Electronic health records: Don’t under-estimate the importance of implementation and staff training

One of the most significant changes I have witnessed during my medical career is the introduction of electronic health records (EHRs). While they have brought many benefits to the NHS, patients and clinicians, they have also posed some challenges.

On the positive side, EHRs have made medical records more legible, accessible and secure. Many doctors and patients will remember the era when a patient’s medical record was often “missing” when they attended for an outpatient appointment. This made the management of the patient more difficult as the clinician attending the patient did not have all the information they needed; usually requiring the patient to return at a later date when hopefully by which time their medical records would be found.

With EHRs, in contrast, clinicians can access patient records from anywhere at any time, which has made it easier to provide care to patients in different locations. EHRs have also made it easier to conduct medical research, as they allow researchers to access large volumes of data in a more streamlined manner. Quality improvement has also been enhanced as EHRs make it much easier to measure the quality of healthcare and the impact of any interventions and change to the provision of health services.

However, EHRs have also forced clinicians to modify how they work, which is not always a positive change. The increased use of technology in healthcare for example can sometimes result in decreased interaction between clinicians and patients; as the clinicians is often focused on reading the EHR and entering new data. In addition, the use of EHRs can be time-consuming, as clinicians have to enter information into the system, which can increase their workload.

Another potential issue with EHRs is the risk of data breaches, which can compromise patient privacy and confidentiality. Cybersecurity is a major concern for healthcare providers, and it is important that they take appropriate measures to protect patient data. We have seen example in the NHS of significant data breaches which have disrupted the delivery of health services and compromised sensitive patient information. We have also seen examples of major IT failures (for example, during the heatwave in the summer of 2022).

Despite the challenges associated with EHRs, they are here to stay. It is crucial that healthcare providers adapt to this new way of working, but also that the systems are designed in a way that minimises the burden on clinicians while maximising the benefits to healthcare providers and patients. The ongoing development of EHRs and other technological advancements must always prioritise patient care and safety. This means designing IT systems with adequate input from staff and patients; and ensuring that sufficient time and resources are devoted to areas such as implementation and training.