Advantages of EHR's

Would a paper-based scan of a paper-based record be an EHR? What are 2 limitations and advantages of such a system based on scans only?

Since beginning my pursuit of a Master’s degree in eHealth, I have noticed a great deal of variability in what can be considered an electronic health record (EHR). According to the National Alliance for Health Information Technology, an electronic health record is “a record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization”1.
When using this definition to assess whether or not a paper-based scan of a health record should be considered an EHR, there are a couple key words that I paid attention to. First, the EHR must “be created, managed, and consulted”. When considering a paper-based scan of a health record, the record is “created” when it is scanned into the clinic or hospital’s patient system. Once the scan is uploaded, these documents can be managed and organized within the system. Given current technology, however, this method of managing records is not ideal. When physicians or other healthcare professionals consult this record for future reference, I believe it meets the minimum criteria, but again this situation is not ideal.
The second part of this definition that I focused on was that in an EHR, patient records must be accessible “across more than one health care organization”, which implies interoperability. As scanned paper records can be sent between healthcare organizations, I believe having scanned patient records again meets the minimum criteria.
Although I believe a paper-based scan of a patient record meets the minimum criteria for an EHR as outlined by the National Alliance for Health Information Technology, I do not believe a paper-based scanning system exemplifies the true potential of an EHR. Systems that scan patient records into their system rather than input their data directly into the computer have distinct disadvantages, and are not sustainable technology. In a “paper based EHR" (I understand the irony of this name), the ability to organize records and data in a meaningful way does not exist. For example, the ability to track patient trends or easily view the patient’s history is not possible. This limits the decision support the physician or healthcare provider has, which I believe to be a cornerstone of a complete EHR. Furthermore, this “paper based EHR" prevents the aggregation and therefore manipulation of data. If compiling of patient data cannot occur, additional benefits of a true EHR (research and public health surveillance) no longer exist.
With that said, a “paper based EHR" still has some advantages. I believe these systems can ease the transition between complete paper based records and true EHRs. As many physicians are resistant to technological changes, this can be viewed as a compromise to increase compliance of EHRs. As well, with physicians filling out patient records manually, they are able to face the patient rather than a computer monitor. I believe many patients appreciate this interaction with their physician.
Although there are some advantages to this system “paper-based HER”, I believe the disadvantages of the system are much greater. As I mentioned, I believe that a paper-based scan of patient records into a patient system meets the minimum criteria to be considered an EHR; I do not believe this system demonstrates the true potential or purpose of an electronic health record.

References
1. The National Alliance for Health Information Technology. Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms. 2008

References: 1. The National Alliance for Health Information Technology. Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms. 2008