The increase of life expectancy in western societies has been accompanied by a similar increase of chronic diseases. In contrast to the not so distant past, people now live longer, coping with numerous afflictions (mostly related to old age). Today, healthcare needs to address the fact that chronic disease is becoming more prevalent and needs attention from widely distributed experts and organisations, each specializing in a narrow field and addressing only a small part of the health issues patients are facing. The result of this combination of geographically dispersion and longer duration of treatment is that patients need to follow complicated routes from hospitals to specialists and back, elevating the importance of information sharing and availability.

In its effort to increase quality and convenience, as well as to decrease errors, the healthcare industry has been increasingly occupying itself with standardizing and optimizing the electronic distribution of pertinent and accurate information to the physicians when and where they need it. Arguably, the most important among the key pieces of information in the system is the patient record, called (in its electronic form) Electronic Health Record (EHR).

Numerous definitions of EHR have been offered and there is quite some confusion of the term, especially with similar ones like electronic patient records (EPR) and computer-based patient records (CPRs). Here, we will use the definition provided by Iakovidis (see first source), according to which EHRs are digitally stored health related information about an individual’s lifetime, with a purpose to support shared care, education and research. As such, EHR is not a goal in itself but, rather, a tool for supporting the continuity of care and, consequently, the quality, access and efficiency of health care delivery. Emphasis is placed on the issue of shared care, the enabling factor of which is the availability of both clinical and administrative patient data, facilitated through EHR.

Based on this definition, one can sense the importance of EHRs for the patients and the system that supports them alike. When (and if) fully implemented, EHRs have the potential to radically change numerous aspects of health and eHealth delivery; in short, among other benefits, EHRs may:

·         Improve physician efficiency by enabling instant access to important information;

·         Constitute the basis for a patient’s complete lifelong record of medical interventions;

·         Become the building blocks of medical decision support systems;

·         Provide readily-available statistical data for the analysis and enhancement of effectiveness and quality in administrative procedures and medical treatments;

·         Facilitate communication among different IT systems and healthcare organizations;

·         Significantly reduce costs, as compared to manually-kept paper-based patient records.

Needless to say, in order for the eHealth sector to reap these benefits on a pan-European (and even global) scale, concrete steps need to be taken and existing obstacles should be removed. Some of the major impediments for further progress and corresponding ameliorating actions, include:

·         Lack of standards for documenting and sharing patient information. Various implementations of EHRs tend to store differing sets of data and even type of data (e.g. structured information versus free text). There is a clear need for standardisation in this field on an international level.

·         Privacy and confidentiality protection of e-patient information. Although various directives and standards concerning the protection of data in a more generalized context exist, health records need to be addressed as a separate issue. Patient-related data protection needs to strike the appropriate balance between privacy concerns and the importance of data sharing among physicians, an issue that is not unique to EHRs, but to health care data in general, regardless of means of storage and communication.

·         Lack of adequate concrete evidence on the benefits of EHRs. Despite developments on this issue, there is still great need for formal evaluation of the usefulness and cost-effectiveness of the use of EHRs, in order to boost policy support on their implementation.

Concluding, EHRs remain at the heart of the advances in information and communication technologies that have already transformed the delivery of healthcare and constitute both an administrative/accountability tool, as well as the main means of medical information transfer. Despite the difficulties, mostly on the policy level, their further development is currently facing, it is rather safe to predict that their usefulness will overcome such hurdles and their use will continue to become ubiquitous with time.

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Nature of documentation: Article