Electronic health records

Electronic Health Records (EHRs) are digital versions of patients' paper charts. They are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider's office and can be inclusive of a broader view of a patient's care. EHRs are a vital part of health IT and can:

• Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
• Allow access to evidence-based tools that providers can use to make decisions about a patient’s care
• Automate and streamline provider workflow

One of the key features of EHRs is that health information can be created and managed by authorized providers in a digital format capable of being shared with other providers across more than one health care organization. EHRs are built to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient's care.

Benefits of EHRs

EHRs offer numerous benefits to both healthcare providers and patients, including:

• Improved Patient Care: EHRs provide real-time access to patient health records, improving the accuracy and speed of diagnosis and treatment.
• Increased Patient Participation: EHRs enable patients to access their own health records, which can help them make informed decisions about their care.
• Improved Care Coordination: With EHRs, healthcare providers can quickly share information, reducing the incidence of medical errors and improving the quality of care.
• Enhanced Privacy and Security: Digital records are more secure than paper ones, as they can be encrypted and are less susceptible to loss and theft.
• Increased Efficiency and Savings: EHRs can reduce the time and resources needed for paperwork, freeing up more time for patient care and potentially reducing healthcare costs.

Challenges and Concerns

Despite their benefits, the implementation and use of EHRs also present several challenges:

• Cost: The initial setup, ongoing maintenance, and training costs can be significant.
• Interoperability: The ability of EHR systems to communicate and exchange information seamlessly with one another is still a work in progress.
• Privacy and Security: Ensuring the confidentiality and security of EHRs is an ongoing concern, with risks of data breaches and unauthorized access.
• User Resistance: Some healthcare providers may resist using EHRs due to the learning curve or preference for traditional paper records.

Regulations and Standards

In many countries, the adoption and use of EHRs are encouraged and regulated by government initiatives. For example, in the United States, the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was designed to promote the adoption and meaningful use of health information technology. Subsequently, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 established further incentives and penalties related to EHR use.

Standards for EHR systems are crucial for interoperability and include Health Level 7 (HL7), Fast Healthcare Interoperability Resources (FHIR), and the Continuity of Care Document (CCD).

Future Directions

The future of EHRs includes further advancements in interoperability, the integration of artificial intelligence to aid in diagnosis and treatment, and the expansion of patient access to their own health records through patient portals and mobile apps.