Patient Access to Health Records: Pros and Cons

When patients have their medical information put into an EHR, they should benefit from the sharing of their information between each of their doctors. If, for instance, the patient’s primary provider refers their patient to an allergist, then these two professionals will be able to access their mutual patient’s record.

When a hospital can share information on a patient with their doctor, this makes deciding on needed medical care much easier. Rather than waiting for paper records to be faxed, emailed, or mailed to the practice, they are there almost in real-time.

One intent of electronic health records is better preventive healthcare. The records show when a patient has received a flu vaccine or other early healthcare services. The Affordable Care Act (ACA) requires everyone with health coverage to receive preventive healthcare. The EHR indicates when a patient has received such a procedure, such as vaccinations.

EHRs serve as a reminder to family doctors to track preventive healthcare services for specific medical conditions. If a patient suffers from high blood pressure and diabetes, they need to have regular blood pressure checks and undergo regular A1C tests. In turn, this helps patients to be more mindful of the steps they need to take to improve their health (diet, medication, exercise).

Doctors, nurses, and clerical staff are required to put significant time into updating charts. With paper charts, this was a labor-intensive chore requiring nurses and doctors to write everything down manually. With EHRs, the hope is that medical professionals can make these entries on electronic tablets or computers, quickly updating each patient’s record without hassle.

Practices also use electronic standing orders to reduce clerical time. Paper checklists are used to communicate between doctors and clerical staff. Clerks enter electronic orders into each patient’s EHR. This shortens the amount of time a doctor spends on the EHR, delegating this responsibility to clerical staff.

Point-of-care settings make it easier for doctors and nurses to order prescriptions, lab tests, and imaging tests quickly. Also, if two separate practices are electronically linked, this allows for collaborative approaches to care. E-prescriptions arrive at the pharmacy, ready for filling and imaging and lab facilities quickly receive test orders.

The patient can then go into a healthcare provider, give their authorization, and discuss with a provider the tests or imaging orders that have been entered. This requires that every EHR be securely linked via the internet and seamlessly integrated with medical information for the doctor and patient.

Charge capture refers to tracking each charge to a patient for medical services given. An EHR makes it much easier for a medical practice to track a charge for each procedure performed. The average increase in per-patient charges is $11.09 and patient collections have increased by $11.48 on average. The increase in charges and collections may be due to more orders for additional services as well as improved documentation in each patient’s EHR. Forced completion of records and fewer errors in coding may also contribute to fewer mistakes in charging and collections.

Providers are required to sign off on each patient’s chart. This used to mean taking each paper chart and signing each patient’s most recent orders, exams, and tests. Today, EHRs make it easier for this sign-off to be completed. This captures notes from the nurse, doctor, and the day’s medical activities for each patient.

Charting in an EHR restricts nurses and doctors to choose from a list of options, using several lists. Rather than writing free form, which can take up a significant amount of time when spread across all patients seen in a day, the doctor or nurse learn to limit themselves to the options available. Even so, professionals are required to thoroughly and accurately document each patient encounter.

In each patient’s EHR, a function for e-messaging with other providers allows each doctor to send off quick notes about diagnoses, tests ordered, and treatment decisions reached. It is quick and keeps each provider up to date on shared patients. It’s also much more efficient than playing telephone tag with each other.

If a primary care doctor is going to refer a patient to a specialist, e-messaging allows them to give the specialist a heads-up that a new patient is going to be requesting an appointment. The PCP also has the option to schedule the appointment via the e-message capability.

Today, an EHR can allow a patient to get more involved in their care. After their initial appointment, they should receive an email from their new doctor. This email allows them to create a login so they can review details of their care and, ideally, get information that they can use to communicate with their doctor in more detail.