Informatics and Application Systems in Health Care - Admission/Application Essay Example

INFORMATICS Informatics and Application Systems in Health Care I. Introduction Nursing informatics is the ability to use information technology in order to make the nursing profession more efficient. There are many ways in which technology can be used nowadays in order to do this. The ability to synthesize information is the wave of the future. According to Edwards (2009), “VeriChip of Delray Beach, Fl., has [a bold] idea: an implanted chip that links to an online database containing all your medical records, credit history and your social security ID” (p. 1). Linking physician practice records with the inpatient (hospital) environment's medical records will be discussed here. First, we will identify what that includes. It will also be specified the benefits of that integration, and what problem this solution would address. Linking physician practice records with the hospital environment’s records makes sense for a lot of reasons. This is not only for the office and the doctor but the patient as well. A nurse, in a very short amount of time, must sort out various sensory data throughout a typical day in a hospital. The staff in an office, a doctor, and a patient could all benefit from the nurse’s technical savvy. Here, the idea presented or put forth is to have a nurse trained in information technology. This would be so that the patient’s hospital records and the doctor’s records would be in sync with each other. Nursing informatics uses a variety of information technologies in order to make transitions like this smoother. Such a transition between office, doctor, and patient would be made smoother if the medical records were kept up with correspondingly. This would make it easier for the doctor’s office for many reasons. First, doctor’s offices are extremely busy. Oftentimes secretaries in doctor’s offices use paper files. That means that every time a patient’s file must be pulled, the secretary has to go to a separate office and retrieve the paper manila folder. This is how things are currently being done in a lot of places. It might almost make sense to have all of these old files digitized by a company that would come in and type in all the information of the patients on-site. This way, doctor’s offices would be much more organized. It is very frustrating for patients to have to wait in the doctor’s office. This is because, number one, files are unorganized sometimes. Then, the secretaries have to look through the entire rolodex of files in order to find what they are looking for. Not only is this frustrating for the doctor’s office, but it is doubly frustrating for the patient. The patient has to wait more than ten and sometimes 15 minutes while their file is found. Meanwhile, the patient is standing in the doctor’s office in front of the secretary’s desk. Other patients are starting to line up. This disrupts the flow of a smooth-running office. In an ideal world, basically the patient’s records would be available immediately. If the patient’s records were available immediately on-site, this would be ideal. Additionally, any records that would be needed in a hospital setting could be accessed from some database, which would be readily available. Obviously, office staff in a doctor’s office would be helped immensely by having these records on file. The office would not have to search through a pile of manila folders. The office would not have to go to a separate room to find the file folders. The office would not have to look all over for the files. The files would be instantaneously available. The files would be ready for immediate viewing. The files would be right there for the people in the office to browse at their leisure. If the patient had a question, he or she could ask a question about something in their file and receive an answer immediately instead of having to wait for a long time to receive an answer to their question. Also, staff at an office in a hospital would be greatly helped if they had patients’ records available to them at their behest. This would be great help. The doctor would additionally be helped if this were the case. A doctor needs to have order in his office. If there is no order in a doctor’s office, the doctor is going to be disorganized. If the doctor is disorganized, the doctor’s ability to help patients will be limited and/or minimized severely. As can be seen here, the ability of the office staff, the patient, and the doctor to all do their jobs is directly proportionate to the way in which the office is run. If the office is run in a shoddy fashion, the patients are going to get shoddy care. II. Executive Summary The benefits of integration are many. The benefits of integrating records between a hospital and a doctor’s office include the fact that patient records could be identified and integrated immediately. Doctors, hospital staff, and office staff would be greatly helped by this sort of integration. Doctors at hospitals would not have to remember every single thing about every single patient they had in order to treat a patient. If doctors could just access patients’ charts right at the hospital, this would be ideal. That way, they would not have to remember almost anything specific to the patient such as drug dosages, etcetera. Linking patient records with the doctor’s office from the hospital would be very beneficial. As mentioned previously, doctors must be organized. Doctors must have all the information they need about a patient readily available. A centralized system would help doctors know what is going on with the patient in other disciplines. Doctors must be continually organized. Having access to patient charts at the hospital would be very helpful. Doctors need to be ready to make decisions at the hospital immediately. Doctors need the access to a patient’s comprehensive records in order to make these decisions wisely. Doctors need access to patients’ charts at the hospital in order to make these informed decisions properly. If they don’t have patients’ charts, they won’t be able to make such informed decisions. Doctors need to have all the correct information at their disposal. If they don’t, it could mean the difference between prescribing the right medication and the wrong medication. If doctors could access patients’ charts at the office that were from the hospital, they would be quite aways ahead of the current system. Obviously, this would be very helpful. Doctors being able to have access to good records is key. This aspect must not be overlooked. Doctors would be greatly helped by having these patient records compressed so that the hospital records would be integrated with the records from the doctor’s office. This way, all the records would be in one place. III. Statement of the Business Scenario It cannot be stressed enough how important this is to the efficiency of a smooth-running doctor’s office. Having good records would greatly help a lot of aspects in the doctor’s office. One thing is that office staff would not be scrambling for records kept on paper. Another issue is that office staff would have all the records in one place in order to give access to the records to the doctor. Doctors must have access to a patient’s complete file in order to be the best they can be at what they do. Complete access means that they know everything there is to know about the patient. Doctors having complete access would mean that they would be much more knowledgeable about any situation that would come up. Sometimes situations arise in which doctors need immediate access to records. Let us say that a patient is admitted to a hospital. If the doctor needs to come to the hospital to visit the patient, it would be ideal if all of the patient’s records were immediately accessible. Having to fumble for records would be a potential disaster. The office staff in the doctor’s office would have to be asked to come in at odd hours in order to fax records over to the hospital, especially if the situation were one in which results were needed immediately. Doctors must have their patients’ records comprehensive because, that way, in the event of a true emergency, they have those records available. That is what would be the benefit of such a system. IV. Analysis of the Organizations and Business Processes Electronic records compressed to reflect both hospital and office records would be, therefore, immensely helpful. Doctors would have access to these records in the case, that, for example, a patient did have a major emergency. Doctors must have information readily available to them which is important. Since these linked records would be of premier importance, they must be able to access them at anytime. It would greatly help if doctors had all of these linked records available to them online. That way, if there were a necessity for doctors to work remotely, they could if it was required. Let’s say a patient were in a different state, territory, province, or country. The patient’s doctor might need to contact the patient and suggest treatment. The doctor could treat the patient remotely by having access to the linked records, which would be in a database or online. Thus, the doctor could prescribe immediately treatment in a worldwide context. It’s possible that wouldn’t necessarily happen, but it is altogether a potential factor that must be taken into account. In the 21st century, many people travel or are mobile in some capacity. The fact is, doctors need to keep up with the changing times. Linking records would make this much more possible. Placing these records online so that doctors could access them would help immensely. Even if a patient wasn’t having difficulties abroad, the doctor may simply want to, in the event he needs to, pull up a patient’s file and review his or her information for a future consult. Online linked records would also ensure security. Online linked records would be encrypted so that no one who was unauthorized would have access to those records except for doctors and office staff. V. Analysis of the Requirements for a Solution to the Business Scenario With the advent of online linked records between hospitals and doctors’ offices, this would be revolutionary in terms of providing better care to patients. Doctors’ access to patient records would, in this respect, be greatly improved. According to Rollins (2005), “The challenges are not technical. They never are. We had to deal with issues involving privacy and organizational process…We also had to develop an appropriate audit trail so that there was a mechanism for patients to know who looked up their records. Another issue was ensuring that physicians were appropriately credentialed in the system, so that if they were in bad standing or had left the area they wouldn’t have access to records” (p. 42). Some people in medical staff might be skeptical this would actually work. According to Intelligent Patient Focus (2010), one “…hurdle involved overcoming skepticism from the staff, particularly…ER staff” (p. 1). The job of office staff is to manage records. According to Health Records (2010), “The role of health records staff is to collate, organize, retrieve and archive the record of a patient or client, for the purpose of recording and informing their care, the communication of their care between health professionals and to meet legal, audit and governance requirements” (p. 1). Health records staff is much needed to take care of these electronic linked medical records. Without them, keeping track of records would be difficult to impossible. VI. Discussion of Health Care Application Systems’ Solutions Recommended Electronic medical record (EMR) systems would greatly enhance doctors’ abilities to do their job effectively. EMRs apparently have been very effective. According to Cell Press et. al. (2010), " ‘The deployment of EMRs offers the hope of improving routine care, not only by enhancing individual practitioner access to patient information but also by aggregating information for clinical research,’ explains senior study author Dr. Dan M. Roden from Vanderbilt University School of Medicine in Nashville Tennessee” (p. 1). Doctor-patient communication may be affected by this change, but most likely the benefits outweigh any potential difficulties. According to Merrill (2010), “Policies promoting electronic medical record adoption should include communication-skills training for clinicians and those using the technology, according to a new study. The study found…while EMRs assist physicians in real-time communication with patients during office visits, they can also be a distraction and take away from visits” (p. 1). Adverse events with EMRs are few and far in between. When they do occur, however, according to Evidence of Adverse Events with EMRs ‘Anecdotal and Fragmented (2010), “Shuren said the adverse events fell into four categories: Errors involving the confusion of one patient's records with another's, or the mistaken combination of two patients' medical files; the loss of information or the corruption of data; medication and/or dosing errors; and software incompatibility issues” (p. 1). Electronic records would be neat. They would also be readable. Electronic records need to be neat in order to know what is being said in a report or file. Without being able to read the records, the records themselves are therefore useless. Having EMRs would make keeping records much easier. It cannot be stressed enough the importance of having such order and organization, in order to ensure that everything runs smoothly in hospitals and doctors’ offices. One of the biggest problems with paper records is that they are difficult to read. This presents a major problem, because EMRs should be legible by everyone that reads them. The positive aspect about EMRs is that they are able to be read by everyone who speaks the main language the records are written in. EMRs are crucial to any serious medical organization’s survival and success as a legitimate medical organization that wants to have a decent client base. The important thing one needs to keep in mind is that these types of records are of premier importance for everyone. Not only does the hospital need to keep neat records, but it is also the doctor’s office which is responsible for keeping good, clean records. In turn, this affects the way the doctor’s office is run. If there are multiple problems with the record system, this could cause a problem. Paper files are part of an old system. It doesn’t make sense to have paper files anymore. Paper files need to be done away with. If there is one major reason why this should be done, it is because they complicate and clutter recordkeeping systems which are efficient. These recordkeeping systems that are not EMRs are out-of-date. They must be changed, transformed. This is why it is so important: we cannot afford to lose lives. Because of someone’s sloppy handwriting, a patient who needs immediate medical attention and whose chart is written with nondescript handwritten symbols could die. There would be no more having to decipher messy writing. Sometimes the computer notes don’t flow—that’s one downfall. If the system goes down, one is out of luck. Doctors would greatly benefit from having linked records because it would make their lives easier. Because they know what’s going on in other disciplines, doctors would know what to prescribe the patient. If the patient records were synthesized, all the consults would be on the same chart. Electronic records would be easy to read. Since they are printed in font that would be a decent size, there would not be anymore incidents where people cannot read a patient’s files because there is a lot of indecipherable handwriting written on a patient’s case. VII. Solution and Implementation Issues According to Iyer et. al. (2006), “The EMR offers several advantages over paper-based systems, such as: the ability to write more complete notes, no time delay between note construction and entering the information into the medical record, legible, easy-to-read-information, [and the EMR] usually contains a link to the billing system” (p. 314). Notes written on patients in EMRs are generally very thorough. There are a number of categories which must be entered into the computer or laptop, however, which can be a headache for medical personnel to complete. It would be more cost-effective if both the hospital charts and the patient records from the doctor’s office were synthesized. This would cut the time in half in terms of manpower being used. The cost issue is a major reason for considering implementation. According to Haqqani (2005), “EMRs have shown to improve cost-effectiveness…and improve quality of health care” (p. 141). Linking records is considered to be the advent of a new wave of technology which will change the way health care is approached. According to Torrejón (2010), “ ‘When [linking records] does [happen], it will…transform how health care is delivered in a number of ways.’ A major part of the effort to reform health care, linking computerized medical records across the country is supposed to save money and reduce medical errors, but it is not without controversy” (p. 1). Additionally, the amount of money expended for paper records is more than would be the amount of money spent for electronic records. In that regard it would be cheaper. This would eliminate the duplication of records if these records were already shared. Records are duplicated when there are two of them for the same patient. Duplication of records can be dangerous because it can waste the doctor’s time. Duplication is a folly which should not occur. Electronic records compressed would speed consult information faster. All the doctors would have the same access to the same information. Electronic records provided at the hospital and at the doctor’s office should be compressed because doctors would have equal access to patient information. This way, they could make better-informed decisions. It would be much more convenient for hospitals to keep compressed files on their patients so that everything would be in order.  If this were the case, hospitals would be more organized. If hospitals had everything taken care of with regards to records, everyone would be healthier, happier, and safer.  This way, more people would not need to worry about whether or not their medical records were kept correctly in the paper files. Since everything would be online or be on a server, the benefit of this would be that one would immediately know when, where, and how to access the records if needed.  Next, another benefit of the hospitals being able to have records on hand would be in order to supplement the doctor's office records. Still another benefit for hospitals would be that they would have an easier time doing hospital charting having full access to a patient's complete medical history at their fingertips.  Additionally, another key to solving the problem of not knowing where files are is that everything would be in the same place. Not only that, but basically everyone who would be in the hospital who had access to medical records would know the appropriate information to be shared between departments.  Anyway, regardless, hospitals having records would do a great service to that industry, as is evidenced here. Another direct benefit of hospitals being able to access medical records is that this method would be faster to pull up that musty old paper files, which could get lost, be burned in a fire, or water and food could spill on them.  Hospitals being able to access medical records from both the hospital and the doctor's office would help the hospital, in turn, be more organized.   The problem is that medical records the way they are kept now are too sloppy. EMRs would be the solutions to this problem. Obviously, EMRs are the way to go for the future. It is apparent that keeping incoherent and unkempt records are bad for everyone—the doctor, the hospital, the office staff, and the patients being served. VIII. Conclusion In conclusion, obviously as we have seen here, there are many reasons why having efficiently-done medical records which would be linked from the hospital to the doctor’s offices would be beneficial. First, we identified what linking records would include. We also specified the benefits of the integration of those medical records, and what problem the proposed solution would address. Electronic medical records (EMRs) would be very helpful for this reason. Not only would notes be able to be compiled immediately on a patient, but there would be many other advantages. For example, the notes would be able to be entered immediately into the computer. Additionally, the notes would be legible. This is especially important, considering the reputation doctors have for having horrible handwriting. Imagine how that could compromise a patient’s file if there were an emergency and the handwriting in the patient’s important medical files were impossible or very difficult to read. EMRs have proven to be very effective in reducing cost. Not only this, but the hassle of having to deal with paper medical records would be over. Hospitals, doctors, office staff, and patients would all benefit from EMRs being used globally. Not only would hospitals run more effortlessly, but doctors’ offices would also run smoother with the introduction of this new technology that would be provided through the electronic medical record—one of the waves of the future in the arena of health medical records. The elimination of duplicate records would serve several purposes. Not only would records only be recorded once. Rather, records would not have to be constantly evaluated or have information crossed out. However, new information could simply be added to the old record, thereby keeping what had already been a part of the record and then adding what would be the new record. Additionally, these EMRs would serve as stalwarts in times of possible medical emergencies. Doctors and hospital staff could have this information available at their fingertips in the case that a patient had an emergency which needed to be tended to immediately. It is of utmost importance to realize how critical having patient medical records linked between the hospitals and the doctors’ offices would be. This would revolutionize health care and make health care more universally accessible and technologically relevant. It is hoped that these proposed solutions will be taken into consideration. Patients deserve a health care system that has efficient, linked medical records. In order for the health care industry to revolutionize, it must change with the times. EMRs must be made mandatory. In this way, it is hoped that paper records will become a thing of the past. It does not make sense to waffle over such important matters. We know that we need these types of technologies to make our lives flow easier. There needs to be less complication in the medical field for professionals. Computer charting being linked between hospitals and doctor offices would make the process of helping patients so much easier. That way, a patient could be adequately cared for. It is the responsibility of the people in charge to ensure that patients’ needs are being met. This is why it is so important for board members of a panel such as this one to make important decisions regarding EMRs and linking those records. Undoubtedly, this will change the face of medicine. With linked electronic medical records (EMRs), the way health care is provided will definitely be revolutionized. It is hoped that these systems can be used as forces of change for the better. Very soon, it is hoped that in the future, electronic medical records will be a requirement and not an afterthought. It is crucial that basic technologies be used in order to make the lives of people in hospitals and doctors’ offices easier, as well as the lives of doctors and patients themselves. This is the only way for our systems to improve. REFERENCES Cell press. (2010). Electronic medical records may accelerate genome-driven diagnoses and treatments. Available: http://www.sciencedaily.com­ /releases/2010/04/100401164623.htm Edwards, J. (2009). Microchip implant to link your health records, credit history, Social Security. Available: http://industry.bnet.com/pharma/10004616/microchip-implant-to-link-your-health- records-credit-history-social-security/ Evidence of adverse events with EMRs ‘anecdotal and fragmented.’ (2010). Available: http://www.massdevice.com/news/blumenthal-evidence-adverse-events-with-emrs-anecdotal-and- fragmented Haqqani, A.B. (2005). The role of information and communication technologies in global development. Geneva: United Nations Publications. Health records. (2010). Available: http://www.nhscareers.nhs.uk/details/Default.aspx?Id=782 Intelligent patient focus. (2010). Available: www.healthmgttech.com/index.../an-intelligent-patient-focus.html Iyer, P.W., Levin, B.J., & Shea, M.A. (2006). Medical legal aspects of medical records. USA: Lawyers & Judges Publishing. Merrill, M. (2010). EMRs a 'double-edged sword' for doc, patient communication. Available: http://www.healthcareitnews.com/news/emrs-double-edged-sword-doc-patient-communication Rollins, G. (2005). Matchmaking: an interview with John Halamka on linking patient records regionally. Journal of AHIMA 76, no.4 (April 2005): 42-44. Torrejón, V. (2010). Linking electronic medical records: national network would enable hospitals and doctors to share critical information. Available: http://articles.mcall.com/2010-04-26/news/all-a1_5records.7233092apr26_1_medical-records- geisinger-health-system-doctor Read More