5 Common Misconceptions With EHRs

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For many hospitals and providers, the costs and issues involved with "electronic health records" might make them known as "electronic hated records." Hospitals must be meaningful users of EHRs by 2015, or it will result in Medicare payment penalties. However, there are several misconceptions with EHRs, ranging from purpose of their function as well as how to achieve meaningful use with an EHR. Nick van Terheyden, MD, chief medical information officer of communication technology company Nuance Communications, debunks five common fallacies associated with EHRs and explains how to get the true value of the technology.

1. Implementing an EHR will allow a site or clinician to meet meaningful use requirements. Dr. van Terheyden says the meaningful use incentives associated with certified EHR systems have created a storm of activity within hospital IT departments, in both positive and negative ways. "Technology has a much wider impact," he says. "It's not just about EHRs."

The point of the federal government's meaningful use incentives is to promote support and insight for the delivery of quality care, he says. An EHR alone will not make a hospital or health system a "meaningful user" if other areas in need of technology — such as imaging, billing and even administrative scheduling — are neglected.

"Focusing on just the EHR doesn't serve the full purpose," Dr. van Terheyden says. "It doesn't encompass all technology that is required and is not always the foundational technology. But that's what meaningful use is trying to achieve: the highest possible quality of care with the best use of resources."

2. Once an EHR is implemented, the job is done. Putting an EHR in place is certainly part of the battle, but hospitals cannot sit back and relax after that step is complete. Dr. van Terheyden compares this point with learning how to drive: When you pass your tests and receive your license, you fulfill your obligations, but only once you have that license and use it do you experience how much more there is to learn, he says.

Implementing an EHR requires hospitals and physicians to realize how practicing medicine is changing. Physicians can now interact with patients by showing them their medical records and data on a computer screen. They must also interpret feedback that is generated by the EHR, such as giving a middle-aged patient advice and health aspects on his or her smoking habits. The entire orientation of health data is displayed differently, and Dr. van Terheyden says health professionals should want to interact with it. "It's the first step of an exciting and positive pathway but one that engenders change, which is difficult," he says. "The goal is to provide better care, and the EHR is just a tool in the process."

3. There is no EHR designed for every practice. Dr. van Terheyden says it doesn't matter what specialty any physician is in: Everyone has different ways of approaching the practice of medicine, but the fundamental basics of clinical medicine are the same around the world. EHRs will require some level of customization for each hospital and physician, but he says practices just aren't as unique, in terms of patients they see, as they think they are.

4. An EHR system is less efficient than a paper system and will slow physicians down. In 1993, Dr. van Terheyden implemented a paperless medical record system in Glasgow, Scotland. In the almost 20 years since, he says the EHR systems have advanced greatly, and it is the old paper systems, not EHRs, that will slow everyone down.

The oft-repeated disadvantages of the increasingly obsolete paper system include the errors and challenges of handwriting and the single point of access. Dr. van Terheyden adds that this day and age of recording massive amounts of patient information and data just cannot be supported by paper anymore. However, he notes that semantic interoperability, or clinicians finding a standardized set of terminology for all medical conditions, has to be normalized.

5. Physicians will either love an EHR or hate an EHR. The concept that physicians can only be placed in one of two extremes when it comes to EHRs doesn't really fit, Dr. van Terheyden says. He adds there is a bell-shaped curve when it comes to EHR adoption, but it's an elongated curve. There were a few early adopters who saw the value, implemented the systems and dealt with the initial challenges and bugs, and there are also the few who would rather have retirement than a new electronic system. However, he says the biggest block of physicians falls in the middle because, ultimately, they have practices to run and patients to see. EHRs can't be a barrier because there's simply too much work to be done.  

"With peer pressure that comes with using these systems successfully, by the time it gets to wide distribution, many problems get ironed out," Dr. van Terheyden adds. Over the course of time, physicians will get used to their systems, especially once they are all able to customize their main views how they want. He says it's all about personal preferences and filtering, similar to how users can use iGoogle and create personalized home pages. Effective presentation of that patient information and data will ease EHRs into normalcy, he says.

Related Articles on EHRs:

Survey: 78% of Hospitals Still Plan on Using Paper Records for up to Five More Years
Could There Be a Correlation Between EHRs and Improved Life Expectancies?
AHA Pushes HHS to Address Meaningful Use, EHR Incentives

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