Advantages & Disadvantages of Electronic Claims & Patient Files

Technology has advanced significantly within the last twenty years. How doctors record patient files and process medical claims unfortunately have not. This has begun to change, as there are many positive benefits to creating electronic medical files and filing insurance claims online. But as with any system, there are also potential drawbacks to using these systems for records and claim processing.

The electronic medical file of a patient is more accessible than the old recording systems that used paper. The file now can be accessed at more locations and shared with specialists and other professionals. The record is therefore more complete when more medical professionals are able to access, use and add information to the file -- compared to the paper system which could be fragmented between different doctors. This access can be vitally important in emergency situations, when staff can get immediate access to a patient's medical history to recognize allergies and previous or current conditions which help determine the path of care the doctor needs to take.

The old paper standard of record keeping required handwritten documents both for paper files and the claims process. Insurance companies would send back claims because the document was unable to be deciphered. Nurses and doctors could experience difficulty reading previous notes. Placing this information in the form of electronic data makes the documents easy to read for everyone.

Once a system is in place, the cost-reduction compared to paper is significant. Claims can be sent electronically to the insurance companies. There is no need to mail the claim -- and no chance of the claim being lost -- since most companies provide a received message after receiving the claim online. Medical offices save money for postage and storage; and staff can work more efficiently and quickly to complete tasks using electronic systems.

As with any computer system, there is a chance that private information may be accessed by unauthorized individuals. A hacked system may reveal parts or all of a patient's information including addresses, birth date, social security numbers, emails and possibly other sensitive financial information along with their complete medical history, which most people do not want to share.

One major obstacle to converting from paper recording systems to electronic systems is the start up cost of purchasing the necessary hardware and software. Other start-up costs include training of the entire staff to learn how to enter and use the system. Once the system is in place, the records of all patients then must be converted to the electronic format, which can take many man hours and is very expensive to complete.

Another draw back to electronic systems is the reliance on the computer. Issues that arise with electronic claims and patient files are incompatible formats for software. There is no one set format that all insurers and medical offices use, which creates headaches and additional costs. System crashes can be devastating, if the outage lasts for any significant period of time.