Improving Patient Safety by Utilizing Information Technology to Integrate Departments across the Healthcare Continuum by the Implantation of an Electronic Health Record System
Mark Anthony Waite
HCS/587
March, 19, 2012
Kaye Brown
Need for proposed change As the push towards patient safety increases with regulatory agencies such as the Florida Agency for Healthcare administration (ACHA) and The Joint Commission (TJC), formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), highlighting the need for higher qualities of standard, hospitals such as Memorial Hospital Pembroke in Hollywood Florida are interested in finding ways of achieving optimal patient care standards and propel themselves up
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Financial and business
The infrastructural implementation of EHR systems requires initial high dollar investment which in the current economic environment may require budgetary restraints on other services and supplies. Although the intent is clear and the potential promising, there is limited evidence of the economic benefits of EHR systems in healthcare mainly because it is in its infancy, the hospital board of governors may require extensive due diligence studies prior agreeing to any such change.
Cultural
The cost-benefits across the continuum of providers e.g. doctors, nurses and recipients e.g. patients of healthcare have yet to be realized and as such much caution and resistance is to be anticipated. Clinicians inclusive of nurses envision health informatics particularly EHRs as being time consuming and takes away from, autonomy, actual time spent with patients, also old habits are hard to break, and question what personal benefits are to be gain from this intrusive system. Not to be ignored is the additional scrutiny as all processes will be documented at time of process and provides a permanent record, errors cannot be deleted. Departments who previously had autonomy on how information is transferred and disseminated from the individual department to other practitioners may show reluctance to “opening up” to the scrutiny of others. Patients
Health providers across America are using Electronic Health Records systems to keep up with patient’s health information. Long hours of filing and writing patients health information manually has become a thing of the past. The Electronic Health Record system, known as EHRs, has changed how patients and health providers communicate as a whole. It has taken information technology to a different spectrum, and has helped patients become more aware of their health history and health conditions. Throughout the years, EHRs systems have been crucially ridicule in the medical world, due to lack of knowledge, high expenses, and apprehension among health providers. Because there will always be challenges when new technology starts to expand in any type of establishment. I believe that EHRs serves a great purpose in health care despite its delays.
Hence, EHR 's are inherently complex amalgamations of diverse subsystems targeted toward varied users. The stakeholders are the users and must have a role in implementing any IT or EHR system into its work flow. An EHR can be customized to accommodate any environment depending on the level of expertise of the vendor and how long they have been in the business of creating an optimum system that 's customized to fit the organizations needs. For the most part, EHR 's must be designed for efficient, error free use. Ideally, an EHR is a system that encompass all the subsystems that make a hospital meet "meaningful use" criteria to acquire incentives for adopting EHR into practice. In the next five years, EHR adoption will no longer be a luxury, it will be a "MUST". EHR 's and other health information technology will be a necessity to practice medicine (econsultant.com, 2010). Rather than purchase several standalone systems, it would behoove one , in my opinion , to purchase an EHR that would satisfy all the needs of the stakeholders, the physician , nurses and other hospital staff and all parties involved in the tertiary practice too. Although LWMS 's budget is not large enough to accommodate the full cost of implementing an EHR,
However, there’s an enormous amount of money involved to acquire these advanced EHR systems. There are fears of losing the capital investment. According to Prasad (2013), “better medicine means stable business.” With EHRs capability to provide efficient healthcare services, it is helping in containing the healthcare cost. However, some CFOs have looked beyond the financial gains of the EHR implementation. “You have to look beyond that to the intangible benefits, the improvements in delivery care and position your organization to be competitive in the future” (“ROI: Look beyond,” n.d.). Indeed, EHR is a long-term investment for HCOs with a great promise for future
In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).
EMR concerns are plaguing the health care industry today that requires change. Healthcare professionals, such as nurses, are on the front lines in the defense against medical errors. Closing the gap between current clinical and hospital practices and the various approaches to improving patient safety requires changes that are cultural and systemic in nature. The greatest challenge to hospitals using an EMR system is the expense of the new system, and the challenge nurses face with technology adoption in usage of EMR and protection of records. Even though spending depends on both the hospital size and the technologies were chosen, implementation and installation of a Health Information Technology system, which includes EMR, are often multi-year investments. The transition from a paper-based system to an electronic system is a very complicated process within every hospital establishment. The transformation is time-consuming and involves numerous staff from across the hospital, including Information Technology personnel, physicians, nurses, ancillary providers, etc. Although hospitals work hard at managing the changes required to move toward an electronic environment, there is no guarantee that hospital personnel will properly utilize the expensive new IT system or EMR. Therefore, the training in the EMR integration is required to all medical staff to have an efficient and uncomplicated system.
In general, there is a need for patient safety improvements. However, the good new is, that there have been some slow improvements, including a better foundation to address patient safety. A good example is the annual Agency for Healthcare Research and Quality (AHRQ) survey designed to help healthcare organizations compare their safety record to other health care organizations. Over 600 hospitals participate each year in the volunteer survey. The results of the survey provide a baseline to track and evaluate patient safety interventions (Para. 15).
The cons of an EHR are part of the driving force behind the model restricted from the need to integrate EHRs throughout the health system and share information with network of referring hospitals. However, this sharing of information is often not possible (EHR,2013). Finding a hospital partner that is willing to open the lines of communication is critical to the success. The cost associated with EHRs is often a deterrent. Not only must the provider pay for the physical hardware and/or software, the organization must also put forth a considerable dollar amount for setup, maintenance, training, IT support and system updates (EHR,2013). With EHRs, much more documentation is required of physicians before, during and after a patient visit. This has its pros and cons. For example, a benefit of more strong documentation is that it provides additional information for the coders that may justify a higher level of service being billed(EHR,2013).
Therefore, several authors share some of the same ideas as to what some of the barriers faced during the transition to Electronic Health Records (EHRs) and if these barriers still exist once the transition to a full EHR system is complete. Herrick, et al., 2010, states that currently, there is no hard-core evidence to support the argument that Electronic Health Record (EHRs) and Health Information Technology is the best route for health organizations to prevent errors. In fact, the use of such technology could potentially lead to errors if information incorrectly entered in the system and Haupt, 2011, statement that smart software could help to prevent life-threatening errors better when administering medicines. Whereas, Boonstra & Broekhuis, 2010, states from a physician point a view need the understanding of the possible barriers that faced during implementation of EHRs because there a tremendous amount of literature on the obstacles but no suggestion on how to resolve these barriers have not been viewed. Barriers such as, financial on great startup and ongoing cost, technical and time to train staff and how much knowledge do they have with computer skills and psychological when support needed from vendors, etc. It suggests that once those barriers have been ironed out and a plan has set in place, then the transition from paper documentation to Electronic Health Records (EHRs) may go a lot easier for the healthcare arena physician, nurses and administrative
Considering the great advances in technology, EHRs prior to January 2009 were underperforming. Often the EHR simply resembled the provider’s unique approach to healthcare. The technology existed, however the healthcare industry was not ready embracing the capabilities of the EHR. EHRs require standardization and each hospital had its own version of practicing medicine. It became apparent healthcare providers were going to continue business as usual; therefore the benefits linked to the capabilities of the EHR went unrealized. Indeed it is interesting the amount of time and legal maneuvers it took to spark the use of EHRs in hospitals. It was apparent government intervention to jump-start the EHR was inevitable. On January 9, 2009 passage of the Health Information Technology for Economic and Clinical Health legislation (HITECH) opened the gateway to technology and implementation of the EHR.
Electronic Health Records (EHRs) is another version of a patient’s medical history, that is maintained by the healthcare facilities or provider over time, and may include all of the key administrative clinical data relevant to that persons care under particular healthcare facilities, including demographics, progress notes, medication, x-rays, surgical history, and etc.(CMS,2012). While the adoption of the electronic health record system seems promising for the healthcare community and having a positive impact on the HIM field with better care and decreased in healthcare cost, and other promising aspects. However, poor EHR system design and improper use can cause EHR-related errors put at risk to honesty of the information in the EHR; causing or leading healthcare facilities and hospital to break that confidential bond they have with the patient. This will cause EHRS to have errors that endanger patient safety or decrease the quality of care that the patients expect from the hospital or healthcare facility (Bowman, 2013). In the paper I will discussed the topics along the lines like managing the Transition from Paper to EHRs, EHRs to redefine the role of doctors, and other ways how EHRs impact will have on the HIM community.
As an organization that pride itself on continuous improvement it is time to move away from an electronic medical record (EMR) to an electronic health record (EHR). The organization currently utilizes three different EMR, each for different reasons. This has and will continue to make accessing patient information difficult and inefficient as access to each database is dependent on individuals role within the organization. Overall, this will continue to influence patient care negatively. Currently, only nurses have the ability to enter and change orders, therefore, all orders must be given verbally to the nurse or be written down. Further, the system only contains information of each clinics patients and not across the
In 2009 the American Recovery and Reinvestment Act which led to the significant investment of $30 billion in health information technology. The RRA provided financial incentives for hospitals, and physicians to use EHR systems in 2014, 83% of physicians use some form of EHRs, and 76% of hospitals have an EHR setup. Even with a basic EHR system a hospital or physician can create an autonomy of service that the patient can take comfort in that they are receiving the highest quality and tailor made health care experience. Noting the physicians and hospitals with EHR Patients feel as though they play an even larger role in determining their need for care but the outcome of the care they receive. If care is given to a patient at a specialized care facility and can, travel to a hospital for a separate issue communication should be seen by both facilities ensuring the patient is not receiving duplicate treatment. Patients who have EHR interface have a more satisfying experience at about 82% (source, 2016). With the open lines of communication, a real collaborative relationship can develop
Adler-Milstein, J., & et al. conduct a research to assess what influence would EHRs have toward Health care costs. It slowed ambulatory cost growth, and
Good job on your post. After reading the article for the week my take away is that with good planning and better research health care organizations can actually eliminative all the negatives associated with implementing Electronic Health Records (EHR). This is why Palma advised that to avoid the negative issues associated with EHR “hospitals and healthcare systems must perform a thorough evaluation of the EHR system before purchase and implementation” (Palma, 2013). Healthcare organizations that follow this advice will not only reap the benefits of EHR but also save a significant amount of money for implementing EHR. For example, according to Kovner & Knickman, Henry Ford Health System attributed $14 million in cost savings to
The electronic health record (EHR) has improved the health care team and patient communication however, there is a downside to the (EHR). Whether we admit it or not there is sharing of electronic information outside of the individuals it was prepared for. As stated in, Views on health information sharing and privacy from primary