Electroni Medical Records.Are They Worth Their Cost - Essay Example

Electronic Medical Records: Are they worth their Cost? Healthcare is one of the most important issues for individuals in the United s. In order to receive the proper health treatment, one must ensure that they have a complete and accurate medical record. Medical records are currently changing from paper form to Electronic Medical Records (EMR). With this transfer, there are advantages and disadvantages. If one chooses to make the change to electronic medical records, it is important to shop around and choose the right software that best fits the need of the healthcare facility. State of the art technology is currently being applied to improve Electronic Medical Records (EMR). However, technology alone will not change the status quo. A thorough understanding of the needs of healthcare workers will only lead to success. Essay: Of late, healthcare has come to become the most important issue in the United States. Being the most advanced country in the world, it is imperative that its healthcare system reflect upon its economic abundance. But contrary to expectations, the cost of healthcare is increasing drastically. In the 21st century, the medical record is slowly making a switch from paper-based patient records (PPRs) to computerized form known as electronic medical record (EMR). This is what is referred in healthcare facilities as a patient’s medical record. This not only includes their past medical history but also their present health condition. A comprehensive medical record will allow a physician to understand the case in depth. This however, cannot be achieved without proper up to date documentation of the medical record. To deliver quality healthcare, the patients’ complete medical history is to be preserved and made available to healthcare personnel whenever needed. The medical history should be more than just an oral account by the patient. This means that a technology to track a patient’s medical history across different hospitals and various states is required. The case for this development could not be overstated. This view is supported by Joint Commission Resources, which states that “one in seven patients in the U.S. health system must be hospitalized only because his or her physician did not have all the patient medical information” (p. 1). A common error that could result from conventional ways of record keeping is when a healthcare professional misfiles a patient’s lab report in another patient’s medical records. This could very well lead to improper treatment and/or diagnosis of both patients involved as well as costing the health insurance company more money to repeat the tests. Furthermore, nearly a fifth of all laboratory tests are repeated because the patient’s medical record was not available. (“Using Electronic Medical Records to Improve Care,” 2007, p.1). This situation would count as improper treatment of a patient and could lead to malpractice lawsuits, which in turn could cost the healthcare provider unnecessary expenses. On a more critical note, the patient’s life could be at stake due to this preventable error. Previously, medical record were prepared and preserved in paper form. This medium makes it very difficult to efficiently coordinate care, measure quality of care, or reduce medical errors in a manner that is not labor intensive ( Follen 2007). This could also leave the door open for unintended cases of negligence. This means that the patient’s entire record is stored in a computer database. This includes the health history report, physical examination report, progress notes, laboratory, diagnostic reports, hospital reports, and so forth (Bonewit-West, 2000). Expanding the use of electronic medical records will help reduce unnecessary treatments and provide fewer variations in care (Brailer, 2007). Electronic medical records will be able to provide quick and precise information pertaining to patients’ data which in turn will provide safety improvements (Chang, 2007). Reduction in the cost of dictation and “chart pulls”, improved efficiency, accessible patient health information 24 hours a day, 7 days a week, and review of patient records by multiple providers at the same time are other advantages to using EMRs ( Brailer, 2007). Another advantage of using electronic medical records is the management of medications. Electronic medical records will not only speed up the process of distributing medications but also decrease medications errors. There have been many studies that prove the advantages of using electronic medical records over manual paper records; the former helping to reduce a variety of different medication errors. Such errors include mistakes related to illegible handwriting, selection of the wrong dose of medication, and also prescribing and administering two different drugs that could end up causing an adverse drug interaction in patients (Brailer, 2007). With the electronic medical record system, physicians have the capability to not only dispense medications but also check for drug-drug interactions. This allows physicians and pharmacists to more collaboratively work together in order to ensure that each patient is given the safest and effective medications available (Follen, 2007). Using electronic medical records is an effective way of discovering a problem of missing important clinical information. Many Physicians state that it is very common when using paper charts to have missing clinical information that is very important to the treatment of the patient. This affects patients due to using up unnecessary consumption of their time and effort (Using Electronic Medical Records, 2007). Guadalupe Woodsen is a Nurse Practitioner who works in a family practice healthcare office employing two full-time and one part-time family nurse practitioner. She states: “How did we ever manage without our electronic chart? Transition from paper to electronic charting was not as painful as we had initially thought. We began with only a couple of patient visits per day and gradually increased to a full day of patient encounters by the end of two weeks. (p.8). this health care facility has been using the EMR system for over two years and the benefits of this system is defiantly a plus. Time is saved as you can begin an encounter in the presence of the patient and complete it at the end of the visit or later that day. a small or a large healthcare facility will see the benefit of the EMR system in more complete patient medical records and the continuity of care” (Woodsen, 2007, p.8). Most healthcare organizations thought that the EMR technology is a new prevailing style of record keeping. Only to discover that one of the largest private practices in the United States developed their own EMR system in the late 1960’s. This healthcare facility is known as Marshfield Clinic located in Wisconsin. The clinic has over 730 physicians in 80 different medical specialties. Follen (2007) states “The EMR system used at the Marshfield Clinic was developed in response to the growing volume of patients served. The clinic implemented the EMR to provide access to large volumes of clinical and administrative data for a single patient with a fast response time, to reduce administrative in patient cost, and improve patient care by minimizing duplication of services while promoting integration of care across specialties” (p.210). In December 2004, the clinic began using a commercial EMR product known as InformaCare. This system is being used to collect patient information as part of the clinic’s Community Health Access program. The commercial EMR now used by Marshfield Clinic also indexes all the events patients have been involved with while being treated at Marshfield. The documentation of this system includes but does not limit itself to office notes, operative reports, discharge summaries, and patient problem lists and alerts (Follen, 2007). Despite such overwhelming advantages offered by EMRs, there are controversies over the change to upgrade from paper form to electronic medical records. Electronic medical records are not widely used by many practicing physicians despite its obvious benefits. According to the CDC, the use for EMRs in healthcare trails far behind the computerization of information in other sectors of the economy. The CDC finds that 31% of hospital emergency departments, 29% of outpatient departments, and 17% of physicians’ offices implement the use of EMRs in patient care (Using Electronic Medical Records, 2007). Catharine Burt (2007) states: "only one in five doctors is using EMRs" (p.2). According to the surveys of the Healthcare Information and Management Systems Society (HIMSS), most hospital information technology executives expect that their organizations will implement electronic medical records within two years. Other issues include lack of staffing resources, difficulty proving return on investment, and lack of clinical leadership (Using Electronic Medical Records, 2007). Until the healthcare organizations becomes up to date with electronic medical records, patient care will continue not to be the best possible one. People in the healthcare industry already see the advantages associated with EMRs. An advantage for the electronic medical record system is the simple fact that 29 billion dollars is saved annually by reducing error and in the ridding of paper form inefficiencies. Not only do the healthcare facilities themselves see the savings of this system, but Medicare also has estimated cost savings of up to 23 billion dollars annually; as well as 31 billion dollar savings for private payers (Follen, 2007). Woodsen (2007) adds “Other benefits include cost effectiveness and no lost documents” (p.8). However, some healthcare facilities showed that the most important issue with changing from paper records to electronic medical records was the financial backing needed to undertake the transition. Inadequate financial support is the most significant barrier for implementing the use of new technology in healthcare organizations. Some healthcare providers cannot sacrifice the funds needed to make this improvement. A mid-size hospital can expect a lofty bill of $1 million to $7 million to advance to the electronic medical record system (“Using Electronic Medical Records to improve Care,” 2007). Spending this huge amount of money reduces the organization’s ability to buy new equipment needed to maintain physician loyalty. Billions of dollars are lost and many negative health outcomes result from use of outdated, paper-based medical records and billing systems. Modernizing our health care system through the use of information technology will empower doctors and other healthcare providers to communicate electronically and will reduce waste and redundancy while improving safety and quality by reducing medical errors. Today, 75 percent of health care claims are submitted electronically (Santa Barbara County Data Exchange, 2003). However, only 71 percent of these claims are automatically adjudicated (i.e. processed without any manual intervention). Paper claims that are clean ( no manual intervention) cost about $1.60 per claim; however, electronic claims cost almost half of that amount ($0.85) and claims that require manual intervention/ adjudication cost 40 percent more than electronic claims.(Collier. et al, 2004). If a healthcare organization chooses to adopt electronic medical records software, it is important to find the right software that best fits the needs of the organization. Chang (2007) believes “When adopting electronic medical record system, healthcare organizations have to be mindful of change, as it may create a disruptive process for some time. It is important to be aware of new hazards and risks that may arise from implementing an unfamiliar system.” (p. 3 of 5). Like anything else you invest in, it is important to shop around for the appropriate electronic medical record system that fits the particular healthcare needs of the organization. The Health Technology Review states 11 rules for buying electronic medical records and Medical Billing Software for the healthcare setting. 1. Look for more than features. Lots of people buy software for features which that does not have proper support. The decision makers need to ask themselves if the expenditure is worth its cost. It is imperative that the chosen software is backed by a proficient service team by the manufacturers. 2. Dont buy cheap software. Buy right the first time. If not, cheap software will cost you more in the long run. Also buying right the first time will save you time and improve the efficiency. 3. Avoid complicated software. Easy to use software will prevent and avoid any intimidation of the staff. It will also avoid any stressful training of staff. 4. Find software that will fit into the future. Within the next 10 years, there will be changes made in the healthcare technology. When buying software, make sure that you find a company that is dedicated to the future. 5. Finding the right price on maintenance plans. Finding out prices on maintenance plans up front will avoid any financial struggle in the future. Know what the price is on the annual maintenance plans. Dont consider this as an option. 6. Get the right computer hardware. The better your hardware is, the better your software will run. Purchase the most reliable hardware that will compliment the software you purchased. 7. Find someone to do the computer maintenance. Dont let healthcare workers work on the computer software themselves. Find a computer professional in the area that can fix or troubleshoot the problem. 8. Dont buy a difficult to use software that is hard to learn. Dont go and purchase a hard to learn system that is not easily understood. The more complicated and sophisticated the technology the more that can go wrong with the system, which would mean more maintenance costs. Start with a basic software application that can grow in the future. 9. Allow learning time. Healthcare workers need adequate time to learn and acquaint themselves with new electronic medical record systems, so that they can learn to use it correctly and also decrease their anxiety during the process of learning. 10. Shop around. Dont buy the first system you look at. Do some research. Get opinions from technology specialists. 11. Evaluate the features and support before installing the demo CD. Dont base the use of this product by the demonstration CD. This could create many errors and give healthcare workers a wrong impression of the software. Even if the healthcare facility uses each and every step listed above, one must realize that a total transition of EMRs will not happen overnight. The transformation process will take time (Deutsch, 2005). Follen (2007) states “The healthcare information technology system that is currently generating much interest is the EMR. The EMR provides access to real-time patient-level medical information. Electronic medical record systems have great potential to enhancing patient care and decreasing medical errors.” (p.209). Technology in regard to EMRs is, for the most part, used as a tool that normally does help to improve efficiency and effectiveness. The thing to realize is that the technology alone will not improve the efficiency and effectiveness of patient care. Full understanding of the technology’s electronic medical record capabilities and limitations is needed to result in successful implementation. The leaders of healthcare organizations can have continued success if and only if they analyze and manage work flows and apply available technology appropriately and correctively. They need to keep the following things in mind: · Being aware that technology is constantly evolving, some faster than others. · Understanding and knowing various stakeholders needs. · Knowing healthcare policy and the impact of the evolution of technology. · Providing the staff proper training to operate the electronic medical record system. · Incorporating the electronic medical record system improvements into the healthcare environment. (Thielst CHE, 2007 p.7): In conclusion, the technology of healthcare is becoming the trend in the future of the healthcare industry. Paper based medical records are becoming a thing of the past and the future of healthcare is focusing on the electronic based medical records. As a healthcare provider, it is important to focus and decide which software based medical record is right for their healthcare facility. However, this transition may not happen overnight. With proper education and training provided to the health staff, Electronic Medical Records will be the foundation up on which all healthcare providers and facilities will base their work in the years to come. References: Deutsch, J. (2005). 11 rules for buying EMR a Medical Billing Software for your office., retrieved from Follen, M. (2007)., Implementing Health Information Technology to Improve the Process of Health Care Delivery: A Case Study. 10(4). 208-215. Maffei, Roxana., Pros and Cons of Healthcare Information Technology Implementation: The Pros Win . Jona’s Healthcare Law. Ethics, and Regulation, October/ December 2006, Volume 8 number 4, Pages 116- 120 Using Electronic Medical Records to Improve Care., Joint Commission Resources (2007)., Pages 1-5., retrieved from (This one had no author) Woodsen, Guadalupe., Electronic Medical Records Prove Effective., Arizona Nurse March 2007, 1 page. Retrieved form Read More