Electronic Health Records (EHR) Essay Examples
Electronic Health Records (EHR) Essay Examples
Week 5: Electronic Health Record
Main Post
Introduction
Electronic Health Records (EHR) are the cause of a major force that is creating change in the health care industry. Dramatic changes, apprehension, excitement, along with fear and concern are the focus of a new era from paper charting to a new electronic health record system. This research paper will examine benefits and challenges electronic health records face, along with resistance to change and fear many have toward this new system. Electronic Health Records (EHR) Essay Examples.
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Electronic Health Record Initiation
The transition from paper based charting to electronic base charting has shown to be very complex and difficult. Not many years ago, there was only one method of keeping medical records and this was utilizing paper charts. These charts, although still used in many practices today, have slowly been replaced by a more advanced method called electronic health record or EHR. The Centers of Medicare and Medical Services (CMS), defines “electronic health records as an electronic version of a patient’s medical history, that is maintained by the provider over time, and may include demographics, progress notes, problems, medication, vital signs, past medical history, immunizations, laboratory data, and radiology reports” (CMS.gov, 2012). Resistance to change is always a crucial challenge for the success of any innovation. Research has found that physician resistance is a challenge in the implementation of a new EHR system when switching from a paper-based practice.
In my organization where I work, I was concerned about incomplete documentation and double entry during EHR transition. For instance, “medication wasn’t documented in the computer because somebody didn’t have time, or somebody didn’t know how.” Also, I m worried about diminishing eye contact between doctor and patients and computer crashes. For some nurses, changes tend to be less resistance who are more tech savvy, those who grew up with a computer, can type quickly and are comfortable clicking around a screen. Some doctors have difficulty adjusting to the use of new electronic charting. Most problems are about their typing skills. Some staff stated, “comfort level with the program and allocating an appropriate amount of time for training will have an impact on the patient volume and overall budget.” Similarly, another staff stated, “medical assistants and nurses will be expected to use the new EHR; there may be lots of variation in technology comfort level among support staff. Training these peoples adequately and making sure they are comfortable with the EHR are significant.”
Challenges
Regardless of the many benefits, EMRs have some challenges. The first significant challenge of EMRs is the high costs. Deltev (2007) reports that electronic record management systems are extremely costly to acquire, and is this is the significant barrier for implementing EMRs on clinical practices. For instance, ongoing training is a big concern and a hidden cost.
Another challenge in implementation of EHR is the potential privacy threat. The high levels of accessibility and portability of EMRs also tend to increase the risk of unauthorized access or data theft. Paper records may be tedious and inefficient, but they don’t face threats from cyber-attacks. Such security breaches could cause substantial harm to patients, as well as result in legal issues to providers. According to the previous study, the common privacy concerns with EHRs are unauthorized access to records, tampering with records and the risk of losing information due to a natural disaster. Since EHRs allow for easier access to sensitive information, there is an increased risk of privacy violations Electronic Health Records (EHR) Essay Examples. These may include intentional “prying” or may be accidental by using improper security measures.
The last major essential challenge is the use of copy and paste. Because documentation is more involved with EHRs, physicians may rely on the copy and paste function as a shortcut, particularly for routine or follow-up visits. While this may save time for the physician, this puts the patient’s safety at risk and impairs quality of care as updates or changes between visits can be overlooked or not documented properly.
Strategies
COST – EHR systems can be expensive. Finding the capital to invest in the infrastructure, personnel, training and support required to install and maintain an EHR system can be a barrier, especially for small to mid-sized practices. Uncertainty over the long-term return on investment can exacerbate this concern. Associated costs, such as increased physician time requirements and decreased patient visits during EHR implementation, can affect providers’ bottom lines (USFHealth, n.d.) Electronic Health Records (EHR) Essay Examples.
Privacy concerns – There are ways in which electronic health record entities can provide superior security and privacy solutions once the EHR is implemented such as; Guide employees through the stringent privacy and security training process, provide identification and verification requirements to all system users, Issue specified punishments to employees not following compliance guidelines, and disguise all data inside medical files through cryptography. Reliable electronic health records companies apply these enhanced security and privacy protocols. Perhaps the most important security protocol is data encryption, which causes data to become unreadable to outside sources. Electronic health records specialists also provide remote storage and data backup systems. While this may not necessarily present as strong of a defense against hackers and data breaches as data encryption, it provides security for healthcare organizations against the potential of software failures or natural disasters that could destroy or damage files.
Copy and Paste Issue – according to The Joint Commission, the American Health Information Management Association recommended the strategies to prevent copy and paste errors in EHR. These includes: development of a policies and procedures addressing the proper use of the copy and paste function (CPF) to assure compliance with governmental, regulatory and industrial standards; addressing the use of features such as copy-and-paste in the organization’s information governance processes; providing comprehensive training and education on proper use of cop-and-paste, to all EHR users; and monitoring compliance and enforce policies and procedures regarding use of of copy-and-paste, and institute corrective action as needed (The joint commission, 2014). The advantages of EHRs to the clinicians and patient alike are considerable. To avoid these issues, hospitals and healthcare systems must perform a thorough evaluation of the EHR system before purchase and implementation. To truly achieve the type of change that health care staff seek, tighter clinical integration across practice settings is a must. I believe these challenges could be addressed with proper education and training. Electronic Health Records (EHR) Essay Examples
References
CMS.gov (2012). Electronic health records. Retrieved from: https://www.cms.gov/Medicare/E-Health/EHealthRecords/index.html?redirect=/EhealthRecords/
Deltev, S. B. (2007). The executive’s guide to electronic health records. New York: Health Administration Press.
The Joint commission (2014. Preventing copy and paste in EHR. Retrieved from: https://www.jointcommission.org/assets/1/23/Quick_Safety_Issue_10.pdf
USFHealth (n.d.). Overcoming Hurdles Faced During HER Implementation. Retrieved from: http://www.usfhealthonline.com/resources/healthcare/overcoming-hurdles-faced-during-ehr-implementation/#.WGLAO2ciyUk
Week 7 Assignment
Information technology (IT) has quickly assimilated into healthcare improving patient care and reducing costs by tracking patient care. The nursing population as a whole resists change, set in their ways nurses have specific routines that propel them through the shift efficiently. As a nurse facilitator, one may encounter an individual resistance when everyday routines are threatened. The purpose of this paper is to use Rogers’s diffusion of innovation (relative advantage, compatibility, complexity, trialability, and observability) as a tool to facilitate a smooth transition into the world of electronic health records (EHR) for nurses in a working hospital setting.
Efficacious execution of new IT involves overcoming the fears and resistance to change most people display, especially if change means learning a new process for a skill you have already mastered. In the world of nursing time, management is crucial in patient care. The American Recovery and Reinvestment Act (ARRA), mandated that U.S. hospitals are to become meaningful users of EHR (Kelley, Brandon, & Docherty, 2011). The U.S. government apportioned an estimated $19 billion for hospitals and ambulatory settings to carry out the necessary application of EHR (Murphy, 2011). The challenge is demonstrating the positive outcomes EHR’s will provide, ease of use when accessing patient information and clear, concise physician orders. Electronic Health Records (EHR) Essay Examples.
Relative Advantage
Rogers (2003) defined relative advantage as “the degree to which an innovation is perceived as being better than the idea it supersedes” While presenting an innovative way of patient care providing evidence to the potential user that the EHR will be an improvement to the outmoded systems. Illustrating the how and why the innovation will benefit all who are concerned with the project. Providing the nursing staff as well as physicians, with efficient, time-saving ways to review patient charts, diagnostic results, and reduced charting time. The CORE Measures and Patient Safety Goals set by the Joint Commission mandates the timeliness and effectiveness of care for specific conditions. By employing the use of EHR, tracking compliance will save healthcare institutions millions of dollars every year Electronic Health Records (EHR) Essay Examples.
Compatibility
Electronic health records must fit the knowledge base of every healthcare organization. Rogers (2003) stated that “compatibility is the degree to which an innovation is perceived as consistent with the existing values, past experiences, and needs of potential adopters” User-friendly programs geared to fit the individual requirements of every unit and department in the hospital or any other healthcare setting. A straight forward, restructured data flow that is repurposed over and over again simply by adding the information into the EHR system allowing access to anyone that logs into the patient record (Friedman, Parrish, & Ross, 2013). Molding the program to correspond to the individual needs of the users is a prerequisite of any new concept. Demonstrating the ease of use and time-saving convenience by charting electronically can alleviate the trepidation of the staff.
Complexity
Rogers (2003) defined complexity as “the degree to which an innovation is perceived as relatively difficult to understand and use”. An individual or individuals can determine whether or not the modernization of patient information will benefit the nurses as well as the patient. A decision stage is a “full use of innovation as the best course of action available” (Rogers, 2003). Determining the level of expertise employees have with computers can establish the degree of training that is required and determine the intensity and success of the training it entails. Specifically targeting older adults that may not have experienced technology in a way the newer generations have. What seems simple to a computer user may be difficult to comprehend for a person with no exposure to technology. Another issue that sways nurse’s decisions is the possibility that technology will pull nurses away from having a personal patient-focused care experience. Nurses are concerned that the advent of modern technology will overstep the abilities of the RN to care for the patient (Gregory & Buckner, 2014). Overcoming the preconceived ideas about EHR, allowing the nurses to have hands on experience before the rollout navigating the program to get a feel for the process. Also encouraging input on how the program can be streamlined to fit the needs of the individual departments. All of these processes can assist the staff in making a sound decision. Electronic Health Records (EHR) Essay Examples.
Trialability
According to Rogers (2003), “Trialability is the degree to which an innovation may be experimented with on a limited basis”. This is the stage where the trialability of the product comes into play. This is where all of the “bugs” are worked out. With most new startups there will be hiccups in the process of actually managing the workload. Some in trepidation and negative opposition will arise in this stage. “The innovation loses its distinctive quality as the separate identity of the new idea disappears” (Rogers, 2003). As a unit facilitator, the encouragement of the process will have a large impact on the negative feelings that begin to appear. Identifying the problematic areas and creating solutions by ironing out the glitches as a unit.
Observability
Rogers (2003) defined observability as “the degree to which the results of an innovation are visible to others”. The use of technology is an observable process, and although problems may arise, there is often a solution. At this point, the level of enthusiasm may wane, and an attitude of detachment may occur (Hayrinen, Saranto, & Nykanen, 2008). At this point of the innovation, some employees may choose not to stay with the facility, even though the inevitability of working with EHR in the near future in another setting is definitive. Peer observation is elementally a motivating factor in the adaptation of the diffusion of technology (Frattini, 2010). Relating knowledge to peers on the unit will encourage the nurses to overcome the obstacles. Employing members of the nursing staff to create a “super user” team to troubleshoot any problems with operating the programs so the workflow of the units will not be interrupted. Electronic Health Records (EHR) Essay Examples.
Summary
By using Rogers’ five determinants of success, innovations complications, difficulties, and setbacks are identified before their occurrence. The feasibility of implementing a once thought too complicated system was made possible through the identification of factors before the execution of the electronic health record program. Successful acceptance brought on by the realization of benefits to nurses, physicians, general nursing staff and most of all the patients. Improving patient care is what nursing is all about; the electronic age is upon us and will always be a part of our modern civilization. The key to introducing and successful transitioning of innovations is total involvement in the process. Nurses worldwide will use technology to develop new skill sets that will impact the future of the medical profession. Acquiring the skills to work with programs that deliver a safer environment for patients will be an invaluable asset to the nursing world (Furst et al.,2013).
References
Best, M. F., & Thurston, N. E. (2004). Measuring Nurse Job Satisfaction. JONA: The Journal of Nursing Administration, 34(6), 283-290. doi:10.1097/00005110-200406000-00007
Frattini, F. (2010). Achieving Adoption Network and Early Adopters Acceptance for Technological Innovations. Gaining Momentum, 81-120. doi:10.1142/9781848163553_0003
Friedman, D. J., Parrish, R. G., & Ross, D. A. (2013). Electronic Health Records and US Public Health: Current Realities and Future Promise. Am J Public Health, 103(9), 1560-1567. doi:10.2105/ajph.2013.301220
Furst, C. M., Finto, D., Malouf-Todaro, N., Moore, C., Orr, D. A., Santos, J., … & Tipton, P. H. (2013). Changing times: enhancing clinical practice through evolving technology. Medsurg Nursing, 22(2), 131.
Gregory, D., & Buckner, M. (2014). Point-of-Care Technology. Critical Care Nursing Quarterly, 37(3), 268-272. doi:10.1097/cnq.0000000000000030
Harrison, J. (2004). Addressing increasing patient acuity and nursing workload. Nursing Management, 11(4), 20-25. doi:10.7748/nm2004.07.11.4.20.c1984
Hayrinen, K., Saranto, K., & Nykanen, P. (2008). Definition, structure, content, use and impacts of electronic health records: A review of the research literature.International Journal of Medical Informatics, 77(5), 291-304. doi:10.1016/j.ijmedinf.2007.09.001
Pravikoff, D. S., Tanner, A. B., & Pierce, S. T. (2005). Readiness of U.S. Nurses for Evidence-Based Practice. AJN, American Journal of Nursing, 105(9), 40-51. doi:10.1097/00000446-200509000-00025 Electronic Health Records (EHR) Essay Examples.
References
Kelley, T. F., Brandon, D. H., & Docherty, S. L. (2011). Electronic Nursing Documentation as a Strategy to Improve Quality of Patient Care. Journal of Nursing Scholarship, 43(2), 154-162. doi:10.1111/j.1547-5069.2011.01397.x
Murphy, J. (2011). HITECH Programs Supporting the Journey to Meaningful Use Of EHRs.CIN: Computers, Informatics, Nursing, 29(2), 130-131. doi:10.1097/ncn.0b013e318210f0fc
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: New York Free Press.
Stokowsk, L. (2013, September 12). Electronic Nursing Documentation: Charting New Territory. Retrieved from http://www.medscape.com/viewarticle/810573_3
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Electronic Health Records (EHR) Essay Examples