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Technology in Action, Introductory Version, 12th edition Evans, Martin and Poatsy, Pearson Higher Education, 2015 ISBN-13: 978-0-13-407947-9, ISBN-10: 0-13-407947-7

There is often a discrepancy between what American physicians prescribe for their patients and how those patients actually follow their doctor’s orders. This is often translated into poor outpatient care and poor results to prescriptive care. In 1991, the Institute of Medicine called for better outpatient care through the use of electronic health records, which is commonly referred to by the acronym EHR.
Those clinical practices that have used electronic health records claim that since they have implemented outpatient EHR, there is easier communication with patients, better communications with other providers, better and faster access to medical records, and fewer pharmaceutical errors. However, most physicians have been slow to adapt the EHR policy. A 2004 study done by Jeffrey Linder, an internist and Assistant Professor of Medicine at Harvard Medical School, asked the question “Do EHRs make you a better doctor?” The study concluded that the evidence of improved outpatient care due to EHRs is lacking.
According to Linder’s data, he found “no quality difference between ambulatory care provided with and without EHRs.” Additionally, several recent studies have also failed to make a connection between the use of EHR and improved quality of care.
Linder claims that there are two principal reasons for the disappointing outcomes in the study. First, the National Ambulatory Medical Care Survey data that Linder and his team had available to use was outdated from a technological perspective. And second, the survey asked physicians whether they use EMR but not how they were using it if they had it.
Says Linder, “If people are simply turning on a computer replacement for their old paper records, why would you even expect quality to improve?”
Linder insists that the data should not be interpreted that electronic health records are ineffective. On the contrary, high-tech medical records—or any high tech systems for that matter—are simply tools. The tools must be used, and they must be used correctly if there are to be major improvements made in outpatient care.
Further research is still needed to hone in on specific facts as to why more doctors are not using EHRs and why patients refuse to avail themselves of the technology. Patients do not always get the advice they need from external sources and they may get information that is wrong. On the other side, sometimes doctors do not know that a patient falls into a specific risk group. The use of EHRs can benefit both the patient and the clinician.
In conclusion, despite the possible benefits of adopting EHRs, many institutions are concerned about the increased costs associated with using these systems. Users also want to know whether the costs are in line when compared to the benefits of using EHRs instead of paper records, and whether this will actually result in better quality of outpatient care.


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