Currently, many hospitals and health professionals are using medical technologies to improve the quality of health care services, especially through enhanced efficiency and effectiveness. The use of information technology has gained a lot of popularity in the health sector. Electronic health record (EHR) is one of the information technologies that are now used in almost all health facilities due to its many advantages. Both small and large facilities now rely on EHR to store and manage patients’ data to improve patient care and the quality of medical services in general. Therefore, the health information system that should is selected and implemented by the project community is EHR because it meets the HITECH and HIPAA security and privacy regulatory requirements.
Discussion and Analysis of EHR
EHR basically refers to a real-time and patient-centered records system that allows instant access to patient information by an authorized user. EHR mainly contains medical records and treatment history of patients. However, some of the EHR systems go beyond the storage of patient data and allows a broader view of the patient's care (Menachemi & Collum, 2011) . EHR enable safe storage of patient data while at the same time it gives health professionals the opportunity to use evidence-based information to provide appropriate and quality health care services that can significantly improve patient outcome. Hence, the system allows hospitals and health professionals to create and manage patient data adequately.
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Summary of Advantages and Disadvantages of EHR
According to Alpert (2016), one of the significant advantages of EHR is its ability to reduce medical error significantly. Medical professionals can use the system to keep detail and reliable medical records of every patient, reducing the possibility of medical errors. Another major advantage of the EHR is that it enables patients to access their records or data, especially when the system is connected to the internet. A patient does not have to visit hospitals to access their health records as he or she can just log in through the internet at home or place of work. Besides, EHR can substantially improve efficiency in the hospital due to the reduce time wastage, making it possible for health professionals to find additional time to attend to patient needs. At the same time, there is a direct relationship between EHR and clinical outcome. A study that was conducted by Menachemi & Collum (2011) found that EHR can enhance both patient safety and the quality of care.
However, like any other system, EHR has some disadvantages that should be considered during its selection and implementation. The main disadvantage that is linked to the system is the high cost of adoption and implementation. For instance, the average initial cost of EHR for three physical offices is between $50,000 and $70,000 (Menachemi & Collum, 2011). The maintenance cost of EHR is equally high because the hardware must constantly be replaced. Apart from cost, EHR is also prone to disruption of work-flow, which may result in some losses productivity. Also, EHR increases the risks of violating a patient’s confidentiality and privacy due to the electronic transfer of information.
The advantages and disadvantages of EHR can also be analyzed based on its usability, interoperability, scalability, and compatibility. Although many hospitals have installed the system, its usability is still low, which is a concern to many health policy measures. For instance, a survey that was done in 2012 revealed that 63% of physicians still rely on the conventional ways of storing and sharing data such as the use of fax machines (Reisman, 2017). Some of the factors that are causing the low usability of EHR include lack of technical knowledge and skills, physical burnout that is associated with technology, and complex regulations.
At the same time, the interoperability of the system is low, even though one of the major objectives of HITECH is to enhance the interoperability of all health information systems (HISs) to improving sharing and use of patient information. Unfortunately, as of 2015, only 6% of health professionals were able to share patient data with others who use the same system (Reisman, 2017). Many hospitals have only been focusing on adopting the system without encouraging users to learn how to utilize the system to maximize its benefits effectively. Besides, interoperability of the EHR system is low because the systems have different technical specifications as well as functional capabilities. Also, according to Reisman (2017), lack of collaboration and coordination among stakeholders is hindering the interoperability of EHR.
Compatibility of EHR is an issue affecting its users. The system is not compatible with many other systems that are used by many hospitals (Reisman, 2017). Consequently, there is a lot of disruption when the system fails. However, the scalability of the system is high, as it can be scaled up or down based on the use or customers’ needs. EHR relies on the internet, which can easily be adjusted to either expand or reduce its coverage or use.
How EHR Affect Patient Care and Documentation
EHR substantially contribute to patient care, particularly concerning patient records. Currently, physicians face the challenge of complex and intertwined diagnosis and treatment process that largely depend on patients' data. Therefore, the system improved patient care by ensuring that capture and persevere important data that are used in the diagnosis and treating patients. At the same time, EHR has improved the delivery of patient care because it improves the sharing and coordination of crucial information and data. Nonetheless, the effect of EHR on patient care largely relies on the ability of physicians to properly and accurately use the system.
One of the main benefits of EHR is that it reduces the documentation time significantly. For example, a study that was conducted by Vinod Manbudiri and his colleagues found that EHR can reduce documentation time by about 3.2 minutes for every patient encounter (Menachemi & Collum, 2011) . As a result, it gives health professionals an opportunity to attend to the cores needs of patients, resulting in improved patient satisfaction and outcome. Nevertheless, some people doubt the ability of the system to reduce documentation time, especially due to its low usability, interoperability, and compatibility. A study by Poissant et al . (2005) found that does not significantly reduce documentation time. The proper use of the system can reduce documentation time.
Effect on Delivery and Quality of Nursing care and Patient Outcome
EHR positively affect the quality and delivery of nursing care by improving the relationship between nurses and patients. The use of the system gives nurses the opportunity to access accurate and structure information about patients (Manca, 2015). Hence, this can improve communication and interpersonal communication between nurses and patients, resulting in a beneficial relationship. At the same time, EHR improves workflow in the nursing care because of the better access to information and patient treatment history. At the same time, nurses can remotely access patient information such as lab results.
How the System will benefit the Organization
The primary objective of implementing EHR is to benefit the organization, particularly regarding meeting its objectives and improving its operations. Therefore, EHR is expected to result in a measurable improvement in health care services as well as the health status of the targeted patient groups. First, EHR is not only used to store and share data, but it can also be used in a way that manipulates the information to make a difference for patients due to improved medical services. Quality improvement (QI) data from EHR will be used to accurately and systematically identify and address health problem that affects the targeted group of patients. Secondly, QI data from the system will assist in revealing the potential safety problem that affects patients.
It is also important for the system to meet HITECH and HIPAA security standards and regulations if the organization wants to avoid non-compliance penalties and improve the security of patient information. The primary aim of the standards and regulations is to protect patient health information that is stored in electronic form (Kruse et al ., 2017). First, the organization will use encryption to protect patient health information. Both the hardware and software of the system will be encrypted to prevent unauthorized access and use. At the same time, any device like flash disk that will be used to transmit or share patient’s data will be encrypted. Secondly, the system will meet the requirement through regular data backup. The system will undergo monthly data backup to ensure that patient information is adequately protected against misuse. Besides, the system will have a clearly written data backup and recovery plan that can be used in case of an emergency.
The system will also meet the technical, administrative, and physical requirements of data storage. First, the system will have its own administrator who will be tasked with the responsibility of ensuring that the best data storage practices are met, especially based on HITECH and HIPAA requirements. Moreover, the data security administrator of the system will conduct regular risks assessment to determine the safety of patient information. Storage devices will be protected and stored in a secure place. Hence, the system will comply with HIPAA and HITCH standards and regulatory requirements.
At the same time, EHR will help the organization to protect patient privacy, primarily through encryption. Encrypting the system makes it impossible for unauthorized persons to access the patient’s private and confidential information. Secondly, EHR ensures patient privacy because it allows the use of data security measures such a password (Kruse et al ., 2017). Passwords will be used to prevent patient privacy breaches. Only authorized people will be allowed to have passwords. Furthermore, the password will be changed frequently to enhance patient privacy. Protecting patient information will be one of the primary objectives of the organization.
Besides, using the system will enhance organizational efficiency and productivity in different ways. First, it will improve efficiency and productivity through standardized documentation, which affects equality and effectiveness of health care services. One of the major advantages of EHR is that it can be used to standardize documents. At the same time, highly standardized documents improve communication and patient care. Secondly, EHR improves efficiency by reducing waste, particularly financial and time wastage (Kruse et al ., 2017). The system reduces time wastage of moving from one place to another in search for patient data. It also reduces the financial cost of buying papers, physical storage devices, and data clerks. The organization will not have to construct or buy capital resources such as data room of closets where data are stored. The system saves money and time. Therefore, with reduced time wastage and easy access to patients, productivity in the organization is likely to increase.
Interdisciplinary Team to Implement the System
Implementation of EHR is not an easy task because it requires skills from different fields ( Su, Win & Fulcher, 2006). Therefore, the organization should have an interdisciplinary team to implement the system. The team should comprise of people of have technical skills in the implementation of EHR. At the same time, the team requires persons with clinical knowledge and skills, which enable them to understand the clinical needs of the application. Besides, the team should comprise of engineers who understand the technical aspect of the system and who can test its viability and effectiveness. In addition, the team should comprise application developers. Therefore, the table below summarizes interdisciplinary team members required to implement the system.
| Member’s title | Member’s role | Member’s expertise and contribution |
| Project Manager |
-Responsible for the overall success of the team and the system -Monitor and coordinate the implementation of the system |
-Should have technical skill of HIS -Effective communication skills -Contributes to the overall success of the team and the project |
| Application Analyst | -Connecting ideas and concepts that the organization requires in place with the interdisciplinary team |
-Should have a clinical background -Should help in understanding clinical needs |
| Application Developer | -Develop various aspects of the system |
-Should have technical expertise on EHR -Determine whether all applications of the system are functioning |
| Quality test engineer | -Test whether the system is working based on the set objectives |
-Technical skills on EHR -Should have the clinical background -Confirm the effectiveness of the system |
Evaluating the Success of the Implementation of the System
The evaluation of the success of the implementation of the system will be based on many factors. First, the system will be evaluated it can adequately protect patient information from unauthorized persons. It is essential for the system to adequately safeguard patients' sensitive and confidential information ( Su, Win & Fulcher, 2006). Secondly, the system will be evaluated based on its ability to reduce medical errors. Thirdly, the success of the system will be determined by its usability. It should be easy to use, leading to comfort and satisfaction.
Therefore, the two professional organization standards that will be used to evaluate the system will include Updated D & M IS Success Model and technology acceptance model (TAM) ( Su, Win & Fulcher, 2006) . Updated D & M IS Success Model will be used to evaluate the system based on its quality, quality of data stored, and ease of using data, net benefit, and user satisfaction. TAM, on the other hand, will be used to evaluate the perceived usefulness and ease of use of the system. The system is expected to meet all the expectations and requirements after the implementation.
Conclusion
The use of health information is now inevitable in the modern healthcare sector. Systems such as EHR are now widely used in both developed and developing countries. Although EHR is associated with many advantages, it also has some disadvantages that should be considered. Organizations should find effective ways of reducing the disadvantage of the system to enhance its effectiveness and usefulness. At the same time, the system should adhere to the HITECH and HIPAA standards and regulatory requirements to reduce cases of noncompliance fines. Importantly, should enhance efficiency, quality, and productivity in the healthcare organizations, which can only be achieved if it is properly implemented.
References
Alpert, J. S. (2016). The electronic medical record in 2016: Advantages and disadvantages. Digital Medicine , 2 (2), 48.
Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for the electronic health records. Journal of medical systems , 41 (8), 127.
Manca, D. P. (2015). Do electronic medical records improve the quality of care?: Yes. Canadian Family Physician , 61 (10), 846-847.
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk management and healthcare policy , 4(2) , 47-55.
Poissant, L., Pereira, J., Tamblyn, R., & Kawasumi, Y. (2005). The impact of electronic health records on time efficiency of physicians and nurses: a systematic review. Journal of the American Medical Informatics Association , 12 (5), 505-516.
Reisman, M. (2017). EHRs: The Challenge of Making Electronic Data Usable and Interoperable. Pharmacy and Therapeutics , 42 (9), 572-575.
Su, Y. Y., Win, K. T., & Fulcher, J. A. (2006). Electronic health record system evaluation based on patient safety . Retrieved from https://ro.uow.edu.au/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir= 1&article=2669&context=infopapers
