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Electronic Health Records

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The electronic health record is a tool that was designed to improve the delivery of services in the health sector. The tool allows for the documentation of the health data records. It as well facilitates the communication between the patient and the doctor. There have been efforts to encourage the health institutions to adopt this technology owing to its great benefits. From the various studies that have been carried out on the subject, it can be seen that the new method of keeping data was gaining popularity in the various health intuitions. However, the adoption in the nursing homes has been slow as compared to other health institutions. This can be attributed to the high costs of installation and the fact that the nursing homes are not profit making institutions.

Several studies on the matter revealed the barriers as well as the importance of the EHR adoption. The barriers include the costs of installation, maintenance and training of the employees. The advantages/ importance of adopting the technique include the improved efficiency, cost cutting and improve the data organization for various uses. The studies as well revealed the low penetration of the information technology use in the health sector especially in the nursing homes compared to other sectors. The world is embracing this technology with some states having laid down the strategy for this tool implementation. Future work should focus on analyzing the effects of the technique adoption.   Introduction

Electronic health records concept refers to a systematic collection and documentation of the information pertaining to the health issues be it of an individual or the population. The records are stored in digital format on a platform that is able to share the information between various stakeholders (Derr, 2009). This facilitates the efficient communication between physicians and patients as well as between different physicians in different locations. This paper aims to shed light on the importance of the electronic health records use especially in the nursing homes. This is an important step towards improvement of the quality health services delivery as it allows the stakeholders to access the information such as the medical history of patients, lab test results, vital signs, images from radiology, immunization and some personal status such as weight, age and the billing details (Center for Medicare & Medicaid services).

There are several advantages that accrued to the use of the technology; these include the enhancement of the records accuracy thus the incidence of errors in the health institutions will be reduced; access to all the information at one platform will improve the efficiency and thus the concerns such as duplication of tests will be minimized. The accumulated data can be used for researches and learning and thus further improving the health care service and quality delivery. The data that has been collected can be analyzed to extract information that can be useful in the formulation of the health policies. The records as well facilitate collaboration between different health care agencies and can be used as a platform to measure the performances (Campbell, 2011).

Electronic health records are not without some disadvantages. These include errors pertaining to the system omission and commission; the initial cost of installation of the system and the inability of the medical personnel to adapt to this new technology and lack of a comparison platform as it is a new technology (Ford, 2010).

In this paper I wish to examine the evolvement of the use of information technology in the health sector with a close reference to the nursing homes. Its benefits as well as the disadvantages and recommend areas need further studies.     

Background History

The use of the information and communication technology in the health service sector has been increasing over the past. This increase has been brought about by the ever growing amount of the patient data and therefore a need to device a way of managing it arises. The needs of the patients have as well evolved thus calling for new techniques of attending to them (Guah, 2011). There have been constant researches on the ways that an efficient organization of this data can be achieved. As a result, school curriculums have been developed in order to enhance researches and teaching the subject to provide qualified man power. The researches as well have aimed at identifying the potential benefits of using the EHR as well as any negative repercussions that may occur. The advantages include storage of the data records for longer period as compared to the paper works, ease in access as well as the analysis, accuracy and efficiency among others (Evolution of Medical Informatics).   

In the United States the adoption of the information and communication in the Medicare technology lags behind other sectors, such as the manufacturing, banking and transportation among others. The other sectors took the advantages in the cost cutting that was brought about by the use of ICT. This has translated to the cost of rendering services in the health care sector remaining high as compared to those of other sectors.

The history of documenting the health data records dates back to the 5th century BC. Hippocrates developed a procedure that emphasized on the medical records to reflect accurately on the disease course as well as the causes. This format of documentation has evolved since then. Currently the information technology has enabled multi-functionality of the records to incorporate functions, such as the interactive alerts, order sheets as well as flow sheets. The modern technology also allows the stakeholders to access the information from any point. All these functions were impractical with the previous paper system (electronic health overview).

In the United States the first electronic health record was launched in the year 1960. The adoption of the technology continued and by the year 1965, there were 73 health institutions which had embarked on the implementation process. Since then the technology industry embarked on researches with the aim to develop the appropriate software that will suit the intended purpose (electronic health overview). The technology grew at accelerated rate owing to the benefits that are associated with its implementation. There was also a parallel growth in European region as well as in other developed nations. By the year 1994, in the EU region already more than 50% of the hospitals had already adopted the technology. The number had grown to 70% by the year 2009. The rate of adoption was however slower in the United States. This has seen the government launch campaigns aiming at encouraging the health institutions to adopt the new technology (Glaser & Salzberg, 2011).

Critical Analysis

The adoption of the use of the electronic health records has been widely received since it was launched. In the nursing homes the adoption is low as compared to other areas of health care. However this estimates that the adoption cannot be given with much accuracy owing to the lack of a concise definition of the EHR term. This makes the outcomes of several researches that have been carried out on the subject to be incomparable. Furthermore, the nursing homes require customized software to be used to record the relevant data. This has seen the technology being accepted at a faster rate in the hospitals as compared to the nursing homes. A study in the year 2007, which was carried out by the University of Colorado on behalf of the federal government revealed that there was a need to adopt the technology (Taxonomy of Health Information Technology in Nursing Homes and Home Health Agencies).

The University of Colorado carried out another study in Denver on behalf of the US government. The study aimed to develop a strategic survey tool that can capture the time change of the adoption of the technology in the nursing homes. The study also aimed to device methods that can be used to evaluate the future penetration of the technology use. One of the most outstanding issues that the study revealed was that there was no concise definition of the EHR terms thus the evaluations could not be compared. The study succeeded in formulating strategies that were to be used in the implementation process (Survey Questions for HER Adoption and Use in Nursing Homes: Final Report).      

Another study by the Texas Tech university on the long term adoption of EHR implications revealed that successful implementation of the HER improves the quality of the care, enhances the satisfaction of the employees and cuts the operational costs and homes intend to continue with the use of the technology. Furthermore the data was linked to other state’s data making it efficient to access it. The system also could be used for the policy formulation and improvement of the service delivery. Despite the numerous advantages, the study revealed that the adoption of the system is costly thus low profit making institutions may not afford to run the system. These costs go beyond the purchase and installation of the hardware includes the staff training. The study concluded that in the long run the adoption of the IT use in nursing homes has potential of saving the government expenses on running these homes (Nursing homes).

The implementation of this system has not been a smooth run all through. It has been caught up in the wrangles with some arguing that the introduction of EHR will cripple the relationship between patients and doctors. This is in the sense that this will remove the direct interaction in favor of a virtual interaction through the system. However, there are more benefits that are associated with the adoption of the practice, thus it is favored. This has seen the government on an intensive campaign to encourage the use of the information technology in the health sector. There have been series of studies aiming to determine the impact of the information technology use on the health sector. Existence of several contradicting findings hinders the drawing of a conclusion on the subject; thus prompting further studies. An example is the study on CPOE (Computerized Physician Order Entry); the studies have depicted contradicting findings with some indicating a decrease in errors in the prescription while others show the opposite. This can lead to a conclusion that the use of the Information technology such as EHR in hospitals can be likened to any other tools of work. The accuracy of results is therefore dependent on the operator.

On the matters of cutting the cost and expenditure cutting, Strassman (1997) in his study found out that in some cases there were no significant relationships between expenses and the use of IT. In others a significant relationship was found leading to emphasizing the conclusion that the impact on the implementation is dependent on the user. That is the strategic management, leadership and administration of the whole process. The implication of this is that the overall success of the adoption of electronic health records will depend on the stakeholders, be it in nursing homes, hospitals or any other health institutions. A continuous effort to steer forward the achievements that have already been achieved should be enforced (Glaser & Salzberg, 2011).               

Recommendation for Future Work

From the above analysis it is clear that the process of implementation is hindered by lack of clear understanding of the possible effects. Future work should focus on analyzing the benefits of implementation in terms of costs, efficiency and accuracy among others. The future studies should also focus on evaluating the possibilities of extending the services beyond organizations to the personal levels. Among others these include the possibility of remote monitoring of the patients and thus reducing the congestions in hospitals. Efforts should also be made to centralize the data for access thus enabling collaboration in learning and researches. Finally the stake holders should come up with a comprehensive definition of the HER term to allow standardized studies to be carried out.   

Learning Experience Summary

From the above researches it is can be deduced that the electronic health records adoption will benefit the health sector in general. Despite the barriers to the adoption, the health institutions are pushing past them owing to the benefits that result from their use. The adoption of the information and communication technology use in the health sectors, especially the nursing homes, is low as compared to the other sectors. This is a result of the high initial installation costs as well as the maintenance costs and the fact that the nursing homes are low profit institutions. There are measures put in place to encourage the adoption of the EHR after various studies that have revealed the benefits of the EHR.     

Support from the Literature

The paper has been compiled from a list of research publications which have been carried out on the subject. The findings are published on various site including federal government websites and other health stakeholders site. Several other works have been cited and all are from credible resources. 

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