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Overview of Cloud-based EHR Systems

Discuss about the Cloud Based Electronic Health Records System.

Amongst the greatest achievements of technology in the medical field is the use of a computer in the keeping of patients' records (DesRoches, et al., 2013). It is this fact that systems such as the EHR, Electronic Health Records have been designed. Records systems are made in such a manner that they facilitate easy keeping and usage of information for the sake of its patients and also for the practitioner's use, (Beasley and Sinsky, 2014). The EHRs are classified into two categories depending on the systems they use. It involves the cloud-based systems and the client server based. The discussion below, therefore, is going to tackle mostly on the cloud-based systems, their advantages, and disadvantages and even on how such systems can be implemented within a medical setting using the SDLC models which are predictive or adaptive. The paper will also give a brief description of the models to understand their usage and enable us to understand the implementation stage of the projects.

The cloud-based EHRs are a technical method of keeping and utilization of the health records using the cloud technology. This is to mean that information pertaining the patient is in-house in the cloud, at a shared location rather than a personal drive or even a disk. Moreover, all the information is stored majorly on an online network. Hence to mean that information can be used at any place by any device, either a MacBook, a tablet or even a smartphone so long as there is an internet source, (Ventola, pp. 356-364, 2014). Unlike the client's servers which store data in-house, within the servers hence requiring a server, hardware, and software installed at a physician's place of work. Hence making the cloud-based EHRs have the upper hand regarding service delivery and efficiency.

The cloud-based EHR systems have many advantages as compared to other systems of electronic record keeping. Therefore using the factors of usability, reliability, performance and security, below is an exclusive discussion as to why the cloud-based systems should be adopted in medical institutions. The cloud-based systems are easily accessible. Since its systems are just available within the cloud platform, one can easily access the systems from a different location using a different device, (Ventola, pp. 356-364, 2014). Therefore to mean that the practitioner does not have to be in his office's computer so as to access information about a patient. The system has enabled the practitioners to practice medicine out of office hence being instrumental in emergency situations out of the medical facilities. The fact has been promoted since the practitioners can as well easily find information from the palm of their smartphones, tablets, MacBook or any other computer gadget that can access the internet. Hence the systems have helped a lot in the field of medicine.

Advantages of Cloud-based EHR Systems

The cloud-based EHR systems are very secure as compared to the client-server systems. Unlike the server systems, which are easy to manipulate and vulnerable to downtime as a result of human mistake or glitches, the cloud-based systems encrypt its data hence deterring people with malicious intent from accessing it, (Sultan, pp.177-184, 2014). The encryption of its data is such that even if the data is stolen, of which its chances are very low, it cannot be used. Moreover, the data is deposited off-site data hubs that have the very tight security level. Hence the systems provide security which is vital in the field of medicine.

The cloud-based systems are less expensive as compared to the server based systems. The cloud system just like any other system needs resources to ensure its smooth running. However as compared to other systems of electronic records keeping, the cloud-based systems of EHR are more cost efficient. Unlike the other system which is server based, the cloud-based system only requires funding regarding internet connections or of a practitioner's monthly subscriptions. On the other hand, however, one needs almost $40000 to install the server system, this is exclusive of the maintenance costs, the regular updates and the licensing fees. As compared to the server system the cloud-based EHR, are pocket-friendly, especially to a growing medical institution. Hence the cloud-based system is more recommended; the cloud-based systems provides privacy.  The client's information managed and stored in the cloud-based system provides privacy regulations as the traditional health records systems, (Rodrigues et al., 2013). The privacy regulations is a tradition of the medical institutions, patients' information is kept a discreet between the institution's practitioner and the patient, (Rodrigues et al., 2013). By using the cloud-based EHR system, information is simply stored in the cloud network hence institutions have no worry of storing such discreet information on their servers. The cloud-based system allows the practitioners have a control on who should view a patient's information. This has helped to maintain the confidence of the clients hence promoting the services of the institution.

Similarly, the cloud-based systems require less IT expertise to operate hence easy to operate. Unlike the other systems that need servers and other complicated IT resources to operate, the cloud-based systems are easy to operate, (Rodrigues et al., 2013). They require the only internet connection and a computer. This means that even any authorized medical practitioner can access patient information without the need of involving the member of the IT staff.  Hence helps to save on not only expenses but also time, which an important factor when someone's life is at stake in the medical line of work.

Disadvantages of Cloud-based EHR Systems


Just like anything that has an advantage, the cloud-based system has its demerits as well. Below is a discussion of such disadvantages of the cloud-based HER Systems. The cloud-based EHR system cannot be used in remote rural areas where there is minimal or no internet connection, (Seymour, et al., 2015). Since the system majorly relies on internet connection so as to gain access to the patient's information. Therefore, making the system not applicable to rural medical facilities. The challenge has made the practitioners incur a lot of inconveniences simply because of lack of internet connection, (AbuKhousa, et al., pp. 621-645, 2012). Besides, the system becomes expensive regarding internet connections. The cloud-based EHR systems require internet so as to operate; this makes the system quite expensive especially when is installed within a rural setting.

Similarly, the cloud-based system holds captive a client. The system is such that information about the client is entrusted within the host of the platform, (Middleton et al., 2013). It, therefore, entails that the details of the client are at the mercy of the host program. Hence, to mean that in case the system fails, the clients' information is at risk of manipulation, by anyone who has a malicious motive.

The SDLC, Systems Development Life Cycle model, which is a model of project management to view such a project by the government or any institution, is a very important model in the formulation of projects (Bassil, 2012). When using the model, the project is seen from its initial proposal stage to its disposition stage hence the name of the model "life cycle." The model is based on two principles; one being the aspect of adaptability and predictability, where the process through which the plan is made is because of a failed system in this case the traditional paper filing system, (King, et al., pp. 392-404, 2014). The predictive approach assumes that the project can be planned out in advance however the adaptive approach is more flexible since it assumes that the project cannot be planned. Both approaches are very mandatory in ensuring the success of a project.

The system is simple to understand and use simply because phases are processed and finished one after the other hence reducing confusion while undertaking critical project for instance the one involving health records. Moreover, the project is very efficient for smaller projects and is very easy to arrange and allocate duties hence offers good management. All such are because of good planning that has to be done before the project resumes. However, the approach ignores the risk of uncertainty since it cannot tolerate changing requirements within the project. Additionally, the approach makes it difficult to measure progress within the stages of planning. Another disadvantage is that the project does not give room for revision or reflection on the already accomplished percentage of the project. All the mentioned challenges and advantages of the approach are due to the fact that the approach requires lots of planning for implementation to occur. As such, consideration such an approach should be properly analyzed before it is implemented.

The SDLC Approach in Project Implementation

The adaptive approach is also another common approach in ensuring the success to any project. The approach promotes teamwork and enhances training among the participants of the project. Moreover, the approach is very pocket friendly since it requires minimum resources. Similarly, the approach is very liberal in terms of giving the project to the developers therefore allowing them to be flexible. Most importantly, the approach requires less of planning so as the idea can be implemented. On the other hand, the approach promotes dependency on individuals therefore an agile; motive and project manager is necessary or else the project will fail. Similarly, the approach does not allow for transfer of new technology to a new team since it lacks proper documentation to facilitate such. The approach also exposes the project to more risk regarding sustainability of the project due since documentation is an issue. Therefore, such hindrances should be considered when one wants to apply such an approach for as a project as serious as that of EHRs.

After an analytic look at the project of installing such a system within a medical facility, the project is of much importance as compared to any other form of electronic medical record-keeping platform, (Shea et al., pp. 119, 2014). Therefore, it should be easily adapted since it provides an alternative form of keeping records more securely, more effectively and is also easily available. However, the challenges of such a project should not be overlooked. If only the challenge of the systems requiring internet connectivity could be sorted especially within the rural settings, the project could be easily used within the vicinity of many of the medical facilities which are in the aim of providing adequate and quality services to its patients. To sum up, the cloud-based EHR is of much use if used carefully within the spheres of medical practice. The system acts as a reminder of the changing times and acts as a challenge regarding looking at how it can be properly implemented.

References

AbuKhousa, E., Mohamed, N., & Al-Jaroodi, J. (2012). E-Health cloud: opportunities and challenges. Future Internet, 4(3), 621-645.

Bassil, Y. (2012). A simulation model for the waterfall software development life cycle. ArXiv preprint arXiv: 1205.6904.ss

Beasley, J. W., & Sinsky, C. A. (2014). Electronic health records. Annals of internal medicine, 161(9), 680.

DesRoches, C. M., Charles, D., Furukawa, M. F., Joshi, M. S., Kralovec, P., Mostashari, F. ... & Jha, A. K. (2013). Adoption of electronic health records grows rapidly, but fewer than half of US hospitals had at least a basic system in 2012. Health Affairs, 10-1377.

King, J., Patel, V., Jamoom, E. W., & Furukawa, M. F. (2014). Clinical benefits of electronic health record use: national findings. Health services research, 49(1pt2), and 392-404.

Middleton, B., Bloomrosen, M., Dente, M. A., Hashmat, B., Koppel, R., Overhage, J. M. ... & Zhang, J. (2013). Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. Journal of the American Medical Informatics Association, 20(e1), e2-e8.

Nguyen, L., Bellucci, E., & Nguyen, L. T. (2014). Electronic health records implementation: an evaluation of information system impact and contingency factors. International journal of medical informatics, 83(11), 779-796.

Rodrigues, J. J., de la Torre, I., Fernández, G., & López-Coronado, M. (2013). Analysis of the security and privacy requirements of cloud-based electronic health records systems. Journal of medical Internet research, 15(8), e186.

Seymour, C. W., Liu, V., Iwashyna, T. J., Kahn, J. M., & Angus, D. C. (2015). Epidemiology of Infection among Hospitalized Patients Using Electronic Health Records in Three Independent Cohorts. In C23. SEPSIS: RISK, RECOGNITION, AND RESUSCITATION (pp. A3991-A3991). American Thoracic Society.

Shea, C. M., Reiter, K. L., Weaver, M. A., McIntyre, M., Mose, J., Thornhill, J. ... & Weiner, B. J. (2014). Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system. BMC medical informatics and decision making, 14(1), 119.

Sultan, N. (2014). Making use of cloud computing for healthcare provision: Opportunities and challenges. International Journal of Information Management, 34(2), 177-184.

Ventola, C. L. (2014). Mobile devices and apps for health care professionals: uses and benefits. PT, 39(5), 356-364.

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