problem or improved care in surgical practice?

The summary of the evolution of patient medical records

Description of the advantages of EHRs, such as instantaneous access to patient information and introduction of data throughout hospital systems.

Identification of challenges caused by the mass adoption of EHRs, such as reduced autonomy and burnout.

The annual RAS symposium was hosted by the Resident Associate Society (RAS) Advocacy and Issues Committee at the American College of Surgeons (ACS) Clinical Congress. Guests and members of RAS extensively reviewed the challenges and trends affecting practicing surgeons and surgical trainees throughout the meeting.

Note: telemedicine Hollywood, healthcare services are remotely delivered via audio and visual forms of technology such as smartphones and live video chats.

The Clinical Congress symposium will take place on Sunday, October 16th in San Diego, CA, which promises to evaluate the dangers and benefits of electronic health records (EHRs), that transformed the conventional practice of new surgical care and come with a significant effect on surgical education.

Below are ideas and conjectures on vigorous discussions that could be the main topic of the symposium.

Introduction

For several years, physicians have retained patients’ medical information. The recent conventional, modern method of recording medical started in the 20th century. In the US< the EHR was initially introduced in 1972 at the Regenstrief Institute. The automation of these data was quite limited during this period and its mass adoption was very hard owing to its cost. As electronics become cheaper in the late 20th century and early 21st century, as well as support from the federal government to introduce computers into the practice of medicine. Incentives and funding were offered by the American Recovery and Reinvestment Act in 2009 which provided both incentives and funding to medical practices that led to the adoption of EHRs.

At its first conception, EHR seeks to improve medical practice by allowing patients and physicians to have interrupted and instant access to patients' medical information throughout every encounter. Researchers can also have access to large information databases to understand patient results and identify future trends in medical practice more significantly. Theoretically, EHR was supposed to be a fast, effective, and electronic alternative to paper charts, that comes with additional benefits like standardizing and streamlining care. This objective has been achieved in several ways, with rapid access to medical data through tablets and smartphones, enhanced communication between medical practitioners, and the advancement of the patient EHR and telehealth portals as experienced during the coronavirus pandemic.

Nevertheless, the recent EHR used in medical practice has been accused of the major cause of burnout, popularly known as death by a thousand clicks. Patients who demand the proper documentation from physicians might be dissatisfied with the EHR which is usually a common occurrence. Although its goal is to help in effectively monitoring patients' care, EHRs have continued to be challenged by implementation-regulations, consistent pop-up modules for compliance, incompatibility of inter EHR, and hospital standards that affect patients' treatment. Several physicians might think the EHR is genuinely optimized for billing or hospital management, or integration into patient data and effective clinical treatment.

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The Objective – Data sharing Access, and Speed - 

In the past, medical practitioners go through physical patient charts beside their bedside, to view important information, consult notes, or become aware of important happenings. Surgeons in those days desired the ability to view this information in other parts of the hospital. This has become possible through the development of EHR. Care providers can easily access any information about their patients on a smartphone or computer anywhere. Updates are carried out instantly in the laboratory, time graphs are used to organize vials, and easy access is no longer a dream through EHR technology.

As a matter of fact, among the initial things, medical students in their third year perform before clinical time is to download and install the EHR application on their smartphone. The mobile EHR application is a significant aspect of clinical training for several years now. Physicians can get alerts on a crucial sign or laboratory figure which would enable them to track the condition of patients. Many EHRs also come with a feature that enables the nursing staff to seamlessly message a physician with precise information concerning the symptoms of a patient. This feature can help lessen the rigorous task of staying in direct communication or answering a page from a bedside medical provider.

It is easy to discover an accurate operative report or consult note. Ths medical provider can also search the chart for necessary contents that would make clinical visits very simple. Residents can properly plan for the operating theater by analyzing the previous operating summary of the patient while the attendings can ensure that the required preoperative optimizations have been carried out by the specialists, anesthesiologists, and primary care physicians.

The EHR ideally extends among hospital systems. EHRs can allow easy monitoring and sharing of imaging, lab test, and notes among hospitals as they are transferred from one to another. This treatment coordination can limit duplicate or unnecessary tests and enhances patient care.

Since EHRs have been out there for about 50 years, some of these benefits can have become obsolete but many surgeons are very happy about the universality EHRs brought. The addition of active healthcare providers is vital in the continued development of recent and optimal EHR for the most accurate and effective healthcare performance and treatment.

The Downside – Inefficiency, Burnout, Loss of Control

The mass adoption of EHRs, promoted by the Health Information Technology for Economic and Clinical Health Act of 2009, was anticipated to offer significant improvements to healthcare quality in the US. But there has been quite a significant effect from the use of EHRs on quality has also offered several measures and unexpected downsides on medical pattern trends and the medical team.

The continued reliance on EHRs seems to generate contention in that they can be seen to be created to reduce the control and autonomy that is known in the practice, and probably the joy of medicine. Inputting just one drug order can require exploring formulary options, pop-up notifications, and scrolling through several chart tabs. Recording patient visitations is now limited to using duplicate templates optimized for billing and coding. The seamless introduction of new outcomes, billing inquiries, and communication to the “in basket” has grown to become a managed task, instead of an advanced area of medical practice. The introduction of EHRs on personal smartphones may contribute to a genuine or conceived mobility to dissociate from work.

EHRs might exacerbate current gender differences, having an effect on professional satisfaction and improvement. Current proof has revealed that female medical practitioners might exhaust too much time recording and using EHR, both during off hours and generally, in contrast to male clinicians. Even with exerting control in the clinic and work hours, the difference is pretty obvious. These discoveries might also add to the gender difference in the burnout of physicians.

Conclusion

The RAS symposium of this year will feature a discussion on the challenges and benefits of EHRs, the possible advantages of electronic advancement, in the accessibility, effectiveness, and study of medicinal information compared to unexpected outcomes of reduced time spent with patients, security concerns, workflow interruptions, physician burnout and adverse modifications of care delivery. What does the future hold for EHRs? What is the responsibility of surgeons in shaping this future? Is there any saving the current EHR or is starting over the way out?

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