An electronic health record is a record containing the medical details of a patient in a digital format. It is an electronic version of the medical history of a patient kept and maintained by a healthcare provider over time. The use of electronic health record systems in hospitals dates way back in 2009 when a recommendation was made by the National Health and Hospitals Commission to introduce Person-Controlled Electronic Health Record (PCEHR) for every citizen of Australia. The technology was rolled out in July 2012 when people got an opportunity to register into the system.
Contained in the electronic health records is information that would permit a streamline flow of the work of the clinician. This paper reviews the benefits that come with the new technology in the hospital set up among them reduced medical errors as well as improved qualities (Harrington 2006, p. 145). Also factored in the paper are the risks or drawbacks of electronic health records which include possible disruptions to workflow as a result of the introduction of new technology as well as the mitigation measures to be deployed in curbing the risks.
Benefits of the use of electronic health records in nursing and patient care
Improved diagnostics and patient outcomes: With electronic health systems, health care providers have access to accurate and complete information about the patient. This information aids in providing the most accurate advice and enhances accurate diagnosis as opposed to guesswork. The accurate information is also very vital as it helps to reduce and even eliminate possible medical errors. Increased access to information about the patients helps in improving the work-life balance of the nurse. Cases of nurses and other medical practitioners working up to very late in the night have been minimized since electronic health systems allow access to remote the patient (Stéfane 2010, p. 141).
The nurses can conduct professional jobs from the dwelling places thereby providing a balance between maintaining the family and work. Still, with electronic health records, nurses do not have to drive back to their offices to retrieve manual information about their patients from the records only to return to the emergency provider's call after (Hoffman 2016, p. 120). In this light, any unnecessary time is completely eliminated as a result of remote access thereby more efficient health care can be provided to the patients.
Reduces errors, improve patient safety and support better patient outcomes: Electronic health records do not only contain and transmit information but also compute it. In so doing, the information is manipulated in such a way that it makes a difference for patients for example; an EHR does not only store records on a patient’s medication but also synchronizes automatically to ascertain any problems whenever the nurse prescribes a new medication. The record also alerts the nurse of any possible conflicts as a result of the newly prescribed medication (Hristidis 2009, p. 321). Electronic health records also have the ability to expose any possible safety problems as soon as they occur. This is of importance to the nurse and the patient as it aids in the avoidance of more complicated consequences for the patient hence better patient outcomes.
A nurse can use primary information gathered and recorded in an EHR to get the details of a patient’s life-threatening medical complications which would allow for appropriate adjustments in the provision of Medicare (Kelley 2016, p. 180). This can be done even if the patient is unconscious. Moreover, electronic health records allow quick and systematic identification and correction of any anomalies with operations. This is contrary to the paper-based setting in which such corrections would take years as retrieving the information would take a lot of time.
Convenient and quality health care: Electronic health records can improve health care quality as well as make health care more convenient for both the patients and providers. The quality health care improves all the aspects of patient care including communication, education, efficiency, patient-centeredness and safety among others (Kulkarni 2006, p. 451). Through electronic health records, healthier lifestyles are encouraged through increased physical activity and better nutrition. With e-prescribing, the doctors have a reason to smile as they can have their prescriptions ordered and made ready even before they leave the offices of the healthcare providers. Still, the nurse and the team can immediately file insurance claims from the office of the nurse.
Increased patient participation: Electronic health records help nurses and patient to collaborate in decision making that would be vital in the management of various medical conditions. Participation of patients is useful in the management and treatment of such chronic conditions that include obesity, asthma, and diabetes. Electronic health records foster high-quality care as the patients can give full, comprehensive and elaborate information of all their medical evaluations. The nurses can as well make follow-up information even out of their workplaces. These follow-ups include reminders for other follow-up care, self-care instructions, and links to web resources (McCormick 2013, p. 94).
Similarly, electronic health records provide an avenue for communication between the nurse and the patients. The nurse can electronically submit appointment schedules as well as exchange e-mails with the patients. The eased and quickened communication between the nurse and the patient also aids in the earlier identification of symptoms and also position the nurse to be more proactive by accessing the patient.
Improves availability of information: with electronic health records, information on the health of the patient is availed at one place where and when it is needed. The nurse, therefore, has access to the information he needs at the time it is required (Stéfane 2010, p. 166). This prompts quick decision making about the state of health of the patient. Reliable and accurate patient health information is key to efficient and safe care. Precise and comprehensive information on the patient's health and the medical history of the patient is availed at the disposal of the nurse. All these lead to a better patient experience which further results in better patient outcomes. The information extracted from EHRs on patients and disease registries are used by nurses to track patient care besides facilitation of quality improvement discussions during their forums and conventions (Steen 2011, p. 102).
Main issue with electronic health records and associated risks with using EHRs
Mainly, the issue with electronic health records is finances. The financial issues are among them maintenance costs, adoption and implementation costs, and declines in revenues. Adoption and implementation costs include the cost of purchasing and installing both the hardware and the software. It also includes converting the manual paper charts to electronic charts besides retraining of the end-users to equip them with the skills required to operate the new technology (Yoshihashi 2014, p. 263).
These costs when summed up together shoots to very high values that require a hospital to make a mega investment to have this program rolled over. At the same time, the time duration spent on training the end-users of the technology would translate to a squeezed time left for the patient-nurse relationship. It, therefore, means the patients may not be adequately attended to as required.
The maintenance costs can as well be very expensive. This is because the hardware must be replaced at specific time intervals and the software upgraded on a regular time basis (Stéfane 2010, p. 158). Moreover, the nurses must as well undergo continuous training to update themselves with the skills on how to operate the most updated software. The adoption, implementation and continuous maintenance costs are compounded since most of the financial benefits of electronic health records do not go the nurse but instead to the third party payers. These accrued financial benefits are in the forms of errors averted and improved efficiencies which in turn translate to a reduction in claimed payments.
High upfront costs in addition to this misalignment of incentives form an obstacle to the adoption and implementation of electronic health records especially for infant practices (Stéfane 2010, p. 366). Most of the nurses agree that adoption, implementation, and maintenance costs are the main issues and stumbling blocks to adoption and implementation of electronic health records.
Of the greatest risks that electronic health records are exposed is privacy of the stored data and depreciation in the accuracy of the patient information as a result of periodic time updates (Stéfane 2010, p. 396). By having the patient information and data on electronic health records, it can easily be accessed by unauthorized persons. It is thus a breach of security to make available to any other person the confidential health information of a patient without the consent or authority of the patient.
Other risks include decreased the time of interaction between the patient and the nurse. This can result since the nurse would over rely on electronic health records as the primary source of information about the patient. In so doing, the nurse may omit or neglect some of the advancements or changes in the medical conditions of the patient. Still, there exist possibilities of malpractice. Such forms of malpractice include loss or destruction of data, inappropriate corrections to the medical records or entry of inaccurate data (Aspden 2003, p. 374).
In case these malpractices are not singled out, and appropriate measures are taken the patient risks receiving stray prescriptions. This, therefore, raises the need to have the patient as the main source of information and the electronic health records to serve us back up and reference guide. Problems of malpractice may as well crop in errors during the time of transition from manual data entry to electronic health records. Another major risk with electronic health records is that of medical identity theft. This would result in major health consequences as there would be an input of inaccurate information into the records of the patient (Steen 2011, p. 210).
The consequences would as well be felt by the patient’s insurance company which will end up billing for health care services to persons who are not the actual policy holders. The future treatment of the patient would also be misinformed that the neither the nurse nor the patient may realize within the shortest time possible enough to take appropriate measures.
Still, the software and hardware of electronic health records just like any other software and hardware are subject to technical problems and mechanical breakdowns. During the periods of breakage or technical problems, all the data stored in these systems tend to be unavailable and inaccessible thereby cannot be used (Aspden 2003, p. 380). It thus means it would be quite difficult to attend to patients when the systems develop technical problems. Electronic health records enable patients to gain access to all the information about their medical condition.
There may need to keep some content of the information out of access to the patient. Access to such unnecessary information by the patients may create fear and anxiety among them. This is especially for information that the patients do not understand or have an idea about. The patient may thus develop such side effects stress that may result in further medical complications.
Strategies used to minimize the risks
Most the risks aforementioned are highly manageable as they result from either negligence of the users or failure to abide by the set-aside provisions. Among the strategies, I would deploy in thwarting the risk would address the security concerns as well as do away with errors as a result of negligence. On security, I would set aside such measures as antivirus software, firewalls as well as intrusion software that would assist in protecting the integrity of data contained and stored within the electronic health records (Stéfane 2010, p. 469). I would also insist on a few policies and procedures that would see the maintenance of the privacy and confidentiality of the patient.
Such measures would be among them the employees strictly not allowed to share their identification cards with anybody and ensure they log off before leaving a terminal (Wegman 2011, p. 127). I would a well recommend a security officer to be designated by the institution to work for hand in hand with the health IT experts’ team. I would also ensure random audits are conducted at the hospital to ascertain that the hospital policies and provisions are followed.
Tracking such information as listings of contents, their duration, and users and generating the specific dates and times of activities would be very vital. The information tracked would help in identification of any stray or misplaced information. Still, unauthorized views, access made due errors or intentionally can as well be tracked (Stéfane 2010, p. 510).
In conclusion, electronic health records have managed to tremendously change the operations of the health sector. It has led to a quick and convenient performance of tasks that have resulted in improved patient care and efficiency of nursing practice. Even with the much-attributed benefits and advantages, electronic health records have a few ethical issues and risks that if ignored may overhaul the benefits. Of serious concern is the security of the patient health information contained in electronic health records. Patients should have their information kept as confidential and private as possible.
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