Installed EHR benefits apparent when Web-based program has outage

Electronic health care records have been shown to increase the quality of care in a study conducted by researchers at the Medical College of Wisconsin and published in the journal Health Affairs. This gives patients the confidence that the U.S. Centers for Medicare and Medicaid Services is doing the right thing by offering incentives for adopting EHR systems. These networks create large databases of information that can be accessed and shared between physicians and providers.

There are essentially two types of EHR programs: Web-based and installed. Web-based EHRs are accessed through Web browsers and information is stored in offsite data centers run by the EHR vendor. According to Medscape's EHR Report 2014, 29 percent of practices and hospitals use these. Installed EHR programs run using computer resources. Health data is still stored in a data center, but this will be local and accessible if the Internet or data center stops functioning properly. The Medscape report found that 36 percent of survey respondents used an installed program. What happens when these systems or networks go down?

When outages occur
​InformationWeek reported that a global Web- and cloud-based EHR program for clinics and hospitals experienced a global two-day outage. Thirty-five percent of customers were affected. Some providers had to send employees home and others functioned without schedules or files. Patients and physicians took to social media to complain and seek support. If a problem like this occurred at a major hospital or clinic, the results would be a decreased quality of care.

The Medscape EHR Report found that 47 percent of providers are concerned about proper access to their patients' health data. Relying on the Internet to treat patients is not why EHR systems were adopted. Installed systems in this regard are much more reliable and user-friendly. Systems that store information locally will be of much greater use to physicians in any specialty.

In cases where Web-based programs are not working, should patients just not receive care that day? If there was an emergency, there is no local storage with Web-based programs that could allow physicians to quickly and properly treat a case. Installed EHR systems create massive amounts of data. Before implementation, this was a concern, but when there is no access to the Internet, those stores of information are very important.

Benefits of installed EHR programs
With EHR systems that store data locally, physicians will know exactly when services will resume or how much information was lost. They have direct contact with their IT departments and employees to assess damage. If the Web-based EHR stopped working in the middle of an appointment, it can be difficult to know how much information was collected before the system shut down. This can lead to lapses in patient care and difficulties or confusion the next time a patient is seen.

Many providers rely on EHR programs for prescriptions and monitoring. When a Web-based EHR system is not working, the doctor cannot even physically call a pharmacy to prescribe crucial medication if he or she do not know what else a patient has been given by other physicians.

Installed EHR programs have many benefits. When other systems crash, those advantages become more apparent.