Many countries worldwide are digitizing patients' medical records. In the US, for example, the recent economic stimulus package signed into law by President Obama includes $US17 billion in incentives for health providers to switch to electronic health records (EHRs) and $US2 billion for the development of EHR standards and best-practice guidelines. What impact will the rise of EHRs have upon medical education? A debate in this week's PLoS Medicine examines both the threats and opportunities.
Discussing the threats, Jonathan U. Peled (a medical student at the Albert Einstein College of Medicine, Bronx, New York, USA) and Oren Sagher (Associate Professor and Residency Program Director at the Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, USA) argue that the EHR could have a harmful impact upon medical education.
The effects of implementing EHRs on patient care have not been uniformly positive, say Peled and Sagher, and a number of reports of risk have already been published. "Our experiences have led us to believe that the potential risk of EHRs to medical teaching may be just as significant and, if not addressed, could erode the education of an entire generation of physicians."
Laying out the opportunities, Jay Morrow and Alison E. Dobbie (Faculty Assistant and Professor at the Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, USA), argue that the EHR can enhance medical education in three ways.
First, they say, "use of an EHR can enhance history taking and physical exam skills." Second, they believe that the EHR can enhance physician-patient communication if it is incorporated into the doctor-patient encounter. Finally, Morrow and Dobbie have found that the EHR "can be an impressive clinical teaching tool."