EHRs
Advanced Information Management in Health Care
Introduction
There has been a state of flux in the adoption of new technologies into the health care system, with old versions of technology being replaced by new ones. The benefit of embracing technology in the sector is astounding, with the quality of patient care as defined by patient experience and satisfaction, and the cost of patient care being at the center of any technological decisions made by the healthcare organizations. The changes in legislative requirements designed to protect the patients has also called for the adoption of responsive technological solutions. Electronic Health Records (EHRs) have proven to be a dependable solution and a major advancement from the previously dominant Electronic Medical Records (EMR), offering an opportunity for health care providers not only to collaboratively store patient information, but to share such information without geographical limits (Menachemi & Collum, 2011). This has contributed in a major way to an increase in the quality of patient care. The process of merging and acquisition of new organizations comes with a major challenge of synchronizing not only the cultures, but also the functions of the joining organizations. Miscommunication is one of the leading causes of medical errors. As such, embracement of Health Information technologies, such as EHRs, is a major way through which merging health care organizations can be able to overcome the challenge of poor quality patient care.
Healthcare Technology Analysis
Electronic Health Records (EHRs) provide a platform through which patient information created during patient care can be electronically shared among the health care delivery team. Some of this information may include progress notes, patient demographics, medications, complications, past medical history, vital signs, radiology reports, laboratory data, and immunizations (Menachemi & Collum, 2011). This system hence provides a shift from the paper system, which has been faced by various challenges including poor penmanship and difficulties in retrieving data. Through HER, data can be easily retrieved by the health care providers and shared among them to ensure proper and timely meeting of patient health needs. By implementing this technology, the merged health care organization will be able to facilitate communication across the health care providers and ensures that the differences in culture between the initial organizations does not affect the delivery of quality health care services. With the health care environment including members from different professions, implementation of the EHRs poses a major challenge in terms of gaining user buyer-in (Menachemi & Collum, 2011). to facilitate such, it is important to ensure that proper an interdisciplinary team is established to push forward the EHRs message. Practical application of the technology is bound to reveal its benefits to the health care providers, which include reduce time-for addressing each patient as information is easily transferred from one user to the pother. Case in point, physicians can easily request patient test result from the laboratory while attending to the patient in the ward. Another benefits involves the ease of retrieving previous patient data upon a revisit (Menachemi & Collum, 2011). Important to note is the ease with which the health care providers can merge their efforts and consult with each other about the patient’s progress without the need to meet physically
Project Committee
The implementation process is the most critical part of any technological adoption process as it involves gaining end-user buy-in and being able to convince the health care professionals across the organization that adoption of the technology is a highly beneficial option for them. According to Kurt Lewin, change is not a mere event, but a gradual process. As such, Lewin proposed a model, referred to as the Freeze-Unfreeze-Refreeze model that suggests that the status quo that currently exists within an organization has to be broken before a new system can be established. To effect such in a newly merged healthcare environment, it is important to establish an all-inclusive team that includes members from the different departments within the organization, who will be able to represent their respective departments on the project tea and communicate the project message to their departmental members. Four of the members that may be included on such a team are: An Implementation Manage, who may be one of the senior physicians; a Nurse Leader; a Physician Leader; and a EHR Builder from the Information Technology department.
The role of the Implementation Manager is to coordinate the efforts of all the members of the interdisciplinary team. He or she is to lead in the creation of a message that is to be communicated across the entire organization and the development of an implementation strategy that defines the roles of each of the members on the team. The expertise of the Implementation Manager as a physician is important as they have a better understanding of the health care environment and the importance of information sharing in meeting the quality health care requirements. On the other hand, the physician champion and the nurse leader are responsible for communicating the implementation message to members of their respective departments and ensuring that they gain buy-in from those they represent on the team. On the other hand, the two are expected to listen from those they represent and present any concerns that may hinder adoption of the new technology to the team to allow for timely addressing of such issues. The expertise of both the physician champion and the nurse leader as a physician and nurse respectively is important as it allows them to develop a better understanding of how important the new technology is and hence in communicating such importance to others in their profession-related terminology, thus promoting a better understanding of such benefits among the health care professionals. Last but not least, the EHR Builder is responsible for engaging the interdisciplinary team in reviewing the EHRs technology and making technical changes to the system to accommodate both the structure and the type of information shared across the organization. The EHRs builder is also responsible for training the interdisciplinary team members on the various aspects of the system including its use in order to allow them to demonstrate its benefits to those they represent. The Expertise of the EHRs builder as an IT specialist is important in allowing them to effectively tackle any technical barriers that may impede implementation `of the technology.
Importance of Interoperability
Interoperability forms the foundation based on which the entire concept of healthcare coordination is across health care communities is based. This term refers to the extent to which different devices and systems within the health care system can not only share information, but interpret such information and present it to the users in a user-friendly manner (Moumtzoglou, 2014). Interoperability is important as it reduces ambiguity, enables better workflow, and allows the transfer of data across EHRs systems all the stakeholders within the health care environment. As a result, an environment that is interoperable improves health care delivery by ensuring that the right kind of data is always available to the right persons at the correct time.
Standardized Nursing Terminologies (SNTs) have brought a new approach to nursing care, allowing for a single language through which the nurses can communicate among them and with other health care professionals. Among other benefits, SNTs promote communication between nurses and the rest of the health care providers (Rutherford, 2008). In addition, unlike previously where the contribution of nurses was undervalued and that they were viewed as assistants to physicians, SNTs have facilitated an increase in the visibility of nurses and their interventions within the health care environment. These nurse based languages have also allowed for better collection of data in order to evaluate the outcomes of nurse interventions and hence improved the quality of care.
Federal Regulatory Requirements
The 2009 Health Information Technology for Economic and Clinical health (HITECH) Act was established as a law in view of the US’s stimulus package that represents their initiative to promote increased adoption of EHRs among health care providers. The Act provides health care providers with incentives to implement EHRs technologies. Health care providers are thus required to adopt the EHRs and use them in a manner that is meaningful, which includes utilizing particular functionalities that are important in cost containment and error reduction (Menachemi & Collum, 2011). This law has encouraged health care providers to increasingly utilize EHRs among health care providers, an aspect that translates to various benefits for patients.
On the other hand, the Health Insurance Portability and Accountability Act (HIPAA) requires all healthcare organizations to observe rules that protect the integrity and confidentiality of patient information (Murray, Calhoun, & Philipsen, 2011). This law requires healthcare organizations to establish safeguards that protect patient information against any hazards or threats to the security, disclosure, and unauthorized use. As such, the HIPAA is important to the process of implementing EHRs as it provides directions on the need to adopt strict measures that would allow for protection of patient information. Organizations that fail to comply with the HIPAA regulations in their implementation of EHRs face criminal and civil penalties for non-compliance.
Potential Security Threats
Like any other online interaction platform, EHRs face the threat of breach. Internet hackers have evolved in terms of their methods and technical skills that they threaten the safety of any sensitive data that is concealed through online databases. Cases of medical information breach and access by unauthorized persons have been reported in various occasions (Harman, Flite, & Bond, 2012). As much as such cases are rare, their occurrences are adequate to input a level of cynicism in patients and physicians. The consequences of such breaches are likely to be devastating, one of which is identity theft. Such can lead to the destruction of an individual’s credit, finances, and reputation. In retaliation, the patients may sue the health care organization or practitioners and mark the beginning of legal tribulations. To counter the problem of patient information breach, the EHRs have been designed with pre-installed Firewall systems to block any unauthorized attempts to access the system. In addition, activity monitoring software have been established to ensure that any unprecedented activities are identified and addressed in a timely manner. On the other hand, the process of converting data to an electronic system from a paper-based system poses a major threat to patient information (Harman, Flite, & Bond, 2012). This process holds the potential of misplacing patient data. Nevertheless, the vendors of electronic health records have established transitional strategies allowing for elimination of the problem of data misplacement.
The International Organization for Standardization (ISO) has established various standards that are aimed at regulating the privacy of information in any cloud service environments. Some of the established controls are highly important to the implementation of the EHRs, including the ISO/IEC 27017 and the ISO/IEC 27009. The ISO/IEC 27017 offers health care organizations with a code of practice that relates to cloud service information security (Whitman & Mattord, 2016). This provides implementers of EHRs with a framework based on which the cloud sharing practices are to be established. This standard also provides recommendations concerning effective security controls that can be adopted by health care organizations to protect the patient information from breach. On the other hand, the ISO/IEC 27009 provides organizations with activities that ought to be adopted in order to manage the risks of information security within the information systems (Whitman & Mattord, 2016). This standard also facilitates increased protection of patient information by providing health care providers with a practical framework that can be used in order to ensure such privacy is achieved.
Implications of Current and Emerging Technologies
Advancement of technology has led to the development of various technologies that are aimed at facilitating patient care while limiting barriers to such patient care. This encompasses different tactics and technologies to deliver virtual health, medical, and education services. This technology has been widely embraced in the health care environment both in facilitating communication, patient assessment, and delivery of health care services (Henderson, et al., 2013). To support communication with satellite facilities in the nonclinical setting, one of the applications of the Telehealth technology includes the use of text messages to communicate with health care providers in the remote facilities on various issues of practice. Another application of such technology involves the live video conferencing to communicate with the health care professionals in the remote satellite facilities during organizational meetings and briefings (Henderson, et al., 2013).
On the other hand, the Telehealth technology can also be applied in clinical settings to facilitate patient assessment and delivery of care. One of the applications of Telehealth in such a setting involves the use if Remote Patient Monitoring (RPM) to collect personal medical and health data from a patient in the remote satellite facility using electronic communication technologies, and transmitting the findings to a health care provider in another location. The health care provider then uses the data in care (Henderson, et al., 2013). This function allows health care providers to monitor patient data after discharge, hence reducing the rate of readmissions. Another application of Telehealth involves the use of live-video to communicate with the patients from the remote facilities and assess their situation from the information they provide, then suggest tests that can be done to ensure proper diagnosis.
Conclusion
It is evident that Electronic Health Records are
high effective in facilitating an increase in the quality of care by promoting collaboration
among the health care providers. To realize the benefits of EHRs, it is important
for health care organizations to engage all the stakeholders within the health
care environment. As such, it is important for a proper message that
communicates the benefits of the system to all the professions to be created
and communicated through an interdisciplinary team that includes members from
such professions. Importantly, proper measures should be established in compliance
with both the legal policies and organizational policies, to ensure that
sensitive patient data is protected from third parties and that both the
patients and the health care providers develop confidence in the EHRs in place.
References
Harman, L. B., Flite, C. A., & Bond, K. (2012). Electronic Health Records: Privacy, Confidentiality, and Security. Virtual Mentor, 14(9), 712-719.
Henderson, C., Knapp, M., Fernández, J.-L., Beecham, J., Hirani, S. P., & Cartwright, M. (2013). Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. BMJ, 346.
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 4, 47–55.
Moumtzoglou, A. (2014). Cloud Computing Applications for Quality Health Care Delivery. Hershey, PA: IGI Global.
Murray, T. L., Calhoun, M., & Philipsen, N. C. (2011). Privacy, Confidentiality, HIPAA, and HITECH: Implications for the Health Care Practitioner. The Journal for Nurse Practitioners, 7(9), 747–752.
Rutherford, M. (2008). Standardized Nursing Language: What Does It Mean for Nursing Practice? OJIN: The Online Journal of Issues in Nursing, 13(1).
Whitman, M. E., & Mattord, H. J. (2016). Management of Information Security. Boston, MA: Cengage Learning.
