EHR Angst
Other considerations have more to do with the sort of practice one has and the need for sharing information. Thinking through the risks and benefits of adopting an EHR in one’s practice can help reduce the angst one feels about this decision:
POTENTIAL BENEFITS:
- quicker exchange of information than with faxing or mailing
- less likely for papers to get misfiled or lost (eg, think Hurricane Katrina)
- better tracking of who accessed what information
- less duplication of tests
- improved coordination of care
- fewer medical errors due to more information available
- decreased liability due to sharing of important information with other providers
- improved legibility
POTENTIAL RISKS:
- decreased privacy due to potential for data breach, identity theft
- loss of data due to technical problems (viruses, hardware failure, etc)
- failure to secure data due to inadequate authentication, authorization, encryption, etc
- more errors in health record due to automated data collection processes
- increased liability due to sharing of sensitive information with other providers
Finally, just because it is electronic doesn’t necessarily make it better or safer. The Institute of Medicine recently recommended that a separate entity investigate errors resulting from the use of electronic health records, while a report in this month’s Journal of the American Medical Informatics Association found that 10% of electronic prescriptions to a commercial outpatient pharmacy chain had errors, one-third of them potentially serious. This is similar to the error rate in handwritten prescriptions.
The APA Committee on Electronic Health Records will be coming out next spring with an improved tool to assist its members in sharing their experiences with the numerous EHR products out there. Until then, ask your colleagues, go online, and share with others. Also stay tuned here, and on my blog, HIT Shrink.
—Steven Roy Daviss, M.D. DFAPA
Dr. Daviss is chair of the department of psychiatry at Baltimore Washington Medical Center, clinical assistant professor at University of Maryland, chair of the APA Committee on Electronic Health Records, co-chair of the CCHIT Behavioral Health Work Group, and co-author of Shrink Rap: Three Psychiatrists Explain Their Work, published by Johns Hopkins University Press. Find him @HITshrink on Twitter and on the Shrink Rap blog.
