An Electronic Medical Record is a digital record of a patient’s chart and it contains their medical history. The computerised system implementation has been unsuccessful in some health care facilities. In most cases, user resistance has been the main factor why the systems have failed. The advantages of the systems are numerous ranging from improved quality care, increased patient satisfaction, financial savings, and decreased time spent on paper records. The following paper will evaluate the benefits of EMR in matters of cost, quality, and patient satisfaction.
Electronic medical records have a number of benefits like prevention of medical errors, improving the quality of care, and reducing care costs. Cost is one of the main hindrances of adopting EMR systems. To evaluate the EMR’s impact on cost, a cost-benefit analysis will be conducted. The analysis will help scrutinize the benefits of implementing an EMR system. Other organisations employ this strategy during decision-making processes. According to Choi, Le, and Rhee (2013), a newly implemented EMR system is expected to create additional benefits that did not exist when using the paper-chart system. The costs can be divided into two, induced and system cost. System costs include building infrastructure, purchasing office supplies, and developing EMR applications. Induced costs are incurred to ensure a smooth adoption of the system. An analysis of the cost is necessary to determine if the cost incurred during implementation is worth the benefits brought by the system. When evaluating the benefits, we will check for the cost reduction due to the elimination of chart systems. Such reductions include reduced number of employees managing the charting system, reduced storage space, and reduced supplies to maintain the charting system. If the benefits resulting from its implementation are more than the cost, then the EMR system has been a feasible project for the facility. The study’s analysis will check the overall benefits since the EMR system was implemented. It will check if the hospital has had a positive or negative cash flow since the deployment of the system. The adoption of information technology systems takes longer in the health care industry. There are other hard-to-quantify benefits that the system may have contributed. We will check for factors like increase of induced costs, the positive effects on NPV, and other additional revenues the EMR has contributed (Choi et al., 2013).
User satisfaction from implementing EMR systems plays a huge role in evaluating the implementation and its use. Despite the various advantages of implementing EMRs, the system can be unsuccessful if it does not satisfy patients. A number of studies have been conducted on the impact EMR systems have on patient satisfaction. A majority of the primary care providers are not likely to see benefits from a patient’s perspective. To check for changes, we will evaluate data collected from pre-implementation and after implementation (Joos, Chen, Jirjis, & Johnson, 2006). It is difficult to get patients to respond to satisfaction if they did not experience the charting systems before the EMR systems. For this evaluation, patients will be asked to fill in questionnaires pertaining to questions of their satisfaction. It will include questions on whether they have noted changes in care and how they compare the changes to the previous system.
The effect of implementing Electronic Medical Records on the quality of care to a patient depends on the quality of interaction between a patient and a physician. The quality of the relationship can be based on skills, language differences, age and education level. The quality of communication between a patient and a physician depends on trust. A number of factors affect the patients’ level of trust in their doctors. Some factors are before the visit and they include doctor’s credentials, past interactions, and reviews. During the visit, factors like the quality of interaction and a doctor’s behaviour affect the trust. The benefits of EMRs are derived from a facility’s ability to look at patterns and identify the problems. It facilitates the improvement of quality and creates an opportunity to redesign. The evaluation will include taking a look at the hospital’s quality report programs to generate reports on performance with benchmarks and trends. We will also check whether the use of EMR system saves time for physicians. Some reports claim that professionals spend more time documenting records on the system. Some claim that the system saves times since the physicians do not have to look for patients’ records when they need to update them or check for other information (Koulayev & Simeonova, 2010). In order to gauge the physicians’ benefit from the EMR systems, the evaluation will check for the time spent with patients, ability to access records faster, the increase in making accurate diagnoses and the patient care. If physicians can make more accurate diagnoses since they can access up-to-date patient information from anywhere, then such a trend shows an improvement in the quality of care. The evaluation will check whether the use of EMRs has made performance faster and has increased the efficiency. This is due to improvements from the ability to review and retrieve charts remotely and find patient information easily.
The implementation of EMR systems will be to the benefit of the organisation. As explained, research shows that cost can be a barrier to this implementation. However, the benefits are worth the risk. It would take some time to implement the system and for the users to get used to it but done correctly it could result in the success of the facility. Some benefits are difficult to quantify during research, including the reduced malpractice premium costs, increased productivity of physicians, accurate evaluations, and reduced staffing requirements (Wang et al., 2003).
Regional Health Information Organisations (RHIOs) perform an electronic exchange of patient information among its different participants. It is necessary for the organisation to establish practices and policies to protect their security and privacy (Rosenfeld, Koss, & Siler, 2007). RHIOs decide the entities and individuals that should have access. They determine the level of access that is needed to support data exchange. The data exchanged include medication history, lab results, and admission information. The decisions depend on information that is readily available, accessible, and adds value to care. Even though they determine the access of patient data and information, it depends on HIPAA standards that govern the use and disclosure policies. The best mode to provide this information to the RHIO is through electronic data exchanges. Through the policies implemented by the RHIO, the healthcare facility can know in advance the information required. Hence, they can make available this data as they receive it from patients (AHRQ, n.d.).
Health information exchanges make it possible to access health data from care organisations with the aim of reducing delays, cost, and improving the quality of patient care. These exchanges provide information on medications, laboratory tests, operative notes, radiology reports and other similar test results. The existing health information exchanges cover certain geographic regions and are referred to as Regional Health Information Organisations. Such an organisation and its members are prone to privacy issues.
The way to protect patients’ privacy is to authorise access to their information based on user’s role in an organisation. The practice should meet HIPAA standards of only releasing minimum information that is sufficient to provide care. That can include the application of role-based access to ensure the physicians adhere to the use and disclosure policies (Rosenfeld et al., 2007). It is the hospital’s obligation to set these rules for its physicians. The role-based access can be interpreted in different ways. Some hospitals have internal policies governing the use of patient data. For instance, the registrars of a hospital can view the data collected when the patient is in the facility. However, when in a different facility, they only have access to limited data like demographic information. That can be different for other provider offices where a physician can view the information for the patients they treat and not for all patients. The implementation depends on the users’ role, RHIO policy, or the specific provider. Protocols that handle the disclosure of information to unauthorised parties must exist. Occasionally, a breach occurs despite attempts to maintain the privacy of patients’ information. A majority of organisations are cognisant to the HIPAA requirements but do not have an implementation of practices that are meaningful to their unique consumers. Procedures for managing and addressing security breaches are very critical since such an organisation is a custodian of sensitive information. There is an obligation to notify participants if data or storage has been breached. Beside the role-based approach, HIPAA privacy rule allows patients to be initiators of their RHIO data. Based on this rule, a patient would log onto a care organisation, select a destination for the data and transfer their records to the facility. In case of emergency care, a patient could do the same when in the procedure room. The patient-control requirement is most likely to cause delays in getting data beyond a local RHIO (McDonald, 2010). There are other variations of this model where a patient can request their data to be harmonised within more than one RHIO. That would mostly apply to patients living in different regions and tend to seek care from different RHIOs. It is important that the organisation provides RHIO with the necessary patient information without violating their patients’ privacy. To do so, the organisation must know the relevant information that it needs, how and when to provide this information, and the necessary policies it should meet during such transfers.
References
Agency for Healthcare Research and Quality (AHRQ). (n.d.) Health Information Exchange Policy Issues. U.S. Department of Health & Human Services. Retrieved from https://healthit.ahrq.gov/key-topics/health-information-exchange-policy-issues
Choi, J. S., Lee, W. B., & Rhee, P. (2013). Cost-Benefit Analysis of Electronic Medical Record System at a Tertiary Care Hospital. Healthcare Informatics Research, 19(3), 205-214. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810528/pdf/hir-19-205.pdf
Joos, D., Chen, Q., Jirjis, J., & Johnson, K. B. (2006). An Electronic Medical Record in Primary Care: Impact on Satisfaction, Work Efficiency and Clinic Processes. AMIA Annual Symposium Proceedings Archive, 394-398. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839545/pdf/AMIA2006_0394.pdf
Koulayev, S., & Simeonova, E. (2010). Do Electronic Medical Records Improve Quality of Care? Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.364.5965&rep=rep1&type=pdf
McDonald, C. J. (2010). Protecting Patients in Health Information Exchange: Defense of the HIPAA Privacy Rule. Health Affairs, 28(2), 447-449. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953709/pdf/nihms122710.pdf
Rosenfeld, S., Koss, S., & Siler, S. (2007). Privacy, Security, and the Regional Health Information Organisation. California HealthCare Foundation. Retrieved from http://www.allhealth.org/briefingmaterials/chcf-rhioprivacy-1091.pdf
Wang, S. J., Middleton, B., Prosser, L. A., Bardon, C. G., Spurr, C. D., Carchidi, P. J., & Bates, D. W. (2003). A Cost-Benefit Analysis of Electronic Medical Records in Primary Care. The American Journal of Medicine, 114(5), 397-403. Retrieved from http://bmirec.asu.edu/edu/sites/default/files/lesson_resources/ehr_and_your_practice/Wang_ROI.pdf
