Electronic Health Records: A Critique of Two Papers

Electronic Medical Records (EMRs) play a critical role in any healthcare setting. The two papers presented dwell on issues surrounding the adoption of Electronic Health Records (EHRs) in primary and tertiary health care. For that reason, this critique will use EMR and EHR interchangeably. The first paper, Electronic Health Records in Primary Care, explores strategic planning, quality improvement, and ethical and legal issues surrounding the adoption of EHR by physicians. In addition, it also discusses the outcome measurement concerns related to the selection, implementation, and assimilation of EHRs. The other paper, Tertiary Care and the Electronic Health Record discuss the adoption of an EHR system within a tertiary care setting while taking into consideration a strategic plan. It also takes note of the Institute of Medicine’s (IOM’s) recommendations, legal and ethical issues, and the measurements of excellence outcome data. However, the two papers do not give a clear picture of the gap in EMR implementation planning and the challenges encountered in the adoption of EMRs. This review attempts to find gaps in EMR planning provides additional points for consideration, and discusses issues related to primary and tertiary health care settings. It is, therefore, a summary of the two papers as well as other works of interest.

The first paper, EHR and the primary health care reiterates the importance of EHR on primary health care. This paper states that EHRs are useful in the utilization, collection, sorting, management, maintenance and distribution of valuable patient data. The second paper, EHR and tertiary health care, also reemphasizes this importance. This paper indicates that EHRs have the capability of generating patients’ medical history electronically. In this regard, accuracy is increased and errors related to legibility are minimized. Moreover, there is a reduction in duplicated services.

The two papers agree that the integration of an EHR into a health care setting involves in-depth strategic planning. According to the paper titled Electronic Health Records in Primary Care, there must be clear and realistic goals set by the health care system before selecting an appropriate HER system. However, this paper does not talk about clear gaps in planning the implementation of an EMR system. It only dwells on clinical components such as analyzing existing workflow and providing sufficient EHR training. Menendez (2012) states that medical coding and charge capture should be prioritized in the implementation planning of an EMR system. Subsequently, health practices involved will be able to receive monetary benefits from EMR adoption. In cases where the software and staff are continuously adapting to changing needs, emphasis should be placed on hardware and software acquisition (Tolar and Balka, 2011). Luo (2006) states that one major frustration with an EMR is the lack of standards in data file format. Therefore, before implementing an EMR, issues relating to data compatibility must be catered for. Other important factors to consider in an EMR implementation include promoting literacy, engaging in training and supporting problem-solvers in the practice (Terry, Giles, Brown, Thind and Stewart, 2009). This enhances the usability of the EMR system. According to the paper on EHR and tertiary health care, usability is one of the main factors considered when developing an EMR system.

It cannot be disputed that Electronic Medical Records (EMR) have improved the health care a great deal (Joos, Chen, Jirjis, and Johnson, 2006). This is something the two papers agree on. However, there are significant challenges in adoption and use of EMR by physicians (Lau, Price, Boyd, Patridge, Bell and Raworth, 2012). This is something the two papers do not tell us. The main challenges associated with EMR s include consistency of variables, the accuracy of the contents in the patient’s record and lack of time and funds to handle change (Lau et al., 2012). Lau et al. (2012) also reaffirm that adequate training to staff and support from the vendor is also a prerequisite that is difficult to cope with. In addition, many studies have been made to explore the impact of EMR. The paper on Electronic Health Records in Primary Care clearly states that “a survey was developed to assess patient’s perceptions of availability of information, appointment scheduling, communication with healthcare providers, coordination between healthcare providers, and responsiveness of healthcare providers”. However, it does not mention any study conducted to review the EMR in an office setting. This further increases the difficulty of implementing an EMR. The paper on Tertiary Care and the Electronic Health Record reaffirms that it is the dream of the IOM is that all individuals must receive quality and affordable healthcare. For that reason, studies on EMR should also be conducted in an office setting to accelerate this dream. This is because most engagements between a doctor and a patient take place in an office.

Issues specific to the adoption of EHRs by primary care settings include strategic planning, quality improvement and ethical and legal issues surrounding the adoption of EHR by physicians in the two settings. In addition, a primary care practice should be able to measure outcome concerns related to the selection, implementation, and assimilation of EHR. However, according to the paper on Tertiary Care and the Electronic Health Record, adopting an EHR system in a tertiary care facility depends heavily on strategic planning and efficient leadership.

In conclusion, it is agreeable that all issues relating to the implementation planning of an EMR should be prioritized. Focusing on clinical issues only can jeopardize the whole setting.


Joos, D., Chen, Q., Jirjis, J., & Johnson, K.B. (2006). Web.

Lau, F., Price, M., Boyd, J., Partridge, C., Bell, H. & Raworth, B. (2012). Web.

Luo, J.S. (2006). Electronic medical records. Primary Psychiatry 13(2), 20-23. Web.

Menendez, D. (2012). Gap in EMR implementation planning. Web.

Terry, A.L., Giles, G., Brown, J.B., Thind, A. & Stewart, M. (2009). Adoption of electronic medical records in family practice: the providers’ perspective. Web.

Tolar, M. & Balka, E. (2011). From troubleshooting to EMR optimization: it support in a general practice setting. Electronic Journal of Health Informatics 6(4). Web.

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