Electronic Health Record (EHR) - Research Paper Example

? Electronic Health Record (EHR) Full Computers in Health Care HITT 1311 WW1 Mary Balla 11 March Electronic Health Records Electronic Health Records or EHRs are defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (Menachemi & Collum 48). These computerized versions of patient’s paper charts contain information about patient demographics, past medical history, diagnosis, progress notes, medications, immunizations, allergies, radiology reports, and laboratory reports (Menachemi & Collum 48). These electronic records are created, managed and consulted by authorized clinicians and staff across different healthcare organization like emergency facilities, schools, workplace clinics, pharmacies, laboratories and medical imaging facilities and conforms to nationally recognized interoperability standards (Baron, Fabens, Schiffman & Wolf 225). EHRs therefore have the potential to transform the healthcare system which is largely a paper-based industry to one that uses clinical and other patient related information to help healthcare providers provide a higher quality of care to their patients (Menachemi & Collum 47). It is estimated that the widespread use of EHRs will save about $77.8 billion in healthcare cost annually, which amounts to about 5% of the total health care expenditure in the United States of America (Baron, Fabens, Schiffman & Wolf 225). Currently, it is estimated that only about 5% to 13% of primary care physicians use electronic health records (Baron, Fabens, Schiffman & Wolf 225). EHRs enable providers to access evidence-based tools to make informed decisions about patient care and thereby automate and streamline providers’ workflow. Since EHRs make all information about a patient’s health available instantly in one place, physicians and policymakers are hoping that electronic health records would improve the quality of healthcare services. EHRs therefore have the potential to assist providers in providing high quality services to their patients. How Does EHRs Apply to Me? With respect to individual patients, the use of EHR ensures easier and safer access to good healthcare services. It improves the efficiency in patient care as important information like blood type, prescribed drugs, medical conditions and other aspects of one’s medical history can be accessed much quickly. It would also save a lot of time at the doctor’s office as medical information is accessed quickly and the treatment can be provided immediately. Especially in emergency situations, the use of EHRs can prove to be lifesaving as important medical information concerning the patient can be accessed quickly and prove helpful in the emergency decision-making process. How Does EHRs apply to Healthcare Profession? Electronic health records can benefit healthcare professionals greatly. Computerization of procedures and computer-generated prescriptions help to speed up the process and reduce waiting time (Baron, Fabens, Schiffman & Wolf 225). One of the most important benefits to healthcare professionals is the real-time access to patient charts anywhere in the office and the ability to ‘message’ or ‘route’ information and tasks electronically in the office (Baron, Fabens, Schiffman & Wolf 225). This speeds up the processing time and improves access to specialist correspondences. Depending on the software, some patient charts can also appear on multiple desktops which help in improving patient care and customer satisfaction (Baron, Fabens, Schiffman & Wolf 225). Reduction in waiting time and faster processing of information also helps to improve provider’s job and career satisfaction as well. Converting Paper Records to Electronic Records The process of shifting from paper records to electronic health records should be carefully planned and implemented. This involves making several complex decisions ranging from selection and implementation to training and maintenance (American Health Information Management Association 60). The existing systems may have historical information that can be used in the EHR (American Health Information Management Association 62). Similarly the availability of direct interfaces may help in retrieving the data easily (American Health Information Management Association 62). These factors therefore determine which method to use for converting paper records to electronic records. According to the American Health Information Management Association, the first step in the conversion process from paper records to EHRs involves carefully planning the needs of the practice in terms of which historical patient data must be available for patient visits during and after the transition and how should this data be converted to EHR without compromising its quality (60). Lack of proper planning can result in the staff falling back on using paper records thereby compromising the success of EHR adoption (American Health Information Management Association 62). Secondly, representatives from each discipline of the practice like physicians, nurses, practice manager, HIM professional, IT department etc should be involved in the planning process. Thirdly, the paper records should be converted to EHR by direct data entry, scanning or other methods, keeping in mind the cost constraints and data integrity and quality (American Health Information Management Association 61). It is also important to determine how long the healthcare facility should maintain the paper records after the conversion. Answers to these questions when considered together with the type of medical specialty and the information management resources available in the facility will help to develop a customized transition process for the medical facility. All healthcare personnel who need to access patient data would need to undergo effective and well-planned training program. Once the transition has been made, the staff should be allowed to use paper version only as a reference since it can affect successful implementation of EHRs (American Health Information Management Association 60). Smaller practices typically convert to EHR at the same time while larger practices implement it in phases. During the transition, staff schedules should be modified and patient schedules should be spaced out as the staff may take more time to process the information on the newly set up EHRs (American Health Information Management Association 60). Policies and guidelines concerning confidentiality of patient data and restriction on printing should also be implemented. Regular quality checks and audits must be conducted to ensure accuracy and data integrity. Once the data conversion from paper records to electronic media is successful, the paper records should be destroyed. Establishing ‘Meaningful Use’ Although electronic health records has great potential to improve the overall quality of healthcare services and benefits both the patients and the providers, the transition from paper based records to EHRs is not easy. To encourage this transition, the Health Information Technology for Economic and Clinical Health Act (HITECH) has authorized incentive payments through Medicare and Medicaid to clinicians and hospitals that use electronic health records (Blumenthal & Tavenner 501). The main goal of HITECH is to ensure ‘meaningful use’ of EHRs so that significant improvements in the area of healthcare can be achieved (Blumenthal & Tavenner 501). This act requires that healthcare providers use certain EHR functionalities that help in reducing errors and contain costs (Menachemi & Collum 48). For example, the legislation requires that EMRs should include key patient demographic data, historical procedures, allergies, current medications and problem list as this information will increase the organization’s ability to meet the patient care measures (American Health Information Management Association 63). Achieving ‘meaningful use’ through improvements in health care processes and outcomes determine if organizations will receive payments from federal government under the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program (Blumenthal & Tavenner 501). Establishing ‘meaningful use’ therefore helps to define the use of EHRs and related technology within the healthcare organization. Advantages of EHRs Using electronic health records has several advantages as listed below: 1. Electronic health records that come with clinical decision support tools have been found to increase adherence to evidence based clinical guidelines and effective care (Menachemi & Collum 49). In some studies, researchers found that computerized physician reminders increased the use of influenza and pneumococcal vaccinations among hospitalized patients from almost 0% to 35% and 50% respectively (Menachemi & Collum 49). 2. Scientific studies have indicated that using electronic medical records considerably reduces the rate of performing redundant tests, which are costly and can result in more false-positive results (Menachemi & Collum 49). Computerized physician order entry or clinical decision support provide point-of-care computerized reminders of previous diagnostic tests. A recent study revealed that this technology reduced the rate of unnecessarily repeated diagnostic tests by about 14.3% and decreased the costs per visit associated with these diagnostic tests by about 12.9% (Menachemi & Collum 49). It is also known to decrease serious medication errors by 55% in hospital setting (Menachemi & Collum 50). 3. Organizational outcomes of EHR use include increased revenue and averted costs in addition to less tangible benefits like improved legal and regulatory compliance, improved ability to conduct research, improved job satisfaction among physicians, decrease in billing errors and improved cash flow (Menachemi & Collum 51). Disadvantages of EHRs Although there are several advantages to using electronic medical records, it comes with some disadvantages as well: 1. Adoption and implementation of EHRs is very expensive as it involves purchasing and installing hardware and software, converting paper charts to electronic records and training the end-users (Menachemi & Collum 51). The temporary loss of productivity during the initial phase of implementation also results in loss of revenue (Menachemi & Collum 51). A recent study in a 280-bed acute care hospital revealed that the cost for a 7 year long EHR installation project was approximately $19 million (Menachemi & Collum 51). 2. There is ongoing maintenance cost as hardware must be replaced and software must be upgraded on a regular basis (Menachemi & Collum 51). Also, end-users must be given ongoing training and support. A recent study on 14 small-group primary practices revealed that the average EHR maintenance cost is approximately $8412 per full time employee per year. 3. During the initial phase of implementing the electronic health records system, healthcare providers frequently struggle using the unfamiliar system which causes delays in patient care resulting in both provider and patient dissatisfaction (Menachemi & Collum 51). 4. Other disadvantages include privacy and security concerns and other unintended consequences (Menachemi & Collum 51). Works Cited American Health Information Management Association. “Migrating from Paper to EHRs in Physician Practices.” Journal of American Health Information Management Association 81.11 (2010): 60-64. Print. Baron, Richard, J., Fabens, Elizabeth, L., Schiffman, Melissa & Wolf, Erica. “Electronic Health Records: Just Around the Corner? Or Over the Cliff?” Annals of Internal Medicine 143.3 (2005): 222-226. Print. Blumenthal, David & Tavenner, Marilyn. “The Meaningful Use Regulation for Electronic Health Records.” The New England Journal of Medicine 363.6 (2010). 501-504. Print. Menachemi, Nir & Collum, Taleah H. “Benefits and Drawbacks of Electronic Health Record Systems.” Risk Management and Healthcare Policy 2011.4 (2011): 47-55. Print. Read More