Do you have evidence of the implementation of Electronic Health Records (EHR) in Japan? Part 2

Having set the research topic as “What are the barriers to implementing EHR in Japan”, I found one relevant article entitled the “Motivations and barriers to implementing electronic health records and ED information systems in Japan (Inokuchi et al., 2014)”.

This article concluded that the two main barriers to implementing EHR into hospitals in Japan were:

① a lack of funding, and

② ineffectiveness in terms of workflow.

With regards to the financial aspect, having looked at other articles through searching various terms on Pubmed, I found that several articles that the main barrier was the question of financial (Yasunaga et al., 2008) (Yoshida et al., 2013).

However, the financial issue is basically caused by the Japanese government’s policy, which can be regarded as an uncontrollable factor, thus I will focus on the inherent effectiveness of EHR.

Therefore, the next research topic was set as:

“What are the effective elements of EHR?”

On Pubmed, I searched through articles not only limited to the situation in Japanese but also wider international scenarios using these following key terms:

・EHR: EHR/EMR/“electronic health record”/“electronic health records”/“electronic medical record”/“electronic medical records”→#1

・Effectiveness; effectiveness/efficacy/benefit→#2

・Implementation; implementation, introduction, deployment →#3

Then, I searched #1 AND #2 AND #3 using a filter of “recent 5 years” and “review”, resulting in 404 articles.

From those, I picked only one systematic review along with a meta-analysis article presenting the following outcomes:

・decreased documentation time

・improved guideline adherence

・a lower number of medication errors

・a lower number of adverse drug effects

thanks to implementation of EHR (Campanella et al., 2016).

From these findings, it is evident that we still do not have sufficient robust quantitative evidence.

References

1,Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., Specchia, M.L., 2016. The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. Eur J Public Health 26, 60–64. https://doi.org/10.1093/eurpub/ckv122

2,Inokuchi, R., Sato, H., Nakamura, K., Aoki, Y., Shinohara, K., Gunshin, M., Matsubara, T., Kitsuta, Y., Yahagi, N., Nakajima, S., 2014. Motivations and barriers to implementing electronic health records and ED information systems in Japan. Am J Emerg Med 32, 725–730. https://doi.org/10.1016/j.ajem.2014.03.035

3,Yasunaga, H., Imamura, T., Yamaki, S., Endo, H., 2008. Computerizing medical records in Japan. Int J Med Inform 77, 708–713. https://doi.org/10.1016/j.ijmedinf.2008.03.005

4,Yoshida, Y., Imai, T., Ohe, K., 2013. The trends in EMR and CPOE adoption in Japan under the national strategy. Int J Med Inform 82, 1004–1011. https://doi.org/10.1016/j.ijmedinf.2013.07.004