Question

Discuss THREE issues or concerns with EHR/EMR systems in healthcare

Answer 1

Electronic medical records (EMRs) are a digital version of the paper charts in the clinician’s office. An EMR contains the medical and treatment history of the patients in one practice. EMRs have advantages over paper records. For example, EMRs allow clinicians to:

• Track data over time
• Easily identify which patients are due for preventive screenings or checkups
• Check how their patients are doing on certain parameters such as blood pressure readings or vaccinations
• Monitor and improve the overall quality of care within the practice

Electronic health records (EHRs): EHRs focus on the total health of the patient going beyond standard clinical data collected in the provider’s office and inclusive of a broader view on a patient’s care. EHRs are designed to reach out beyond the health organization that originally collects and compiles the information. They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care.

The National Alliance for Health Information Technology stated that EHR data “can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.”

Issues with EHR/EMR systems in health care:

Many healthcare professionals have reported improved patient safety and more accurate clinical documentation by using EHR systems, but they have also encountered several challenges ranging from difficulties meeting the demands of quality reporting programs to setbacks linked to poor system usability.

Although this set of requirements now only applies to eligible hospitals and critical access hospitals, many are still feeling challenged to meet interoperability, patient engagement, and clinical quality measure requirements.

Hospitals and health systems continue to face many challenges in implementing, maintaining and upgrading their electronic health record systems. These challenges range from technical to security to strategy to human interaction.

Thus we can say the 3 main issues with the EHR/EMR systems in health care are:

*Interoperability

EHRs have improved elements of clinical documentation, helping to improve patient safety. However, technologies from different vendors don’t always play nice, presenting issues when one patient receives treatment at two different points of care. Although interoperability and health information exchange are both significant aspects of meaningful use and the Quality Payment Program, providers are still being hung up on the issue. Systems need to be able to talk with one another to successfully gain the complete picture of a patient as possible. Technology and strategies exist to help tackle this challenge. We need improved functional interoperability, and the data must be available and needs to be seamlessly transferred from one source to the next.

*Usability

EHRs consistently had flaws or technological glitches getting in the way of their workflows of health care professionals.

EHR usability issues are also getting in the way of the patient and provider relationships. When staff get overwhelmed and start to feel burnout, their productivity goes down and possible patient safety issues can creep in.

A recent survey from the American Medical Association shows that for every hour providers spend face-to-face with patients, they spend another two working on clinical documentation and desk work. This shows that providers have too much work to do on their EHRs and that it is getting in the way of delivering personal and patient-centered care.

*Quality measure requirements

It is often assumed that electronic clinical quality measures (eCQMs), expressed in a format suitable for automatic extraction from electronic health records (EHRs), will be reliable by their nature. But several reliability challenges exist for quality measurement across providers, including different EHR systems, and provider variation in how EHRs are implemented. E-CQMs are expressed in formats unfamiliar to many hospitals and clinicians and can be quite complex and lengthy, potentially leading to difficulty in understanding their intent and logic. Such understanding is needed to ensure that the data requirements are mapped properly to local systems and data capture patterns and workflows in each location.

The understandability of the eCQMs varied by measure; measures that included nested logic in the population criteria were more likely to be poorly understood. Hospitals varied in how specific data elements were captured or coded, and how data flowed from ancillary IT systems to the inpatient EHR. Education of local implementers and EHR vendors will help to improve the reliability of data capture for eCQMs.