Electronic Health Records

There are several benefits that can be obtained through the use of electronic health records. These benefits go to all the parties involved in the healthcare facilities mainly the clinicians, healthcare managers and the patients. Below is an outline of the major benefits that each party will get (Kastania, 2010).

Clinicians

Clinicians are the medical workers directly involved with the patients, to be they nurses, physicians, psychiatrists or psychologists. They may be operating in private practice or they may be in the public health sector. All medical facilities keep records on the patients they attend. The following are the benefits that EHR may have for them in the course of their practice (Carruthers, 2009).

Promotes evidence – based decision making

Availability of a system of information that is easy to access and which is detailed pertaining to a patient will assist the clinician to make solid decisions about the patient’s needs based on the past data such as drugs administered, allergies found, reactions to certain drugs or procedures and effectiveness of initial treatments (Health & Medicine, 2006). For instance, if a patient had been treated in a certain healthcare facility for a particular disease and then he returns with the same complaint, the clinician, after referring to past medication given to the client, may choose to change the medication. They will find it easier to locate the patient’s health records from the EHR than from physical documents such as files, which can easily be misplaced or be concealed in huge volumes of files (Milewski, 2009).

Allow easy access to support information

Most systems offering EHR will also have integrated research and technical data on medical practice information regarding a wide range of health issues. Information such as current research, online doctors’ consortiums, and other developments in the field of healthcare provision will be easily available using EHR from many hospitals all over the world. It will be easier, for instance, for a clinician to perform a quick search of documented similar health issues to those of a patient they are handling without having to leave their station and search in file cabinets, journals and statistical manuals (Haugh, 2006).

Timely, reliable, easy patient information management

Presence of an integrated electronic health information system will allow clinicians to find and follow up on patient issues such as bookings, progressive lab reports and medical history more easily and conveniently than paper records. As such, it also allows easy patient file sharing and information access between clinicians in facilities where patients are not assigned personal doctors (Koeller, 2002).

Healthcare Managers

Health care managers are the professionals responsible for the leadership, administration and management of hospitals, healthcare systems or networks. They have the responsibilities of ensuring a progressive, efficient working environment in the healthcare units (Menachemi, 2006). They oversee all departments such as radiology, laboratory and pharmacy among others. They also possess practical skills as clinicians. Some of the benefits of EHR as pertains to their role are as follows:

Easy workflow management

Electronic Health Records combine total patient experience in a healthcare facility including laboratory reports, bookings, billing reports, referrals among others. Additionally, the EHR’s may contain statistical analyses of a healthcare facilities operations such as a number of patients seen in a unit time, medical traits of patients in response to a particular treatment, number of referrals into and from the hospital and so on. Such information is necessary for healthcare managers and hospital management teams. It may also be required by the National Public Health Committees (Kathleen, 2000).

Easy inter-hospital patient information sharing

EHR’s provide each patient with a unique patient identifier number, called a Master Patient Index (MPI) (Menachemi, 2006). This number can be traced back to a particular patient regardless of which care facility they access. Even though EHR’s do not automatically result to patient data access outside of the primary institution where it is retained, and any such data sharing may be governed by certain industry and privacy regulations, EHR’s will ultimately allow health care management to do vital services such as referrals, pharmacy transcriptions, more easily with completed, updated patient records. This will allow continuity in health care for patients in different hospitals (Health & Medicine, 2006).

Cost reduction

Though the initial cost of equipment installation maybe costly, the day-to-day expenses of a healthcare unit can be greatly reduced if it applies the appropriate EHR system. Far from saving time thus reducing the workforce, it will also reduce other facilities like cabinets, files and free up space that can be used for other purposes (Favreau, 2011).

Patients

The benefits of the EHR to the patient are as follows:

Easy access to Personal Health records

EHRs provided easy access by the patient to their health records including past diagnostics, medical traits, drugs administered and much more. If the EHR is available online, the patient may also be able to manage health bookings and consultancy (Perlin, 2006).

Easy record retrieval

Due to the fact that EHRs are centrally stored and managed, the cases of personal information loss due to negligence or misplacement are reduced. This means that patients will not have to fill in fresh forms each time they visit a healthcare facility (Appel, 2008).

Time saving

Patients spend less time waiting to be attended, as in the case with physical records retrieval. With EHRs, the clinician has all the files centrally placed and easily accessed (Bourne, 2009).

Barriers and Risks Associated with Electronic Health Records Implementation

There are, however, barriers hindering optimization of EHRs, as well as risks that should be resolved. The issues as discussed below.

The information contained in EHRs is accessible by various departments in a healthcare unit, an aspect that requires a very secure maintenance procedure. High standards of security also translate to high cost of implementation and maintenance, which majority of care providers may not afford. Further to this, clinicians in a facility may have different competencies in EHR systems usage. This may become dangerous when vital information is either omitted or accidentally altered (Hoffman, 2008).Apart from security concerns within the organizations, it is also to be considered that such health record systems are prone to unauthorized access and damage by external parties such as web hackers, viruses and other internet based security threats.

EHRs are centrally managed where different personnel may have access to them. For instance, a patient’s medical record may be easily accessed by different departments within a facility and even externally by other healthcare units. This means malicious usage of patient information can result. There is also the issue of manipulation of data, where patient’s information maybe wrongly entered leading to wrong diagnosis and medication (Smaltz and Eta, 2007). Due to the fact that EHR usage is a relatively recent development in medical practice, there are no sufficient rules governing the use and disclosure of personal information. This is a major challenge in the use of EHR systems.

For the EHR system to succeed there need to be an accountability and integrity in carrying out the different roles in medical practice. This will include accountability on the parts of the patient, clinician, other hospital staff, health management and insurance companies. While health care key players and governments may try to implement such measures, there are concerns that the number of personnel with access to EHR would be so great and the patient base so huge that there would be mass breach of confidentiality and patient privacy ( Bourne, 2009).

There are no clear set rules and regulations governing the creation, retention and sharing of patient information. Firstly, there need to be a harmonized way of creating a patient’s file. This involves having a unique patient identifier that will apply across all health care providers. Secondly, there is a need for a standard layout for patient information collection across the healthcare profession (Menachemi, 2006). Thirdly, there must be a standard way of information sharing between the various hospitals of healthcare units when the need arises. Such circumstances include referrals, change of preference by the patient or even cases where certain healthcare units close down and patient information needs to be retained.

There have been two approaches suggested to enhance health data sharing between hospitals. These were the centralized data server model and the peer-to-peer model of file synchronization. While both are viable, they are still rendered unusable because there is no standardized method or format of record creation (Association of American Medical Colleges, 2007). This means that even if the records would be passed to different units, the usability of these records would be limited.

Bourne (2009) indicates that a discharge summary is an important document for the purpose of transferring information between the primary care physician and hospitalist, although it has not been accorded the priority, which it deserves. Some of the information to be included in the discharge summaries includes reasons for hospitalization, methods and treatment offered significant findings among others. The main challenge facing the information to be included in the discharge summary is determination of the extent of the significant findings. Although some healthcares interpret significant findings to mean only the abnormal results, most of them do not recommend the limiting of this summary to the abnormal findings. For example, the failure to indicate that a mass was changing may result to a repeated testing process, thus there is need specific on aspects such as imaging among other notable tests. Generally, over 90% of challenges facing information to be included in the discharge summary mainly results, due to lack of time for hospitals to adequately harmonize care with primary care practices.