Health Information Technology - Essay Example

Use Electronic Health Record to Build a Patient Safety Net Health information technology (HIT) Health Information technology is the framework matrix that consist of computer hardware and software, and information systems that forms the comprehensive management of health information through secures channels by use of computerized systems (Davis et al, 37). HIT ensures that generation, storage, retrieval and exchange of information between providers, quality bodies, government consumers and insurers is safe and efficient. Health Information Technology is quickly becoming the standard for efficient physician/medical practice all over the world. What are the current primary functionalities? The chief concern for the development of HIT is the enhancement of patient safety, improvement of the health delivery system and the overall quality. Use of the HIT will enable health care providers to enhance the overall quality of patient care greatly. The Institute of Medicine defines quality health care as the extent of which health services for individuals and populations enhances the likely hood of desired health outcomes, which are consistent with the current professional knowledge. However, quality patient care is measured in standards comprised of the five Ds, death, disease, discomfort, dissatisfaction and disability (Williams 27). Health Information Technology improves quality patient care by promoting safety, improving continuity of care, providing a support system in clinical decision-making and reduction of errors. An efficient HIT provides doctors with accurate and comprehensive information about a patient’s health. The physicians are then able to provide the best care for both the outpatient and the inpatient. The coordination of care for patients with serious medical condition is better and easier with since information channels are efficient and secure. HIT provides convenience and more room for family caregivers and patients to share information and effectively participate in the decision making process about their health care. Furthermore, the availability of information from various medical records enables doctors diagnose health problems faster, reduce medical errors such as misdiagnosis and provide a safe and cheaper healthcare. For instance, patients are able to move between various physicians and specialists with ease and have their medical records updated. Similarly, the physicians can prescribe, bill, and obtain patient feedback in real time thereby saving time, money and a huge load of paperwork. On the national level, the interoperability of HIT guarantees early detection of infectious disease outbreaks in the country. The detection of outbreaks can be made sooner due to the availability of patients’ data that can be analyzed and diagnosis made sooner. The online patient’s medical information enables the government to trace the source and location of the outbreaks coordinate treatment measures, such as quarantine and efficiently deal with the outbreak thereby saving human live. A fully functional Health Information Technology ensures an overall improvement in the nation’s health. Government and other health bodies are able to evaluate health care from time to time in order to upgrade the quality of patient care and reduction of health care costs. As a result, health accessibility is realized for the citizens. The global direction of health information technology There are various forms of HIT in the United States. Pharmaceutical and medical equipment companies utilize fully functional HIT. Nonetheless, the US hospitals use various forms of HIT majority of which are incomplete. Physicians and medical billing, tracking supplies, profit and loss accounts, inventory and payroll processing, use computers in all hospitals. The use of technology is growing, for example, software controlled digital imaging like MRI, and a growing number of hospitals are adopting Electronic Medical Records (EMR). Diagnostic images are sent electronically and interpreted by radiologist on the other part of the world through the internet (Neil 21). The United States continue to lag behind in the adoption of HIT in comparison to other developed nations. Despite the 19 billion dollars issued by the American Recovery and Reinvestment Act of 2009 to incentivize the use of EMR in all hospitals and doctors’ offices. Obstacles to adoption of this technology include; the installation capital cost of HIT in hospitals is very high and only affordable to bigger health institutions (Neil 44). In addition, there is lack of evidence concerning the perceived benefits of HIT as well as the lack of open discussion on the experiences of using the technology. Statistics show that between 8%and 10% of hospitals in the United States use EMRs while only 17% of physicians use. On the other hand, only 24% of physicians use emails to communicate with patients. This is against 90% of patients who would like to communicate with their doctors via email (Singh et al 22). What do stakeholders want to know from HIT? Stakeholders remain optimistic about the development of the interoperability standards although much needs to be done to ensure that the fragmentation of the HIT system is diminished. In addition, there is anxiety of the HIT perceived benefits and how the organization settled on the high construction capital cost (Neil 121). Furthermore, poor reception of the HIT is attributed to the forceful manner in which the government is implementing HIT. Health care providers believe that the technology proposed by the government is not tailored for their specific needs leading to likelihood of errors What is wrong with the current health information system? Health advocates and policy makers believe that the expansion of HIT use will improve quality and lower costs. However, according to the journal of American Medical Association HIT is not a destination but a vehicle. The complexity of installing HIT systems is just one obstacle. Health data kept by one provider is always inaccessible to other providers making information retrieval across various provides difficult. HIT enhances information flow; it can also cause information blockage and fragmentation (Edward 96). Elimination of human error is one of the reasons why Health Information Technology is becoming more popular. However, while elimination human error the system also creates errors. There is a risk that with the full adoption of HIT, there more errors will be created. Furthermore, adoption of HIT leads to over reliance on the accuracy of the technology making it harder to detect errors on time. Such overreliance leads to misdiagnosis in case of a system error. Cases of misdiagnosis have been reported. For instance, an error created by an EMR caused a misdiagnosis, it took about three days before the physicians, and the patient care team realized the result entered was for a biopsy he did not order for the treatment of a lesion he did not have. The main mistake was the over reliance of on the accuracy of the EMR (Harold 216). Data overload is a possible problem. Studies show that some systems do not offer full information leaving physicians with extra cognitive work that usually results in more paper work. The government has imposed the adoption of the HIT especially in the US. As such, the hospitals rushed to install these systems without paying full attention to the unique needs of every health institution (Edward 106). Therefore, the rate of failure has increased. Besides, the new brings in a new dimension of operations that the hospital staff are not used to. As HIT becomes available, issues of privacy and security continue to emerge. Cases of identity theft are on the rise creating anxiety over the security of HIT systems. There are also concerns over the government accessing private medical information especially over integrated systems. While it is believed that the providers who own medical data, but the data is squarely in the debatable Edward 66). Privacy and security risks are a concern because of hackers, alteration of patient information, identity theft and unauthorized access. Data collection In the health arena, data sources include news, government documents, patients’ records, reports, research publications. Collecting information for the development of a health record must adhere to the principles and features pertaining to a health record model. Failure to follow the guidelines may lead to misinformation, misdiagnosis and mismanagement that may prove disastrous to the patients and the healthcare institutions. The health data collected by health care services vary in terms of data type, information depth, file system or procedure. However, in order to capture health data successfully from different health care sources, there is a need to create a health record capable of capturing all the data (Edward 96). An integrated health record system ensures that data collected adheres to the principles of clarity, appropriateness, coherent/consistent, secure and confidential. Security and confidentiality are the most important aspect of healthcare data collection. Administrative data Administrative data occur from the process of health care delivery, enrolling members into health insurance plans and payment for services. The primary sources of administrative data are private health care insurers, health care providers and governments. Hospital report cards and physician profiles constitute administrative data. Administrative data is mainly used to evaluate the quality health care provided although studies show that administrative data provide misleading information on the quality of care. This is blamed on the gaps in clinical information and billing. Clinical Data The current use of paper-based process of collecting date has proven inefficient because it is prone to transcription errors. Despite this over 75% of clinical data collection, still use paper data collection despite the fact currently electronic data tools exist. Nevertheless, adoption of electronic data collection method is on the rise with 98% of Biopharmaceutical companies, and major health providers promoting the need for electronic data collection for clinical data (Proskcha 67). What are the features to form a good quality of HIT data? A good quality HIT data present various benefits; Provides real time decision support leading to quick and accurate diagnoses. System edits ensures more comprehensive and reliable data that is of higher quality (Proskcha 92). This systems, enables creation and recovery of information for patients and other administrative duties. These data facilitates fraud detection through variance detection. Strategies to improve data quality As the EHR initiative gets intensive the fully benefits of HIT will be realized. Data quality improvement can be achieved through the following; Full adoption of electronic data collection tools that will; reduce the challenges of data collection and aggregation. Ensures continued collection of data continually during the care process in order to provide a long-range view of patient care (Proskcha 82). Integration of data sources such as radiology, administration and lab systems to allow for efficient decision support and improved data tracking enabling reliability and accuracy. Data analysis How to construct a file for analysis? How to use analytic techniques? Describe a story Make inference Do prediction or forecast How to interpret the results of an analysis? The experience of HIT has brought with it various problems. Data acquisition is very difficult due to lack of interoperability of the electronic systems. Therefore, mining clinical data is a great challenge. The cost and risks associated with the HIT is problematic for small health care providers and solo physicians (Proskcha 91). Furthermore, the quality of data collected will be compromise. For instance, Enrollment data may be out of dated missing values measurement Quality of care improvement using HIT The Institute of Medicine defined six domains of quality that health care must adopt in order to improve the quality of health delivery, Safety; the elimination of injuries to patients. Effectiveness ensures that services are provided based scientific knowledge targeting only those who are likely to benefit from them. Reduction of harmful delays during patient care for example late diagnosis (Proskcha 217). Patient-centered care ensures responsive and respectful care that caters for individual patient’s needs and values and ensuring that patient values guide clinical decisions. Care provision should be efficient by reducing waste of equipment, energy, ideas or supplies. The quality of care provided must not vary based on gender, ethnicity, socioeconomic status or geography (Williams 47). Ambulatory setting Ambulatory care is defined as health care services provided by physicians in outpatient settings such as clinics, community health centers, and emergency departments or practitioners offices. The scope of ambulatory care is increasing and so is the complexity of intervention. Emergency setting Emergency care represents an important portion of health care. In 2010, there were over 120 million visits to the emergency care in the US. Emergency services occur over short time periods, between separate healthcare systems therefore, limiting emergency physicians’ access to clinical information. Emergency medicine gives care twenty-four hours a day. According to Committee on Energy and Commerce and Subcommittee on Health, the Physicians are prone to errors when access to the complete medical history of the patient is limited (Williams 62). Furthermore, patients may not be able to provide critical medical information due to their immediate conditions. Medical data such as diagnoses, lab and radiology data, prior visits, allergies become very crucial especially when time is of essence. Timely access to electronic medical information within and among healthcare facilities is the most important in an emergency setting. Even though, 85% of patients remain in the same system, 75% return to the same hospital after short periods of time (Harold 65). Emergency visits are one of the compelling reasons for the development of a fully functional HIT to ensure exchange of health information. Health Information Technology in the emergency settings must perform the following functions; accurate identification of unique patients; Must ensure that access of patient’s data from another health care system is permitted and correctly effected. Data exchange should happen in real time. The movement of patient date through different healthcare systems must not breach security and confidentiality of the patient (Williams 76). Patients’ records must be updated consistently as it moves through the various systems. It is crucial for all hospitals to build infrastructures for health information exchange in order to enable the interconnection of department systems, hospital systems and healthcare enterprise systems. In the US, the National Health Information Infrastructure (NHII) has enabled nationwide sharing of clinical data. These efforts have greatly enhanced effectiveness, efficiency and quality of health care especially in the emergency sector. However, emergency healthcare remains fragmented and the need for interconnection is great (Skinner 201). Opportunities exist for the networking of local health information infrastructures, which in turn facilitates health information exchange both within and without the community. The adoption of these criteria will elevate quality standards throughout the nation. Some of the benefits include reduction of cost of care and time (Williams 187). Challenges of the current system such as medical errors, rising costs and inconsistent quality can be eliminated through this infrastructure. Hospital inpatient services There are three important technologies used in the inpatient services. They include; Computerized Physician Order Entry (CPOE), Electronic Medical Records Picture Archiving Systems. Electronic Health Record is a comprehensive electronic record of patient medical information that results from more than one care settings (Williams 58). It contains information like orders, medications, medical history lab results and many more. It is capable of generating a complete medial record of a patient and integrates care- related functions such as clinical reporting, decision making and quality management. Home/Telehealth Telehealth is the application of electronic information and telecommunication technology to sustain long-distance clinical health care. Technologies used in telehealth include, internet, streaming media, telephone and video conferencing. Telehealth has revolutionized health service provision in so many ways (Williams 30). Through this technology, doctors can now monitor their patients at home or in remote locations. The care for patients with long-term health conditions is now easier as doctors can monitor them remotely. The use of current technology such as smartphone applications and video check has made it easier for patient to access doctors who are not within their locality (Antony and Meader 88). The benefits of telehealth to patient care comprise early deduction of monitoring of illness. The patients are discharged early while the continued monitoring done using telehealth. There is better communication between the health providers and the patients because the mode of communication chosen is one that is most convenient for the patient (Williams 51). Patients access high quality medical care from the comfort of their own local community and reduced medical cost for both patients and hospitals. Other technologies used in telehealth include; telestation, which enables a two-way flow of information between patients and physicians, web based clinical review software, are used to flag patient with serious medical conditions for immediate treatment (Williams 72). These technologies are used on patients with long-term medical conditions. Health plans and managed care organization Managed care organizations are organizations that offer managed care using different business models. For instance, some organizations comprise of hospitals, physicians and other providers. MCOs and health plans constitute programs aimed at reducing health care costs using various methodologies. For example, beneficiary cost sharing, selective contracting with health care providers and provision of incentives to patients or physicians to select less costly forms of care. Preventive care Preventive care consists of measures taken to prevent disease and injuries. Delivery of optimal preventive is dependent on a functional information processing and patient involvement. Though HIT is still fragmented, various inventions have emerged to enhance preventive care through the HIT. For instance, Dr Snyder and Dr. Zuckerman developed a software- facilitated system that encourages Medicare patients to schedule the annual wellness visit and aid in the completion and billing of the visit (Williams 97). The system identifies and responds to the needed preventive and screening services. Patients are able to receive them during the 20-minute visit or leave with a follow up appointment. Other preventive services offered through this system include personalized prevention plan, and immunization. This program has succeeded in improving preventive services among the patients. Primary care Proper provision of primary care is possible with the adoption of HIT. For example, next generation electronic medical records are used to enhance the healthcare process. The EMR performs the following functions, systematic review of electronic ordering prior to the patients’ visits, computerized decision support to (Williams 77) further review and deal with additional health issues. The care also deals with the Proactive outreach to patients who have not been attended to in the recent past. As a result, the program developed by Quinnipiac internal Medicine, has improved the quality care required for people with long-term illnesses like stroke, diabetes, cardiovascular and breast cancer. Conclusion Health Information Technology is continually gaining ground and will greatly improve patient safety in the end. The potential benefits of HIT on patient safety are numerous. Some of them include accurate diagnosis of disease, proper medical care both at the hospital and at home. Improved accessibility of quality healthcare by all patients, elimination of human errors and improve patient-centered care. On the other hand, overreliance on HIT may hamper the detection of machine errors, security and confidentiality breach through hacking or unauthorized access, fatal consequences when vital medical information cannot be retrieved due to system breakdown. Nevertheless, the advancement of technology, it is important that all health care providers, physicians, and all stakeholders promote the adoption of HIT. All the health information systems should be interoperable to enable better health services delivery Work cited Davis, Nadine A, Melissa LaCour, and Nadinia A. Davis. 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