Benefits and Drawbacks of the Electronic Health Record - Research Paper Example

Benefits and Drawbacks of the Electronic Health Record The objective of this paper is to outline the advantages and drawbacks of the implementation of an electronic Healthcare Register (EHR). This paper has introduced the topic outlining the various aspects of EHR and how it has changed the modern healthcare facilities. The second part of this study presents a review of literature on the various advantages and drawbacks emanating from its implementation. In the last section, this paper presents a conclusion and summary of the paper including the risks and recommendations necessary to ensure safety and security of electronic information. Introduction The past decade has witnessed technological advancement in virtually every industry. Compared to a decade ago, many people in developed economies can now purchase goods online, buy air tickets and earn degrees online. Health records have for a long time depended on the traditional system of record keeping that is tedious and prone to errors. Electronic health Record (EHR) system plays a vital role in transforming the healthcare system mainly from a paper based system to a comprehensive computerized system through the use of clinical information to deliver high quality care to the patients. Various countries have come up with laws that manage require the healthcare facilities to adopt EHR and utilize it in a “meaningful way” with respect to cost containment and errors reduction. This is expected to transform the healthcare institutions for the benefits of both patients and administrators. However, there are various concerns over the use of EHR and questions are asked whether it really meets the intended benefits that are to improve care with acceptable level of errors. This study focuses on the review of literature on the impacts of EHR. As stated by Dentler et al (2014), EHR impacts are either beneficial or drawbacks, thus this study embarks on the merits and demerits of implementing an EHR by a healthcare facility as identified by experts in various studies. Electronic Health Register (EHR) refers to the longitudinal electronic record of patients’ information with respect to health that has been generated through one or more encounters with the patient. EHR contains the patients’ information related to progress, demographics, past medical history, vital signs, radiology reports, laboratory data, problems and medications (Page et al, 2011). According to Menachemi & Collum (2011), three attributes defines a “meaningful use” of EHR: Computerized Physician order entry (CPOE) systems, Clinical Decision Support (CDS) and Health Information Exchange. These are attributes of electronic health Register that are expected to help in reducing cost while improving the quality of care. The availability of the above data in electronic form is vital since it helps in sharing of patient information with ease. In the following sections, we are going to review literature on the effects of EHR on the various healthcare facilities. Literature review Advantages of Electronic Health record System Health professionals have studied the impacts of EHR by considering three main areas of impacts; the organizational outcomes such as improvement in financial and operation management and patient satisfaction, clinical outcomes such as reduction in errors and improvement in quality of service to the patients and societal outcomes such as improving the health of society through accurate scientific research based on factual and accurate data which is necessary for the overall improvement in patients’ health. Research show that the use of EHR has positive impacts on organizational performance and outcomes of both inpatient and outpatient activities. According to a study by Rothman et al (2012), Electronic Health record improves the performance of an organization with respect to the revenue collection, reduced cost, improved regulatory and legal compliance, increased job satisfaction and improved ability to conduct high quality scientific research (Rothman et al 2012). Several studies have suggested that the implementation of EHR results into reduction of billing errors with subsequent increase in charge capture. This is important since it is critical in maintaining favorable cash flows which is necessary for organization to meet their operation costs and improve performance. Manual health registers are associated with averted costs of which Electronic health register intends to eliminate. Revenue can also be enhanced by the use of electronic health reminder for providers and patients for routine visits that can potentially enhance revenue collection (Rothman et al 2012). In this respect, the use of electronic health register play a vital role in reducing redundancy associated with mailing of hard copy prescriptions or the cost of transcriptions and the management of hardcopy. As stated by Mold et al (2012), EHR supports the point of care documentation thus capture patients record accurately as well as the other structured documentation procedures. A study by Dentler et al (2014), documented a reduction in dedication of staff resources to anemia management for hemodialysis patients when CDC was implemented for use for medication dosing. The reduction in malpractices and fraud was also documented by Menachemi & Collum (2011), who reported a reduction of fraud claims from 10.8% to 6.1% as a result of implementation of EHR. The clinical outcomes are closely related to the quality of patient care as well as the safety of the patients. Mold et al (2012) defines quality of care as “doing the right thing at the right time and in the right way and for the right person and having the best possible outcome”. Research has shown that the implementation of EHR is closely correlated to the improvement of patient safety as well as reducing chances of injuries to the patients by improving accuracy of medication (Page et al 2011). It is important to note that even though the intention of providers is to give the best care possible to their clientele, certain encounters often lead to practices that do not adhere to stipulated guidelines. These may be due to clinician’s ignorance of the guidelines, lack of enough time during patient visit or lack of knowledge on the application of the guidelines. Page et al (2011) conducted a study on the impacts of EHR on efficacy of vaccinations and documented that physician reminders through a computerized system increased vaccinations against serious illnesses including influenza from zero to fifty percent for hospitalized patients. EHR also play vital role in enhancing patient safety through reduction of medical errors. Research has shown that implementation of CPOE is correlated to up to 55% reduction of serious medication errors in the hospital and healthcare setting while integration of CDS with CPOE results into up 86% reduction in errors (Mold et al, 2012). CDS also results into reduced complication and mortality rates since there is enhanced safety of medication procedures at reduced costs. EHR has the potential of improving research and development thereby bringing lots of benefits to the society. Having patients’ data stored electronically increases its availability hence it would be easier to get and analyze data for quantitative outcomes hence decision making based on factual information (Mold et al 2012). This is critical as a public health process since it is used to conduct research that is beneficial to the society. Moreover, there is evidence showing that there is satisfaction among the physicians as a result of implementation of electronic health register in both public and private health set ups (Bouamrane & Mai, 2013). Potential Drawbacks of Electronic health Register Even though many studies have identified several advantages associated with implementation and the use of EHR functionalities, certain potential disadvantages have been identified. One of the major disadvantages identified by experts is the security and privacy concerns (Menachemi & Collum, 2011). Due to the increasing exchange of patients’ information among health professionals, there is potential risk of violating the privacy of patients. It is therefore important for the policy makers to take appropriate control measures with a view to ensure privacy and safety of the patients’ information and data. A legislation to control patient data must strive to guarantee 100% data security which poses serious challenge between the need to balance sharing of data and protecting privacy. The implementation cost is the other disadvantage associated with Electronic health register in a healthcare system. There is high cost of implementation, maintenance as well as the temporary loss of revenue during implementation and transition period. Other costs associated with HER implementation are the cost f purchasing software, hardware as well as training costs for staff and the time and financial costs involved during the transformation of hard copy medical charts into electronic ones (Rothman et al, 2012). These high initial costs as well as the maintenance costs have been cited as the potential barriers to the implementation and adoption of electronic health register by small healthcare and clinics. This is because the high cost may not result into high returns if the number of patients visiting the facility is low. The other disadvantage is the temporary loss of productivity due to the disruption of the workflow for the medical providers and staff. According to Rothman et al (2012), the implementation of electronic health register is estimated to result into approximately 20%, 10% and 5% loss in productivity during the first, second and third months respectively. It is important to note that the loss of productivity is expected to result into serious financial losses depending on the type and duration of implementation. Errors in implementation and maintenance are also likely to result into higher losses if not detected earlier especially during the initial implementation periods. Conclusions and Summary Electronic health records (EHRs) is the modern trend in healthcare services since its associated with many benefits. These benefits are: improvement in operational and financial performances enhanced clinical outcome and increased research and development which is beneficial for the society due to new inventions. While EHRs enhance the overall process of healthcare delivery, there are certain concerns with respect to its implementation. The first is the high cost incurred during implementation and maintenance, second is the temporary loss of productivity during implementation, training and maintenance and thirdly is the growing concern over the safety and privacy of electronic shared records. It is however important to note that the benefit outweigh the disadvantages hence policy makers must implement policies necessary to ensure 100% safety and privacy guarantee of EHRs. This can be achieved through proper legislation, testing and validation of the system on a regular basis. References Bouamrane, M., & Mai, F. S. (2013). A study of general practitioners perspectives on electronic medical records systems in NHSScotland. BMC Medical Informatics & Decision Making, 13(1), 1-12 Dentler, K., Cornet, R., ten Teije, A., Tanis, P., Klinkenbijl, J., Tytgat, K., & de Keizer, N. (2014). Influence of data quality on computed Dutch hospital quality indicators: a case study in colorectal cancer surgery. BMC Medical Informatics & Decision Making, 14(1), 1-17 Menachemi, N., & Collum, T. (2011). Benefits and drawbacks of electronic health record systems. Risk Management And Healthcare Policy, 447-55 Mold, F., Ellis, B., de Lusignan, S., Sheikh, A., Wyatt, J. C., Cavill, M., & ... Jones, S. (2012). The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol. Informatics In Primary Care, 20(4), 271-282 Page, L. A., Seetharaman, S., Suhail, I., Wessely, S., Pereira, J., & Rubin, G. (2011). Using electronic patient records to assess the impact of swine flu (influenza H1N1) on mental health patients. Journal Of Mental Health, 20(1), 60-69 Rothman, B., Leonard, J. C., & Vigoda, M. M. (2012). Future of Electronic Health Records: Implications for Decision Support. Mount Sinai Journal Of Medicine, 79(6), 757-768. Read More