Brief summary of author’s main points
In this article, Murphy talks about the need of considering the possibility of making the healthcare system to revolve around the patients and hence bring to an end the common system of which the patient is the one seeking health services in hospitals. The author also proposes that the patient-centric point of view upon implementing and optimizing the use of health information technology (HIT) will be able to provide the new perspectives on the meaning of ‘integrated’ health care. Murphy also states that there is need to convince the patients that their participation in health care matters makes sense, on top of giving the patients opportunities to participate as true partners in health care. The author also states that not all patients will be willing to accept this level of involvement as some will not be ready to engage all their health records electronically. However, the consideration and use of these practices are important steps in initiating health care reform process towards improving quality and decrease cost. Finally, Murphy in this article argues that many patients will be able to benefit, as medical professionals will be working closely with them in demystifying health care experiences through the patient-centric practices and use of HIT (Murphy, 2011).
According to the article, the general value of clinical decision support systems (CDSSs) in achieving patient-centred care goals is that it will allow patients to participate and make decisions in their health matters and hence the delivery of care basing on the patient’s view. However, a challenge to this system, in general, is that some patients are unwilling to collaborate in sharing and using this system of care. Another challenge is that some clinicians fail at explaining to patients the significance of their participation in the CDSSs, hence the slow pace of its implementation. In specific, the value of a computerized physician order entry system (CPOEs) will help cut on costs of healthcare. For example, it will avoid the repeat of conducting fresh tests since the information of previous records will be available. Another value of CPOEs is that it will improve the quality of health care as medical records of all patients will be available online for all medical professionals, physicians, and nurses. However, the challenge to this system is similar to the latter, whereby some patients are still not willing to be involved in their care today (Murphy, 2011).
Pros and cons of linking electronic health records (EHR) to clinical information systems (LIS, PIS, RIS) and physician mobile devices
There are numerous advantages of using EHR in the clinician information systems. The first advantage is that it has an impact on the quality of care. The EHR has been able to improve communication among providers, which leads to better-coordinated care among providers of care. For example, the EHR enhances better communication between laboratory information systems (LIS) and the patients as information about previous lab examinations are easily accessible. The same applies to the pharmacy information system (PIS) whereby medication records of patients are easily accessible, hence allowing the pharmacists to dispense medications to the patient easily. Finally, the EHR system will enhance better communication to the radiology information system (RIS) to help doctors at diagnosing and treating disease and injuries more easily (Audet et al., 2006).
The second advantage of linking EHR to clinical information systems is that it enhances performance reporting and accountability. Those hospitals that use comprehensive EHRs also participate in generating performance reports with trends and benchmarks. The reports generated will include data from various levels of physician, department, and hospital levels hence allows sharing with other clinicians and staff into supporting quality improvements. The joint quality committees, the board of directors, and executives in health care setting will thus use generated data at promoting accountability. For example, such committees will use data obtained from the radiology information systems (RIS) through EHR at holding doctors and physicians accountable for diagnosis, treatment, or injury scans that they offered wrongfully. The same will apply to both PIS and LIS clinical information systems as a procedure of enhancing accountability.
Another advantage of linking EHR to the various clinical information systems is that it speeds up the delivery of healthcare services and reduces operational costs. According to Audet et al. (2006), the EHR ensures that there is the easy accessibility of data and information about patients in an online platform, whereby all health care professions can access such information from different locations. For example, patient’s information will be easily accessible in the radiology information system; therefore, there will be no need to conduct fresh tests, unless it is necessary. The doctor will be able to make a quick decision and hence offer the quick patient treatment. Similarly, linking EHR to the various clinical information systems helps at reducing costs of operation significantly. For example, there will be no need to conduct extra lab tests on a patient since the data of their medical records is readily accessible in the laboratory information system. In the end, the EHR system is essential as it play a part in speeding medical operations, improving the quality of service, and reduces costs of operation.
Another advantage of linking EHR system to the various clinical information systems is that it enhanced consistent, evidence-based care and improved patient safety. According to Robert (2013), hospitals that follow structured processes when considering and selecting optimal practices and gaining consensus among clinicians and other essential staff report high levels of consistent evidence-based care. The clinical guidelines enhanced by the EHR system have been able to raise the providers’ concerns regarding the ‘cookbook medicine.’ Similarly, the EHR system enhances patient safety because it prevents the occurrence of drug interactions and preventing allergy conflicts. The new system also prevents the human error conflicts in ordering, filling, and administering drugs that commonly occur in the ancient system of proving healthcare.
Despite having its many advantages, linking the EHR system to the various clinical information systems also has its disadvantages. The first disadvantage is that the new system requires training of staff and the community clinicians on how to use the EHRs. The program thus becomes costly to the health system as more finances need to cater for the training of staff and community clinicians. Another disadvantage of the EHR systems is that it is costly and time-consuming. The adoption of the comprehensive EHR system is both an expensive and long process, thus forcing hospitals to develop strategies for containing, managing, recouping costs, and managing time through rollout processes. All of these disadvantages would lead to difficulties in implementing the EHR systems in the delivery of health care services to patients (Robert, 2013).
In conclusion, the EHR, CPOEs, and CDSS are all subject to classify as patient-centred management systems as they all aim at enhancing the participation and contribution of the patient in his or her health in a timely and orderly manner. Patients will not only be using these systems for their medical benefits, but they will also be active participants by contributing to various aspects that would improve the quality of care and better delivery.
References
Audet, A.M., Davis, K., Schoenbaum, S.C. (2006). Adoption of patient-centered care practices by physicians – Results from a national survey. Archives of Internal Medicine, 166, 754-759.
Murphy, J. (2011). Patient as Center of the Health Care Universe: A Closer Look at Patient-Centered Care. Journal of Information Systems & Technology. NURSING ECONOMIC$/January-February Vol. 29/No. 1
Robert, G. (2013). Participatory action research: using experience-based co-design to improve the quality of healthcare services. Understanding and Using Health Experiences, 138-149. doi:10.1093/acprof:oso/9780199665372.003.0014
