Electronic Health Record (EHR)
An Electronic Health Record (EHR) is a digital collection of an individual's medical information, encompassing diagnoses, treatment records, medication details, and other health-related data. Unlike electronic medical records (EMRs), which focus on specific issues within a single healthcare facility, EHRs facilitate the sharing of comprehensive health information across various providers and settings. This interoperability enhances the ability of healthcare professionals to access timely information, improving patient care and decision-making.
EHRs gained prominence starting in the 1960s, with significant advancements in the following decades led by both private companies and government initiatives, notably during the administrations of Presidents George W. Bush and Barack Obama. Despite their benefits, EHR systems pose challenges such as high development costs, questions regarding their effectiveness in improving health outcomes, and concerns about data privacy and security. Additionally, the compatibility of different EHR systems remains a critical issue in ensuring seamless information exchange among healthcare facilities. By 2021, there were an estimated 1,000 different EHR systems in use in the U.S., while efforts were underway in the EU to standardize EHR formats for better interoperability among member countries.
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Subject Terms
Electronic Health Record (EHR)
A digital collection of an individual’s medical information, an electronic health record (EHR) contains not only diagnoses, records of treatment, and medication information, but other data relevant to a total picture of an individual’s health. Occasionally, the term electronic medical record (EMR) is used interchangeably (but incorrectly) with EHR. An EMR is usually created in one place (a clinic, doctor’s office, or hospital) and only focuses on a specific problem and its treatment. EHRs have become a preferred means of recording information because of the ease with which they can be sent from one facility to another as well as their ability to easily contain information from different sources.
Overview
EHRs provide an increased capability to transfer timely information among clinicians caring for an individual and to maintain that record. One benefit and an intended use of EHRs is that patients can access their records themselves, allowing them a greater ability to make intelligent healthcare decisions. For those reasons and for their effect on managing healthcare from both wellness and financial perspectives, the US government has encouraged EHR development. Government entitlement programs (Medicaid and Medicare) and the Affordable Healthcare Act have made the government a significant party in the development and implementation of EHRs.
While EHR systems are well known today, they began in the 1960s when mainframe computers, although expensive and complicated, were being introduced to store and manage data. By the end of that decade private hospitals were creating systems to manage medical information, as were medical schools such as those at Harvard and Duke. Over the next two decades the activity increased and private companies began to develop medical computer programs. Eventually, companies emerged to develop digital medical management systems.
By the 1980s the US government was purchasing systems to manage the medical care it provided at Veterans Administration hospitals. By the 1990s several companies existed (such as Epic, Allscripts, Eclipsys, and Cerner) that were competing for both government and private customers in hospitals, clinics, and doctors’ offices. By 2004, when President George W. Bush stated that his goal was to make EHR available to a wider percentage of the population, much of the technology had been developed or was in the process of development. The Obama Administration further supported the effort.
While benefits of using EHR systems have been recognized, some questions have not yet been answered. First, developing EHR systems is expensive. Measuring cost benefits to hospitals, insurers, and the government has proven to be elusive. EHR effectiveness in improving healthcare outcomes must be studied as well. Implementation and maintenance by IT staff is another cost factor. Additionally EHR systems developed by competing companies must be compatible if health records are to be transmitted and received by different facilities. Privacy and the security of personal information in health records is another major concern. Finally, whether doctors will use the EHR systems and how effectively they will use them must also be considered.
Bibliography
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