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What are the Disadvantages of Electronic Medical Records?

A computer freeze can cause patient care delays.
A doctor may focus less on a patient while figuring out how to enter data into a computer tablet.
Viruses and malware may damage a computer database and erase records.
Medical records contain information about a patient's health and medical treatment history.
Stealing electronic medical records is a cyber crime that may be punished with a jail sentence.
Article Details
  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 18 August 2014
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Electronic medical records seem to be the current trend in health care, and you’ll find many physicians, allied health professionals, pharmacists and hospitals using some form of electronic recording of patient data. Despite the many advantages of a more uniform approach to documenting medical care and coordinating care when patients see several specialists, there are some disadvantages to electronic medical records. As patients more regularly experience doctor’s visits with electronic health records (EHRs) they may notice some of the disadvantages immediately. Other problems occur “behind the scenes,” outside of a patient’s surveillance.

One of the chief disadvantages to electronic medical records is that start up costs are enormous. Not only must you buy equipment to record and store patient charts (much more expensive than paper and file cabinets), but efforts must be taken to convert all charts to electronic form. Patients may be in the transitional state, where old records haven’t yet been converted and doctors don’t always know this. Further, training on electronic medical records software adds additional expense in paying people to take training, and in paying trainers to teach practitioners.

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Despite training, most people creating medical records are now nurses, and often doctors. Unfamiliarity with technology, especially when an EHR program is implemented can significantly detract from patient time as the doctor or nurse struggles with unfamiliar equipment. Many patients report visits with doctors where the doctor has to divert focus to figuring out how to enter things electronically and thus has less time for the patient. Medical care in already crowded offices may be delayed when technology is not reliable. A frozen computer could steal minutes or more from patient care for that day. It’s also still easy to miss recording relevant details, or to type in incorrect information.

Along with reduction in doctor/patient time, some people find that electronic medical records and their accompanying systems have depersonalized doctor visits or needed calls to a doctor’s office. Protocol of a system may require, for instance, any patient questions to be emailed to a doctor, even if a receptionist takes them and even if the doctor passes that receptionist multiple times a day. This can increase wait time for callbacks, or for doctor emails, especially if emails are not checked regularly.

Additionally there is not one electronic medical records system. There are many. Streamlining patient care can only be achieved when a single system is used, since two or more systems may not work together. If the hospital uses a different EHR system than your primary care physician, health records may not be available to the hospital, or vice versa from hospital to the physician. Electronic medical records may reduce office paperwork, but they may not coordinate care between several treating physicians, pharmacies, and allied health workers as they promise to do when different systems are used by each group.

Lastly, some are concerned about the security of their medical records, which should be completely confidential. Hackers may ultimately be able to penetrate EHRs despite security precautions, and they may then release confidential information to others. This has some patients worried about how safe and confidential their electronic medical records really are.

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Discuss this Article

anon924429
Post 22

I agree that eventually the medical field needs electronic connectivity. However, the present system with EHR for profit companies running it is too expensive and does not connect physicians and hospitals.

I bought Vitera Intergy EHR and they have been horrible! They cost me hundreds of thousands of dollars, is too complicated to use, are always gauging me for more services, and have poor support.

We need an open source, internet based system that can connect all physicians, pharmacies, labs, and hospitals. --Dr. B

anon334919
Post 21

I agree that the EHR systems has its advantages, but also its disadvantages. The main disadvantage to me, is it takes too much time away from the patient. Instead of them concentrating on the patient's needs, the doctors and nurses or MA's are busy putting all that information in the computer. It makes the visit too long. That's just my opinion.

anon290842
Post 20

As the wife of a physician who is trying to take care of patients while also now doing the job of full medical dictation, I can you he has less time with patients, is doing something he never wanted or desired to do (clicking a computer screen all day), and is developing symptoms of carpal tunnel after three months. He has headaches and is not finishing completely with charts until 9-10 p.m. most nights.

Even with implementing very slow voice recognition, which hopefully will get faster, he is having to put in the correct sentence periods and editing each note. For meticulous note-making to ensure patient care, it is not working. It is making life miserable, and adds up to less accurate notes than he had before, and there are limits to the system which make it impossible to provide good health care, one of which is his particular system does not allow you to make an appointment for follow up beyond 365 days.

We love good patient care, but if we want the next generation to want to become doctors, we are going to have to let them do what they are paid to do, and that is interact with and treat patients, not spend 70 percent of their time doing meaningless and repetitive paperwork for various agencies, all with different standards.

It's becoming unworkable for doctors, families and patients. Growing pains are fine, but a childbirth that never ends needs a C-section. You don't keep on groaning for months on end with no improvement in sight.

anon271932
Post 19

The best medical record is a well-informed patient and family member who knows their condition and medications.

In my personal life, I have encountered more medical errors in our family related to electronic records than I ever did with paper. As a health care provider, I encounter erroneous information in electronic records weekly. Electronic medical records do not decrease medical errors because the same people who make mistakes on paper are doing the same things using a keyboard and mouse and trying to understand software that doesn't do what they want it to do.

The bad part about electronic records is that the erroneous information is then disseminated more easily and widely to more recipients without the patient's or family's knowledge. and trying to get the bad information removed or changed is next to impossible.

Electronic records have a tendency to keep patients and family out of the loop of their own health care because the providers are overly dependent on just pulling up a record on their screen instead of verifying information with the patient and family. Therefore, bad care is carried out because someone pulled up a chart and did not check with patient or family to verify the info.

Our hospital administered the wrong medication to one of our family members. It came up as a routine medication on her electronic record even though it was not. Last year was the first time she took the drug. She had a bad reaction and stopped it.

It was never prescribed again, but nobody made the correction in the electronic record. So, a year later, the hospital pulls up her record without verifying it with family members and and just starts giving her the same med again, causing another reaction. If they had called us first, this error could have been avoided. When the patient was transferred to a rehab facility, the rehab facility started giving the same medication again because the hospital never corrected the entry in the computer.

Also, health care providers have another nasty habit. If the record says something different than what the patient or family member is telling them, they will believe the record and think that the individual does not know what they are talking about. Patients and family members need to verify medical information with health care providers - and health care providers (and I am one) need to shut up and listen.

closerfan12
Post 17

@anon257888 -- I think that it mainly has to do with the nature of the article -- it's only supposed to be about the disadvantages. I know that wisegeek has a few other articles on the subject, including one on the benefits of electronic medical records entitled "What Are the Advantages of Electronic Medical Records" and one that's just on EMR in general called "What Is An Electronic Medical Records System."

Hope that helps!

anon257888
Post 16

This article is only valid when measuring EMRs vs. paper. You can pick apart any system you want. But, you have to measure it against the alternatives with a fair, objective approach. Start-up costs and training are consistent with ANY new change. There are many operational and medical benefits to EMRs that simply aren't possible on paper. Hopefully there are more objective articles that measure the positives and negatives of each solution.

anon251576
Post 15

Patients should be given a choice to participate or not in an electronic medical record. Just as some folks choose to pay bills the "old fashioned way," rather than electronically.

anon227444
Post 14

EMR's lead to better patient care. That's a fact. Less medication contraindication errors, less medication administration errors, and simply put, a more complete picture of your health, which will one day be available nation-wide, outside a given practice, network, or HMO.

Providers having access to all your visits, your various diagnoses, notes, films, and other records within, will allow for better patient health, and lower mortality rates. And this is just the beginning. Once years of accumulated patient data has been gathered, data mining groups will be able to identify trends and help improve what it is that doctors and nurses do within their various daily workflows, as well as identify relationships between patients who have X, and then later on end up developing Y - something that just cannot be done in the paper world.

Other than a low-probability of record theft, and the cost, the pros of being up on EMR far outweigh any perceived cons. And it just so happens I work on the largest EMR deployment in the world, so you may think I have a bias for this particular reason, and I do. My bias is based on first hand experience and evidence I have seen that shows a huge benefit, despite the cost to deploying, as large organizations will in the end save millions of dollars in the long run.

Naysayers can continue to denounce EMR's, but I tell you this - there is no escape. This technology is not going away, and right now there are massive federally funded incentives going out to all doctors and healthcare providers, to help make the transition to EMR. All Americans will, at some point, end up with their medical records in electronic form. This is the future, and the present, so I suggest you change your perspective.

Last, I use the metaphor of the internet. Before the internet, you had to look up facts in an encyclopedia, or go to the library. Now all imaginable information is available online. Now look at patient care. Before, you had charts on paper, which had to be transferred from one part of a facility to the other via chart pulls, and paper is subject to degrading over time, as well as the legibility issues with doctor handwriting. Now, it's all available, all the time, from any location (within your given organization). Even better? Multiple providers can view your chart at the same time. And the list of benefits goes on and on.

Wishing to keep your own records on paper is akin to wanting medical treatment that was derived 100 years ago, and never validated using scientific means. Why would you do that, when there is so much we have learned from science? And why would you put yourself at a higher risk, but not wanting all of your doctors and caregivers to have access to all your health information? It's simply crazy.

anon203978
Post 13

While the learning curve will take some M.D.'s time to get used to, typed or voice recognition can be added to the patient visit to more personalize the patient note during a visit.

With ANSI 5010 and ICD 10 coming to fruition, EMR systems will be more and more useful as they evolve. One should not just consider the patient visit. One should look at the big picture, including the time saved after the patient visit that is included in the true ROI value of a REC endorsed EMR system. Various industries across the board use information systems to process information and healthcare can benefit from such. Those who think otherwise are living in the past, not seeing the potential for the future.

amypollick
Post 12

@anon197701: If the appointments are on the computer, print out the day's appointments. Pull the patient files for each appointment and place them in order, with the earliest appointment on top, then give the appointment list and the files to the nurse to organize according to office procedure. Since the nurse is authorized to look at patient files without violating HIPAA, then the responsibility of keeping them confidential passes to the nurse when he or she takes the files. Just my opinion.

anon197701
Post 11

I have a question for a case study. If someone could help, that would be fantastic!

You have just arrived at work and your first task is to make sure all patient medical records are retrieved from the filing cabinet and placed in order of appointment times for the doctor to access easily.

Describe how would you complete this task and include how you would ensure confidentiality of the patient records?

anon173725
Post 10

My medical group has used EHR for the past three years, and the results are not encouraging. Theoretically, the selling points of an EHR are increased legibility,

more accurate coding of conditions and treatments, reduced medication errors, increased efficiency, reduced use of paper, and better, faster coordination of care between providers.

Legibility of records has been a problem for at least 60 years, and has been successfully addressed using dictation. At the end of a visit, or at the end of the day (using scribbled notes) narrative reports were dictated, transcribed and placed in the chart. Since the 1980's the problem-oriented medical record POMR format has become the standard, taught in medical schools, and used in every hospital.

Scanning narrative notes seems to be a logical bridge to integrate this method with EHR. Unfortunately, the government's new "meaningful use" criteria excludes this, insisting that all entries be created using templates, with the addition of (limited) notes narrative.

Thus, the physician is forced into the role of data entry clerk while sitting with the patient. As your article points out, this is disruptive and distracting during an encounter. Patients perceive this as rude. Eye contact is reduced. Many docs over the age of 45 do not type (they didn't train to be clerks) which slows the process further.

Medication errors are not necessarily reduced, because a physician, PA or NP can now enter the wrong drug with the click of a key.

Coding was introduced in the mid 1980's for purposes of cost containment by hospitals, but has become the instrument for tracking, chart review, payment and

now "meaningful use". At a coding seminar, one speaker said, "this is important, because the codes tell your patient's story". If that is so, it tells a very superficial tale, and a less human account of my patient's situation than a narrative.

Life cannot be reduced to a digital framework without sacrificing the most human aspects. Ultimately, what has been a very personal blend of art and science will be reduced to a mere technical exercise, coded, catalogued and digitized, for various agencies and insurers to review while the doctor and patients are sleeping. A

truly Orwellian scenario is at our doorstep.

anon171742
Post 9

EMR is not completely reliable and nature friendly. Having papers stored in the computer, you would have to print information a thousand times if needed to be faxed to HIPAA compliant people such as insurance companies, hospitals, or other clinics, versus faxing the original document together with a cover sheet.

As the article pointed out, software security is not in its 100 percent best. It can be compromised anytime by intelligent hackers from around the globe. Basically, your personal information is stored in a server, where anyone can access to given that they have permission to do so or get hacked unknowingly.

anon135235
Post 8

I think many of these disadvantages can be avoided by using a company that specializes in document storage.

anon115014
Post 7

Don't want an electronic medical chart. I'll tell a doctor anything I want them to know.

anon69723
Post 6

not what i was looking for. need more about medical technology.

anon43292
Post 4

i liked the article. it was very useful.

anon34955
Post 2

I completely agree with you...

anon33561
Post 1

Many of these disadvantages could be applied to the introduction of any new technology. So just for the sake of brevity, imagine we're discussing Henry Ford's assembly line and the effects of adding hundreds of new automobiles to the rustic landscape of the early 20th century. Not one of these points stopped or even slowed what we now agree was inevitable: modern society finds the utility of an automobile exceeds the disadvantages of producing and owning and operating and disposing of them. The generations of Americans born in the last 20 years will expect electronic medical records so I think they'll get 'em. --James Werner

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