Pros And Cons of EHR systems Essay

Review the history of electronic health records (EHRs) and discuss the pros and cons of EHR systems. How do EHRs help maintain accurate patient records? Which types are available to the health community? What are the ethical considerations needed when using EHRs? Support your responses with scholarly research. Use the Internet and the WCU online library databases to research peer-reviewed articles on EHRs. Compose a three- to four-page research paper in APA format. Your research paper should have a title page, an abstract, headings that delineate the specific assignment requirements, in-text citations, and a reference page. Cite a minimum of three references. Pros And Cons of EHR systems Essay

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The paper demonstrates that the author fully understands electronic health records. The history of EHRs, including the different types of EHRs available, is discussed. Both the pros and cons of using EHRs is presented. Accuracy and ethical considerations with using EHRs are presented. All evidence is supported with timely scholarly research.

A clear and concise topic statement in the abstract provides direction for the paper Headings that delineate the specific assignment requirements are present. Concluding remarks demonstrate analysis and synthesis of ideas. Writing and integration of source materials is eloquent and skillful. Pros And Cons of EHR systems Essay

The advancement in technology has rapidly transformed the world today, and the increase in the number of web-enabled devices has completely changed peoples ‘ lives especially the way they communicate. Electronic Health Record system, which is a digital copy of a patient’s medical history is one of the revolutionary ideas that have come with this advancement. Electronic Health Records (EHRs) are instantaneously updating records that are patient-centered designed with the aim of providing real-time information to the authorized users (Cohen, 2010). It contains all the patient’s information that is in the hand of the medical providers including their medical history, treatment dates and types, immunizations conducted to the patient and their dates, radiology images and all the laboratory results from the tests conducted in the past. All this information is held in a digital format and can only be updated by authorized users who are stationed in the medical facilities. Electronic records are designed to make it easy for different health providers and organizations to share patients’ information which streamlines their operations since all the necessary information and history can be accessed from any location at any time. Pros And Cons of EHR systems Essay

Did you ever think about how much time is spent on computers and the internet? It is estimated that the average adult will spend over five hours per day online or with digital media according to Emarketer.com. This is a significant amount; taking into consideration the internet has not always been this easily accessible. The world that we live in is slowly or quickly however you look at it: becoming technology based and it is shifting the way we live. With each day more and more people use social media, shop online, run businesses, take online classes, play games, the list is endless. The internet serves billions of people daily and it doesn’t stop there. Without technology and the internet, there would be no electronic health record. Therefore, is it important for hospitals and other institutions to adopt the electronic health record (EHR) system? Whichever happens, there are many debates about EHR’s and their purpose, and this paper is going to explain both the benefits and disadvantages of the EHR. Global users of the internet can then decide whether the EHR is beneficial or detrimental to our ever changing healthcare system and technology based living. To begin, there are numerous advantages throughout the EHR system. Considering this, enhancing patient safety is priority in the healthcare industry. Reminders, alerts, and pop-ups are just a few of the safety features an EHR can provide. These items can prevent medication errors, by alerting a nurse or physician of a blood sugar that is out of range, or a medication with too high of a potency, such as a wrong dosage amount. Reminders can be as simple as an immunization reminder to get a flu shot. Another example could be a drug interaction between NSAIDS Pros And Cons of EHR systems Essay

Electronic medical records (EMRs) are becoming the new normal in medical clinics and hospitals across the United States. Medical practitioners are utilizing this form of patient data recording system that is replacing the traditional paper trail of patient records. The aim is to make patient records available in one system that follows the patient to each medical practice setting so that data does not have to be continually re-entered from one entity to the next. This new system enables doctors, nurses, and medical administrators to access and update patient data as needed which provides timely and accurate information.
The primary objective of EMRs is to provide a higher level of patient care that stems from “increased efficiency, better accuracy, reduced costs, and improved outcomes” (Rantz, Skubic, Alexander, Popescu, Aud, Wakefield, & Miller, 2010, p. 13). By compiling patient data that is a combination of standard healthcare assessments and emergency medical assistance into one record, this vastly reduces patient data being compromised. It further eliminates the time involved waiting for critical patient information to be transferred from one place to another. Moreover, this enables medical practitioners’ greater ability to accurately diagnose and treat patients in a greater timely fashion which results in greater outcomes for patient healing and recovery from illnesses. Pros And Cons of EHR systems Essay

EMRs come in all forms utilizing a variety of technology and technological devices in the securing and housing of patient medical data. Not only can patient data be accessed via computer, but many doctors and nurses carry handheld devices with them throughout the day and are able to access patient data as needed. For example, it is not uncommon to walk into a doctor’s office and see a computer setup in the examination room. Upon taking patient vitals, the nurse logs the information into the computer along with information obtained from the patient regarding symptoms. The doctor comes into the room and goes to the computer to read the notes taken by the nurse. He can also refer to previous illnesses and determine when the last time a patient had the same illness, what he prescribed, and make his assessment based on the information he has coupled with examination of the patient. This method works in similar fashion to the medical charts that were previously used to record patient data. The only difference is now information can be accessed not only in the doctor’s office but anywhere the patient goes for medical treatment. Transmission of patient data is a streamlined over a secure server if needed to be transmitted to doctors and hospitals outside of a given patient network. For example, if a patient needs medical attention while on vacation or out of town on a business trip, his records can be accessed by the attending physician from the patient’s existing medical practitioner. Having accurate patient data readily accessible enables any medical provider to accurately examine and treat patients based on their history rather than through traditional trial and error means of diagnosis. Pros And Cons of EHR systems Essay

An extension of making patient data available as EMRs is through pharmacies. Patients can get prescriptions filled and refilled at national-chain pharmacies across the U. S. because their existing data will be housed in their system and can be accessed from any local branch. This eliminates patients from having to go to a particular location to have their medications filled/refilled. This has provided ease and convenience to patients when on vacation, on business trips, and traveling who may suddenly run out of medications or find they have forgotten to take their medications with them. Pros And Cons of EHR systems Essay

The medical industry has designed a myriad of EMR recording software applications that are compatible in a variety of formats and offer various integrated functions. Most software applications are designed to be a comprehensive one-size fits all package that enables users to do everything from record patient data, to sending patient appointment reminders, to generating and tracking prescriptions that can be pushed out to patients’ pharmacies of choice, and integrated insurance and billing system. These software programs are designed to be used by various individuals involved in a patient’s total delivery of care (Captera, 2011).

A new, innovative means of utilizing EMRs is through a new process called telehealth. As the Internet and digital resources have become integrative and accessible, this has generated new ways of connecting with patients (Cason, Hartman, Jacobs, & Richmond, 2013). This system allows patients to access medical practitioners remotely via the Internet, using apps such as Skype, and specially designed software programs that are specific to a given medical office. Telehealth is currently being used in the diagnosis of common ailments such as colds, the flu, and other acute illnesses. Patients can have one on one conversations with doctors and nurses about their symptoms, check their vitals remotely and upload data to web portals, and be treated accordingly. They do not need to visit their medical practitioner unless testing or additional treatment is required. Pros And Cons of EHR systems Essay

This means of patient care is the latest in new technologies that are making it possible for patients to get adequate care in a timely manner. Treating patients in this way greatly reduces the number of patients that have to be seen in the medical practitioner’s office. Thus, with fewer patients being seen for treatment, this reduces exposure to other patients and the spread of germs. One of the many positive things about telehealth treatment is it is available to populations such as the elderly, chronically ill, and patients living in rural areas making the quality of care of patients exponentially improved in ways like never before.

With the strides and innovations that have been made in the integration of EMR technology, the medical profession is seeing a much improved system of overall patient care. One of the biggest benefits of EMRs is the ability to gather and archive data for assessing to which level diagnoses are improperly and incorrectly determined. EMRs provide a tracking system that enables medical professionals to connect with patients in a timely manner regarding test results, schedule appointments and set reminders to keep patients on track (Pros and cons). Overall, EMRs have proven most effective in the treatment and care of patients. Pros And Cons of EHR systems Essay

With passage of the Patient Protection and Affordable Healthcare Act, electronic health records have been widely adopted across healthcare organizations large and small. While there are many benefits to EHRs — improved accessibility to patient data, increased charge capture and improved preventative health — there are inherent problems in adopting this technology.

An EHR is only as good as the processes that it supports. If the technology is not supported with well-thought processes, hospitals may invest in complicated and expensive technologies that create more waste in a system already fraught with inefficiency.

When adopting new technology, vendors and healthcare providers from the early stages of EHR planning need to identify and eliminate waste in processes that involve the use of EHRs to ensure positive outcomes before making large investments. Lean management in healthcare is a valuable tool way to meet this objective as it educates hospital executives, clinicians and staff to seek out and eliminate waste. Pros And Cons of EHR systems Essay

When an EHR is implemented, unnecessary waste is often eliminated. However, if the system is flawed, implementing new technology can create more problems, and the results can be “bad,” or worse, “ugly.” It is imperative that healthcare executives understand the benefits and challenges of EHRs and what can be done to eliminate them.

Let us begin on a positive note and take a look at the “good” EHRs can offer practices and health systems alike to start. I’ve outlined from my experience the six main benefits.

The good

1. Improved data accessibility
Before EHRs, access to medical charts required a fair amount of physical labor. For example, every time a patient visited the office or hospital, their file had to be physically pulled from a storage space, transported, delivered (batch processing), stamped and sorted all in one visit. As a result of this back and forth, there was a greater chance of human error and charts would sometimes be missing information or be chronologically out of order. In my experience, it was not unusual for five out of 15 charts for a clinic day to be unavailable at any given time, which ultimately resulted in wasted time, space, motion and frequent defects to care. Pros And Cons of EHR systems Essay

EHRs, on the other hand, have eliminated the physical transporting, sifting and filing of charts, making data available at all times. Additionally, for systems that allow remote access to charts, clinicians can even be off site and still securely access patient files. Storage and inventory is also reduced, freeing up physical space within the hospital or office, and allowing the redeployment of human resources. Unnecessary movement is eliminated, ultimately eliminating batch delivery and improving the flow of patients and information. Most importantly, the culmination of the reduction in waste is improved quality of care for the patient.

2. Computerized physician order entry
CPOE allows physicians to place lab and imaging orders, prescriptions and other notices electronically, reducing the error of hand-written orders and allowing the patient’s other physicians within the EHR network access to the order. That means, if a patient is prescribed a drug from his/her cardiologist and they are on the same EHR, the primary care physician will have access to the prescribing information. This not only reduces time, but also dramatically reduces errors — such as duplicate prescriptions or drug interactions — and potential harm to the patient. Pros And Cons of EHR systems Essay

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3. Charge capture
Healthcare organizations keep track of (“capture”) a patient’s use of hospital resources, such as equipment, medical supplies, diagnostic testing, medication and hospital staff. These charges are recorded and then billed to patients and third-party payers. Often, the use of a resource may be overlooked. The process behind “charge capture” can be complex, making it very important that that a system is in place to capture charges completely and correctly, maximizing the potential reimbursement for revenue.

With an EHR system, at least one diagnosis must be captured along with a level of service that documents what was done for the patient at the end of every encounter. Additionally, the EHR includes a list of selectable Current Procedure Terminology codes that allows for easy input and helps reduces errors, ensuring the right code is used. Pros And Cons of EHR systems Essay

4. Preventative health
EHRs allow for prompts for preventative health screenings. During routine doctor or urgent care visits, the physician has access to preventive health records conveniently in one place. If the patient is due for a cancer screening (such as mammogram or colonoscopy), or blood pressure testing, the doctor can set easily look this up via the EHR system and schedule an appointment for the patient.

What’s more is EHRs allow data analysts to mine the entire system for say, all patients with diabetes who haven’t had their hemoglobin A1C and cholesterol check within the past year. From there, the analysts can provide the physician with a list that allows practice management to contact the patients to schedule these preventative health appointments. This type of data mining cannot be done through paper records.

5. Ease sign off for PAs and NPs
While this varies from state-to-state by law, physician assistants and nurse practitioners are typically required to have their notes approved and signed off on by their supervising physician. EHRs allow the revision and cosigning of notes to happen electronically as opposed to physically moving and signing paper. Pros And Cons of EHR systems Essay

6. e-messaging between providers
As any physician can attest, telephone tag between providers can be common, and is a big time-waster. With EHR software, physicians can e-message across practices. One situation that benefits in particular from e-messaging is referrals. Rather than playing telephone tag to get an appointment scheduled, the physician electronically send a message to schedule the appointment. Pros And Cons of EHR systems Essay

The Bad

1. Lack of interoperability between information technologies/EHRs
With more accountable care organizations emerging across the U.S., technology plays an essential role in developing an ACO, allowing primary care physicians to track and follow the patient flow throughout the healthcare system. Part of the driving force behind the model stemmed from the need to integrate EHRs throughout the health system and share information with network of referring hospitals. However, this sharing of information is often not possible. Finding a hospital partner that is willing to open the lines of communication is critical to the success. For example, Simpler Consulting client Atrius Health worked closely with Beth Israel Deaconess Medical Center and Epic Systems to develop a web portal that allows the two provider organizations to access each other’s EHR systems for shared patients.1 If this planning and integration is not put into place, communication can become a serious problem and result in additional follow up, time and waste. Pros And Cons of EHR systems Essay

2. Cost of set-up and maintenance
The cost associated with EHRs is often a deterrent. Not only must the provider pay for the physical hardware and/or software, the organization must also put forth a considerable dollar amount for setup, maintenance, training, IT support and system updates. For many smaller practices with lower cash flow, cost alone prohibits the ability to properly implement and maintain the system. Pros And Cons of EHR systems Essay

3. Productivity
A study conducted by the University of California-Davis found a 25-33 percent drop in physician productivity in the initial implementation phases of the EMR.2 While ultimately the goal is to increase productivity in the office or hospital, expect to see a significant drop in productivity, and ultimately revenue, in the first several weeks, and perhaps longer. Pros And Cons of EHR systems Essay

4. Delays in documentation
This may come as a shock to many, however, EHRs actually increases the physician workload. With written notes, documentation tended to be briefer and straight to the point. With EHRs, much more documentation is required of physicians before, during and after a patient visit. This has its pros and cons. For example, a benefit of more robust documentation is that it provides additional information for the coders that may justify a higher level of service being billed. On the negative, it can cause further delays and errors as physicians often wait to close notes until the end of the day or, sometimes, days later. Thus they rely on memory to enter correct information. Additionally, if a patient is seeing a different provider, others will not be able to access this updated information until the note is closed. Pros And Cons of EHR systems Essay

As with most systems, however, shortcuts can be built into and customized for the physician to reduce some documentation. Standard work is needed to ensure provider support and learning.

5. e-Messaging between providers
While e-messaging is listed above as a benefit, it can also be a drawback as it can result in a lack of face-to-face or phone-to-phone conversation. With EHRs, there are no give-and-take conversations or question-and-answer scenarios. There is no way to express emotion, nuances or voice your concerns or fears. Rather, physicians must trust that the information they are providing is what the other physician needs, interpreted without confusion and read at all. This is not always the case.

6. Continuous need for updates and lack of accountability for doing so
For every task large or small — whether it’s a basic wellness visit, a diagnosis, a procedure, a treatment or a prescription — the EHR system requires a corresponding update. For example, when you have an active “problem list” for a patient (e.g., diabetes, hypertension, high cholesterol, etc.) someone has to be responsible for updating his or her medication and keep the problem list accurate. Pros And Cons of EHR systems Essay

However, in my experience, I’ve seen a significant lack of accountability for making constant updates which needs to be addressed across all health systems. For example, when patient has a surgical procedure, this needs to be added to the health record so that all those with access to the EHR can see the work that has been done. The question is, however, who is responsible for updating? The primary care physician or the surgeon? There needs to be a clear, communicated system between all of the patient’s doctors and nurses so that updates are made efficiently and by the right persons.

The Ugly

1. HIPAA violations
Since EHRs allow for easier access to sensitive information, there is an increased risk of privacy violations. These may include intentional “snooping” or may be accidental by using improper security measures. Thankfully, many systems have implemented a forensics piece to track what files are accessed when and by whom. Pros And Cons of EHR systems Essay

2. Empty data fields
While this issue varies by the proprietary nature of the system being used, many EHR systems allow for auto-population of data for new records. While these shortcuts save some time and effort on behalf of the physician, they can also result in inaccurate new records if the previous auto-populated record is not current. For example, if a patient went in for surgery in June and this was not or improperly documented, a “no data available” empty data field error message or, even worse, inaccurate information could be displayed. Once again, the creation of standard work and managing to these standards is critical to prevent this type of problem.

3. Copy and paste
Copy and paste is by and large the biggest ugly of all the shortcomings of EHRs. Because documentation is more involved with EHRs, physicians may rely on the copy and paste function as a shortcut, particularly for routine or follow-up visits. While this may save time for the physician, this puts the patient’s safety at risk and impairs quality of care as updates or changes between visits can be overlooked or not documented properly. Pros And Cons of EHR systems Essay

In closing
The advantages of EHRs to the physician, hospital or physicians’ office and patient alike are considerable. That being said, the “bad” and the “ugly” can often outweigh the “good.” To avoid these issues, hospitals and healthcare systems must perform a thorough evaluation of the EHR system before purchase and implementation. Unfortunately for many, this is a step often overlooked. In fact, a recent Black Book Rankings survey mentioned above found that 79 percent of the 17,000 participants surveyed reported they did not sufficiently evaluate their needs prior to selecting their EHR system.3

Taking the time to evaluate new technology and implement a new process, such as Lean management, to evaluate workflows and identify and eliminate waste before implementing a new EHR system, will help improve implementation, foster communication, decrease non-value added work and ultimately increase adoption…Pros And Cons of EHR systems Essay