Why Electronic Health Records Are Needed. A Three Part Series
The following are the most significant reasons why our healthcare system would benefit from the widespread transition from paper to electronic health records.
Paper Records Are Severely Limited
Much of what can be said about handwritten prescriptions can also be said about handwritten office notes. Most doctor’s handwriting is illegible and the document cannot be electronically shared or stored. It is not structured data that is computable and hence sharable with other computers and systems. Other shortcomings of paper: expensive to copy, transport and store; easy to destroy; difficult to analyze and determine who has seen it; and the negative impact on the environment. Electronic health records represent a quantum leap forward in legibility and the ability to rapidly retrieve information. Almost every industry is now computerized and digitized for rapid data retrieval and trend analysis. Look at the stock market or companies like Walmart or Federal Express. Why not the field of medicine?
With the relatively recent healthcare models of pay-for-performance, patient centered medical home model and accountable care organizations there are new reasons to embrace technology in order to aggregate and report results in order to receive reimbursement. It is much easier to retrieve and track patient data using Electronic Health Records and patient registries than to use labor intensive paper chart reviews. Electronic Health Records are much better organized than paper charts, allowing for faster retrieval of lab or x-ray results. Electronic Health Records also have an electronic problem summary list that outlines a patient’s major illnesses, surgeries, allergies and medications. How many times have you opened a large paper chart, only to have loose lab results fall out? How many times have you had to re-order a test because the results or the chart is missing? It is important to note that paper charts are missing as much as 25% of the time, according to one study. Even if the chart is available; specifics are missing in 13.6% of patient encounters, according to another study.
The table below shows the types of missing information and its frequency. According to the President’s Information Technology Advisory Committee, 20% of laboratory tests are re-ordered because previous studies are not accessible.This statistic has great patient safety, productivity and financial implications.
Types and frequencies of missing information
|Information Missing During Patient Visits||% Visits|
|History and physical exams||27%|
Electronic health records allow easy navigation through the entire medical history of a patient. Instead of pulling paper chart volume 1 of 3 to search for a lab result, it is simply a matter of a few mouse clicks. Another important advantage is the fact that the record is available 24 hours a day, seven days a week and doesn’t require an employee to pull the chart, nor extra space to store it. Adoption of electronic health records has saved money by decreasing full time equivalents (FTEs) and converting records rooms into more productive space, such as exam rooms. Importantly, electronic health records are accessible to multiple healthcare workers at the same time, at multiple locations. While a billing clerk is looking at the electronic chart, the primary care physician and a specialist can be analyzing clinical information simultaneously. Moreover, patient information should be available to physicians on call so they can review records on patients who are not in their panel. Lastly, electronic health records provide clinical decision support such as alerts and reminders.