|Type of paper:||Case study|
For the last decade, the Department of Health at Wall County has been applying the Electronic Medical Records maintained and provided by the State Department of Health and Human Services. This organization has been paying a nominal fee for implementing this system. However, following a huge cut on the budget, the Department of Health and Human Services has informed all the stakeholders that it will no longer get involved in the maintenance of the EMRS within the next four months. In spite of this problem, the primary challenge that the Wall County Health Department is facing is on whether to maintain and install its EMRS or switch to conventional medical records storage. For this fact, this proposal proposes to come up with a recommendation on how health care facilities can install an Electronic Medical Records system.
Henry Fayol discusses 14 principles managerial theory that is applicable in the case scenario (Khorasani & Almasifard, 2017). The principle of impartiality, which states that all employees in an organization are bound by the same rules, relates to the EMR system since all hospital staff ought to use it when retrieving patient information. The EMR system improves access to information and relationships since everything is stored in one large database. The traditional filing system remains rarely used as well. Improved access to patient data such as clinical history by the EMR system is an excellent pointer to population health improvement. Through the system, primary care providers could view and print graphs of cholesterol levels, weight, and blood pressure while tracking changes over a particular time durations (Manca, 2015). The system also improves the multidisciplinary communication among physicians working on a similar patient, which hastens diagnosis and care provision.
A physician can incur a total cost of $163,765 through the application of electronic medical records. By May 2015, CMS also known as the Centers for Medicare and Medicaid Services had incurred a total cost of $30 billion in financial application to more than 468,000 providers of Medicare and Medicaid services for adopting EMR systems (Hayes, 2015). The management indicated that EMRs make it easier for patients and providers of health care services to schedule appointments, track preventive care, administer and manage drug prescription, check test results, and access health information. According to Magaly (2015), the providers of health care who do not adopt EMR have high chances of losing federal funds as stipulated by the law. Therefore, the cost of adapting to EMRs has been high in the previous years, and hospitals need the government's intervention to implement this system.
Electronic Medical Records Analysis
EMRs also was known as electronic medical records are a database system that is computed for paper charts which are composed of treatment and medical history of a patient that can be transmitted, accessed, stored, processed by any authorized interdisciplinary member of a team of health care professionals (McGonigle, & Mastrian, 2018). Electronic medical records can increase the responsiveness, coordination, effectiveness, and efficiency of the interdisciplinary team and better the provision of quality care. Besides, electronic medical records can improve the safety of patients and minimize medical errors. Electronic medical records enable medical practitioners and doctors to stipulate time more effectively by reducing the time that physicians would spend of secondary activities and use most of their time on activities and duties that can improve the quality of care offered in hospitals (Pinsonneault, Addas, Qian, Dakshinamoorthy, & Tamblyn, 2017).
On the contrary to the paper-based patient records, electronic medical records facilitate easier and faster to summarize, search, graph, and share data (Hobson, 2017). Looking at the article written by Bae, Rask, & Becker (2018), electronic medical records can offer more quick and accurate communication. This action and application lead to improving the flow of patients, faster responses, and fewer duplicative testing to inquiries of patients. IT systems or also known information technology systems promote quality improvement and patient safety through the application of alerts, checklists, and predictive tools that are embedded clinical guidelines which facilitate standardized and evidence-based practices; electronic test ordering and prescribing that minimizes redundancy and medical errors (Bae, Rask, & Becker, 2018). With all the health information of patients easily available when a medication is ordered or to be administered an electronic alert can warn the medical practitioner of contraindications, allergies, and improper dosing. Moreover, electronic medical records are also a possible solution to minimize the events of patient safety by organizing and simplifying the health process.
Electronic medical records can also facilitate to unintended outcomes and consequences such as enabling new, unique safety and improving the incidence of adverse events of patient safety and errors in administering medicines and drugs (Bae, Rask, & Becker, 2018). This system and technology can only operate as well as the information computed into it that would be carried out by any member of the medical team. If the evidence of allergy is wrongly computed or not entered at all, it would never be detected or picked up to be alerted, and potentially facilitates medical errors. Accessing information of a patient through a computer is just as quick compared to how an emergency can take place but leaving the monitor of the computer open to patient information can lead to a confidentiality breach. It can be possible to breach a system, facilitating too many records of patients to be viewed and accessed unintentionally. Additionally, the technology or the system has a high probability to crash leaving no person to access the information of a patient while care requires being continuous. Lastly, this technology can have its limitations along with its benefits.
It is the duty and responsibility of a nurse to uphold and maintain the confidentiality of the information of a patient. This information is contained in the electronic medical records for legal purposes and is preserved by the code of ethics. If a nurse or a medical practitioner breaches this confidentiality, various stakeholders of the hospital such as Board of Nursing and the government may hold them accountable through monetary, disciplinary, and legal action (McGonigle & Mastrian, 2018). Nurses are required to only access the electronic medical records of the patients in their direct health care for a particular shift. Applying their ethics and morals to act ethically and not acquire any information of a patient for any reason in which the given nurse is not assigned to. The other ethical and legal implication to electronic medical records is the ease of copying and pasting notes as an attempt to conserve and save time that could lead to wrong and incorrect data and information being applied to diminish the integrity of a medical practitioner (Balestra, 2017).
Apply the electronic medical system would have to be modified and adapted for vulnerable populations. According to Madden et al. (2016), there is wrong and incompetent information about patients in the electronic medical record system associated to mental illness due to information not passing through various systems when a patient seeks treatment by many system providers. The wrong and incompetent information can facilitate medical errors that would risk the safety of a patient. The senior citizens or the elderly may not be in a position to view and access their information and records in the portal of a patient if they are not computer literate. In the homeless population, there may exist incomplete information as well as if the patient seeks treatment in more than one healthcare facility.
Given the discussed key elements in the implementation of the EMR system, hospital board members need to convene meetings and the main agenda being the adoption of the EMR system. The policy-making process has to put into consideration the necessity and urgency of the matter, the cost implications for various hospitals, and the implementation period. Moreover, there should be budgetary allocations for purposes of training hospital staff who would be the main system users. System security and maintenance is paramount since the EMR would run on cloud databases. As a precautionary measure, proper backup mechanisms need to be put in place as well as protection from external penetrations.
Electronic Medical Records and Quality Improvement: Recommendations
It is evident that the application of the Electronic Medical Records (EMR) system can be of immense value in the delivery of healthcare. However, its drawbacks need to be fixed, one major one being the possibility of documentation of wrong and incomplete information about patients. To resolve this issue, it is recommended that provider education is established at the classroom level. The EMR should be integrated into teaching so that training healthcare providers are conversant with every aspect of the system hence can use it perfectly. For hospitals, internal training for physicians on how to use the EMR should be incorporated to make them savvy in information technology with top-notch skills on entering patient data. Introducing internal training needs to begin with agenda-setting where the hospital staff alongside policymakers determines the issue of wrong and incomplete information about patients. The problem identified will call for the formation of the policy, which is legitimized and implemented.
Educating physicians on EMR will enhance their competency in entering complete patient data. Complete patient data sets the foundation for effective, quick and efficient delivery of medical services to the patients with the least medical errors (Khoury, Iademarco & Riley, 2016). The importance of complete patient information also needs cooperation by the patient and the carers who can be informed through public forums conducted by public health professionals. The information can also be posted on hospital walls by the use of charts to remind the patient of the need for providing complete information.
Enhancing training for providers to be effective users of EMR promotes healthcare delivery principle that advocates for the use of EMR with a view to limiting clerical work and dedicating more time to engaging direct patient care (Bastable, Sopczyk, Gramet & Jacobs, 2019). This is because savvy physicians will efficiently enter and retrieve patient data from EMR with ease and use much of their time addressing patient health issues. Training for physicians on being effective users of EMR utilizes budgeting for allocation of resources for internal training with a view to enhancing competency in the application of database systems. It is part of strategic planning to enhance quality improvement in healthcare delivery. Financing methods such as grants support internal training for physicians because such investment is deemed as a direct improvement of provider skills which leads to efficient care delivery and improvement of health facilities. EMR reduces paperwork and makes health facilities tidy and well organized.
The EMR system could improve population health by a significant margin since it enhances faster retrieval of patient data and subsequent diagnoses. It also improves the monitoring of patient progress and treatment outcomes since every information is recorded on a single database.
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