Answers and comments will be published on a future issue of Destination Health Magazine
Over the past few decades our medical knowledge has increased. More investigative and treatment options are available; as a result our patients are living lon- ger and we are dealing with more chronic conditions.
There was certainly a lot of hope that EMR would, and quite a lot of money and effort expended based on that hope. Electronic medical records were specifically identified as critical to quality improvement activities.
We need tools that improve access to information and relationships. We have had to transform how we practice, and the EMR, with its associated information technology, has facilitated that transformation.
However, there is still little conclusive evidence that EMR positively affected healthcare services.
Dear @ Omer Tontus
Absolutely that EMR or EHR have a high level of patients enhancement towards quality of life. Although there are a several article published and answer your question, but I think this is a good question and need to systematic survey in between both terms especially for detect the enhancement, contribution, and tools for EMR and EHR in medical informatics.
Regards
The short answer is yes for very narrow applications and No in general. EMRs could contribute to worse outcomes, for example, if they increase the clerk burden on care providers, be disintegrated, error-prone, or poorly designed. The premise of "better and more data naturally leads to improved outcomes" has failed, as evident by many reports and papers on disappointments, unsuccessful or borderline results. Such as a highway, EMR is an infrastructure, designed with the primary purpose of handling data and then helping us to achieve better insights and decisions. However, a few additional layers of the functionality on top of EMRs are required to produce those insights and improve decisions that would affect the quality of care and eventually the outcomes. Examples are business intelligence services to generate reports, data integration services, pattern mining, decision support systems, predictive and prescriptive models. Each of these extra layers comes with additional complexity. It is a long way from having EMR/ EHRs implemented to improved outcomes.
A logical and even straight answer to your question
"Do electronic medical records (EMR or EHR) improve quality of care? "
is YES for the following reasons among many;
1) EHR facilitates speedy consultation.
2) EHR enhances communication among healthcare providers.
3) EHR facilitates seamless continuity of care via its vibrant interoperability.
4) EHR offers better security for patients' health records and the information therein.
5) EHR ease quality review, medical audit and care evaluation.
and so on...................................
We all know that the patient's health record is the key to quality patient's healthcare and good living. Therefore, anything whatsoever that will improve the quality of the records can in effect improve quality of care.
Than you
Adeleke IT
Nigeria
041040H
070619M
In the US, EHRs have been weakly associated with modest improvements in care process metrics and guideline adherence, but they have not had any significant impact on such major health outcome measures as
- hospital length of stay
- inpatient mortality
- 30 day readmission rates
- patient safety incidents
or on public health measures such as
- life expectancy
- infant mortality
- pregnancy complications and maternal mortality
In fact, poor interoperability and suboptimal human factors engineering have led to decreased clinical productivity, increased clinician fatigue and dissatisfaction, and an epidemic of burnout. Until these problems are addressed, it is unlikely that EHRs will accomplish the worthy goals they were designed for. You might take a look at my paper:
Krenn L, Schlossman D. Have Electronic Health Records Improved the Quality of Patient Care? PM R. 2017;9(5S):S41-S50
or at http://fortune.com/longform/medical-records/ or
https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers
Happy to discuss further off line. Thanks.
David Schlossman, MD, PhD, FACP, MS (Medical Informatics), CPHIMS
EMR and EHR helps to improve diagnosis and reduce/prevent medical errors, thus improvement in health outcomes. Health providers usually mention that EMR allows them to deliver better patient care. The EMR or EHR technology provides the health service providers in less cumbersome formats compared to paper base. For instance, primary care providers would be able to view and print charts or graphs of values of their patient's health parameters to review the changes in trend. For instance, EMR technology will clearly depict the trends and changes in patient's weight, cholesterol levels, and blood pressure, tracking over time
I do not think there is a straight forward answer to the question. Like your last sentence reads " However, there is still little conclusive evidence that EMR positively affected healthcare services." While there is a general perception that EMR/EHR contributes to improved quality of care, the evidences have been weak and there have also been some unintended consequences.
My answer then will be - it depends. It depends on the context of assessment, as such it may be difficult to give a general answer.
That depends on the level of functionality of the EHR and of the implementation. Both of which still are far from optimal. So in the best case the EHR doesn't realize its theoretical potential. And unfortunately in some cases it can even introduce risks for patient care.
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