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The Necessity of Electronic Health Record Implementation and the Positive Long-Term Effects on

Patients

Madison H. Pridemore

Department of Health Care Informatics, University of San Diego

HCIN 540: Introduction to Health Care Information Management

Tennille Gifford, RN MSN

Oct. 25, 2021

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Abstract

The implementation of electronic health records has been proven necessary for an ever-growing and

adapting healthcare system. The importance of implementation can be seen through conducted

research and positive long-term effects on patients. This paper seeks to highlight that while

implementation might conjure certain issues, it is necessary to push through any problems to gain the

long-term positives. Electronic health records aid in patient care through a higher level of accessibility,

consistency, and communication. How electronic health records improve these qualities in patient care

is portrayed throughout this paper and provides clear examples of how the long-term possibilities

outweigh the short-term frustrations.

Keywords: Electronic health records, EHR Implementation, long-term effects, scale

improvement, patient health

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The Necessity of Electronic Health Record Implementation and the Positive Long-Term Effects on

Patients

Introduction

Purpose statement

There can be practical challenges that inhibit the use of electronic health records (EHRs) in the

beginning stages of implementation. Fortunately, more studies have shown that the long-term

possibilities outweigh the short-term frustrations. EHRs are known for their efficiency and ability to

display patient information, yet the benefits of EHRs do not stop there. After a healthcare professional

gains access an EHR to gain patient health information, there is a world of possibility to then utilize the

EHR for better patient communication. If patients can acquire a complete understanding of where their

health lies, they are more equipped to make decisions that benefit their long-term health.

Explanation of how the topic relates to published literature

Goetz (2010) suggests in his Ted Talk addressing medical data that “When you give people

specific information about their health, where they stand, and where they want to get to, where they

might get to, that path, that notion of a path -- that tends to work for behavior change.” Many studies

have addressed how EHR implementation affects long-term patient health. One notable research team

discovered how EHR adoption in a large academic radiotherapy clinic caused minor challenges at the

beginning of implementation but recorded that “no increase at all in incidents reaching patients can be

observed” (Jacobs et al., 2019). This implementation created a healthcare environment that values the

long-term health of patients. EHRs also affect the timelines of task completion in in-home care and
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encourages positive patient outcomes and long-term health (Sockolow et al., 2014). There is a significant

increase in long-term beneficial outcomes, vs. the immediate frustrations that develop from the early

implementation stages of EHRs.

Importance of topic

It is important to emphasize the long-term benefits of EHR implementation, because while many

organizations and physician’s groups have adopted EHRs as standard practice, there are still many

groups and doctors relying on paper records. Addressing research and studies showing the ongoing and

consistent benefits of EHR use may aid in highlighting the importance of implementation. The utilization

of paper records is convenient for some, and EHR implementation is indeed difficult; however, if we can

shift our focus to real-life examples of how patients, healthcare professionals, and organizations have

gained long-term from EHR usage, we can recognize the importance of EHRs in quality and consistent

healthcare.

Background

When an individual seeks attention from a healthcare professional, there is an expectation of

receiving personal medical information or advice from the encounter. While patients do typically receive

medical advice from their doctors or other healthcare professionals, long-term benefits take a

behavioral change from the patient that may or may not occur. For example, information is readily

provided by healthcare professionals about a range of ailments such as diabetes, obesity, and heart

disease, yet individuals often disregard that information (Goetz, 2010). There seems to be a disconnect

between the patient and their understanding of how to become and stay healthy. One way healthcare

professionals can work together to resolve this issue is the universal use of electronic health records.

The Center for Disease Control and Prevention (2019) states that an effective health curriculum

includes but is not limited to “providing of functional health knowledge that is basic, accurate, and
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directly and directly contributes to health-promoting decisions and behaviors” and “building of personal

competence, social competence, and self-efficacy by addressing skills.” If these are the characteristics

which help with proper health education, it would make sense to implement the same characteristics

when giving medical advice or information to patients. Electronic health records are resources that can

significantly aid in the information-sharing process. EHRs present patient information in a way that is

accessible and easy understand for individuals with little to no medical experience.

Mortensen and Mortensen (2019) write, “Figures, facts, and data—they are integral to

reinforcing your statements and helping you drive your message home. But if you’re presenting data in a

boring way, you’re losing the attention of the audience. Worse, you could be presenting data in a way

that leaves the audience confused, forcing them to make their own interpretations.” While the author of

this statement intended it in a business sense, the same ideas can be applied to sharing medical

information. With electronic health records, healthcare professionals no longer must work with the

complicated structure of paper records. They can now easily access patient records electronically in a

layout that allows for clear interpretation and communication. Similarly, when patients are efficiently

communicated with about their health or they can access their information and health records

electronically, it takes away the ability to make incorrect interpretations. Instead, patients can make

informed decisions that will positively influence their long-term health.

Statement of Problem

Berkovich and Sitapati (2020) discuss systems that will allow for scale improvement in chapter

three of Applied Population Health: Delivering value-based care with actionable registries about moving

into the future of healthcare and creating a learning health system. These systems include

communication, access to the right information, transparency, and business intelligence. Not only do
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electronic health records play a vital part in the growth of organizations and physician groups, but EHR

implementation can be directly correlated to all the systems mentioned above.

Berkovich and Sitapati (2020) described communication in a healthcare setting as, “aligned,

coordinated, and efficient patient notifications and outreach.” Electronic health records allow for clear

communication between healthcare professionals, which then allows for clearer communication with

patients. For example, if a patient moves cities and therefore changes doctors, EHRs allow doctors to

coordinate about the patient’s information and ultimately give the patient clearer and consistent

medical advice. EHR involvement in the access to the right information, defined as “driven by actionable

registries” (Berkovich & Sitapati, 2020), is similar to communication. EHRs allow doctors to evaluate

previous actions taken by other healthcare professionals and helps them determine areas of needed

action. The concept of transparency is observed using electronic health records at the core of what EHRs

are: available to any healthcare professional directly working with the patient to improve their health.

Instead of being locked in a drawer and stored away, electronic health records are quickly and readily

available for the professionals in need of them. Finally, there is business intelligence significance in EHR

usage as well. Defined as “analytics that highlight improvements in delivery cost, outcomes, and patient

safety” (Berkovich & Sitapati, 2020), the business intelligence of EHR usage includes but is not limited to

lowering costs and increasing revenue (Kleaveland, 2020). The implementation of electronic health

records encases the systems needed for a learning health system and overall will push organizations to

move into the future of healthcare. This in turn allows for quality and consistent patient care that

ultimately benefits patients in their immediate and continuing health maintenance and improvement.

While it may seem like the use of traditional paper health records wouldn’t affect the overall

treatment of a patient, there are disparities between traditional health records and EHRs that may not

be immediately noticed. Disparities in healthcare have the potential to be damaging to the long-term

health of patients. For example, Dentzer (2011) shared how the Institute of Healthcare Improvement
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determined that “adverse events occurred in one-third of hospital admissions, even in hospitals that had

instituted advanced patient safety programs.” This was an extremely unfortunate discovery in terms of

overall patient safety and health. Electronic health records can be part of the solution of filling in

potential information gaps. When a patient’s information is in a centralized location available to

clinicians and healthcare professionals to access, there is less room for error in both admission and the

overall care of a patient. Consistency in information is highly needed to ensure that patients are not only

given accurate medical advice in the immediate but helps patients to acquire the needed information to

make informed decisions about their long-term health.

Application

When adopting the use of electronic health records, whether it be in hospitals, small

organizations, or physicians’ groups, challenges often present themselves in the early implementation

stages. This can sometimes cause a barrier when a change in the health record system needs to be

made. It's vital when implementing electronic health records as a new normal practice that the focus of

the group or organization stays on the long-term patient benefits, rather than the short-term

frustrations.

In 2019, research was done to determine whether the immediate problems caused by EHR

adoption would become long-term and how they affected the long-term health of patients. This was

done through, “measuring disruptions in patient processes by the number and type of EHR related root

causes and EHR-related incidents that reached patients, in the patient safety system 12 months before

implementing the new EHR, 6 months after implementation (transition period), and 24 months after the

transition period” (Jacobs et al, 2019). Results from the research showed that “An increase of

disruptions occurred only temporarily during 6 months. After this period, the number stabilized to the
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level before implementation while having more functionalities and benefits. Neither the number nor the

severity of incidents reaching patients increased” (Jacobs et al, 2019).

The above-mentioned research and conclusion are important to note for many reasons. Firstly,

the findings show that there are no negative long-term effects from EHR implementation, only positive

ones. This implies that if organizations and physician groups can get through the beginning period of

implementation, there will be positive outcomes. This ultimately translates to positive patient

outcomes. Secondly, any incidents that do end up reaching patients and the severity of said incidents do

not increase because of the implementation. This implies that there are virtually no reasons involving

patient success to not adopt electronic health records as normal practice. It is in the greatest interest of

the patient, both for immediate understanding of health information and long-term health, that the

problems presented at the beginning of EHR implementation be overcome.

Conclusion

A patient’s health is of the utmost importance and involves giving them information they need

in a way they can understand and make applicable in their life. There are certain characteristics the CDC

has identified for an inclusive and effective health education; it would make sense to implement those

same characteristics with electronic health record use to educate patients. With the use of EHRs,

healthcare professionals can, in a sense, meet the patient where they’re at. Instead of putting an

individual in the predicament of getting medical advice they don’t understand, EHRs also give the

individual the ability to assess their personal health information without the confusion of a middleman

who may have explained the information in a way the individual doesn’t understand.

Electronic health record implementation is not only a necessity for the immediate needs of a

patient, but plays a vital part in the enhancement and growth of the healthcare industry, ultimately

helping patients now and in the future. This can be seen through relating EHR implementation to
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Berkovich and Sitapati’s (2020) systems for scale improvement. The systems, communication, access to

the right information, transparency, and business intelligence, can all be observed within the positive

outcomes of effective electronic health record implementation and adoption. Not only do EHRs promote

the future of healthcare, but they do their part in ensuring a more consistent treatment for patients

right now. The use of EHRs takes away a large amount of confusion and possible misinformation

between different healthcare professionals treating the same patient.

One significant problem healthcare organizations and physicians’ groups have faced and are

currently facing are the challenges that present themselves during early electronic health record

implementation. It is key for these groups and organizations to direct their focus on long-term benefits.

This can be done by reading about the positive outcomes of EHR implementation by other organizations.

Evidence has supported that the immediate frustrations of EHR implementation are temporary

compared to the eventual benefits of the implementation, particularly for patient health.

When discussing electronic health record implementation in future conversations, healthcare

organizations and physicians’ groups should continue to address the potential challenges and seek out

research on those challenges being overcome. As more organizations and groups accept EHRs as normal

practice, there will be more challenges that present themselves. Any adoption of a new system has the

potential to cause problems. Fortunately, more studies have shown that the long-term possibilities

outweigh the short-term frustrations. If we can shift our focus to real-life examples of how patients,

healthcare professionals, and organizations have gained long-term from EHR usage, we can recognize

the importance of electronic health records in quality and consistent healthcare.

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References

Berkovich, B., & Sitapati, A. (2020). Applied Population Health: Delivering value-based care with

actionable registries. CRC Press, Taylor & Francis Group.

This educational book provides clear actions on how to apply new population health technology

and how to create a leaning healthcare system. Within the book, the authors provide clear

systems to help implementation that further influence the positive reasons to implement

electronic health records.

Centers for Disease Control and Prevention. (2019, May 29). Characteristics of effective health education

curricula - sher. Centers for Disease Control and Prevention. Retrieved September 27, 2021,

from https://www.cdc.gov/healthyschools/sher/characteristics/index.htm.

This section found in the Center of Disease Control and Prevention’s website and highlights the

attributes and characteristics of an effective health education curriculum. These characteristics

can be tied into educating healthcare professionals and patients about electronic health records

and make adoption smoother.

Dentzer, S. (2011). Still crossing the quality chasm—or suspended over it? Health Affairs, 30(4), 554–

555. https://doi.org/10.1377/hlthaff.2011.0287

The author of this academic article discussed the challenges that the healthcare industry still

faces in maintaining quality care. It showcases how damaging disparities in healthcare can be in

an environment that isn’t moving forward in ensuring quality through appropriate systems.

Goetz, T. (2010, October). It’s time to redesign medical data [Video]. TED Conferences. Thomas

Goetz: It's time to redesign medical data | TED Talk

Goetz discusses the importance of utilizing health records so that patients are able to fully

comprehend where their health lies and how to proceed in improving their health. Focusing on
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EHR implementation, Goetz emphasis on improving patient health ties well into the adoption of

EHRs.

Jacobs, M., Boersma, L. J., Swart, R., Mannens, R., Reymen, B., Körver, F., van Merode, F., & Dekker, A.

(2019). Electronic Health Record implementation in a large academic radiotherapy department:

Temporarily disruptions but long-term benefits. International journal of medical

informatics, 129, 342–348. https://doi.org/10.1016/j.ijmedinf.2019.07.008

In this academic article, the author provides research done at a large radiotherapy department

and their adoption and implementation of electronic health records. Having proven that the

disruptions of implementation are short-term, the author further emphasizes the long-term

importance.

Kleaveland, B. (2020, November 16). Roi: The dollars and sense economic impact of an EHR. Physicians

Practice. Retrieved September 28, 2021, from https://www.physicianspractice.com/view/roi-

dollars-and-sense-economic-impact-ehr.

This article provides the numbers and expenses involved in implementing electronic health

records in real organizations. It encourages the business intelligence of EHR usage includes but is

not limited to lowering costs and increasing revenue.

Mortensen, E. (2019, August 19). Presenting facts and figures clearly and effectively. Modicum Agency.

Retrieved September 27, 2021, from https://modicum.agency/blog/presenting-facts-and-

figures-clearly-and-effectively/.

While the goal of this article was to describe the importance of proper presentation in

advertising and business, the author shares ways to present facts and figures in ways that

healthcare professionals can utilize. Further, the systems presented in this article can be utilized

in presenting patients with their health information using electronic health records.
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Sockolow, P. S., Bowles, K. H., Adelsberger, M. C., Chittams, J. L., & Liao, C. (2014). Impact of homecare

electronic health record on timeliness of clinical documentation, reimbursement, and patient

outcomes. Applied clinical informatics, 5(2), 445–462. https://doi.org/10.4338/ACI-2013-12-RA-

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In this academic article, the author provides research done in home care settings and their

adoption and implementation of electronic health records. Researchers compare differences

before and after EHR implementation.