The Electronic Health Record Discourse, Essay Example

Going by standard conventional definition of the Electronic Health Record practice, then it can be said to be all the processes that goes into the keeping patient information on an automated system supported by software technology (Hillestad et al, 2008). The computerized storage that comes with this system makes it relatively easy to transmit or share the information stored about a given patient amongst persons or institutions that needs the information in question. Typically, the most common types of information sustained on an electronic health record system may include, a patient’s medical history; radiology images, the results of laboratory tests, allergies and medications.

According to Gunter and Terry (2005) it is important to state in clear terms the context under which the system is operated and that is definitely within the institutional which includes primarily a hospital, a clinic, integrated delivery network and the office of a physician. The cardinal reason for the use of an electronic health record system is to ensure that a comprehensive informational profile of a patient is readily available and responsibly accessible within the chain of treatment in a speedy manner. It also has the additional purpose of reducing human errors associated with inaccuracies because the automated process allows for evidence-supported decision making especially in diagnosing, drug prescription and administration. Ultimately a patient becomes better off and by extension the health care system earns a somewhat scaled up credibility [iii].

Taking cognizance of the fact that there is no universally applicable functional healthcare environments, it is also true that developing an applying a uniformed system of electronic health recording will not yield the needed results. For this reason it is imperative to come out with ways of making the system responsive enough to address the diversity in the healthcare environment.  As a principle the first step towards realizing this objective is to ensure the availability of standardization in record keeping that has the capacity to be customized to meet the individual needs of the institutions that will use it through the incorporation of modularity in the electronic health recording system. A common practice in recent times amongst producers of electronic health recording systems has to do with making room for vendors to engage in the customization process for individual buyers (Himmelstein & Woolhandler 2009).

The electronic health recording system and its application especially when it comes to the issue of customization can be likened to a two-edged sword with an equally compelling depth of impact on the record keeping process in a health institution. It goes without saying that the general level of efficiency that comes with the implementation of the system cannot be overemphasized. That is however not to say that the system does not have its share of weaknesses. An immediate factor that comes to mind when discussing the challenges that has to be confronted in the application of the system includes the initial high cost that comes with the implementation of a customized system. The costs are both financial and non-financial in scale. Beyond the initial implementation costs comes the additional cost of maintaining the customized systems to function at optimum capacity (Himmelstein & Woolhandler 2009).

In the light of the foregoing, coupled with the lack of a precisely forecasting on returns framework, it is understandable that the level of motivation to invest in electronic health recording systems is still somewhat low within the healthcare sector. To some extent this does not come as a complete surprise given the fact Raymond & Dold in a 2002 study disclosed that in the most general sense when it comes to investment in information technology the health sector is caught dragging its feet, thus reflecting the same sentiment on any decision to purchase electronic health recording systems. However, the tides are progressively shifting using recent events as a justification, developments in the United States, the world’s leading market for information technology came out with the legislations such as the HITECH Act 2009 designed to alley the financial fears of investing in health information technology and most specifically an ongoing move to encourage the use of electronic health recording systems (Himmelstein & Woolhandler 2009). Having said so, the indicators are positive that within the short to medium term framework electronic health recording systems will attract a significant sales boost lead by the United States Market. Besides the cost factor, the need for such a system is a matter of consensus amongst stakeholders.

As stated earlier in this write up, the adoption and implementation of the electronic health recording system is a direct prime factor of cost. Suffice to cite concrete illustrations that illuminate the cost factor that comes with the system. Citing the United States market once again, according to authentic estimates it will cost an estimated $44, 000 to set up the system per physician in the first month. The start up capital is incorporated into this figure in addition to the monthly cost of $1,200 to maintain the system in a bid to achieve optimum performance (Scot 2009).

In a related study carried out by the Commonwealth Fund regarding the cost-benefit factors involved in the introduction and implementation of electronic health recording, it emerged that opinions were slightly divided. Some experts remain convinced that within a time space of three years the initial investment costs will be regained whilst other experts give a period of five years to achieve the same returns. What is apparent here is that granted the system is efficiently implemented, then overtime the cost factor becomes subsumed by the accompanying positive returns on investment. The form of cost that comes with maintenance has to do with the need to keep regularly upgrading software technologies. There are varying degrees of software technological upgrading and arguably the type of upgrading will largely depend on the task to be accomplished; it is also worth noting that governmental regulations do also play an important role in influencing the degree to which such upgrades can be carried out.

The personnel component is very strategic in the process of implementing the electronic health recording system. It therefore becomes imperative to have personnel with the requisite know-how to ensure the successful operation of the system. In the event of the unavailability of qualified personnel then, the concerned institution must carry out an in-service training to get the system operational.

Privacy remains a sticky point in the bid to get a centralized information pool about patients. It is especially a contentious issue in some industrialized countries, which therefore calls for maximum caution and safeguards to address privacy concerns. But like it or not, privacy concerns is nothing new in healthcare circles as it is in most sectors of developed countries. Computerizing information systems will not usher in a dramatically vulnerable privacy dispensation as some skeptics tend to put it. Besides existent legislations across most countries are robustly stern in safeguarding electronically collated and saved data in a manner that is not even practiced with regards to information storage on paper.

Notwithstanding all that has been said, implementation of the system remains an integral part of the system itself. It is therefore incumbent to look at the issue of implementation with the same degree of seriousness that has been given to other policy components of the system. With this in mind, this paper articulates for the following implementation drives. Begin by conceptualizing in explicit terms the factors that constitute a health record to ensure that a comprehensive distillation process supports the process. The reason being that as stated earlier the operational framework in the healthcare sector is not universally constructed therefore wholesale transfer will not serve the good of the system.

Come out with suitable standard barometer upon which to gauge the performance expectation of the system. Being what it is, the producers of the system have placed an unlimited seal on what it can do, it is therefore wise to streamline the system in accordance with a pre-defined standard to better serve the interest of the institution, its patrons and stakeholders. Finally, the crucial determining factor has to do with the choice of technology that is suitable in the midst of the massive pool of information on offer by scores of vendors on the market. It will make all the difference at the end of the day.

Reference

Gunter, T.D. & Terry, N.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)

Hillestad, Richard et al. (2005). Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, and Costs. Journal of Health Affairs, 18(22).

Himmelstein DU,  & Wright A, Woolhandler S (2009). Hospital Computing and the Costs and Quality of Care: A National Study. American Journal of Medicine, 10(1016)

Raymond, B. and C. Dold (2002). Clinical Information Systems: Achieving the Vision” Kaiser Permanente Institute for Health Policy.