With the continued advancement in technology, more organizations are adopting digitized methods of storing data. Private organizations are leaders in this trend, with government institutions being slow in the adoption. There are, however, many inherent benefits of digitizing records, leading the government to implement a mandatory electronic health record (EHR), also known as electronic medical records (EMR) for the health sector.
President Obama signed the Patient Protection and Affordable Care Act (ACA) in 2010. The act was a comprehensive healthcare reform that had many aspects to it, including Electronic Health Records (EHR). EHRs are the official health document of an individual that contains his or her detailed health records, generated and shared by health providers across the industry (Evans, 2016) . Among the data captured by EHRs include contact information, insurance info, allergies, immunization, and family history, among others. The federal government’s implementation plan mandated health care centers and eligible professionals (EPs) to all ensure that they all demonstrate “meaningful use” of EHR by January 1, 2014. Failure to fulfill the criterion of “meaningful use” would lead to the progressing reduction of Medicaid and Medicare reimbursement levels. With these stringent measures, the federal government hoped that it would provide enough impetus for all the stakeholders to implement EHRs.
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EHR Federal Rationale
The federal government had two main reasons for making EHR implementation mandatory. Evans (2016) points out that f irst, it hoped that with the use of EHR, it would reduce the overall cost of provisions of the health to patients. Secondly, it also targeted an improved quality of healthcare to patients since healthcare providers would leverage the benefits and potential of real-time data availability. All these fell in line with the mandate of the federal government to provide quality and affordable care for its citizens by making it more effective and efficient.
Pros and Cons of Electronic Documentation
Pros
The electronic documentation of health records has many benefits. According to Mudumbai, Chan, & Banoub (2017), the four most important pros are easy to access, lower costs, increased collaboration, and error prevention. With EHR, a patient can access their medical records from any location as long as they can access the internet. For patients, easy access to their medical records is beneficial when they need to convey the information to health providers. On their end, health providers can also access the information hence increasing collaboration among health providers, be they private or public health centers. The sum of all this ensures that in the provision of health to patients, there is a reduction of errors as records and all their medical health history go into consideration. The collaborative nature of EHRs also ensures the reduction of costs for both the providers and patients. Costs associated with the eliminated redundant and duplicate tests to the patients save money for both the patients and the caregivers.
Cons
Despite all the pros discussed above, EHR also has its shortcomings. Mudumbai et al. (20170 further point out that t he main cons of EHR are that it may be less secure, cost more money upfront, and require training. With the continued advancement in technology, the world has witnessed a surge in the sophistication of cyber-attacks. Digital health records are, therefore at risk of being hacked, stolen, and misused. Medical health records are also at a higher risk of being misplaced than traditional medical records. Apart from security, initial cost is also a problem. The high initial costs of investing in EHRs include the requisite software and hardware to withstand security issues and pass the stringer regulations. Even after the acquisition, there is a need for an organization to train or hire specialized employees on health informatics and continuously improve their skills.
The Desired Redesign of the Current EHR
In the past, I have worked as a student nurse in a health center that was new in its use of electronic health records. Though the organization’s EHRs system was relatively effective, there are some ways I could redesign it through some additions to make it even more effective for the initial intended purpose.
Drug Interaction Checking
The current electronic health records system does not support drug interaction checking. It is, therefore, a feature that I would add. Drug interaction checking is important for the general health of a patient since there are some drugs which, when ingested concurrently by patients, have negative side effects. An EHR should support drug interaction checking (McEvoy, Sittig, Hickman, Aaron, Ai, Amato, & Krall, 2016) . Drugs given by one hospital may be different from those given in another hospital with regards to their components. Getting an EHR that supports drug interaction checking is, therefore, important for the health facility. It will ensure that the health center can increase the health outcomes and improve its service quality as patients; all drugs prescribed to patients, will not have negative effects when they interact.
Patient Support
The EHR implemented by the organization does not have patient support; hence, my redesign would add it. Calman, Little, & Garozzo (2015) argue that f or an electronic health records system, it is prudent that it has a patient support feature. A patient support feature enables patients to not only access their records but also actively educate themselves. The redesigning and addition of interactive patient support would help the patients carry out home monitoring and self-testing, hence enhancing their health.
Data Retention, Availability, and Destruction
Another feature I would add is the retention, availability, and destruction of data. For an EHR, the adherence of standards and policies on the data that is captured by and shared with the system is key. Not all the data should be made available (Omotosho & Emuoyibofarhe, 2015). Moreover, there is data that should be retained, whereas the destruction of some forms of data should occur, all to ensure that the data is relevant and respects privacy policy. However, the organization’s current EHRs do not have this feature, with all the information and data strewn all over, including redundant and irrelevant data.
EHR Influence on Nursing Practices
Streamlines Of Nursing Activities
With the implementation of EHRs, streamlining of the activities or nurses has taken place. Nursing activities are now preplanned, and specific timelines put on them (Lee & Chang, 2016) . A nurse can, therefore, know his or her work schedule and activities in advance, with a high level of certainty. It has, therefore, increased the motivation of nurses, hence increasing their productivity.
Time-Saving and Documentation
The use of EHR by nurses improves their time saving and documentation. Lee & Chang (2016) posit that w ith the electronic health records system, nurses have an easy time in the documentation of patients’ records. The ease in this documentation helps these nurses spend considerably less time than they did in the analog medical record system. The time saved is then used to focus on other core nursing tasks that include actual treatment of the patients. The nurses are also able to get out of work earlier than usual.
Impact of EHR on Health Outcomes
One of the biggest impacts of EHR on health outcomes is the decrease in medical errors. With the electronic health records, Campanella, Lovato, Marone, Fallacara, Mancuso, Ricciardi, & Specchia (2015) posit that both the patient and the institution providing the health service have all the information needed . Even more important is the health history of the patient. It, therefore, eliminates cases of misdiagnoses or even benign given drugs that are incompatible. Reduced errors are most beneficial to the health of the patient.
EHR also reduces delays during treatment. Campanella et al. (2015) further point out that electronic documentation and their subsequent sharing ensure that all the data and information about the patient happen in real-time. By providing all the past health records of the patient, EHR eliminates the need to conduct unmercenary tests that waste time. All these work in unison to ensure that the eventual decision on the treatment of the patient happens in the least time possible and is most objective. It, therefore, positively impacts the health of the patient both in the short run and in the long run.
Conclusion
The mandatory federal EHR and its subsequent implementation are all helpful to the health of the nation. It reduces the cost of health care and improves patient care. It also improves the streamlining of health activities and saves time on documentation, among other benefits. Some redesigns should, however, be done always to ensure that the EHR in place has the latest and best features. From all these, the EHR system is worth it because the pros outweigh the cons.
References
Calman, N., Little, V., & Garozzo, S. (2015). Electronic Health Records: Optimizing Communication to Support the Nonverbal Medical Patient With Developmental Disabilities. Progress in community health partnerships: research, education, and action , 9 (4), 591-594.
Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. L. (2015). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. The European Journal of Public Health , 26 (1), 60-64.
Evans, R. S. (2016). Electronic health records: then, now, and in the future. Yearbook of medical informatics , 25 (S 01), S48-S61.
Lee, T. T., & Chang, C. P. (2016). Nurses' Experiences of an Initial and Re-Implemented Electronic Health Record Use. Studies in health technology and informatics , 225 , 802-803.
McEvoy, D. S., Sittig, D. F., Hickman, T. T., Aaron, S., Ai, A., Amato, M., ... & Krall, M. A. (2016). Variation in high-priority drug-drug interaction alerts across institutions and electronic health records. Journal of the American Medical Informatics Association , 24 (2), 331-338.
Mudumbai, S., Chan, L. Y., & Banoub, M. (2017). Committee News: Electronic Health Records–Pros and Cons. ASA Newsletter , 81 (10), 74-78.
Omotosho, A., & Emuoyibofarhe, J. (2015). A criticism of the current security, privacy, and accountability issues in electronic health records. arXiv preprint arXiv:1501.07865 .
