Healthcare: MHI 502 Case #2, Term Paper Example

Introduction

According to Barretto, Warren and Goodchid (2004) electronic health records (EHR) reference models (RM) are record management structures while archetype models (AM) are rules validating the system or defining its limitations.Precisely, (AM) is a mechanism, which offers ‘formal structured constraint definitions’ (Barretto, Warren & Goodchid, 2004, p. 3) pertaining to the clinical concepts acceptable for use in the database. These are expressed using inferences obtained from an underlying reference modelwithopenEHR system applications (Barretto et.al, 2004).

An example of how archetypes determine concepts’ transfer used in databases; take the concept fluid and electrolyte; if this concept has not been defined in the database model it cannot be used within the system to describe any fluid irregularities occurring in patients neither send information. Users will have to modify the terminology for appropriate utilization as an electronic health record prototype. The architecture of electronic health records system actuallyrelates to a number of principles guiding the way information ought to be programed and disseminated for enhancing accurate and efficient data transfer (Beale & Heard, 2008).

Structurally, workflow mechanismsencompass five distinctsteps beginning with clinical intervention; then data collection; next administrative; activity_ proxy andfinally wait. Work item describes specific activities, which the electronic health record system must execute in completing a particular transaction after an ‘atomic activity instance is assigned to a party or role’ (Barretto, Warren & Goodchid, 2004, p. 3). Importantly, identifying the specific data to collect is essential to workflow accuracy. Here is where the archetype model is applicable towards facilitating the process(Heard & Beale, 2005).

Body

In describing my interpretation of advantages/ disadvantages these modelsor approaches bring to the electronic health record technology science is to freely express major impacts these approaches have on the traditional medical health records system. Analysts researching the technology from its inception contend that there are debatable issues pertaining to the contemporary models adaptation. This pivot ondifferentiating whether originating record ought to supply complete data or just a summary of it (Gunter & Nicolas, 2005).

Another concern relates to deciphering whether the data generated subsequently is episodic or longitudinal. Ultimately, experts ask if patients and providers would have an opportunity to control what data is “pushed” into central record or be merely spectators while comprehensive data is “pulled” systems outside of that particular database. The contention is the modern electronic health record models (HER) models developing in Australia and the United States seem not to have fully addressed these concerns (Gunter & Nicolas, 2005).

The advantage lies in its visibility. There is less access to patients’ records from a worldwide web perspective than occurs in governmental of extensive institutional databases.It would appear that that third model focuses a third on a web-based, distributed “personal” longitudinal record. Essentially, while there is less visibility web-based tendencies do compromise quality and confidentiality. As such,this openEHR approach encompassing shared governed archetypes globally should make sure that openEHR health data be consistently manipulated and accessed irrespective of the organization’s technical and cultural predispositions (Gunter & Nicolas, 2005).

Challenges, which must be considered and overcome in order for these models to be successful, include securing the finances for establishing a national health information infrastructure with data interoperability and comparably patient safety enhancement. It was recommended to facilitate the process core standardized EHR terminologies must be implemented. Examples were ICD-9 for diseases and CPT-4 form coding medical procedures(Beale & Heard, 2008)

Conclusion

Argument for or against the usefulness of the presented models and architecture beyond the context of the “early supported discharge case study” presented in this paper.

This case study is an Australian health care model, which does not function exactly the same way in United States of America. While these projects are joint efforts between the two countries differences in health care management styles must be considered as arguments regarding the usefulness of models in the case study offered are tendered. First it would appear that the system is very beneficial for the Australian community. The profound network connection is appreciated especially, with the precision exemplified in refer patient sub-flow model (Barretto et.al, 2004)

Importantly, this Early Support Discharge (ESD) design shows where the model enforces a very strong coordination mechanism utilizing ‘hospital discharge planner, occupational therapists (OTs), domiciliary care nurses obtain from the Royal District Nursing Service (RDNS)), general practitioners (GPs), long-term domiciliary care organisations ‘(Barretto et.al, 2004, p. 3) along with many local governmentservices. It was admitted that the description and implementation phasesencompass expert intervention whereby participants are dedicated towards efficiently executing the process(Barretto et.al, 2004).

As it pertains to the Australian society this is an excellent model ensuring a smooth safe transition of patients/clients from hospital into the community. It shows that this health care system is concerned and addresses the future of patients after they leave a facility. With regards to America’s health care system where the cost of health care and insurance coverage to pay for essential services predominates this model while useful may be shelved since it could increase health care cost for the client/patient (Barretto et.al, 2004) .

References

Barretto, S. Warren, J., & Goodchild (2004).Designing Guideline-based Workflow-enabled Electronic Health Records.Advanced Computing Research Centre, University of South Australia

Beale, T., & Heard, S. (2008). Archetype Definition Language.openEHR Foundation.

Gunter, 1.,& Nicolas, P. (2005). The Emergence of National Electronic Health Record Architectures in the United States and Australia: Models, Costs, and Questions.J Med Internet Res, 7(1);e3

Heard , S. & Beale. T. (2005).Archetype definitions and principles.openEHR Foundation.