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The Impacts and Challenges of Electronic Health Records and Artificial Intelligence in Healthcare

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Zara Nwosu
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The Impacts and Challenges of Electronic Health Records and Artificial Intelligence in Healthcare

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The Potential Risks of Electronic Health Records

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Electronic Health Records (EHRs) are a central component of modern healthcare, designed to streamline patient data management. However, recent research points to potential risks and challenges associated with EHRs. These issues include patient harm, increased costs, and significant burdens on physicians and healthcare systems.

The Burden of Unnecessary Procedures

Recent studies have highlighted how EHR design and configuration can contribute to unnecessary medical procedures and consequent patient harm. For instance, a study found a high volume of unnecessary esophagogastroduodenoscopies (EGDs) for uncomplicated gastroesophageal reflux disease (GERD) detected by an EHR measure. These unnecessary procedures can lead to delays in clinically indicated EGDs and other procedures, overburdening healthcare systems and raising costs for patients and payers. This study developed an eMeasure that identified low-value EGDs frequently occurring in their healthcare system, mainly concentrated in a minority of clinics.

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The Financial Impact of Low-Value Procedures

A retrospective cohort study involving 518 adult patients diagnosed with GERD revealed the financial burden of these low-value EGDs. The eMeasure identified 16% of initial EGDs as low-value, costing approximately US$75,573, including US$14,985 in patients' out-of-pocket costs. These findings underscore the potential impact of EHR measures in healthcare settings.

The Role of Artificial Intelligence

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The advent of Artificial Intelligence (AI) in healthcare has sparked debates about ethical, clinical, and human impacts. Despite potential benefits, such as streamlining healthcare data and mitigating physician shortages and burnout, there are concerns about privacy, ethical issues, and potential medical errors. The adoption of AI is expected to challenge the status quo and alter patient-provider relationships. However, experts believe that a blend of human experience and digital augmentation can improve care delivery.

Transparency in AI

The final rule from the Department of Health and Human Services (HHS) on transparency in AI aims to make algorithms more fair and transparent. This rule was developed due to the lack of transparency in the marketplace, even for paying customers of predictive models. Biases and other issues in AI predictive algorithms have led to adverse outcomes for patients. Experts suggest that EHRs are an area ripe for potential problems related to AI, and these risks could be reduced or mitigated with more transparency.

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EHR-Related Stress and Burnout

EHR design also contributes to clinician stress and burnout in hospital settings. A systematic review of hospital settings found that factors such as user interface design, information overload, and lack of interoperability contribute to EHR-related stress and burnout. Such conditions can potentially impact patient safety and quality of care, highlighting the need for improved EHR design and use.

Conclusion

While EHRs and AI have the potential to revolutionize healthcare, their implementation comes with significant challenges and risks. It is crucial to continuously evaluate and improve these systems to ensure they benefit patients and healthcare providers while avoiding unnecessary burdens and potential harm. Future efforts should focus on enhancing transparency, reducing unnecessary procedures, and alleviating clinician stress and burnout associated with EHR use.

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