Nov 19, 2020 in Health

Electronic Health Record Implementation
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Electronic Health Record Implementation

Advances in communication and computer technology have significantly changed almost all spheres of life, including health care services. For decades, the traditional paper-based approach to clinical documentation has handled collection, analysis and storage of information. However, legal, financial, and health care providers demands of the modern health care environment together with growing chronic care needs from aging patients, the increasing rate of biometrical knowledge, as well as possible medical errors associated with handwritten notes have evidenced an acute need for changes. Ultimately, applications of computer and communication technology to clinical medicine through the implementation of electronic health record (EHR) were provided as a solution. EHR systems are likely to address the abovementioned problems of traditional medical records. Being another example of technological progress, EHR implementation systems are associated with a variety of improvements in the scope of care delivery.

 

The positive contribution of the recent innovations in the sphere of health care providing services has a number of improvements for medical institution and its patients. EHR systems are characterized by the Institute of Medicine as an essential technology that can significantly improve the quality, safety, and efficiency of health care (Chiang et al., 2013). Moreover, the potential of the innovation can notably improve clinical care and public health. In this respect, health care practitioners have better understanding of the distribution and level of disease, function, and well-being within populations (Friedman et al., 2013). Additionally, implementation of EHR systems can prevent conflicts and stimulate collaboration within a facility.

The term EHR is associated with a broad range of electronic information systems that are used in health care. These notions are usually used in health care units on a regional level and nationwide. The following institutions belong to health units that utilize EHRs: general practitioner surgeries, pharmacies, hospitals, and nursing homes, to name a few. Due to a number of factors, such as organizational structure, human skills, technical infrastructure, and culture, the implementation of hospital-wide electronic systems relates to a complex matter that involves a wide range of technical and organizational factors.

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In the majority of cases, their EHR systems for nursing homes are designed to decrease the time spent on lab reports documentation and increase the time spent on taking care about changes in health status and behaviors of the residents. The purpose of other specially developed electronic systems for nursing homes might be improvement of the quality of care. EHR systems in these facilities guarantee patients privacy and data security. Human factor means much during implementation and exploitation of EHR systems. The data collected in the process of research and documentation are extremely important and require following well-organized and secured data utilization strategies. To complete this assignment, there should be the integrity of research protocols and honesty in reporting the findings (Burkhardt & Nathaniel, 2013, p. 343).

According to the Health Insurance Portability and Accountability Act, patients health information should be secured due to privacy rights. Specifically, under the privacy rule, any patient has rights for information, including obtaining a copy of a medical record or information regarding personal health records usage and sharing among others. In terms of safety measures that are provided together with EHR implementation, the following should be mentioned:

 
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Encrypting personal stored information, namely, personal health information cannot be read or understood except by someone who can decrypt the data by applying a special key available to authorized personnel only;

Access controls similar to passwords and PIN numbers, which limit the access to personal information;

An audit trail that might record the individuals, who accessed personal information, what changes were made and when (Rodriguez, 2011).

Despite the potential benefits of EHR adoption, this process has been relatively limited in the United States. By 2008, about 17% of ambulatory physicians across the country had undergone complete EHR adoption (Chiang et al., 2013). To compare, over 90% of primary care physicians in many industrialized countries have already adopted EHRs (Chiang et al., 2013). Under these circumstances, the need for EHR implementation in nursing homes and other health care institutions is obvious. At the same time, there is a need for recruiting, training, and retaining of qualified and experienced staff, especially in rural areas.

Implementation of EHR systems is a complex and expensive procedure that involves commitment of the key people in the organization during the phase of planning and implementation. In addition, the level of organizational resources should include value realization and vendor management. In general, strategies of implementation EHR systems involve the phases of planning, focusing on finance, building an EHR committee, designing a communication strategy, and installing an IT strategy. Further, the development process covers workflow analysis, clinical decision support implementation, and creation of the strategy of Health Information Exchange. Together with these phases, workforce training is conducted. Finally, the phase of patient engagement starts. A standard strategy for EHR implementation has the following points:

Performing a need assessment;

Performing a readiness assessment;

Performing a workflow analysis;

Creating a roadmap for selecting and implementing a system (Ginsberg, 2011, p. 65).

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Overall, implementation of EHR systems improves health care quality and effectiveness, patient safety, and reduces medical errors. Discussing patient outcomes, it should be stressed that they can be regarded from 3 perspectives, including patient, clinical, and societal. When striving to enhance patient safety and prevent the safety issues, electronic data is used to assist in detecting, managing, and learning from potential safety events in near real-time. Of course, electronic and man-made disasters might occur from time to time. However, the nursing home should be able to detect errors of different types, as well as manage and overcome errors that are serious.

To conclude, systems of EHR offer many benefits and improvements for the current health care system. Much work should be done in terms of technological progress in the sphere of providing medical services. Nonetheless, EHR systems have the potential to benefiting patients, healthcare professionals, organizations, and society at large.

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