Electronic health records: The smart person's guide - TechRepublic

Image: iStock/kopitinphoto

The days of messy folders stuffed with charts and indecipherable doctor scribbles are over: electronic health records, or EHRs, are the new standard in medical care. You may not even realize that there was a transition to digital medicine, but if your doctor has ever been typing on a computer during an appointment you've seen EHRs in action.

TechRepublic's smart person's guide about electronic health records is a quick introduction to this new standard in medical care, as well as a "living" guide that will be updated periodically as new laws are passed and software platforms are developed.

SEE: Check out all of TechRepublic's smart person's guides.

Executive summary

• What are EHRs? EHRs are digitized patient files that contain an individual's complete medical history. Several EHR platforms are available for doctors to work with, and digitization means instant sharing between providers.
• Why do EHRs matter? EHRs make life easier for medical professionals because they eliminate the need for messy paper files. Digitization also means records can't be lost as easily.
• Who do EHRs affect? EHRs affect everyone who has ever seen a doctor. With over 80 percent adoption as of January 2016, there's a good chance your medical records have already been digitized. Security is also an important issue, and that greatly affects IT professionals.
• When is the EHR transition happening? The US government mandated EHR adoption starting in 2011, with a timetable for adoption continuing to 2016. Medical professionals were given incentives to transition and were penalized if they didn't.
• How do I benefit from EHRs? EHRs don't just make medical provider's lives easier: they also simplify continuity and quality of care for patients. You might not even realize EHRs were the new standard in medical practice, but if your doctor has ever entered the room with a laptop instead of a folder you've already experienced the change.

What are EHRs?

An electronic health record is a digital document containing (ideally all) information about a patient's medical and health history. It includes records of any interaction with the medical system, including immunizations, diagnoses, medications prescribed, lab test results, and allergies.

There are multiple EHR platforms that medical professionals can choose from. The top five (eClinicalWorks, Epic, McKesson, Care360, and Allscripts) each offer local installation options and cloud hosting. Many EHR systems operate from onsite servers, but nearly 90 percent of new EHR installations are cloud based.

The other major advantage to EHRs is instant sharing. Paper records either had to be hand carried or mailed between offices, but EHRs make the process much simpler. Healthcare providers can use health information exchanges (HIEs) to send EHRs back and forth.

There are three types of HIEs:

• Directed: providers can send records directly to other providers
• Query-based: a provider can look up a patient's record in a database
• Consumer mediated: the patient keeps, maintains, and shares their record

Additional resources

Why do EHRs matter?

EHRs are maintained by all clinicians a patient comes into contact with. So if a patient visits multiple specialists, those doctors can look at the EHR and see what kinds of tests and procedures the patient's other doctors have done, or what medications they've prescribed. This is meant to cut down on redundant treatments and help providers collaborate with each other.

In the IT world EHRs matter because they contain highly sensitive personal data; therefore, security is of the utmost importance. All EHRs must be stored and maintained according to security rules outlined in the Health Insurance Portability and Accountability Act (HIPAA).

Additional resources

Who do EHRs affect?

Patients and doctors are far from the only ones affected by EHRs: IT professional face a whole host of security and policy changes that affect the way they work and how they interact with medical clients.

IT teams are a key part of HIPAA compliance, which in turn is a key part of EHR meaningful use. Meaningful use is as the core of the US government's EHR push, and drilling even further down we find IT's fundamental role.

The government's EHR mandate includes financial incentives for medical professionals meeting meaningful use goals, with security being a key component. Take a look at any of the government pages on EHR adoption for long and you're likely to stumble upon the term "health IT" because that's what's happening: Healthcare is going completely digital.

Additional resources

When is the EHR transition happening?

The Obama administration made EHR adoption mandatory starting in 2011. With three phases of adoption planning running through 2016 we're now at the end of the period in which medical providers should have transitioned.

Penalties for non-compliance started in 2015 with a one percent reduction in Medicare reimbursements. The reduction will grow by one percent each year, ideally pushing providers to adopt EHRs quickly.

Adopting an EHR system takes months: IT has to plan infrastructure, records have to be digitized, staff have to be trained, and government paperwork has to be filled out. In some cases a total transition can take years, which is why the government had a five-year plan for implementation.

The bottom line: if you're a health care provider or IT professional who has yet to transition time has run out and penalties have begun.

Additional resources

How can I benefit from EHRs?

The benefits of EHR implementation happen behind the scenes and in most cases patients won't even realize a large-scale transition has occurred.

Providers don't just benefit from easier records access: there are also considerable financial benefits to EHR implementation. Unfortunately, many of the larger-scale payouts took place several years ago, though there are still benefits available for Medicaid providers who adopt EHR this year.

Patients benefit from EHR due to more health record transparency: most EHR platforms feature online portals where patients can log in, see their records, and contact their doctor in a secure, HIPAA-compliant system.

IT professionals don't necessarily benefit at all, though: EHR implementation simply means more work, more systems to learn, and more points of failure to keep track of.

Additional resources

Health
#Health