Electronic health records (EHR) are steadily replacing traditional paperwork in the digital era. There are numerous benefits in the digitalization of the patient’s record in a healthcare organisation. For example, 82% of the medical practices in the United States reported that they had saved time through electronic prescriptions, while 75% saw their lab results being delivered faster. The number of medical errors has also been reduced, which is crucial as medical errors have been reported to be the third leading cause of death in the country.

Reduction of medical errors through sharing of information

In Singapore, as the population ages and patients are afflicted with more than one chronic disease, they receive healthcare services from different institutions. Polypharmacy, where patients take five or more medications on a daily basis, is on the rise. Missing a single detail in prescribing medication or designing treatment plans can be fatal, and patients might not necessarily know what details they need to notify their doctors. In this regard, the country’s electronic medical records would allow all details of the patients to be shared among the various healthcare institutions, thereby reducing the chances of medical errors.

Time spent with patients directly was reduced by EHRs

While medical errors have decreased with the implementation of EHRs, physicians in the United States have complained about EHR being detrimental to their work in another aspect – the doctor-patient relationship. The Annals of Internal Medicine found that physicians in the United States spent only about 27% of their time on direct interaction with patients in a consultation. And for one hour of face-to-face time with their patients, physicians spend almost double the time on EHRs and other administrative work.

Treating patients is the main source of job satisfaction for many physicians, while administrative burdens are sources of dissatisfaction. When consultation hours were cut as a result of EHR, this meant a lesser amount of time physicians could spend on interacting with their patients directly. With their main job satisfaction removed, it is perhaps little wonder that the burnout rate of physicians has increased. From 2011 to 2014, the rate of burnout increased from 45% to 54%, and the poor usability of EHRs was found to be a major source of distress for the physicians.

Improvement of EHRs the most important for physcians

In the same report, the physicians ranked the improvement of EHRs and the relevant technologies as the most important change they wish to see in the respective healthcare systems. Surveying the patients, McKinsey found that the things they wished for in the healthcare systems are simple: more access to information and integrating of other channels. From all angles, EHRs will remain vital in the healthcare system, so the crux of the problem then is to design an EHR system that can support and not hinder the healthcare professionals in their duties of caring for the patients, and that can improve the patient’s experience.

A system that reduces medical errors and saves time

Already, the nature of electronic medical records in Singapore has seen some changes. The Ng Teng Fong General Hospital (NTFGH) has a fully integrated EMR suite. One feature of this suite is that medical devices, such as vital signs machines and dialysis machines, have been integrated into it. Instead of having the healthcare team manually input the readings into the system, data from these medical devices are directly input into the system. The system achieves both goals of reducing medical errors, by avoiding transcription mistakes made by humans, and saving time for the healthcare professionals, which allows them to spend more time on their patients.

NTFGH is also the first hospital in ASEAN to achieve the Healthcare Information and Management Systems Society’s EMR Adoption Model (HIMSS EMRAM) Stage 7 award, which recognised their patient record environment as advanced. Thus, it is not impossible for EHR systems to achieve such goals, and healthcare professionals can perhaps anticipate a future where these systems will give them the time they need to spend on their patients instead of taking it away from them. MIMS

Read more:
Electronic health records: pros and cons
Doctor-Patient relationship in the era of social media
Medical errors: Negligence leads to patient mix-up