Posted: March 28th, 2021

Initial Post NURS 6051 Week 5 Electronic Health Records

Initial Post

NURS 6051

Week 5

Electronic Health Records

The use of Electronic Health Records (EHR) continues to become more popular as doctors and hospitals implement this software in their practices and/or hospitals. There are myriad of reasons why many in the healthcare field have begun to feel comfortable with its use and see the benefits compared to other systems they may have had in place. Nonetheless, the implementation of EHRs has not gone without resistance from a few in the medical field. While many are enthusiastic about the benefits it can produce, a few others see a nugatory end result. “Despite the challenges, the future of EHRs is an exciting one for patients and clinicians alike” (McGonigle pg. 285). Change in any environment requires for many to change a set mindset and be open to new innovative ideas of doing things.
Benefits of EHRs
For the most part, implementing EHRs has begun to make an impact in healthcare for those using the system efficiently, they have experienced firsthand the benefits. For example, the four most common benefits of Electronic Health Records are, increased delivery of guidelines/base care, enhanced capacity to perform surveillance and monitoring for disease condition, reduction of medical errors, decrease use of care (McGonigle?). The main objective of the use of EHRs is efficiency. Healthcare professionals want more accurate patient diagnosis without the use of ineffective or unnecessary tests or even surgeries. Preventative healthcare is the future in medicine. As a whole, we should be proactive instead of having a reactive approach to healthcare. Execution of EHRs is becoming common practice. More administrations adopting EHRs will facilitate broader distribution of best practices, with the expectation of reducing the time required to take advantage of advanced EHR features (McGonigle). The realization that EHRs is being adopted by healthcare organizations, shows that many have begun to share in the benefits and will continue to become a standard practice.
Three Challenges and Responses of Implementing EHRs

Nevertheless, it goes without saying that whenever a new practice or procedure is introduced (especially when it deals with technology) it usually goes through a period of uncertainty by those who oppose it. Some of the challenges experienced by some when the implementation of EHRs took place were: entering a wrong test code, concerns over patient privacy and funding for the program. Many of healthcare professionals feel uneasy and are/were a bit hesitant about learning how to use a new system and therefore making errors when entering a code. A solution for this concern was addressed with “the EHR-LIS interface now in place, we have more accurate data available on order, collection, and laboratory receipt times to include in future TAT metrics and will work with the clinicians to develop acceptable performance goals from collection to receipt to result” (Petrides, A.K.). Unfortunately, medical errors have always been a concern and will continue to be. However, if staff is trained with efficacy and strong back up routines are put into place, this can help prevent or at least reduce such errors. Another major concern is patient privacy. “Although the intentions of the exchange were to promote patient safety and increase health care efficiency, it raised significant concerns about security and privacy” (McGonigle pages 284-285). This is valid concerns all of us should have when it comes to sharing personal information. However, this is a list of measures that have already been considered in order to address this issue. For example, there are Access controls” like passwords and PIN numbers, to help limit access to your information; “Encrypting” your stored information. This means your health information cannot be read or understood except by someone who can “decrypt” it, using a special “key” made available only to authorized individuals; An “audit trail,” which records who accessed your information, what changes were made and when. (Leon R.) This is a great example that tries to convey the importance of privacy concerns that the individuals behind the creation/implementation of EHRs have thoroughly tried to address with substantiated proof. Also, the concern regarding funding for EHRs into all healthcare settings has been addressed as the following: “Since one substantial beneficiary is the payer, and most providers deal with a multiplicity of payers, a mechanism that partially shares the cost of adoption in practices and hospitals across this multiplicity of payers (including Medicare) would dramatically ease one of the main barriers to adoption. Decreasing the financial barriers and providing a much more robust evidence base regarding health IT can be expected to greatly accelerate its adoption. (Caroline Lubick Goldzweig) In the long run, investing in the implementation of EHRs will be more cost-effective and in return the burden of the financial aspect (when applied and adopted with efficacy) will decimate.

Implementation of robust and interoperable EHRs is becoming more common place. More organizations adopting EHRs will facilitate broader dissemination of implementation best practices, with the hope of further shortening the time required to take advantage of advanced EHR features (McGonigle).

Three Challenges of Implementing EHRs
1. Some of the unanticipated challenges were the increase in the number of patient venipunctures and orders placed using the wrong test code. Not surprisingly, by reducing paper requisitions and the manual entry of orders into the LIS, the TAT from specimen arrival to result improved significantly (Petrides AK).
Response: However, with the EHR-LIS interface now in
place, we have more accurate data available on order,
collection, and laboratory receipt times to include in future
TAT metrics and will work with the clinicians to develop
acceptable performance goals from collection to receipt to
result. (Petrides AK)

2. Although the intentions of the exchange were to promote patient safety and increase health care efficiency, it raised significant concerns about security and privacy. For health exchanges such as these to reach their full potential, members of the public must be able to trust their privacy will be protected, or else the health care industry risks that patients may not share a full medical history, or worse yet, may not seek care, effectively making the exchange useless (McGonigle pages 284-285).
Response: Some safety measures that may be built in to EHR systems include:
• “Access controls” like passwords and PIN numbers, to help limit access to your information;
• “Encrypting” your stored information. This means your health information cannot be read or understood except by someone who can “decrypt” it, using a special “key” made available only to authorized individuals;
• An “audit trail,” which records who accessed your information, what changes were made and when. (Leon R.)

3. The most commonly stated barrier was cost (72 percent); other barriers were time necessary to train staff (40 percent), lack of proficiency among staff (26 percent), and lack of an IT culture within the office (18 percent). (Caroline Lubick Goldzweig)
4. Response: Since one substantial beneficiary is the payer, and most providers deal with a multiplicity of payers, a mechanism that partially shares the cost of adoption in practices and hospitals across this multiplicity of payers (including Medicare) would dramatically ease one of the main barriers to adoption. Decreasing the financial barriers and providing a much more robust evidence base regarding health IT can be expected to greatly accelerate its adoption. (Caroline Lubick Goldzweig)

Reference

McGonigle, D., & Mastrain, K.G. (2018). Nursing Informatics and the foundation of knowledge (4 ed). Burlington, MA: Jones and Barlett Learning.
Rodriguez, L. (2011). Privacy, Security, and Electronic Health Records. Retrieved from https://www.healthit.gov/buzz-blog/privacy-and-security-of-ehrs/privacy-security-electronic-health-records/
Privacy, Security, and Electronic Health Records Leon Rodriguez | DECEMBER 12, 2011

Privacy, Security, and Electronic Health Records

Petrides A.K. The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes. Available from: https://tikessays.com///publication/314143624_The_Benefits_and_Challenges_of_an_Interfaced_Electronic_Health_Record_and_Laboratory_Information_System_Effects_on_Laboratory_Processes [accessed Jun 25 2018].

Nursing Informatics and the Foundation of Knowledge Chapter 14, the Electronic Health Record and Clinical Informatics

Caroline Lubick Goldzweig, Ali Towfigh, Margarate Maglione, and Paul G. Shekelle: Costs and Benefits of Health Information Technology: New Trends From The Literature https://www.healthaffairs.org/doi/full/10.1377/hlthaff.28.2.w282