Electronic health record (EHR) systems allow hospitals to stock and retrieve comprehensive information of a patient to be used by a health care giver or physician during their hospitalization across the health care setting (Sobel, 2012). The process by which electronic medical records are created, preserved or received for the evidently purpose is referred to us Electronic medical document management (EHRM). An electronic record includes information that potentially formed in response to subpoena duces tecum, recorded in an electronic medium, and intended to give long-term retention documentation that has a business or legal evidentiary value.
EHRs can also be defined as a longitudinal electronic record of the health information of a patient generated aftercare delivery encounters. Electronic record keeping helps the timely destruction of records after they seize to have any more value reducing overall cost (Turner, 2014). Electronic record keeping is an essential technological management as it is digitalized, clean efficient and effective. Cox Business, (2016) explains that this type of record keeping is more popular in health facilities.
Sobel (2012) explains that significant progress has been made by the healthcare industry in the pursuit of electronic health records that helps in improving the safety and quality of a patient care to achieve health care delivery system actual efficiencies. It lays its emphasis on intelligent systems which support clinical decisions and care process as well as crafting medical information for patients. Based on a strategic view, it is necessary to move past the creation phase that results in an EHR and its system in maintaining a high business integrity level and legal purpose.
Traditional health records management and business processes and concepts are evaluated and applied in the new EHRs world. Healthcare organizations assess and analysis all downstream EHR users and see to it that the uses are reflected in proposal requests, development, system selection and implementation in meeting all the needs of the organization. EHR facilitates the sharing of health information of a patient between different groups through Health information Exchange (HIE) to produce many efficiencies in health care system (Gordon, 2012).
The benefits of EHR are examined by researchers by considering societal, organizational and clinical outcomes (Turner, 2014). Turner continues to describe societal issues, include being better while conducting research and in the achievement of improved population health. On the other hand, regulatory issue includes items like operational and financial performance as well as clinician and patient satisfaction after using EHR. Lastly, is the clinical outcome that includes; quality of care, improvements in medical errors reduction and other inpatient level measures which describes the appropriateness of health care.
EHR and Clinical Outcomes
Studies have it that majority of EHR critical outcomes relates to patient’s safety and quality of care (Gordon, 2012). Patient safety involves avoidance of injuries to the patient from care that is intended to help them while the quality of care involves ‘‘doing the right thing at the right time in the right way to the right person and having the best possible results’’. The quality of care is measured in six dimensions: patient’s safety, effectiveness, efficiency, patient-centeredness, equitable access and timeliness. Saver (2010) explains that empirically, EHR has linked with increased adherence to adequate care and evidence-based clinical guidelines. From the perspective of societal public health, adhering to guidelines keeps individuals health while lowering their risk of disease outbreaks.
EHR organizational outcomes includes averted costs, increased outcome and other less tangible outcomes like improved regulatory and legal compliance, increased career or job satisfaction amongst physicians, and improved ability to conduct research. The majority of the averted cost is as a resultant formed by the available electronic patient’s information. The EHR tends to reduce the unnecessary use of tests or mailing of hard copy tests results to different providers. In societal benefits, EHR can conduct research as electronically stored data for patients is easily available thus; facilitating more qualitative analysis that quickly identifies evidence-based best practices. Additionally, electronic clinical data continues being used by public health researchers that aggregate across the populations in producing beneficial research to society (Gordon, 2012).
However, despite the many advantages of EHR, studies has it that this technology has potential disadvantages. These may include; privacy and security concern, temporary loss of productivity associated with EHR adoption, changes in workflow, financial issues and several unintended consequences (Sobel, 2012). Saver (2010) describes economic issues like the decline in revenues, ongoing maintenance cost, approval and implementation costs and loss of income that links to temporary loss of productivity, presents an impediment for physicians and hospitals too in implementing and adopting EHR. EHR implementation and adoption costs include installing and purchasing software and hardware, training end users and converting paper charts to electronic ones.
EHR are cost can also be expensive, like on regular basis software may be upgraded and hardware replaced. According to Saver (2010), EHR cost of adoption, implementation, and ongoing maintenance, is compounded by the element that many EHR benefits do not accrue to the provider who makes the upfront investment but instead to the third-part payers inform of improved efficiencies and averted errors that translate to reduce payment claims. Many physicians have cited that ongoing maintenance cost and upfront cost are the; largest barriers to implementation and adoption of EHR (Gordon, 2012). EHR also disrupts the workflow for medical providers and staff resulting in temporary loss of productivity. Another major drawback of EHR is patient privacy which is at risk which concerns many patients due to increasing in the exchange of health information.
Nationally, EHR implementation is a necessity; although it is not satisfactory to transform the health care system in US for better, its adoption is one of the many approaches that focus on cost reduction and quality improvement. The existing major political and legislative HER support represents the greatest health information technologies investment in the US. The increased accessibility and portability of electronic medical records increases accessibility by unscrupulous users or unauthorized personnel which calls for Health Information and Accessibility Act. EHR is effective and efficient while compared to paper records as its advantages far outweigh the disadvantages.
Cox Business, (2016). System interoperability provides massive benefits. Healthcare IT News. Retrieved 19 September 2016, from http://www.healthcareitnews.com/news/system-interoperability-provides-massive-benefits
Gordon, L. (2012). Electronic Health Records And Improved Care. Health Affairs, 31(6), 1366-1366. http://dx.doi.org/10.1377/hlthaff.2012.0474
Saver, B. (2010). One System For Electronic Health Records. Health Affairs, 29(6), 1273-1273. http://dx.doi.org/10.1377/hlthaff.2010.0514
Sobel, A. (2012). The Move Toward Electronic Health Records. Computer, 45(11), 22-23. http://dx.doi.org/10.1109/mc.2012.387
Turner, S. (2014). Parting with paper: best practice in electronic record keeping. Nursing And Residential Care, 16(5), 278-282. http://dx.doi.org/10.12968/nrec.2014.16.5.278
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