Electronic health records are missing a "substantial" amount of data, which could have "profound" implications for clinical care, medical research and public health, according to a new study in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from Harvard Medical School and Harvard Pilgrim Health Care Institute, reviewed the EHRs of 5,500 patients diagnosed with either depression or bipolar disorder who were insured by a major insurer and who receive their primary care from the leading area multi-specialty group, Harvard Vanguard Medical Associates. The EHRs were compared to the insurance claims data.
The researchers found that the EHRs were missing a lot of data. For instance, about one-fourth of the depression and bipolar diagnoses and more than half of behavioral health visits were not recorded in the EHR. Almost 90 percent of acute psychiatric services at hospitals also were not in the primary care provider's EHR.
Although the study focused on behavioral health records, which have been known to have trouble integrating with physical health records, the authors point out that the problem of incomplete and missing data is not limited to behavioral care, and that much specialty treatment is underrepresented in primary care physicians' EHRs. These gaps likely result in medication errors and other patient harm, and are a "widespread problem."
"[W]e found that the lack of integration, interoperability and exchange in U.S. health care resulted in a major EHR missing roughly half of the clinical information," the researchers said. "Poly markers should put more focus on the quality and utility of health information and ways these can be improved, instead of simply tallying up EHR purchases and supposed capabilities."