Electronic health records: patient access and data entry in healthcare settings

Electronic Health Records

The medical community has begun using electronic health records (EHR) as an alternative to paper records (Gunter & Terry, 2005). While there are many benefits to this, there are also concerns with hacking and security. Another concern is how patients get copies of these records, because they want to make sure that they are able to access information that is rightfully theirs. It should also be able to be transferred to other doctors and hospitals easily, and provided to people who are legitimately allowed to have it -- such as family members or friends that a person has specifically authorized to view his or her medical information. Doctors and hospitals that like having the EHRs prefer them because the information can be sent to another person so quickly and accessed almost anywhere, making it convenient during emergencies (Gunter & Terry, 2005). These EHRs also reduce the need for so much paper, which means they take up significantly less space that the hospital or doctor's office can use for something else (Kierkegaard, 2011; Sittig & Singh, 2011).

While these health records are very important to the medical community, there are other ways patients choose to keep track of their health and medical information. Personal health records (PHR) are becoming popular with people who want to chart and track their own health by inputting information regarding it into a database they can access (Kupchunas, 2007; Lewis, et al., 2005). It is an excellent way to store everything that a patient might want to keep on hand, without the need for a lot of paper information which could become lost, damaged, or even destroyed. The medical community does not have the information in the PHR unless the patient chooses to provide it, which not all patients do (Ackerman, 2007). Many will offer the information to their doctor, though, as a way of keeping their doctor updated when it comes to personal health information that might be important for diagnosis or medication changes. This paper will explore how integrating PHRs into EHR platforms could impact both doctors and patients.

The Impact on Doctors

The impact on doctors when it comes to incorporating EHRs and PHRs is significant, and it is both good and bad. On the positive side, doctors are already using EHRs and are used to them. They see the value these electronic records offer, and they appreciate the information they can get and store about their patients (Gunter & Terry, 2005). The ease of use is also important, and when PHRs are combined with EHRs there would be even more patient information all in one place where doctors and hospitals could access it more easily (Agarwal & Angst, 2006). This information would come from the doctors and hospitals where the patient has been, but also from the patient himself or herself. One of the reasons this can be so vital is that the patient may record information into his PHR that he or she might not remember to mention to the doctor during an appointment (Lewis, et al., 2005). Even information that the patient does not see as being that important may be something the doctor can use to help make a diagnosis if he or she is aware of it (Agarwal & Angst, 2006).

As with anything, there is a negative side to merging EHRs and PHRs. The most significant concern many doctors have is whether the information the patient is putting into his or her PHR is actually accurate (Kupchunas, 2007). In other words, the doctor does not want to rely on information provided by a layman (the patient) because the patient is not able to make a medical diagnosis and may not be diligent or particularly accurate in recording information (Ackerman, 2007). However, that is not always the case, because patients are often very careful regarding the medical information they provide in their own personal record. If they are using that record for their own needs, they would provide information on anything they are taking, signs and symptoms they are having, exercise and diet, and other areas of health (Kupchunas, 2007). This information would, most likely, be no more and no less accurate than what the patient would actually tell the doctor during an exam, so there is no reason for the doctor not to use it in order to have a stronger, clearer picture of the patient and his or her overall health (Lewis, et al., 2005).

Doctors are also very concerned about one other aspect of merging EHRs and PHRs. This is the privacy and safety aspect of the merger. Right now, doctors can see the EHR information, but patients cannot access it from home (Ackerman, 2007). If patients were able to access it, that could make the risk of others hacking into it higher. There are few guarantees that patients would safeguard their computers and passwords in the same way that doctors and hospitals do, which could result in a high level of risk for the patient's personal information (Ackerman, 2007; Lewis, et al., 2005). Doctors want to protect patient privacy, and under HIPAA laws they have to do so. If they allow the patients to have access to their EHRs, it could become far too easy for that privacy to be violated, even by the most well-meaning of people who were not deliberately trying to expose information.

The Impact on Patients

There is also an impact on patients when EHRs and PHRs are incorporated, although it is not as severe. Just like with the impact on doctors, there are pros and cons to the record merging. Patients who have a merged EHR and PHR will be able to access both from wherever they are, meaning they can see not only the information they have provided, but also the information their doctor has placed into their record (Lewis, et al., 2005). The convenience of being able to see all of their records is the biggest benefit for patients. They want to be able to access their records so they can read and understand the information their doctor has provided (Kupchunas, 2007). They can also feel more empowered when they have access to their records, because they can look for mistakes and get errors corrected that the doctor might not otherwise be aware of (Kupchunas, 2007).