Electronic Health Records

Adoption & Implementation News

Physician EHR Use Impacts Patient Disclosure, Communication

By Vera Gruessner

There are a variety of reasons why the federal government including the Department of Health and Human Services (HHS) encourage physician EHR use and the adoption of health IT tools across the healthcare industry. From the potential to improve the quality of care and lower costs to boosting population health outcomes and reducing the rate of medical errors, health IT adoption seems to have many positive attributes.

However, over time, a variety of issues began popping up after the passage of the HITECH Act. The lack of EHR interoperability and the amount of time data entry took away from the patient-physician relationship all led many providers to regard physician EHR use through a negative light. Another risk among physician EHR use is the potential lack of patient feedback and complete honesty.

With health information privacy and security at the forefront of many patients’ minds and the large amounts of data breaches occurring on a regular basis, it is understandable that many patients may not fully disclose their symptoms and past diagnoses or treatments.

Researchers from the University of Wisconsin published a paper on this subject in the Journal of the American Medical Informatics Association (JAMIA). Prior studies have found a mix of results when it comes to patients withholding information from their doctors due to the potential threat to patient data privacy and security via EHR technology. This study was established to reconcile the contradictory findings.

The study called “The double-edged sword of electronic health records: implications for patient disclosure found that 13 percent of survey takers did withhold information from their doctors due to privacy and security implications. However, bivariate analysis illustrated that this may not be due to physician EHR use alone.

Essentially, there are patients who do not inform their doctors about certain symptoms or health problems due to this perception of security risks. The researchers conclude that, nonetheless, EHR technology outweighs its drawbacks and promotes the quality of care. As such, physicians would be wise to encourage their patients to disclose all pertinent information and educate patients about their facility’s privacy and security measures to alleviate their concerns.

Another study published in JAMIA found that varying communication patterns among medical practices could lead to differing ways of implementing and using EHR technology. This may also lead to potential risks and issues within physician EHR use. When communication patterns were more split and ineffective among medical staff, physician EHR use differed greatly.

“Within-practice communication patterns provide a unique perspective for exploring the issue of standardization in EHR use,” the researchers wrote in the published paper. “A major fallacy of setting homogeneous EHR use as the goal for practice-level EHR use is that practices with uniformly low EHR use could be considered successful. Achieving uniformly high EHR use across all users in a practice is more consistent with the goals of current EHR adoption and use efforts. It was found that some communication patterns among practice members may enable more standardized EHR use than others.”

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