What the good and bad of using EMR

[Wirichada Pan-ngum]

What the good and bad of using EMR instead of the traditional paper based medical records in your setting? (10 Marks)

————————- Due date 8 March 2021 ————————–

[Rawinan Soma]

Using EMR make benefit for both provider and patient. In example, for provider, we could service same routine but faster, more decisive, and safer to patient. Data in EMR has more security, privacy, and confidentially if we use the right technique to apply in database. For patient, they will receive faster service and safety treatment. If possible, they could know their health status, and receive health suggestion for some issue like hypertension or DM lifestyle modifications. In the downside of applying EMR, bad things are how to start using EMR with minimal resistance, we could cover this problem by good change management. Secondly, the implementation phase. How to implement EMR in the hospital, where to start first, and how to transform into new system seamlessly.

[Wachirawit Supasa]

In the clinical trial setting, using EMR provides many benefits for the researchers such as data utilization, data storage, and data dissemination. For example, we have an appointment application to manage participant schedule, a web application to record case report and adverse effect, a laboratory app which record all detailed about testing etc.

After using these applications for a while, I can summarized pros and cons of EMR into following aspects:

Pros
– Working collaboratively which users can access and edit data in the same time.
– Transfer data more efficiently where users can send and receive data through the computer network.
– Better Back-up procedure when all data has been digitalise, we can back-up them with multiple solution.
– More environmental friendly because tradiontal EMR producing a lot more waste from paper and office supplies.

Cons
– High cost upfront because digital EMR required setup of hardware, software and technician.
– Required consistence network infrastructure such as power and internet.
– Required safeguard policy and personnel training to prevent data breakage and malicious attack.

In my opinion, the benefits from digital EMR is far outweighed and many disadvantage can be prevent by good management.

[Navinee Kruahong]

Advantages of EMRs
– Providing accurate, up-to-date, and complete information about patients at the point of care
– Enabling quick access to patient records for more coordinated, efficient care
– Securely sharing electronic information with patients and other clinicians
– Helping providers more effectively diagnose patients, reduce medical errors, and provide safer care
– Improving patient and provider interaction and communication, as well as health care convenience
– Enabling safer, more reliable prescribing
– Helping promote legible, complete documentation and accurate, streamlined coding and billing
– Enhancing privacy and security of patient data
– Helping providers improve productivity and work-life balance
– Enabling providers to improve efficiency and meet their business goals
– Reducing costs through decreased paperwork, improved safety, reduced duplication of testing, and improved health.

Disadvantages of EMRs;
– Creating potential privacy and cybersecurity issues
– Consuming years to select and set up an EHR system and completely switch over all your paper records to digital ones
– maintaining an EHR system requires frequent updates

[Saravalee Suphakarn]

The study review the implementation of EMR in Myanmar, Thailand’s neighbor country. Thailand also have implemented EMR in many sectors and be classified as developing country.

Advantage of EMR including…
– increasing efficiency and quality of data collection, data storage, data management, data analysis, and information utilization.
– reducing time of working and workload.
– providing ability to share and transfer data both internal and between the organizations.
– reducing time and cost of patients
– improving quality of health care to better health of people.

Disadvantage of EMR including…
– privacy and security of personal data have been concerned.
– may increase workload in transition period.
– users have to have basic of computer and technology especially health care provider.
– the system need technology infrastructures, internet access, and power supply.
– human training and technical support is important especially when system downtime.

Although the implementation of EMR need more preparation (human, knowledge, resource), I agree with Wachirawit’s answer, it can be prevent by good management.

[Wirichada Pan-ngum]

Agreed too.

[Kridsada Sirichaisit]

I use EMR for 16 years ago by HOSXP. EMR is very useful in many aspect. I write my first study by EMR (MySQL query result and put data to SPSS for analysis) and I use the result of that study to compare outcome of patients in 10 years later. This is the my benefit experience of EMR.

The advantages of EMR
– Easy to review medical history.
– Laboratory data compare.
– Drug alert
Drug interaction
Drug allergy
Dosage
Disease specific alert
– Laboratory critical value alert
– Availability for 24 hours
– Data interoperability for transfer referral data

The disadvantage
– Wrong data input correct by machine data input such as blood pressure data input, LIS.
– Can not access if server down both master or replication server. Correct by IT emergency plan and server maintenance.
– Network speed correct by intranet network design by layer3 core switch and use only gigabit switch, gigabit media converter.
– Heavy query may slow down speed to access EMR corrected by query in replication server instate of master server
– Cyber security.
– Workload to input in IPD situation. I think this can correct by new HIS that support tablet for input data.

[Sittidech Surasri]

Thank you for sharing this good experience in using EMR. I’m curious to know as you mention that “Can not access if server down both master or replication server. Correct by IT emergency plan and server maintenance.” Do we have any disaster recover (DR) technology or plan to get the system back in a short-time or real-time.

[Pongsakorn Sadakorn]

Agree with you that notification is a good feature that the paper-based could not do this.

[Sila Klanklaeo]

Advantages and Disadvantages of electronic medical records.

Advantages
– Increase efficiency in serving patients.
– Saves a lot of time: able to access information quickly and reduce certain steps in the service.
– Clearer and more accurate information: because it is computer storage, it can reduce service errors.
– Easy access to information: The system can be accessed via mobile devices or computers anytime and anywhere.
Disadvantage
– Security Issues: It is very important to ensure that information is not leaked.
– Problem of use In terms of system access to use, it requires a high investment to provide services.

[Sittidech Surasri]

Currently, I am not using/ directly working with any EMR in the study/ project. But I have seen some EMRs of the subjects who participated in the clinical study. Subject’s records were collected and maintained in both paper-based and electronic-based. However, if back to about 15 years ago where I was working in the district hospital, only paper-based medical records were used. So, with my experiences the good and bad of using EMR instead of the paper-based are as follows:

Good:
• Data integrity: Providing accurate, up-to-date, and complete information about patients in the hospital and clinics or even in point of care setting.
• Data processing (volume, variety, velocity): It can retrieve the medical history in patients much more quick access.
• Security and Accessibility: Securely sharing electronic information with patients and other clinicians with authorized login and password of accessible person.
• Quality and Efficiency: Increasing more effectively diagnose of the patients and reduce the medical errors.
• Timely: Improving waiting time for the patients in the hospital and increasing the relationship between clinical and patients
• Enabling safer, more reliable prescribing
• Helping promote legible, complete documentation and accurate, streamlined coding and billing
• Improve work productivity
• Reducing costs through decreased paperwork, improved safety, reduced duplication of testing, and improved health.

Bad:
• Increased provider time, it increases the amount of time physicians spend entering orders.
• Computer down time.
• Lack of standards, and threats to confidentiality; privacy and security of patient data is still question.
• Data sharing and interoperability; sharing electronic information with patients and other clinicians or even in National security health system or insurance system need to clarify.
•Need budget in implementing and maintaining the system
• Require IT specialist/ expertise.
• Need time for implementation when transfer the data or during regular upgrade.

[Wirichada Pan-ngum]

Thanks for sharing your experience in the previous job. I think a lot of bad points you mentioned can be improved with more training, more resources and better management like your peer mentioned.

[Pongsakorn Sadakorn]

I am not familiar with EMR in the hospital because I live at the national level organization. However, I have experience with digital transformation in my organization.

pros:
1. Track the history: by using a digital record, the activity can be tracked and observed.
2. Provide a quicker service: digital records can assist the process of service quicker than paper-based.
3. Provide more benefit: digital-based records can be used in research and other benefits.
4. Accessing anywhere: the user can access the data anywhere which is useful for analysis in an emergency.

cons:
1. Privacy and data security: inappropriately managed the system may lead to data breach and cybercrime.
2. High cost of installing and training
3. People: user needs to well-understand the system before use.
4. Workload: certain systems increased work-load data entry.

[Wirichada Pan-ngum]

Thanks for sharing on digital transformation. The benefit on the future use of this data should be emphasized. The risk of data breach and cybercrime is most challenging in my opinion. You are far more advance than the example of my EMR 🙂

[Khaing Zin Zin Htwe]

The health setting I’m working at is the care of drug-resistant tuberculosis patients. I would like to briefly describe the functions of my project before listing pros and cons of the implemented EMR in the process.
The main functions of the DR-TB patient care project is providing money support, supervising regular taking of drugs, monitoring disease progress, drug side effects and infection control practices, and regular screening of close contacts. The following pros and cons of EMR are stated in relation to the functions mentioned above.

Pros: Alert features, proper recording of patient’s demographics, increased accessibility (indirectly reduced cost of transportation), and timeliness provided by the EMR can lead to:
– decrease in loss to follow up rates
– improved regularity of drug taking and consequently, less change into worse drug-resistant forms of TB
– improved outcomes
– early catchup of side effects and therefore no unnecessary morbidity and mortality
– better infection control practice and reduced transmission
– early diagnosis and prompt treatment.

Cons:
– increased workload during transition period
– Initial setup and training cost
– Burden to users with less IT knowledge might lead to reduced work satisfaction
– Potential security and privacy threats.

[Wirichada Pan-ngum]

Thanks for sharing your TB work experience here. I think still, for long term, the EMR would make life easier for health workforce, right.

[Naphat]

Thank you for explaining how I understand EMR in work on tuberculosis, where I worked in the short term before, but I had no idea what it was about EMR until I read yours. Thank you krab

[Naphat]

I never have any experience with EMR, but by reading the journal “ELECTRONIC MEDICAL RECORDS IN MYANMAR: USER PERCEPTIONS AT MARIE STOPES INTERNATIONAL CLINICS IN MYANMAR” and searching for additional information, I was able to divide the advantages and disadvantages of this system as follows.

The advantages of EMR

– Data integrity and more accuracy.
– Data available; Physician, medical staffs and patients can access information anytime easily.
– Data security and privacy; Data security and privacy limited access and have strong measures to prevent cyberattacks.
– The system can track patient information and know the status of the patient, easy to communicate within the organization or outside the organization if the patient is transferred to another hospitals.
– Reducing redundancy work and paper usage. saving a lot of time for workers.

The disadvantages of EMR

– Investment and support budget; Implementation of technology is the most important driver of innovation but must have government funding and support.
– Cyber security; need personnel with the ability to protect the storage system. Security systems are updated all the time. And training staff on a regular basis in cybersecurity.

[Wirichada Pan-ngum]

I am glad you have managed to self-study the EMR. If you have any further question please post into this discussion broad. I think we have a few experienced ones here.

[Naphat]

Thank you for guiding me krab Professor. After reading the comments of everyone and found that Some of the work I’ve done are part of EMR. Even without doing the fullest, but it gave me enough to understand EMR krab

[Kaung Khant Tin]

One of our organization’s projects is to give treatment and care to the people living with HIV at different service delivery sites across the country. Previously, traditional paper-based medical records are used for the data management system. Anyway, the organization has been implementing an EMR system which is called the OpenMRS system for a couple of years. The change from paper to EMR has been completed at some of the service delivery sites whereas most of the sites are still in the transition period. And I like to discuss some of the advantages and disadvantages of using the OpenMRS system at my organization.

Advantages
1. Effective and fast-paced data entry (no more exhaustive and time-consuming manual data entry)
2. Less space (No need to store paper-based medical records)
3. A better data backup system (no more worries over the vulnerability of the paper records)
4. Fewer workloads
5. A better control over the clinical management of HIV
6. Good analytical data capacity
7. Efficient data, information, and reports flow in a timely manner to support the information management system at the operational, tactical and strategic levels of the project

Disadvantages
1. Complexity in the data legacy transfer process at the transition period
2. Double data entry (both paper and EMR) at the transition period
3. High costs to implement and sustain electronic devices related to the EMR system
4. End users’ attitudes towards the change
5. Limited technological abilities in the end-users
6. Frequent electricity outage
7. Potential risks of data security

[Phone Suu Khaing]

It is a very useful article to read as we are also doing EMR in our TB and MDRTB projects in our organization.
EMR system has both pros and cons in many aspects according to the article as well as according to our experience in our projects.
Benefits
It can save unnecessary time consuming to file records and search records when needed.
It can help avoid duplicate data as there will be unique identifier for each patient.
Patients do not need to carry medical records when coming to clinic.
Management team can access real time data 24/7 so that it is valuable and supportive for timely decision making.
When clinical decision support system is integrated, it can be great support to both clinicians and patients.
Drawbacks
It may increase workload of staff during transition period.
Repeated training with feedback response as well as continuous technical support is needed.
EMR system is vulnerable to electricity outage, internet cut off and computer breakdown.
It also is prone to be attacked by cyber criminals when thorough security measures are not taken.
However, benefits outweigh risks when considering to substitute traditional recording system with EMR. Thus, EMR should be deployed by preparing every basic mandatory steps.

[Author]

Posts