TechnologyInnovation in Healthcare
Theimportance of healthcare cannot be understated as far as the progressof the society is concerned. This becomes true particularlyconsidering that only healthy individuals would have the capacity tocreate wealth in the long-term. Essentially, scholars, researchersand policymakers have been striving to come up with ways that wouldallow for the enhancement of the efficiency of healthcare. Perhapsthe most important way of achieving this would be throughtechnological advancement, which would enhance the speed,effectiveness, accuracy and efficiency of entities in serviceprovision. This paper examines the efficacy of Electronic HealthRecords and Electronic Medical Records, including the history, costinvolved and its role in the improvement of medical servicesprovision.
TechnologyInnovation in Healthcare
Theevolution in technology has played a big part in improving allsectors of economy as well as in individuals’ life. Indeed, thehealth sector has not been left behind. Out of all sectors thattechnology has played a major role, health is the most important astechnology has been responsible for saving lives all over the world.Everyone, at one time will go through aspects of life includingbirth, sickness and eventually death. This brings about heateddebates about priorities and approaches on how to provide qualityhealthcare.Medical technology advancements have also allowed medicalpersonnel to better diagnosepatients the quality of life improvesover time(Skolnik, 2011). The medical personnel’s are required torecord details about each and every patient they encountered on dailybasis, detailing their conditions and actions taken or rather labtests conducted, the prescriptions given and what happened after thetreatment. This kind of information is vital to both the medicalpersonnel and the patient and should be kept in the hospitalsarchives for future reference. However, different medical personnelreceive fragmented and redundant information as most of thephysicians hate documentation since it diverts them from their majorrole making communication between the practitioners hard(Carter etal, 2001). Medics also are bombarded with new information on dailybasis and do not have tools to record new techniques so as toincorporate them during treatment therefore relies on their memory orare forced to go through large textbooks which is time consuming.
Theneed to manage medical patient’s data led to invention ofdigitalized recording system inform of Electronic Medical records. The dependence on Electronic Medical records cannot be overstated.They were first introduced by Larry weed under his concept of problemOriented Medical record in 1960. Weed intended to introduce a medicalrecord that will allow third party verification of diagnosis. Thefirst medical records system was developed by the RegenstreifInstitute in 1972 but their utilization was hindered by lack ofcomputers until in the year 2000 when the institute of Medicinerecommended all the physicians to be using computers it theirpractice(Carter et al, 2001). Today, information technology have madesignificant role in advancing the use of Electronic Medical recordswhose accessibility has been made easier due to frequent use oftelehealth services, smartphones and tablets. Both the medicalpersonnel are experiencing the benefits of EMRs(Skolnik, 2011). TheEMRs was limited to patient scheduling, registration, documentingpatients encounters and prescriptions, receiving lab and diagnosticimaging reports, managing inter office communications, clinicaldecision support and billing. The technology developed byRegeinstreif institute was beneficial to them but was nottransferable. There was need for Electronic Health Records (EHR), asystem that brought about information sharing and authentication ofpatients and providers. EpicCare provided a product that combinedboth EMR and EHR. In essence, EMR (used by the physicians in theiroffices) and EHR (used by health systems to manage health care data)are complementary technologies that symbiotically rely on oneanother. For a country to enjoy full benefits of electronic datarecording, both have to be in place.Efforts by the US government andthe Health maintenance organizations increasingly encouraged the useof EMRs as the recent invention of Electronic Health records highlyrelied on Electronic Medical records(Skolnik, 2011). The adoption ofelectronic health records have therefore increased over the years.This is due to the efforts of the Health information Technology forEconomic and clinical health(HITECH) Act of 2009 which directed theNational Cordinator for Health Information Technology (ONC) topromote the adoption and meaningful use of Electronic health records. There has been notable increase in the adoption of Electronic Healthrecords from 2008 in non-federal acute care hospitals from 10% in2008 to 59% in 2013. This represents a more than five times increasecompared from 2008. Consequently in 2013, 93% hospitals had adoptedthe Certified Electronic Health Records technology by 2013. Theadoption of Electronic Health records varied significantly betweendifferent states, ranging from 26% to 83%(Carter et al, 2001). Utahhaving the lowest adoption rate followed by Kansas 36% and Nebraska41%. The states with the highest adoption rate include Hawaii 83%followed by South Dakota 82% and North Dakota 79%.
Thebenefits derived from introduction of Electronic medical recordsinclude but not limited to the following. First, the reduction ofpatient encounters time from over ten minutes before the introductionof EMRs to at least two minutes. This allows the medical personnelto attend to many patients at a given time thus reducing long queuesthat were being experienced in Hospitals. Secondly, the medicalpersonnel are able to give proper diagnoses to all the patients dueto their ability to access vast information(Varshney, 2009). Sincethe introduction of EMRs, physicians are able to access medicineinformation, research and studies, records of patients’ historyeffortlessly within a short time. The EMRs also contains evidencebased clinical guidelines providing valuable decision support for thephysicians.
EMRscontains information about all medical personnel involved in thepatient’s life, previous diagnosis, treatment, test results andmedical history which can be accessed by all authorized personnelacross the world. Therefore, they are used to track patients’ dataover time. The physicians can also use the EMRS to do follow up onthe patients since they are able to be notified on patients who aredue for appointments, preventive visits and screening(Carter et al,2001). They are also used to monitor patients’ conditions such asblood pressures and blood sugar levels.
Theuse of EMRs has critically contributed to reduction of medical errorsleading to more improved lives. Starting from eliminating the old agechallenges of reading someone else handwriting, the recommendedprescription are typed in the Computer thus making it easy for therecipient to read thus improving the turnaround time(Carter et al,2001). The system will also indicate any history of diverse reactionto certain types of medicine, allergies and alert the physician, Thephysicians will therefore use an alternative drug to treat thepatient or prescribe an additional drug to take care of counterreactions thereby eliminating such diverse reactions and allergies.
TheEMRs has helped improve the confidentiality of patient’s healthinformation since only the authorized physicians have access to suchinformation. It also eliminates situation where the patients maywithhold information especially if the patients suffers fromconditions that are likely to attract stigma from thesociety(Skolnik, 2011). Once the condition has been diagonised by thephysicians and recorded in EMRs, it is readily available to all otherphysician making the patient-doctor interactions friendlier.
Lastly,the use of integrated systems largely provides a reliable method ofdata storage to the facilities that has already adopted the system.The system is user friendly and protects data loss. It is able tostore large information in hard disks there by reducing officestorage space consequently reducing the cost of renting office space.Also, data is stored for future referencing. It is much easier torefer to data and information stored in EMRs compared to conventionalway where one has to search through several files to get clientinformation or read through volumes of books when researching aboutclinical information which could be easily installed in EMRs.
Inspite of the many benefits derived from EMRs, the major drawback isthe cost involved in implementing the technology both direct andindirect costs. The cost of purchasing the technology, training thestaff and the maintenance cost are a major drawback.Currently thecost of implementing a combination of EMRs ranges from $10,000 to$20,000 annually. For the breakthrough of EMRs, there is need tolower the cost to about $3,000 to $4,000 annually for it to beaffordable to a great number of physicians. This was observed inCanada during a research study, aimed at computerizing Medicalpractices and its resulting effectiveness(Carter et al, 2001).Also,subsidizing the cost of EMRs by the US governments facilitatedtheir adoption in European countries.
Theuse of one technology for all may not fit all the specialties in themedical field as each healthcare environment functions differently.The current EMR only favors the primary physicians leaving otherspecialties less satisfied with the technology. An ideal technologyshould incorporate interfaces that can be customized to the needs ofdifferent institutions. Such customization should contain all theinformation that was previously captured on paper forms. Thuscustomization enables the institution to purchase a technology thatis manufactured for general users and tailors it to workflowsspecific to the institution.
Mostof the physicians feel that the data input process in EMRs istedious. The technology will be embraced more by the physicians ifthere was an invention of a more user friendly data technology. Inessence, data input technology in itself will not lead to thebreakthrough as most of the physicians feel that no matter how manypatients they see, their remunerations are controlled by the federalgovernment and therefore most of them, unlike the private physiciansare not willing to take on the technology(Carter et al, 2001).Physicians on private practice argue that the cost involved iscompensated by increase in client inflow as one will be able tohandle more clients each day(Lighter, 2011). However, not all privatephysicians are willing to take more clients as some of the privatepractice physicians feel that they have more than enough patients toattend to each day are therefore, not willing to increase the numberof clients they see per day.
Therole of government in this aspect cannot be over emphasized. The dayto day policies implemented by the government may affect the privateinvestors in the system. For the technology to be accepted publicly,it is crucial to come up with compatibility standards which must bemonitored by the US government, to ensure that the public continuesto get high quality standards(Varshney, 2009). The governmenttherefore, must set the specifications required to be met by thevendors providing the technology so as to protect the public. Thiswill eliminate the possibility of lower standards that sets in whenthe public is required to rely on a private organization to procurepublic goods(Lighter, 2011). Also, being the largest purchaser in thehealth sector, the government should facilitate use of EMRs in publichospitals to ensure that all citizens enjoy quality healthcare(Carter et al, 2001). This may include giving to the physiciansin federal hospitals who are using the EMRs or provide an annual feeto physicians for maintaining a centralized health record in case ofemergency.
Anothermajor concern of implementing this technology would be the issuanceof patent rights and authorization of access rights. The currentparadigm shift is that the patients heavily depend on the physiciansfor medical consultations. Poor authorization measures may lead toinformation stored in such records being accessed by the generalpublic especially because of the fact that such EMRs containsclinical guidelines, which if diffused to the public, the physiciansmay be replaced by the EMR(Ciampa& Revels, 2013). In thisscenario, the need for doctors will not be felt anymore as thepatient would just log into the software, key in their condition andthe prescriptions will be readily available. This has been thebiggest worry slowing down the rate at which the physicians adopt thetechnology(Carter et al, 2001). Also, personal information may leakto the public if the system is hacked. With proper controls on accessrights, the risk is kept at minimal levels.
Inconclusion, Electronic Medical records should be able to benefit theintended society if the challenges facing them or causing uncertaintyin their adoption are addressed. Starting from identifying a reliableprovider whose activities should be regulated by the government toprotect its people from negative effects of a monopoly. Issuance ofcontrolled rights to regulate data accessibility, ensuring that thepatient information is confidential and only authorized physiciansare able to access such information(Ciampa& Revels, 2013). Thismay also entail closing up of open source technologies available inthe market of warning people against their purchase. Suchtechnologies are easily hacked or duplicated therefore it will hardto attain the required privacy. The implementation of subsidies willhelp take down the major costs involved in the installation andmaintenance of the EMS technology. Therefore, such subsidies shouldbe affected. The EMRshould have common language to ensure that itcaptures all the information required to be used for reporting in thehealth sector such as the population data, analysis of the impact ofvarious vaccines and information required by other stake holders suchas Insurance Companies. The language should also be coded to preventhacking and should address the variety of needs across differenthealth institutions both private and federal Hospitals(Carter et al,2001). Finally, successful implementation of EMRs is possible wherethe users are trained in how to use it, allowing flexibility fordevelopment where the physicians are consulted to ensure that themodifications address their departmental needs. Such modification,should also be made with considerations of the possible futurechanges in the health institution. The implementation should bepioneered by the process owners assisted by competent project teams.Regular reviews should also be conducted to assess the productivityof the technology, to identify correction measures required and noteunforeseen eventualities to be incorporated into the product.
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Ciampa,M. D., & Revels, M. (2013).Introductionto healthcare information technology.Boston, MA: Course Technology.
Lighter,D. E. (2011).Advancedperformance improvement in health care: Principles and methods.Sudbury, Mass: Jones and Bartlett Publishers.
Skolnik,N. S. (2011). Electronicmedical records: A practical guide for primary care.New York: Humana.
Varshney,U. (2009). Pervasivehealthcare computing: EMR/EHR, wireless, and health monitoring.New York: Springer.