Contemporary society is thoroughly technology-driven. Hence, digital era innovations change the healthcare sector dramatically. Among a variety of technological advancements in the field, establishing electronic recording of medical data plays one of the leading though controversial roles at the same time. Foremost, such a procedure requires careful planning and implementation to achieve adequate changes in workflow, enhancement of staff roles, and better patient outcomes (Ventura et al. 163). While the proponents of this approach emphasize its possibility of cost- and time-efficiency as one of the benefits, the opponents list a number of factors as discouraging. To illustrate, George Palma, the medical director of Simpler Consulting, has aptly noted that, “If the technology is not supported with well-thought processes, hospitals may invest in complicated and expensive technologies that create more waste in a system already fraught with inefficiency” (par. 2). Therefore, the current paper identifies and clarifies pros and cons of application of this strategy of making records as a common healthcare standard.
To start with, scholars, practitioners, and policy-makers distinguish several positive implications of electronic record-keeping. These advantages reveal win-win outcomes for both healthcare providers and patients.
First and foremost, digitalizing of healthcare-related data is a great way to incorporate a variety of different-character records at one place, for instance, a hospital’s intranet system. Secondly, digitalizing of healthcare-related data ensures its authorized accessibility at the moment of necessity. It is important to mention that such an approach allows timely and efficient diagnosing of patients, immediate interprofessional collaboration, instant review of the one’s medical history, to list a few. For instance, Ventura et al. have researched the issue in neonatal intensive care units and, therefore, have emphasized the value of electronic record-keeping as “a paperless system capable of effectively coordinating bedside clinical observation with machine monitoring data, life-sustaining instruments and results from the laboratory” (163). Moreover, patients do not have to recollect their memories in terms of their previous health conditions and issues since all the necessary records are already gathered and stored in the electronic healthcare recording (EHR) system. Therefore, a collection of multidimensional patient-related data in such a way is a great approach to make a variety of treatment-based procedures easier for both parties.}}
The current healthcare system experiences a paradigm shift to “growing complexity of activities performed today” (Ventura et al. 163). In this light, availability of the multifaceted patient-centered data which should be only retrieved from the place of their secured storage rather than collected anew allows a quicker response to patient concerns and needs. Furthermore, a part of EHR involves a collection of the most up-to-date best practices and research findings structured per different characteristics of the healthcare system. For example, these big data may refer to symptoms of a particular disease, the most successful approaches to its treatment, medications to be prescribed in a specified case, and factors to be avoided, to name but a few.
Whereas incorporation of technology in hospital operations is based on the benefits of time efficiency, the issue of enhanced and instant communication within the context of multidimensional healthcare system should not be underestimated. Following the reasoning by Palma, medics of different specialties or ranks can easily communicate with one another using online-based EHR. This factor includes a quick consultancy, practice details and experience exchange, scheduling of meetings in accordance with individual plans and aspirations or electronic notifications and canceling of an appointment, if needed, among others. It follows that EHR can make the entire healthcare system more time-and-cost efficient and better planned.
What is more, Gastaldi et al. have identified such an implication of EHR as “knowledge exploration and exploitation” (13). Namely, the greater part of academic research in the healthcare field is accessible online. Similarly, a variety of professional communities, such as different organizations uniting healthcare practitioners per specialties, are Internet-mediated. Hence, an opportunity of sharing knowledge with one another and electronic experience exchange can be developed not only inside of a particular organization but also in the context of global cooperation. The data of this type can also be accumulated in the scope of an EHR system as an implication of both internal and external shared-knowledge framework aimed at advanced and quality care provision. As a result, staff members can explore the knowledge accessible online and exploit any time they need it for their working process.
Apart from that, EHR is favorable in light of professionals’ accountability. On the one hand, this factor implies development of an advanced system with relation to the hospital’s medical equipment, staff involved in the treatment and other processes, testing and other facility-centric resources and activities whose use is further billed to patients (Palma). Thus, aggregation of such data enables smoothness and transparency of patient-to-provider relationships. On the other hand, accountability can be regarded in the context of minimized ordering and drug or treatment prescription errors as contrasted to handwritten ones (Palma). To illustrate, a provider can immediately clarify an availability of a particular drug in pharmacies or, in other cases, typed recipes of drug prescriptions can be easily read by pharmacists without misinterpretation of the prescribed drugs because of a bad calligraphy of a physician.
EHR can be a valuable instrument for screening and preventive health measures. As previously noted, EHR is a system incorporating huge amounts of multifaceted data regarding the population as a whole. Further, the obtained information is segmented and classified. Thus, a physician has an opportunity to trace the state of health of specified groups of population in accordance with their health records, epidemics, threats to their due to specific factors, such as seasonal acute condition. For instance, a doctor can look through one’s records stored in EHR system and identify individuals classified with respect to belonging to at-risk cancer patient group. If their time for a check-up visit has come or they should perform a specified diagnostic procedure, such as mammogram, a healthcare practitioner can notify them via e-mail and schedule an appointment for a consultation (Palma). Similarly, notifications for medics may be scheduled in this respect as well.
Apart from some advantages linked to EHR incorporation in healthcare data management, both scholars and practitioners emphasize several factors discouraging from overreliance on this technology-centered strategy.
The problem of cost is especially acute for the healthcare system whereas it faces a challenge of increasing cost pressures from multiple perspectives (Groves et al. 2-3). In terms of EHR implementation, the procedure requires sufficient expenditures as well. Specifically, these costs involve not only investment in user-friendly software and hardware packages but also employee training, information technology support programs, constant updating in both EHR tools and staff technical skills (Palma; Groves et al. 2-3). While for large healthcare providers, these operational costs may be quite affordable, the smaller ones can suffer overspending and even losses or increase their long-term debts through loans in order to remain competitive in the market and meet current consumer needs. Hence, this factor is important to be taken into account when a decision of EHR implementation is at stake. Moreover, the technological skills require constant updates, because this industry evolves all the time. This issue presumes constant supplementary financing of the above procedure. Therefore, EHR cannot be once paid and once launched, but needs permanent sourcing not only in terms of electricity and other technology-centered spending but also staff-related costs.
In accordance with Palma, EHR requires more documents to be created which causes delays in medical documentation in general. On the one hand, more documents should seemingly mean more detailed records. Thus, more multifaceted information about the patients can be available regarding one’s visiting a healthcare practitioner. On the other hand, a technology-mediated approach of record-keeping may be not only delayed but rather inaccurate. In case a physician uses handwritten notes in developing a patient’s history, diagnosing, and treatment administering, these records are immediate and made as soon as a patient is examined and appropriate procedures are prescribed or performed. In contrast, EHR is mostly based on a physician’s memories, which can consequently result in errors in medical records made after some time after a patient’s visit. In addition, handwritten notes and documents require supervisor’s signatures on each of them as a way to authorize them and make the orders or records valid and credible every time these papers are written. While electronic recording eliminates this link in data processing, authenticity and accuracy of these documents may be questioned. Finally, medical practitioners can frequently use a copy-paste option instead of typing the actual data about a particular patient, which also undermines the quality of the records made in the EHR system.
Oftentimes, an electronic record-keeping is associated with dehumanizing of patient- and employee-centered activities where technologies are used instead of human actions. For instance, while e-communication means time-saving, face-to-face communication opportunities are minimized in this case. As a result, individuals are left one-on-one with machines which may negatively impact further interpersonal communication quality with a real person. In this regard, Palma has listed the lack of emotionality, “give-and-take conversations or question-and-answer scenarios,” as well as (par. 17). What is more, the scholars from the University of California-Davis have reported about 25-33% lowered performance outcomes of healthcare professionals at the beginning stages of EHR implementation (Palma). Regardless of that, dehumanization of the process was not listed among preventive factors in the above study, this aspect can be boldly assumed as one of implications of change resistance and flawed practice.
With respect to any software application and use, the issues of customer privacy and rights violation arise as one of the most acute concerns in patient-to-provider relationships. The core of this problem is the fact that no perfect data security system exists to date. The most popular clouding computing providers, such as Google and Microsoft, were sued several times for the sensitive customer data releases, misuse, and violation. No valid and efficiently operating regulations and policies are in place to prevent and eliminate these threats. Due to that, EHR can contain very important personal information, such as health insurance data. In addition, both patients and healthcare providers may suffer sufficient losses related to finances and reputation.
In conclusion, the findings of the paper clearly demonstrated that incorporation of EHR in the healthcare system as a standard procedure has both beneficial and disadvantageous aspects. On the one hand, numerous implications of EHR evidence its multi-level efficiency for healthcare providers. The issue involves enhanced communication between practitioners, easy access to a variety of healthcare-specific theoretical and evidence-based data, smoother cooperation opportunities, to list a few. On the other hand, availability of consumer-sensitive data at one place presupposes an issue of its misuse and illegal activities. At the same time, dehumanization of this aspect of healthcare activities and constant supplementary funding and updating of the software and hardware packages become sufficient disadvantages for EHR. Nonetheless, thorough awareness about these issues will allow their elimination at the planning stage.