EHR in Primary Care Setting - Admission/Application Essay Example

Journal Article Analysis: EMR/EHR in Primary Care Setting Article Analysis: EMR/EHR in Primary Care Setting The provision of primarycare is an indispensible process in virtually all countries. There is an increased demand for medical professionals and health care systems that can help in the administration of patients and other obligatory health care needs. Primary care physicians have developed a recent interest in adapting the EMR/EHR in their medical practice, although few actually appreciate its applicability. Internationally, there is a widespread need to integrate digital systems into the health care setting owing to the belief that they are efficient, and provide quality, and safety for health care processes. Largely referred to as eHealth technologies, electronic systems have proved useful in health care administration and greatly reduced costs incurred by medical facilities. In relation to this, four articles were analyzed to uncover the benefits and shortcomings of the EMR/EHR as eHealth technologies within a primary care setting. In addition, the systematic reviews involved an assessment of their applicability and effectiveness in the quality and safety of health care. Holroyd-Leduc, J, M., Lorenzetti, D., Straus, S, E., Sykes, L & Quan, H. (2011). The impact of the electronic medical record on structure, process, and outcomes within primary care: a systematic review of the evidence. J Am Med Inform Assoc 2011; 18:6, 732-737 Published Online First: 9 June 2011 doi: 10.1136/amiajnl-2010-000019 Holroyd, Lorenzetti, Straus, Sykes, and Quan explore the usefulness of the electronic medical record (EMR)/electronic health record (EHR) in a primary, outpatient, health care setting. The article assesses the potential benefits and negativities of the EMR/EHR in primary-care practices. Holroyd et al review existing literature to uncover the effect of the EMR/EHR within primary-care outpatient practices. After searching relevant literature materials from ABI Inform, CINAHL, Cochrane Library, EMBASE, and Medline, the authors were able to find 30 articles that met their inclusion criteria. The structural and process benefits of the EMR/HER are varied, but the impact on clinical effects is indistinct. In the discussion, analysis was on the impact on healthcare structure, healthcare process issues, and health-related outcomes using Donabedians framework. . Essentially, this means that the system requires evaluation against a comprehensive system of measurement that analyzes its benefits throughout the entire cycle of its operation. There is a possibility that only part of the process may be effective, and in consequence, there is a need to associate a specific value to each function of the system. This evaluation must include a social and technological perspective in which the relationship of humans and the electronic systems is argued from an informed perspective. Mohan, M, K., Bishop, R, O & Mallows, J, L. (2013). Effect of an electronic medical record information system on emergency department performance. The Medical Journal of Australia. 198 (4): 201-204.doi: 10.5694/mja12.10499 Mohan, Bishop, and Mallows explore the effectiveness of the Cerner FirstNet electronic medical record system and the Emergency Department Information System (EDIS) in an emergency department setting. Similar to Holroyd et al analysis, the cost of implementation and maintenance of the EMR system and training of the responsible users of the systems had associated challenges. While there is information on the postulated benefits of the system, FirstNet in this case, there is no specific data on its benefits on specific processes. For instance, there is no specific data on patient mortality because of the generalization. Mohan’s article indicates that there is the need for a ground-up approach in the implementation of an electronic system in health care for staff to understand and enjoy its applicability. Clinical information systems must be specific to purpose for everyone to enjoy their benefit. Both inside and outside forces affect the efficiency of hospitals, similar to the EMR systems. Although there may be an increase in waiting time for patients, there was an insignificant change in the overall waiting time process. This means that the system may be advantageous in one process, but not be effective in the overall process. Little research has been done to explore the risks of implementation of this system in a health care system. It is still unclear if the benefits outweigh its disadvantages, despite the buildup policymakers and technology enthusiast accord the system. There is minimal evidence of its effectiveness in management apart from scattered reports on its timesaving and cost-saving benefits O’ Malley, A, S., Cohen, R, G & Grossman, M, J. (2010). Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less? O’Malley, Cohen, and Grossman’s systematic analysis prove that EMRs both benefit and hinder the functioning of medical practitioners. In their brief, they explore the need for primary care givers to have real-time and face-to-face exchanges with their colleagues and patients. EMR systems discourage interpersonal communication, and this largely intensifies time pressures. In essence, this means that there is a need for communication training for clinicians to ensure that machinery does not hinder the communication and information process. EMR’s are a “double-edged sword” for clinician-patient communication because of the associated shortcomings. Although the system may be useful for a clinician during an office visit, they are also interference during visits (Merrill, 2010). They are useful in communication about treatment plans, which benefits patient outcomes. However, it hinders the communication process because clinicians already have information about the customer, and therefore there is no need for ‘trustworthy’ and first-hand information from the patient. Ultimately, this means that the clinician-patient relationship becomes insincere. For instance, the distance from the computer to a patient may be too long to an extent that a clinician cannot communicate effectively with a patient. In consequence, there is a concentration lapse, which is a hindrance to the whole process. There is a ‘silent period’ when the clinician uses the EMR system, which is awkward in a clinical setting. There should be a lively and productive communication process between the two, to realize better results. Sittig, D. & Sigh, H. (2012). Electronic Health Records and National Patient-Safety Goals. The New England Journal of Medicine. 367:1854-1860 In response to the American Recovery and Reinvestment Act of 2009, health care providers have implemented Electronic health records (EHRs) to advance clinician-patient safety. However, the pace of its development and implementation has been wanting because of the risks it poses. In their article, Sittig and Sigh’s emphasizes the need to explore risks alongside potential benefits. Clinical results present different forms of data sets, for example, lab results or vital signs. The cognitive patterns of clinicians do not follow this pattern, and the introduction of EMRs has complicated the whole issue in multifarious means (Burks, 2012). Adaptation to the electronic process of healthcare not only needs accurate models of clinical knowledge and practice, but also considerable training in EMR/EHR systems. An EMR system presents safety concerns that have multifaceted sociotechnical backgrounds Top of Form. An ill-timed decision may be made if one fails to use the system adequately. Generally, the effectiveness of the system depends on the organizational context in which it is applied. A well-organized setting results in a more successful integration than a poorly organized health care setting. Primarily, there is the need for effective leadership to ensure that a top-down approach exists and every member of staff is aware of the operational process of the EMR/EHR system. This largely depends on whether there is an available instructor to provide technical support and training. The system often involves communication and relaying information, mostly about critical information, and any miscommunication may result in a catastrophe. For that reason, there must be adequate resources to ensure the coverage of all the elements of the system comprehensively. Conclusion Based on the analysis of the articles, it is evident that the EMR/EHR system has a significant organizational impact on community-based practices. However, there is the need for considerable experience to handle the system for a successful health care process. A large gap exists between the hypothesized and empirically established benefits of the EMR/EHR system. Both physicians and members of staff appreciate the use of the EMR/EHR system in the management of patients’ records and management of their job responsibilities. In addition, they are useful in the communication process in a hospital setting, and necessary in the provision of patient health care. The systems may seem complex at first, but after the needed training, they ease the whole administration and management process. The results from the articles indicate that the system is virtually a cost-saving process as compared to paper work. Most health care facilities that implemented the system indicate that it is a less costly process. Despite that, there is no need for generalizations of the whole process. References Burkes, P. (2012). Health care reform is more about caregiving than electronic records, providers say. Retrieved from http://newsok.com/health-care-reform-more-about-caregiving-than- electronic-records-providers-say/article/3638245 Holroyd-Leduc, J, M., Lorenzetti, D., Straus, S, E., Sykes, L & Quan, H. (2011). The impact of the electronic medical record on structure, process, and outcomes within primary care: a systematic review of the evidence. J Am Med Inform Assoc 2011; 18:6, 732-737 Published Online First: 9 June 2011 doi: 10.1136/amiajnl-2010-000019 Merrill, M. (2010). EMRs a double-edged sword for doc, patient communication. HealthCare IT News. Retrieved from http://www.healthcareitnews.com/news/emrs-double-edged-sword-doc-patient-communication Mohan, M, K., Bishop, R, O & Mallows, J, L. (2013). Effect of an electronic medical record information system on emergency department performance. The Medical Journal of Australia. 198 (4): 201-204.doi: 10.5694/mja12.10499 O’ Malley, A, S., Cohen, R, G & Grossman, M, J. (2010). Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less? Retrieved from http://www.hschange.com/CONTENT/1125/ Sittig, D. & Sigh, H. (2012). Electronic Health Records and National Patient-Safety Goals. The New England Journal of Medicine. 367:1854-1860 Read More