When effectively implemented, EHR systems can automate processes, enhance engagement, improve outcomes, and boost margins.
What is an electronic health record? In this article, we go deep into the world of EHR systems, unraveling the complexities and showcasing how these digital tools can help healthcare practices. With over 75% of office-based clinicians and 96% of hospitals in the United States using an EHR system, according to HealthIT.gov, the shift from traditional paper records to digital platforms is nearly ubiquitous. Yet, despite their widespread adoption, EHRs are often a significant source of frustration for healthcare providers.
EHRs are often badly designed and don’t integrate with other systems, leading to wasted time and unnecessary friction. Providers often feel frustrated because their EHRs promised them flexibility and efficiency — but what they’ve got is rigid and inefficient.
However, when effectively implemented, EHR systems can automate key processes, enhance patient engagement, improve health outcomes, and boost operational margins. In sum, they allow healthcare professionals to focus more on patient care and less on administrative tasks.
Let’s learn how to make an informed decision about your practice’s EHR.
An EHR is a digital version of a patient's medical record. Think of it like a comprehensive online chart that securely stores and organizes a patient’s important health information, usually in reverse chronological order, including:
EHRs are accessible by authorized healthcare providers involved in a patient's care, who can view and share crucial data instantly and securely. They streamline communication, promote coordinated care, and reduce the risk of errors due to incomplete or outdated information. EHRs can combine large databases of patient information to follow healthcare trends, develop new treatments, and innovate healthcare delivery. These features were especially beneficial during the COVID-19 pandemic.
The history of EHRs and EMRs began in the 1960s, but there were challenges around technology limitations and lack of standardization. EMRs and EHRs were also so expensive that primarily the government used them in partnership with health organizations. In the early 1990s, widespread EHR adoption was further delayed due to physician reluctance because of a lack of any real incentive.
The early 2000s saw the introduction of government incentives in the United States, like the Medicare and Medicaid EHR Incentive Programs. These incentives encouraged healthcare providers to implement EHR systems, which led to a surge. By 2020, nearly 90% of hospitals and 75% of office-based physicians in the U.S. had adopted at least a basic EHR system.
However, the widespread adoption of EHRs led to concerns about patient privacy and data security. As a result, several laws and regulations were established to protect patient data and ensure proper use of EHRs.
Some key examples of these regulations include:
These regulations outline various requirements for healthcare providers using EHRs, including:
As a result of improved safety and security, EHRs now help physicians determine optimal patterns of care while preserving privacy. EHRs have also changed the dynamics of the doctor-patient relationship with better communication and documentation.
An EHR solution is a dynamic and secure information hub accessible across different healthcare providers.
We’ve covered the core elements of an EHR, such as medical history, medications, labs, vital signs, and clinical notes. But there’s more to the story, as recognizing health is more than just a history of electronic medical records.
EHR records can also contain the following information for full patient context:
There are 3 major types of EHR software: software as a service (SaaS), on-premise (also known as enterprise), and custom.
Cloud-based EHRs
In this EHR model (also known as a SaaS solution), your practice accesses the system via the Internet. You do not need servers and other infrastructure on-site.
Typically, a SaaS solution has lower upfront costs but requires a monthly or annual subscription, making it suitable for smaller practices or those with limited IT resources.
SaaS EHRs have some customization, but are not as customizable as on-premise EHR software.
On-premise EHR software
Choosing an on-premise EHR solution means you buy the software product from an EHR supplier and install it on your own servers.
You need to invest upfront in software, servers, and local network connectivity — plus ongoing maintenance. However, this type of EHR software generally does not require a subscription fee.
Most on-premise EHR software can be used immediately, but your practice will probably need to customize clinical content, templates, reports, or other functions to fit your needs and workflows.
Hybrid EHR systems
This hybrid method combines elements of both on-premise and cloud-based models.
Typically, some data is stored locally, while other information is hosted in the cloud. A hybrid option offers greater flexibility and personalization than a true SaaS model, but still needs local IT management and support.
For example, a hybrid approach for your practice may look like building custom interfaces, templates, and reports into a flexible enterprise on-premise EHR.
One of the key benefits we've mentioned — convenient access — is vital in strengthening the patient-provider relationship. This is how.
A strong patient-provider connection relies on more than just efficient information flow.
Here's how EHRs — when used thoughtfully — can bridge the gap and cultivate trust with patients:
Shared stories, not just charts: Accessible EHRs allow patients to actively review their medical history, lab results, and even progress notes alongside you. This fosters trust and often means they’re more confident to ask questions, discuss concerns openly, and collaborate in treatment decisions. Improved documentation may include examples such as before and after photos, radiology or pathology images, and graph representations of data such as blood glucose or blood pressure readings.
“ EHRs — when used thoughtfully — can bridge the gap and cultivate trust with your patients. ”
From transactions to partnerships: Medical consultations shouldn't feel like rushed transactions. Patient portals built into EHRs are an excellent way to communicate with patients to answer questions, address concerns, and securely share educational resources. This ongoing dialogue builds trust, ensures you hear them, and empowers patients to be active participants in their health journey.
Empathy through knowledge: Healthcare professionals who already understand the context of a patient's situation are able to engage in deeper, more nuanced conversations. This demonstrates empathy and genuine interest in their unique experiences — ultimately strengthening the bond and create ongoing trust in your expertise.
It’s important to remember that the technology that delivers EHRs should enhance, not replace, human connection.
Look beyond the data and see the person with a story. Use EHRs to build bridges and cultivate patient trust. By doing so, you'll not only improve outcomes but also create a more rewarding experience for your team and your patients.
Independent providers face the challenges of operating within tight budgets, limited resources, and keeping pace with rapid technological advances.
With this in mind, it’s interesting to consider whether EHRs, despite their transformative impact on healthcare, help or present new obstacles for independent providers.
The first consideration is cost.
For independent healthcare providers, the financial burden is substantial. This includes the upfront costs of software, hardware, and training, along with the ongoing cost of maintenance. These expenses may strain the resources of independent providers, so careful budgeting and resource allocation is essential.
Nonetheless, incentive payments from Medicare and Medicaid EHR incentive programs are available to eligible independent providers, providing some financial relief.
Ensuring continuity of care is vital, as it ensures all providers have access to up-to-date and comprehensive patient information for informed decision-making and improved patient outcomes.
This is why sharing patient records can become problematic if independent providers use their own EHR. Using the same EHR facilitates access to any patient’s records, ensuring seamless continuity of care.
Despite the challenges they pose, EHRs offer several benefits that can positively impact independent providers and their practices:
Unlike larger healthcare institutions, independent providers often have smaller teams with limited administrative support.
EHRs can streamline workflow processes by automating tasks such as appointment scheduling, charting, and billing. This allows independent providers to manage their practice more efficiently with fewer resources. EHRs may allow independent physicians to access large data resources including local and national trends, clinical studies, and pharmacologic formularies.
Independent providers rely heavily on building strong relationships with their patients.
EHRs provide tools such as patient portals and secure messaging systems. These allow providers and staff to engage directly with their patients, answer questions, provide educational resources, and involve them more actively in their healthcare decisions.
Independent providers often specialize in niche areas of medicine or serve specific patient populations. As such, providers can customize their EHRs to meet the unique needs of these practices. For instance, tailor templates, workflows, and decision support tools to align with specialized areas of expertise and provide more personalized care to patients.
Independent providers must comply with the same regulatory requirements as larger healthcare organizations, such as HIPAA for patient privacy and security. EHRs designed specifically for independent providers incorporate built-in compliance features and updates. This helps providers maintain regulatory compliance without additional burden or complexity.
Let’s turn now to some of the key EHR advantages and disadvantages.
CMS.gov describes an ideal EHR with “the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.”
But what else does an EHR bring to the table?
Improved efficiency: EHRs eliminate the need for manual data entry or searching for records, reducing errors and saving time for both providers and patients. This allows providers to spend more time focusing on patients and less time worrying about technology.
Decreased waiting times: Options like telehealth enable patients to connect with their doctor virtually for consultations, medication reviews, or follow-up visits — saving them valuable time and travel. For instance, Tebra’s Telehealth equips patients with secure messaging, provider unique URLs, group appointments, and virtual waiting rooms so you can deliver the effortless experience patients expect.
Easier medication management: Alleviate frustration on all sides with faster, easier ePrescriptions that give patients a transparent view of their medication orders and providers a better way to document medications, and manage refills, changes, and cancellations. EHRs can also flag potential drug interactions based on a patient's complete medication history to ensure medication safety and reduce adverse effects.
Enhanced accuracy and accessibility: Patient information is readily available from anywhere with an internet connection, which mitigates the risk of lost or misplaced records. Moreover, electronic health records can help to reduce errors by using features such as drop-down menus and automated checks.
Better care coordination: Real-time data sharing across different healthcare providers ensures informed treatment decisions and can reducethe risk of medication conflicts.
A survey by the Center for Connected Medicine (CMM) involving technology executives from U.S. hospitals and health systems reveals that nearly a third acknowledge their data-sharing efforts are insufficient, even within their own organizations. Less than 40% of these technology executives state that they are successfully sharing healthcare data with other health systems.
Personalized care: Data analysis can identify potential health risks and tailor preventive measures or treatment plans to individual needs.
Patient engagement: Secure patient portals can empower patients to review their records, schedule appointments, and communicate with providers to promote active participation in their care.
Maximize revenue: Maximize reimbursements and earn positive performance-based payment adjustments.
Research and innovation: De-identified EHR data can contribute to research initiatives and lead to advancements in healthcare and improved population health.
