Davis and Khansa (2015) in their study, discuss the adoption of the electronic health records as a requirement by law of the HITECH. The health care organizations in America, both the public and the private, ought to implement the EHR to facilitate storage, integration, while still consolidating all the protected data on a patient’s case (Davis & Khansa, 2015). HITECH Act made the adoption of EHR paramount by the end of January 1, 2015, as a deviation from the law would face negative adjustments hence, the mass adoption (Davis & Khansa, 2015). The EHR is the record of information and data related to the health of an individual that allows creations, gathering, management, and consultations by authorized personnel and clinicians within a particular healthcare institution.
Notably, the recent legislation on the implementation of the electronic health records in the US has made their implementation paramount to almost all the hospitals for storage and processing purposes of their patient's data. By the year, 2006, there was a 160% increase in EHRs, among the physicians in the US, 78% representing physicians, office-based and by the year 2013, 59% of medical institutions had adopted EHR (Alkureishi, Lee, Webb and Arora, 2018). Kalra and Ingram (2007) highlight how clinical care increasingly demands frequent retrieval of a patient’s recorded data, which at times is highly distributed in various sites, recorded on different papers, and applying different electronic formats. More so, the information can be represented as narrative mixtures, in codes, structured, and other multimedia entries. Dykes et al., (2014) root for a longitudinal EHR which is person-centered to help meet the frequent demands of accessing a patient’s recorded information. Notably, a great challenge exists in providing clinical personnel in various fields with an integrated view of individual healthcare history.
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Adoption of the EHR in some clinical encounters can cause ubiquity in their professional practice. Alkureishi, et al. (2018), systematic review, discusses the importance of the health care providers to understand the repercussion of using EHR during clinical encounters on the overall interactions with the patient. The patient-doctor relationship seems to be on the line when assessing the effects of EHR in clinical encounters (Alkureishi et al., 2018). Alkureishi et al. (2018), study, identifies the physician's behavior in the application of EHR as affecting negatively on the relationship with their patients as well as in their communications.
EHR aspects of constant typing in the process of important discussions with the patients and minimal sharing of the data recorded on the screen tend to result to reduction in transparency of the health provider actions, which leads to confusion, and distrust on the patients’ side as what is being done on the computer. Stanhope and Mathews (2019) focus on the improper application of EHR during a clinical encounter leads to patient dissatisfaction with the whole communication process thus, affecting their overall perception of the care accrued because of the distrust aspect. The application of EHR, in a patient-centered aspect, is the way to go, as it incorporates best practices in the interaction between the physician and the patient. Dykes et al. (2014) systematic review confirms that the application of a patient-centered EHR system can enhance the engagement between the physician and the patient through enhancing the communications, promote easy decision making because of open conversations while ensuring the patients are well aware of their medical conditions.
Many important benefits are accruing to a patient-centered type of care. Akureishi et al. (2018), emphasizes the positive impacts the patient-centered type of EHR has on aspects relating to an individual's compliance with the health system, their satisfaction and the overall results relating to one's medical condition. The benefits associated with the patient-centered EHRs mandates; namely, WHOs strategy on aspects relating to patient-centered and health services integration is calling for improvements in the sector to incorporate empowerment, education and engages people while incorporating the modern type of technology effectively and efficiently.
The US’ body mandated with accrediting degrees in medical education, also recommends education on the best behaviors during practice especially when applying the EHRs thus ensuring the trainees get enough training that is likely to facilitate a person-centered type of care (Alkureishi et al., 2018). This narrative review seeks to explain the mass adoption of EHRs in US medical institutions. It discusses the medical organizations’ communications current state between various levels of communications through the application of various settings. It is fixated on the adoption of a longitudinal individual-centered EHR, to curb the existing communication gaps in aspects relating to coordination, and care transitions thus improving efficiency in the medical settings.
References
Alkureishi, M. A., Lee, W. W., Webb, S., & Arora, V. (2018). Integrating patient-centered electronic health record communication training into resident onboarding: curriculum development and post-implementation survey among house staff. JMIR medical education , 4 (1), e1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773818/
Davis, Z., & Khansa, L. (2016). Evaluating the epic electronic medical record system: A dichotomy in perspectives and solution recommendations. Health Policy and Technology , 5 (1), 65-73. https://www.researchgate.net/publication/283282348_
Dykes, P. C., Samal, L., Donahue, M., Greenberg, J. O., Hurley, A. C., Hasan, O., O’Malley, T. A., Venkatesh, A. K., Volk, L. A, & Bates, D. W. (2014). A patient-centered longitudinal care plan: vision versus reality. Journal of the American Medical Informatics Association , 21 (6), 1082-1090. https://www.researchgate.net/publication/263710012_
Kalra, D. & Ingram, D. (2007) Electronic Health Records, Centre for Health Informatics and Multiprofessional Education, UCL pp. 135-181 https://www.researchgate.net/publication/226959625_
Stanhope, V., & Matthews, E. B. (2019). Delivering person-centered care with an electronic health record. BMC medical informatics and decision making , 19 (1), 1-9. https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0897-6
