An Electronic Health Record (EHR) is a digital version of a paper chart that contains all of a patient’s medical history that is maintained by the provider over time and is mostly used for diagnosis and treatment. This may include all of the key administrative clinical data relevant to that person’s care under a particular provider. This can include demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates access to this information and has the potential to streamline the clinician’s workflow and therefore increase the number of patients seen. EHRs are designed to contain and share information from all providers involved in a patient’s care – the data can be created, managed, and consulted by authorized providers and staff from across more than one health care organization. EHRs also allow a patient’s health record to move with them to other health care providers, specialists, hospitals, nursing homes, and even across states.
EHRs allow physicians and practices to improve overall standard of care by reducing the incidence of medical error by improving the accuracy and clarity of medical records. These records help to track data over time, identify patients who are due for preventive visits and screenings, and monitor how patients measure up to certain parameters including vaccinations and blood pressure readings. By making this health information readily available it greatly reduces the duplication of tests, delays in treatment, and gives patients the opportunity to become more well informed thus allowing them to make better decisions.
As paper charts become more obsolete, converting to electronic health records not only alleviates the stress of the provider but ensures the precision and quality of the patient’s experience.