Published on March 7, 2014
Electronic Health Records Due date : 14 September 2013 Name : Adel Khwaji ID : 07157355 Lecturer : Prof. Tony Norris
Adel Khwaji 07157355 Introduction: An electronic health record (EHR) system is now a standard method of using information technology within the healthcare industry. Smaller clinics and practices that continue to use paper systems need to seriously consider investing in this technology (Blumental and Tavenner, 2010). Issue: Our practice has long relied on paper records for its patient backgrounds and treatment information. Paper-based record systems have significant limitations, such as difficulty in searching for specific information, issues with handwriting, and problems with physical space, accessibility, and sharing within and outside of the organization. (Ayatollabi, Bath, and Goodacre, 2009). Proposed approach: EHR systems are an alternative means of storing patients’ records. An EHR uses a digital format that provides relatively unlimited capacity in a consistent, searchable format (Hayrinen, Saranto, & Nykanen, 2008). It enables sharing of records within our network’s system and with other compatible systems owned by other healthcare providers. Possible benefits: This report examines how an EHR can help meet specific stakeholder goals for clinicians, healthcare managers, and patients. Clinicians Reduction of errors. Studies have documented increased legibility, accessibility, and comprehensiveness of records (Black et al., 2011). 1
Adel Khwaji 07157355 Improved patient-clinician communication. A reminder function can provide automatic communication between the patient and provider at regular intervals (Ueckert, Goerz, Ataian, Tessmann, & Prokosch, 2003). Improved productivity. Automated surveillance and a report generation function can identify and manage over-arching practice issues to increase practice productivity (Atreja et al., 2008). Healthcare Managers Improved patient care. Empirical studies link EHRs with the following of evidence-based clinical guidelines. This results in more effective patient care (Menachemi and Collum, 2011). Improved cost containment. EHRs help increase the number of patients who can be seen per day and improve billing practices (Adler-Milstein, Green, and Bates, 2013). Improved facility parity. Clinicians and patients expect EHRs due to their widespread use in the UK under the National Programme for Information Technology (Crompton, 2007). Patients Improved portability. Electronic records are more easily moved when a patient relocates or switches providers. Improved accessibility. Allowing patients access to their records gives them information central to effective personal healthcare (Bau, 2013). 2
Adel Khwaji 07157355 Increased confidence in healthcare quality. Improved clinician-patient communication, better quality records, and reduced treatment errors raise patient confidence in healthcare received. Risks with EHR implementation: The system must be high quality ensuring record integrity, authenticity to users, and good availability across all stored data (Hoerbst and Ammenwerth, 2010). Security and privacy issues are significant as highly confidential information is potentially more accessible by those without authorisation (Appari and Johnson, 2008). However, system safeguards and organisational procedures can reduce risks surrounding these issues. Financial view: Return on investment has been achieved for a number of healthcare organisations that have focused on rapid, complete conversion (Alder-Milstein, Green, and Bates, 2013). For example, a four-hospital system in the United States experienced a breakeven point less than four years after implementation and a full three years before predictions (Konschak, n.d., 22). Conclusion: EHR systems provide significant advantages over paper-based systems. In particular, EHRs assist in meeting clinician, hospital management, and patient goals. While there are risks, awareness of these issues will help prevent them from becoming factors within our organisation. Based on these considerations, it is recommended that we select and implement an EHR system as a supporting organisational asset. 3
Adel Khwaji 07157355 References: Adler-Milstein, J., Green, C. E., and Bates, D. W. (2013). A survey analysis suggests that electronic health records will yield revenue gains for some practices and losses for many. Health Affairs. 32, 3, 562-70. Appari, A., and Johnson, M. E., (2008). Information security and privacy in healthcare: Current state of research. Dartmouth College. Retrieved from http://www.ists.dartmouth.edu/library/416.pdf Ayatollabi, H., Bath, P.A., and Goodacre, S. (2009). Paper-based versus computerbased record in the emergency department: Staff preferences, expectations, and concerns. Health Informatics Journal. 15, 3, 199-211. Bau, B. (2013 August 7). Meaningful use benefits of HER patient access for providers. EHR Intelligence. Retrieved from http://ehrintelligence.com/2013/08/07/meaningful-use-benefits-of-ehr-patientaccess-for-providers Black, A. D., Car, J., Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., Sheikh, A. (2011). The impact of eHealth on the quality and safety of health care: A systemic overview. PLOS Medicine. 8, 1, doi:10.1371/journal.pmed.1000387 Blumenthal, D., and Tavenner, M. (2010). The “meaningful use” regulation for electronic health records. New England Journal of Medicine. 363, 6, 501-4. Crompton, P. (2007). The national programme for information technology – An overview. Journal of Visual Communication in Medicine. 30, 2, 72-7. Hayrinen, K., Saranto, K., and Nykanen, P. (2008). Definition, structure, content, use and impacts of electronic health records: A review of the research literature. International Journal of Medical Informatics, 77, 291-304. Hoerbst, A., and Ammenwerth, E. (2010). Electronic Health Records. A systemic review on quality requirements. Methods of Information in Medicine. 49, 320-36. Konschak, C. (n.d). The electronic health record: Is there a return on investment? Sentera. [Powerpoint presentation]. Retrieved from http://www.vahimss.org/presentations/EMRROIPresentation.pdf Menachemi, N., and Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy. 4, 47-55. Ueckert, F., Goerz, M., Ataian, M., Tessmann, S., and Prokosch, H. U. (2003). Empowerment of patients and communication with health care professionals using an electronic health record. International Journal of Medical Information. 70, 2-3, 99-108. 4
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