Question

1. One goal of EHRs is to facilitate providers

Answer 1

Advantages :

EHRs, especially those with CDS tools, have been correlated with providers adhering to clinical guidelines. Some reasons for this non-adherence include clinicians not knowing the guidelines and clinicians not realizing that a guideline applies to a given patients. The utilization of EHR systems have shown an increase of provider adherence specifically in preventive services, such as vaccine administration. For example, researchers found that computerized physician reminders increased the use of influenza and pneumococcal vaccinations from practically 0% to 35% and 50%, respectively, for hospitalized patients. Adhering to these guidelines keeps individuals healthy and provides optimal patient care. There has been a significant association between computerized reminders and pressure ulcer prevention in hospitalized patients. They found a 5% decrease in the development of pressure ulcers 6 months after the implementation of computerized reminders that targeted hospital nurses. Another study found that computerized reminders as part of a CDS have been linked to an 11.3% increase in hypertension treatment in a primary care setting.

Efficiency is the appropriate use of health care through the avoidance of wasting resources, such as redundant diagnostic testing. Evidence indicates that there is a significant an association between a decrease in redundant diagnostic testing andthe use of an EHR and/or its components. Studies have shown through the use of EHRs a 18% decrease in tests ordered for medical visits in the emergency department, a 27% decrease in redundant laboratory tests of antiepileptic medication levels in hospitalized patients, and a 24% reduction in redundant laboratory tests in a hospital.

Studies focusing on patient safety have frequently examined the effect of EHR components on medical or medication errors. In a widely cited study, experts found that a CPOE system was associated with a 55% reduction in serious medication errors in the hospital setting.

Disadvantages :

Although there is an increasing body of literature that shows the

benefits of EHRs, there are several concerns, which include workflow,

temporary loss of productivity associated with EHR adoption, privacy

and security concerns.

In a 2002 study conducted in a 280-bed acute care hospital, the

projected total cost for a 7-year-long EHR installation project was

approximately US$19 million. In the outpatient setting, it is estimated

an average initial cost of US$50,000