Electronic Health Records (EHR) are systems that digitize and centrally manage patient medical information. They are essential tools for promoting information sharing among medical institutions and improving the quality and efficiency of healthcare services.
In this article, we will explain what EHR is, its functions, benefits, drawbacks, and more.
What is Electronic Health Record (EHR)?
An Electronic Health Record (EHR) is a system that digitizes and shares medical information, test data, medical history, allergy information, and other patient data collected at medical institutions. This integration of medical information by patient allows for information sharing across medical institutions and regions, enhancing the quality of medical care and supporting infection control measures.
EHRs also integrate with EMRs (Electronic Medical Records) and PHRs (Personal Health Records) to support information sharing inside and outside medical institutions and manage individual health information.
Main Functions of Electronic Health Records (EHR)
EHRs offer various functions ranging from patient information management, creating medical records, viewing test results, issuing prescriptions, creating statistical information, and more. The main functions of EHRs include:
- Patient Management
- Outpatient Functions
- Creating Medical Records
- Order Functions
- Inpatient Functions
- Department Functions
- Document Management
- Information Sharing Among Staff
- Integration with Other Systems
Patient Management
The patient management function of EHRs centrally manages basic patient information, medical history, and allergy information. This allows medical staff to quickly and accurately understand patient information, enabling appropriate medical care. Past medical records and test results can be easily referenced, facilitating smooth treatment planning and follow-up. Additionally, access permissions can be set to protect patient privacy, ensuring information security.
Outpatient Functions
The outpatient functions of EHRs support various outpatient services, including reception, interviews, appointment management, and online medical consultations. Reception tasks are streamlined with pre-appointment and online entry of interview forms, reducing waiting times and improving reception efficiency. The online medical consultation function allows medical services to be provided to patients in remote areas or those with mobility difficulties.
Creating Medical Records
EHRs provide multi-functional medical record creation capabilities, including creating medical records, referencing medication history and test results, and using templates. Using templates for medical record creation allows for quick and accurate recording, reducing the burden on medical staff. Medication history and test results can be easily referenced, enabling comprehensive understanding of the patient’s condition and appropriate treatment decisions.
Order Functions
The order functions of EHRs support a wide range of tasks, including issuing prescriptions, ordering tests, and managing surgeries and admissions/discharges. The prescription issuance function allows for the swift and appropriate prescription of medications, ensuring smooth patient treatment. The test order function enables easy test instructions and quick reference to results. Additionally, managing surgeries and admissions/discharges optimizes the use of resources within medical institutions and facilitates efficient patient treatment planning.
Inpatient Functions
The inpatient functions of EHRs comprehensively support inpatient care, including patient management, nursing records, and creating care plans. The patient management function centrally manages patient room and bed assignments, and admission/discharge schedules, improving ward operations. The nursing record function allows nurses to quickly record patient conditions and care details, sharing information with other medical staff.
Department Functions
The department functions of EHRs support various department tasks within medical institutions, such as scheduling and managing tests, and creating related documents. This improves the efficiency of test schedule management and reduces patient waiting times. Automated input and sharing of test results enable medical staff to quickly grasp results and proceed to the next treatment step. The document creation function allows for the automatic generation of test result reports and test request forms, contributing to operational efficiency and error prevention.
Document Management
The document management function of EHRs enables the creation of consent forms, diagnostic reports, label printing, and wristband printing. This ensures that various documents are created quickly and accurately, facilitating smooth patient handling. Using templates for consent forms and diagnostic reports allows for standardized document creation, preventing entry errors. The label and wristband printing function ensures accurate specimen identification and patient identification, enhancing medical safety.
Information Sharing Among Staff
The information-sharing function of EHRs supports in-hospital emails, bulletin boards, and sharing patient information, smoothing communication among medical staff. Utilizing in-hospital emails and bulletin boards ensures quick information transmission, and all staff receive important notices and communications promptly. The patient information sharing function allows attending physicians and nurses to grasp necessary information in real time, strengthening collaboration. This enhances effective team-based medical care and consistent patient care.
Integration with Other Systems
EHRs integrate with systems such as patient card issuance, wait time display systems, and automated billing systems, improving patient service and operational efficiency. The patient card issuance function quickly issues patient cards at reception, improving patient identification and reception efficiency. Integrating with the wait time display system allows patients to check their appointment order and wait time in real time, reducing waiting time stress. Integration with automated billing systems smooths accounting tasks, reducing patient wait times for billing.
Benefits of Electronic Health Records (EHR)
Introducing EHRs brings numerous benefits. The main benefits include:
- Instant Information Management and Utilization
- Preventing Mistakes
- Operational Efficiency
- Reducing Storage Space for Paper Records
- Easy Sharing When Establishing Branches or with Other Medical Institutions
Instant Information Management and Utilization
One of the greatest benefits of EHRs is the immediacy of information management and utilization. EHRs allow patient medical information and test results to be shared and updated in real time. This enables medical staff to make quick and accurate decisions based on the latest information, providing appropriate treatment and care for patients. Additionally, information can be easily searched and referenced, allowing for quick confirmation of past medical records and test results, and understanding treatment progress.
Preventing Mistakes
EHRs significantly reduce reading errors and entry mistakes compared to handwritten records. Handwritten records are prone to misreading and omissions, leading to medical errors. EHRs automatically check for incorrect information and omissions during entry, preventing inaccurate information and missing entries. Using standardized templates ensures uniform information recording, preventing misunderstandings and confusion.
Operational Efficiency
EHRs significantly improve the operational efficiency of medical staff. Creating, managing, and searching medical records becomes easier, allowing doctors and nurses to quickly access the information they need and efficiently proceed with their tasks. This allows medical staff to dedicate more time to patient care, improving the quality of service provided to patients. EHRs also automate tasks such as issuing prescriptions and ordering tests through integration with other medical systems, further enhancing efficiency.
Reducing Storage Space for Paper Records
Introducing EHRs greatly contributes to reducing physical storage space. Paper records accumulate in large quantities, requiring significant storage space. EHRs allow these physical records to be stored as digital data, saving space. Additionally, costs associated with storing and managing paper records are reduced, alleviating the financial burden on medical institutions. EHRs also come with backup features, increasing data security and availability, enabling quick access to information.
Easy Sharing When Establishing Branches or with Other Medical Institutions
EHRs are powerful tools for easy information sharing among medical institutions, enhancing collaboration. When establishing branches or transferring patients to other medical institutions, using EHRs maintains the continuity of patient information, enabling consistent care. EHRs are often integrated with regional medical networks and healthcare coordination systems, allowing for the rapid and secure sharing of patient medical information. This enables multiple medical institutions to collaborate in patient treatment, improving the quality of medical services.
Drawbacks of Electronic Health Records (EHR)
While there are many benefits to introducing EHRs, there are also some drawbacks. The main drawbacks include:
- Implementation Costs
- Risk of Information Leakage
- Risk of System Failures
- Learning to Operate the System
- Changing Operational Systems
Implementation Costs
One of the main drawbacks of EHRs is the high initial cost of implementation. Purchasing systems, setting up infrastructure, and staff training require significant initial investment. Additionally, ongoing maintenance and updates incur regular running costs, which can be a financial burden for medical institutions. Especially for small to medium-sized medical institutions, the high cost of implementation is often a barrier.
Risk of Information Leakage
EHRs, being digital data, are constantly exposed to cybersecurity risks such as hacking and virus attacks. Medical data is highly confidential, and any information leakage can severely impact patient privacy and the credibility of medical institutions. Strong security measures are essential, requiring regular security checks and system updates. Internal information leakage risks also cannot be ignored, necessitating appropriate data management and access permissions by medical staff.
Risk of System Failures
EHRs, being digital systems, are at risk of technical issues such as power outages and system downtimes, making access impossible. This can hinder immediate access to medical information, causing delays and confusion in treatment. In emergencies, system failures can severely impact medical operations that require swift response. High reliability and stability are required for EHR systems, along with established backup systems and regular system maintenance.
Learning to Operate the System
EHR systems are multifunctional and complex, and it can take time and effort for medical staff to get accustomed to their operation. For staff not familiar with IT, the introduction of a new system can be a significant burden, necessitating education and training, which also require time and costs. Operational mistakes and system misuse may impact the efficiency and safety of medical operations. Continuous education and support are essential for improving staff skills, increasing operational costs.
Changing Operational Systems
Introducing EHRs may require changes in the existing workflow of medical institutions. Transitioning from traditional paper records to digital records often involves restructuring entire operational processes, potentially causing resistance and confusion among staff. Adapting to new operational systems requires ongoing education and support, along with additional costs and resources. Temporary decreases in operational efficiency may occur during transitions, impacting patient services.
Current State of Electronic Health Records in Japan
The current state of EHRs in Japan has the following characteristics:
- Increasing Adoption Rate
- Foundation of Digital Healthcare
- Standardization of Medical Information
- Consolidation of Systems
- Promotion of Data Utilization
- International Comparisons
Increasing Adoption Rate
The adoption rate of EHRs in Japan is increasing year by year, with a 57.2% adoption rate in general hospitals as of 2020. Large hospitals with 400 or more beds have an adoption rate of 91.2%, indicating significant progress in EHR adoption among large hospitals. However, the overall adoption rate remains around half, with small clinics and practices lagging in adoption due to high implementation costs and technical challenges.
Foundation of Digital Healthcare
The Japanese government is actively promoting the foundation of digital healthcare, with plans such as introducing online qualification confirmation systems and creating national medical information platforms. These initiatives aim to share and update patient medical information and insurance information in real-time, improving the quality and efficiency of medical services. The online qualification confirmation system allows for immediate verification of insurance qualifications and medical information when patients visit medical institutions, contributing to smoother reception and cost-appropriate medical care.
Standardization of Medical Information
Efforts are being made in Japan to standardize EHR information and enable secondary use of medical information. However, there are still challenges in the standardization and operation of clinical information. Standardization facilitates smooth information sharing among different medical institutions, ensuring consistency in patient treatment. The standardization of medical information requires developing systems that comply with international standards and enhancing data compatibility.
Consolidation of Systems
In Japan, EHR systems for hospitals are increasingly consolidated by major vendors, while there are many vendors for clinic EHR systems, lacking uniformity. This results in low data compatibility between different systems, hindering information sharing. Consolidation by major vendors contributes to improving stability and reliability, but flexibility is needed to meet diverse needs. Vendors for small medical institutions should also pursue integration and cooperation, promoting the development of compatible systems.
Promotion of Data Utilization
In Japan, the Data Health Focused Reform Plan and the Next Generation Medical Infrastructure Act promote the digitalization and utilization of medical information. This aims to leverage vast medical data to improve the quality of healthcare and develop new medical technologies and treatments. The Data Health Focused Reform Plan collects and analyzes medical data to enhance public health and reduce medical costs. The Next Generation Medical Infrastructure Act provides a legal framework for secondary use of medical data while ensuring personal information protection.
International Comparisons
Japan ranks 14th in the world in terms of e-government achievement and is also recognized for its high level of digital medical infrastructure. Japan continues to strengthen its position by learning from advanced examples in Western countries while promoting its own initiatives in EHR adoption and digital healthcare foundation. Aligning with international standards for medical information standardization enables global sharing and collaboration of medical information.
Current State of Electronic Health Records Worldwide
The state of EHRs worldwide varies greatly by country. Here we will explain the situation in:
- United States
- United Kingdom
- Singapore
- Sweden
- China
- India
- Africa
United States
In the United States, the adoption rate of EHRs varies by hospital size but boasts an overall adoption rate of about 80%. This is largely due to the HITECH Act of 2009, which provided financial support for EHR adoption, leading many medical institutions to implement EHR systems. As of 2020, the EHR adoption rate reached about 80%.
United Kingdom
The United Kingdom has nearly achieved a 100% adoption rate for EHRs and is widely recognized as a leader in medical IT. The National Health Service (NHS) completed EHR implementation nationwide by 2016, establishing a unified system. This enables comprehensive medical services through regional healthcare networks, with smooth information sharing enhancing healthcare quality and patient health management.
Singapore
In Singapore, EMR (Electronic Medical Records) implementation is nearly 100%, ensuring access to the latest patient information for appropriate medical care. A national EHR system was introduced in 2011, reaching a 98% adoption rate. However, the connection to EHRs is less than 10%, indicating incomplete integration. The Singapore government continues to improve systems and promote EHR adoption.
Sweden
Sweden has achieved over 90% adoption of EMRs, with a national EHR system introduced in 2010 reaching a 99% adoption rate. This allows medical staff to quickly access patient information, providing consistent treatment. Sweden’s EMR system facilitates smooth information sharing between regions, contributing to healthcare quality improvement.
China
In China, the National Health Commission has promoted EHR adoption since 2009, gradually increasing the adoption rate. As of 2020, the adoption rate is about 50%, with implementation advancing mainly in large medical institutions. However, regional disparities and infrastructure issues slow adoption in smaller medical institutions. The Chinese government strengthens infrastructure and educates medical personnel to further promote EHR adoption.
India
In India, the government promotes EHR adoption, but challenges such as infrastructure development and medical staff education remain. The adoption rate is about 20% as of 2020, with slow progress particularly in rural areas. Information sharing and consistent medical services are difficult in these areas. The government takes various measures to promote EHR adoption, but long-term efforts are necessary.
Africa
The state of EHR implementation in Africa varies by country, with many countries yet to adopt EHRs. Challenges include inadequate infrastructure, financial constraints, and lack of medical staff education. Particularly in remote areas and among the poor, EHR adoption is slow. However, some countries progress in EHR implementation with international aid and NGO support.
Future of Electronic Health Records
The future of EHRs includes the following prospects:
- Increasing Adoption Rate
- Integration with Digital Health
- Slight Market Growth
- Shift from On-Premise to Cloud-Based Systems
- Strengthening Collaboration with Regional Healthcare
Increasing Adoption Rate
The adoption rate of EHRs is expected to increase even in small to medium-sized medical institutions, particularly due to the accelerated adoption of cloud-based EHRs. Cloud-based EHRs significantly reduce initial costs and maintenance burdens, making them more accessible for smaller practices and clinics. This will allow even small medical institutions to adopt EHRs while keeping costs low.
Integration with Digital Health
EHRs are expected to integrate with other digital health elements such as online consultations, PHRs, My Portal, treatment apps, and medical AI, mutually developing. This will advance the centralized management of medical information, enabling more efficient and comprehensive patient health management. For example, using EHRs in online consultations allows doctors to access detailed patient records for appropriate diagnosis and treatment. Collaboration with medical AI improves diagnostic support and prognosis predictions, enhancing the quality of healthcare.
Slight Market Growth
The EHR market is expected to experience slight growth. While the market for hospital EHRs may shrink after 2025 due to widespread implementation in large hospitals, the market for cloud-based EHRs, electronic prescription systems, and appointment/test scheduling systems is expected to grow significantly. The shrinkage of the hospital EHR market is partly due to the near-completion of implementation in large hospitals. However, the cloud-based EHR market is anticipated to expand with the spread of EHRs in small medical institutions and new installations.
Shift from On-Premise to Cloud-Based Systems
The cloud-based EHR market continues to expand, with this trend expected to accelerate. Cloud-based systems are attractive to small medical institutions due to their low initial costs and easy maintenance. The market for on-premise EHR systems is expected to shrink, with existing systems transitioning to cloud-based ones. The adoption of cloud-based systems improves accessibility and sharing of medical information, enhancing the quality of medical services.
Strengthening Collaboration with Regional Healthcare
There is expected to be a further strengthening of collaboration with regional healthcare and care facilities using EHRs. Centralized management of patient information through EHRs allows for smooth information sharing with regional medical institutions and care facilities, providing comprehensive care. For example, sharing patient medical information and care plans through regional healthcare networks strengthens collaboration between different medical institutions and facilities. This ensures consistent care for patients even when transferring or being discharged. Using EHRs in home medical care and visiting nursing also facilitates smooth communication among medical staff, providing high-quality care.
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