing providers and office staff to focus on caring for patients and maintaining profitability.
To be able to provide the best care possible, healthcare professionals need to be able to quickly understand patient histories and maintain efficient ongoing communication with patients about their health and treatment plans.
EHR / EMR software allows providers to use note templates that capture relevant information during patient encounters, and to quickly recall this information as needed. As interoperability between medical information systems becomes more commonplace, patient records are more accessible along the entire care continuum. For instance, having easy access to a patient’s medical history can dramatically improve the quality of care they receive during a visit to the emergency room, when time is of the essence.
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EHR systems also improve the communication channel between providers and patients. For example, the EHR system can integrate with scheduling systems to automatically remind patients of upcoming appointments. Then providers can use patient portals to securely communicate treatment plans, prescription instructions, and other helpful information to patients.
Alongside patient portals, the emergence of telemedicine is making healthcare even easier for patients. Telemedicine sessions allow providers to diagnose and treat patients over the phone or via video chat. Patients can benefit from medical advice from the comfort of their own homes, and save time and money that would have been spent on travel.
The cost of most EHR systems depends on the number of providers using the software and/or the number of patient encounters per month. Additional functionality, such as e-prescribing
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