Patients Electronic Health Records - Essay Example

? Health Sciences and Medicine Patients’ Electronic Health Records of the of the School/ This paper has investigated whether the new computer-based system of recording patient information through electronic health records should be implemented, despite resistance from health care providers and other medical facility staff. Physicians’ unwillingness to use the new system is attributed to Davis’ technology acceptance model and Ajzen’s theory of planned behavior. Hence, physicians’ concerns should be addressed by the facility management. At the same time, the findings reveal that there is increasing use of the new system by physicians. The important advantages of using the new approach include its ease of use and accessibility, and the availability of all the health records of the patient in one place, in a comprehensive form. These advantages offset the drawbacks such as physicians’ and other health care staff’s resistance, and disadvantages of patients having direct access to their medical records causing hesitation by physicians from briefing other physicians on particular confidential decisions. Other disadvantages from the perspective of other health care staff pertain to the requirement to constantly update patient information in the record, to avoid discrepancies. However, these drawbacks can be considered as advantages, helping the management to take corrective action, to promote efficient updating of patient records. Thus, the advantages of using electronic health records are far more significant than the drawbacks. Further, the increasing numbers of patients, and advanced medical technologies being used in different health care departments necessitate the use of electronic medical records in contemporary health care. Patients’ Electronic Health Records Introduction Electronic health records are rapidly becoming a necessity in the field of health and medicine. Patient records were earlier written documents created in material form, and stored for future requirement or reference in hospital and health center archives, states Kluge (2001). Electronic health records are patient information recorded electronically and stored in hospital or clinic computers. The patient information may be shared among several computers in the same institution, or among geographically separated computers in institutions. Further, they may be in the form of records stored in an encoded form on electronic tapes, disks, CD ROMs, etc. With greater development in digital medical imaging, telemetry, ultrasound, and other technologies, there has been parallel advancement in electronic patient records as electronic-based devices that fulfill the same role as the previous material or paper-based medical records (Kluge, 2001). Resistance to the use of electronic health records from some health care providers is due to the increased costs associated with its implementation, as well as employee resistance to change. Thesis Statement: The purpose of this paper is to discuss whether the new approach to recording patient information through electronic health records should be implemented, despite the drawbacks perceived by health care providers and their staff. The Importance of Using Electronic Health Records There are both advantages as well as drawbacks in using electronic health records instead of the earlier paper-based system of recording patient information. The advantages are significant. Electronic medical records are more easily accessible than earlier paper-based records. This is due to the availability of a comprehensive account of a patient’s health records in one place, accessed with the help of a few clicks on the computer. Thus, electronic health records are are more easily operated, and give a more complete representation of the patients health. Paper- based records may be stored in archives, and different files may exist for various health conditions, making them less easy or quick to access. The shift from paper-based to electronic medical records enabled a functional development that “radically altered the relationship between the subject of the record and the record itself, and widely expanded the uses to which the record could be put” (Kluge, 2001, p.2). With a shift to electronic medical records, the relationship between the patient and their record changed to a more personalized, more comprehensive link under one page, where all information related to the patient’s health would be readily and quickly available. Electronic records also help to cut costs and improve efficiencies in the area of health care (Seeman & Gibson, 2009). Physicians’ Resistance to the Use of Electronic Health Records Physicians’ resistance or acceptance of electronic health records is a core issue in implementing the new technology. Both Davis’ technology acceptance model, and Ajzen’s theory of planned behavior explain physicians’ unwillingness to use electronic medical records. Any doubts about its efficiency or utility value impacts the individual’s conception of control he has over the performance of that behavior, attitude towards performing the behavior, and discernment of social norms or approval to perform a behavior (Seeman & Gibson, 2009). Behavior control reflects an individual’s belief about the ease of completing a task. Behavior control is similar to the technology acceptance model’s perceived ease-of-use concept. The technology acceptance model was partly derived from the theory of planned behavior. Further, “the theoryof planned behavior incorporates the individual’s past experience as well as a sense of control into choosing a behavior” (Seeman & Gibson, 2009, p.22), as opposed to the behavior being mandatory. Thus, unless physicians are convinced of the usefulness of using electronic medical records, or the system is made mandatory, they may choose to continue with the earlier paper-based method. Healthcare professional centred problems include the fact that the effectiveness of the treatment provided to a patient may be judged by the changes in medication prescribed and recorded in the electronic medical records (Kluge, 2001). The data shown by the medical records may not cover all aspects of the treatment such as physician’s advice, or patient’s addictions or drug uses not revealed to the doctor. Hospital managers should be aware of how different groups experience and use the technology of electronic medical records. An improved understanding of physician acceptance will allow health care organizations to modify technology implementation strategies to remove physicians’ concerns “through increased participation, training or developmental initiatives” (Jensen & Aanestaid, 2007, p.35). Regional Extension Centers (RECs) offer technical assistance, guidance and information on best practices to promote health care providers’ efforts to use electronic medical records under the Medicare and Medicaid incentives programs (News, 2010). A survey of Ontario doctors revealed that physicians are becoming increasingly reliant on electronic medical records (EMRs), with greater confidence in their benefits (News, 2011). Resistance to Use of Electronic Health Records by other Stakeholders There are some drawbacks to the use of electronic patient records, which fall under four categories: patient-centred issues, health professional-centred issues, facility-centred issues, and information professional-centred issues. Patient-centred problems are based on the role the electronic records play in contemporary health care decision making. In this connection, due to the fact that patients have direct access to their medical records, physicians’ entries may become less frank, thereby making the record less accurate for another physician to understand the case. For example patient’s alcoholism, and consequent medications prescribed for a health condition of the patient, which the patient is not supposed to have access to (Kluge, 2001). On the other hand, the rich synthesis of medical reports from various health care professionals available in one place is useful for patients also, particularly since they can be accessed from any geographical location. It may be necessary for patients to have access to their own records, for understanding the changes and progress/ reversal in their health over time, or to refer to the different medications that have been prescribed over a duration of time, for any health condition. Therefore, allowing patients some access and control over their records may be necessary. However, Greely (2000, p.1588) argues that “with medical records, the crucial question is not how to control secondary access but who should get primary access”. Institution-centred problems originate in the delivery and quality assurance obligations of the health care facilities. Electronic medical records would clearly reveal any discrepancies in the working of the various departments of the healthcare facility, and thus reflect the efficiency of the health care institution. Information professional oriented problems may be practical, legal, or administrative in nature, dealing with the maintenance of medical records in a facility. Hence, a clear system should be followed between the information professional, the physician, the various departments related to a patient’s health conditions, as well as the patient (Kluge, 2001). The problems related to the nature and role of electronic patient records falling under the four categories: patient-centred issues, health professional-centred issues, facility-centred issues, and information professional-centred issues discussed above, can also be considered as advantages instead of disadvantages. This is because any discrepancies in the different aspects of medical treatment can be easily identified by reviewing electronic medical records, and corrective measures can be undertaken. Conclusion This paper has highlighted the importance of using the new computer-based technology in recording patient information, as opposed to the earlier system of using paper-based records; and examined the resistance by physicians and other staff to its use. To explain physicians’ unwillingness in using electronic medical records, Davis’ technology acceptance model, and Ajzen’s theory of planned behavior have been examined. Thus, initiatives to address physicians’ concerns may be required. However, increasing acceptance and use of electronic health records by doctors has been indicated by research evidence. The evidence indicates that significant advantages of using electronic health records include its ease of use, of accessibility, and comprehensive representation in one place for all health records of the patient. Thus, the advantages of using electronic health records far outweigh the drawbacks such as physicians’ resistance, and issues related to patients having direct access to medical records. Other disadvantages pertain to the requirement for health professionals, facility and information professionals’ to update information constantly on the electronic patient records, because of the ease of identifying shortcomings in entering required patient information. It was found that the disadvantages related to these factors can also be considered as advantages, because they help to take corrective actions against the relevant individuals or departments in the health care facility. It is concluded that with rising numbers of patients, advancing technological development, and improved health care services, increased use of electronic medical records is a crucial necessity in the field of health care and medicine. References Greely, H. T. (2000). Trusted systems and medical records: Lowering expectations. Stanford Law Review, 52(5), 1585-1593. Jensen, T. B. & Aanestaid, M. (2007). How healthcare professionals “make sense” of an Electronic patient record adoption. Information Systems Management, 24(1), 29-42. Kluge, E-H. W. (2001). The ethics of electronic patient records. New York: Peter Lang Publications. News. (2011, January 11). Ontario survey indicates increasing reliance on electronic medical records. Canadian Medical Association Journal, 183(1), E54-E55. News. (2010, September 27). New funds support rural hospitals’ switch to electronic health records. Managed Care Weekly Digest, 42. Seeman, E. & Gibson, S. (2009). Predicting acceptance of electronic medical records: Is the Technology Acceptance Model enough? SAM Advanced Management Journal, 74(4), 21-31. Read More