Electronic Health Records: Cure-all or Chronic Condition?

TL;DR

Electronic health records are promoted as cost-effective and efficient, but their success varies due to issues in knowledge codification, communication, and coordination, though there is optimism for their future potential.

Contribution

This paper analyzes the challenges and limitations of EHR systems in achieving their intended benefits and discusses potential pathways for improvement.

Findings

EHR systems often fail to reduce costs and errors as intended.

Problems with knowledge codification hinder EHR effectiveness.

There is optimism about EHR systems fulfilling their potential.

Abstract

Computer-based information systems feature in almost every aspect of our lives, and yet most of us receive handwritten prescriptions when we visit our doctors and rely on paper-based medical records in our healthcare. Although electronic health record (EHR) systems have long been promoted as a cost-effective and efficient alternative to this situation, clear-cut evidence of their success has not been forthcoming. An examination of some of the underlying problems that prevent EHR systems from delivering the benefits that their proponents tout identifies four broad objectives - reducing cost, reducing errors, improving coordination and improving adherence to standards - and shows that they are not always met. The three possible causes for this failure to deliver involve problems with the codification of knowledge, group and tacit knowledge, and coordination and communication. There is, however, reason to be optimistic that EHR systems can fulfil a healthy part, if not all, of their potential.