The Difficulty in Implementation of the Electronic Health Record and Ethical Dilemmas of Its Use - Research Paper Example

? The Difficulty in Implementation of the Electronic Health Record and Ethical Dilemmas of Its Use ] [Date] Electronic health record system is a database system that is created by private physicians who look at their patients in their private clinics. These systems can also be found in various hospitals. They are usually standalone systems that have all the records of patients that come to a particular doctor for treatment. No one other than a person who uses the system or has access to the data can store new data or edit the existing one in an electronic health record system. The system can also be used for retrieval of the personal and medical history of the patient. The introduction of such systems has helped the doctors remain up to date about their patients in a much more accurate and easier way. There are many advantages of using the electronic medical record system. The data is centralized and whenever a need arises the data of the related patient can be accessed without any delay. The use of the electronic medical record system also helps when a doctor has suggested some tests for the patient. When the patient gets them done at a laboratory and there is any delay in the retrieval of the records in the printed form, the physician can access the reports through the electronic medical system and therefore there is no delay. It has been seen in many laboratories that there usually is a back log of reports to be printed and the introduction of the system can help get rid of this issue. If we compare the electronic medical record system with the paper recording system the first major advantage that exists is the storage space. Paper filing system requires a lot of space while the electronic system has no issue (KUTNEY-LEE AND KELLY, 2011). Many physicians who practice privately are not so keen in using the electronic medical record system as they are of the view that as their practice is small and they already do not have a lot of patients, the system would be quite expensive for them and would not prove to be economical. There have been many studies conducted to identify whether the electronic system is effective and at the same cost effective across the whole of the medical circuit. It has been derived from all of the study that has been conducted that the electronic medical record system proves to be cost effective for only large hospitals whereas small clinics and private physicians will find it expensive and in some cases even hard on their finances. Despite many criticisms on the electronic medical record system, many big hospitals have adopted the system and also connected with each other through a local area network. This corroboration between the hospitals will enhance the medical research that is being carried out as they can share information and data over a secure network without any fear of losing the data or the falling of data in the wrong hands. Some of the big hospitals who have many centers located in different areas use this system to the highest effectiveness as they share medical reports, medicinal data and other information over secure network. The carrying cost of files and paper work from one place to the other is reduced and the data is shared without any hassle and that too in real time. The sharing of the data is a lot easier through the Electronic medical recording system (WATKINS, HASKELL, LUNDBERG, BROKEL, WILSON AND HARDIKER, 2009). CRITICISM There are quite a lot of advantages of using the electronic medical record system but there are still some issues related to cost effectiveness and security that has made hospital managements vary of implementing the Electronic medical recording system. The concern over security is one of the most pressing issues in the case of Electronic medical recording. The issue is a serious one as many practitioners as well as patients feel that the data is not safe as people have access to it in a much easier way as compared to the paper records (JHA, BURKE, DESROSCHES, JOSHI, KRALOVEC, CAMPBELL AND BUNTIN, 2011). The paper records are usually kept in a record room and only authorized personnel have an access to it. Despite the fact that the access is limited even then a written request is usually required to gain access. Though the advancement in the field of hospital management has been quite fast paced, the application of electronic medical record has not been fully implemented because of some of the constraints that exist (FRANCIS, 2010). Though EMR would make retrieval quite easier as the smaller database at a smaller hospital branch can be connected with one large database at the main hospital, but then again the availability of same data over a number of networks will reduce the security of the data. The increased emphasis by the government to transfer the data into electronic form from paper form has made it very difficult for the hospital management as there were a lot of issues with the availability of old records. Legal issues that arise from this transference is that sometimes the writing is not legible and while entering the data the person who is responsible for entering the data might make mistakes and the information entered may be complete wrong. Also, some of the data might even be missing and hence the case history of each patient might not be complete and there might be issues because of this. It might happen that the same patient is being treated by a physician and he has asked some kind of tests to be done (CALMAN HAUSER LURIO, WU AND PICHARDO, 2012). The use of this system will cause the results to be updated in the patient’s database. If an abnormality is identified the alerts are received immediately. A slight lack of proper action on doctor’s part can cause serious consequences and through the use of this system the accountability of the physicians increases and if some kind of error in the form of overlooking occurs then they are liable to face legal action as well. The third issue might happen when the templates of pre prepared forms that are used, ethically it’s the duty of the doctor to ask the patient and identify the issues that are being faced by the patient, but with the implementation of the electronic medical recording system the doctors ask the predetermined questions that are present in the form and hence the open ended questions that helped the doctors identify the condition of the patient in a much deeper way is reduced. The superficial questions will not help the doctor and if later the patient faces some kind of severe medical condition because of the unaccounted for symptom the doctor will have to face a lawsuit (NATIONAL RESEARCH COUNCIL (U.S.) 1995). Another issue that has been arising with the use of electronic medical recording system is that the data is accessible to many people at one time. Patients are worried, as they feel that their data is not secure this way and people can use it later for some other purpose that might even end up in harming them. This issue has been prevalent throughout the time when the implementation has been taking place, people throughout that time period have been claiming that all is fine with the increased automation but then again they have been raising issues about their concern over the security of the data. People feel that with the increased easy availability of the medical records their personal information is not safe. It is now a requirement in every hospital that has implemented the electronic medical recording system they are supposed to keep a log that will help identify people who have had access to the data (HORBST, 2010). Recently, there have been quite a lot of incidents which have involved hacking and this is why people feel that the data is not safe. Hacking has been taking place for quite a lot of time and with advancement in time the hacking has become more discreet and effective. Hacking today is so efficient that even the users of the software come to know about it quite late and hence the action taken is usually quite late. The software that is sold always has a backdoor access to the vendors and this is what makes the software usage quite a big question for every person involved. The access is for repairing purpose, but this access in the wrong hands results in detrimental consequences (KELLEY, BRANDON AND DOCHERTY, 2011). The most prominent issues with the implementation are the cost that are involved and the returns that are expected. The cost of implementing the electronic based medical recording and the cost that is involved in maintaining the whole setup is so high that the hospitals are not willing to spend in this. Another cost that is involved is that of hiring the professionals that will transfer the paper based data to the electronic records. CONCLUSION The most prominent ethical issue that can be concluded from the whole research is that the main concern is about security of the data. People feel that their personal data is not safe with the hospitals. The reality of the Electronic medical recording system is that there are a lot of issues that are there and need to be addressed if the system has to be successfully implemented. Majority of the hospitals today have created these systems on their own and some of the hospitals have bought these systems from software houses. The trend of using these systems to enter patient’s data and medical record has been increasing for the past few years and now there would hardly be any hospital that does not have this system. Now there have been additional features in these systems where patients enter their symptoms and the system interacts with the patient in real time and then helps in the diagnosis. REFERENCES CALMAN, N., HAUSER, D., LURIO, J., WU, W. Y., & PICHARDO, M. (2012). Strengthening public health and primary care collaboration through electronic health records. American Journal of Public Health, 102(11), e13-18. http://dx.doi.org/10.2105/AJPH.2012.301000 FRANCIS, L. P. (2010). The physician-patient relationship and a national health information network. Journal of Law, Medicine & Ethics, 38, 36-49. http://dx.doi.org/10.1111/j.1748-720X.2010.00464.x HORBST, A. (2010, September). Electronic Health Records. A systematic review on quality requirements. Methods Inf Med, 320-36. http://dx.doi.org/10.3414/ME10-01-0038 JHA, A. K., BURKE, M. F., DESROSCHES, C., JOSHI, M. S., KRALOVEC, P. D., CAMPBELL, E. G., & BUNTIN, M. B. (2011, December). 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Terminology use in electronic health records: basic principles. Urologic Nursing, 29, 321-327. Retrieved from http://myedison.tesc.edu/webapps/portal/frameset.jsp?tab_id=_4_1 Read More