The implications of electronic health records

Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care.

The implications of electronic health records


But we now commonly hear of breaches of privacy in which thousands of records are lost or compromised by having an unencrypted laptop computer stolen.

Such events violate the ethical principles of beneficence and nonmaleficence. Indeed, there are dozens of ways the privacy of the client can be weakened or violated with paper or electronic records but I want to discuss some less obvious risks to our ethical promises.

This data transferability is termed interoperability and while beneficial e. There is a famous video online http: As systems and databases become connected it becomes impossible to know who has access to what PHI.

The risk to privacy is obvious but there is also a risk to care providers. Threats to privacy include relatively easy re-identification and efficient data mining as well as hacking and accidents. In hospital settings a way to provide the heightened privacy felt necessary for psychiatric PHI vs.

Recent evidence indicates this actually harms patients. Workflows Each EHR has its own ways to enter and display data. The frames of this sequence are called templates.

All of these distract you from your clinical work. There is less observation of the patient, interrupted observations, and so less information is gathered and communicated by each person. There is also a diversion from the relationship with less eye-contact, less conversation, less exploration and less rapport.

Research suggests that when there is less trust clients withhold information — a barrier between client and clinician. Expected benefits include easier communication, patient education, monitoring and feedback and the simpler provision of administrative documents like Record Releases and Notices of Privacy Practices.

It is expected that such transparency will enhance trust and improve the relationship of client and clinician. By the time that happens, the evidence could be outdated and so clients suffer from substandard treatment.

Similarly it appears that our professional knowledge deteriorates in validity and usefulness with time and new findings. Recent research suggests that the half-life was about nine years and will become about seven for some fields.

The implications of electronic health records

An EHR could incorporate ways of reminding clinicians about more and more recent options for diagnostic or treatment decisions. The tools to do this are called Clinical Decision Support Systems.

They can provide suggestions from the professional literature and even options based on algorithms and reminders specific to each patient. Concerns arise when the clinician must respond to these. Simple prompts and reminders present no ethical concerns and may improve care just as the routine use of checklists has.

But suggestions or even advice go beyond this. Who decides on the content of this advice? What role can and should such information have in clinical work? Any system of ethics requires the locating of responsibility. In such situations we usually turn to the government to enforce responsibility but here it has abdicated its responsibility.

There is no method to publicly report safety issues and failures. Practice management EHR programs allow discovering relationships that are invisible with paper records. The manager of a clinic can integrate data across clinicians and clients by asking the EHR for practice management reports.

For example, suppose clinicians were compared by their outcomes and one was found to have much worse results than another. What should the manager do?Since that date, the use of electronic medical and health records has spread worldwide and shown its many benefits to health organizations everywhere.

“Meaningful use” of electronic health records (EHR), as defined by, consists of using digital medical and health records to .

Ethical issues in electronic health records: A general overview

The use of electronic health records allows multiple care providers, regardless of location, to simultaneously access a patient’s record from any computer.

The electronic record can provide up-to-the-minute information on the patient’s full history, including current test results and the recommendations of other physicians, allowing more.

As in the managed care expansion of the s, recent health reforms, including but not limited to the Affordable Care Act (ACA) and the American Recovery and Reinvestment Act (ARRA), have begun to have effects “in the exam room,” changing how patients, physicians, and allied health professionals interact. Practice-specific electronic medical records (EMRs) were the first sources used to digitize patient information, followed by electronic health records (EHRs), to go beyond standard clinical data collected in a provider’s office and include a broader view of a patient’s care. 4 x 4 Garrett P, Seidman J. EMR vs EHR—what is the difference? HealthIT buzz. An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs 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.

Indeed, there are dozens of ways the privacy of the client can be weakened or violated with paper or electronic records but I want to discuss some less obvious risks to our ethical promises. Interoperability. A major goal of Electronic Health Records programs (EHRs) is to share information to support comprehensive treatment.

Keywords: Confidentiality, electronic health record, paper record, security breaches INTRODUCTION An electronic health record (EHR) is a record of a patient's medical details (including history, physical examination, investigations and treatment) in digital format.

Oct 09,  · But as health care providers adopt electronic records, the challenges have proved daunting, with a potential for mix-ups and confusion that can be frustrating, costly and even dangerous. Electronic health record (EHR) systems can improve communication and coordination of clinical care, resulting in better health-care outcomes.

Current regulations focus on documentation requirements that support clinical care, billing compliance, and the privacy and security of EHRs.

5 Legal Issues Surrounding Electronic Medical Records