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DDHA 9100 Doctor Of Healthcare Administration

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  • Course Code: DDHA 9100
  • University: Walden University
  • Country: United States

Question:

Overview of the research problem.

            Since the last president of America, President Obama, electronic health record has attracted a lot of attention. This has, in turn, stimulated a presentation of about 19 million dollars in stimulus funds. These funds were provided to help in the growth of the hospitals and ensure healthcare facilities are digitalized to make patients comfortable and the running of the healthcare a smooth runway. This also was with the aim of making data available online for patience and doctors to have easy access (Kern et al., 2012). As a whole, the healthcare sector has over the years been very slow in adopting changes with the information technology. Integrating of the current computer systems with the older ones has been a real menace to them. And for this, questions have aroused to whether having a digital system will empower doctors to lure them into working better and providing excellent decisions or to lag on their jobs (Carli-Ghabarou et al., 2013).

            However, previous studies were not clear about this issue to whether the impact of electronic systems will improve the quality of care of patients and reduce cost or would be a dangling investment. Since 1970, the ERHs were available commercially, but it was only recently that the health information technology sector decided to fully launch it in hospitals (Kern et al., 2012). As stated earlier, this was catalyzed by the funds which were provided to boost on buying and equipping hospitals with the required materials. Thus, this is a solution to some of the health problems that were hard to be treated (Tsai & Bond, 2008). Take an example of cancer, one of the deadly diseases. Through improved electronic systems, such can be cured, and patient life improved. Also, data is stored and kept confidential for the clients and the doctors only (Carli-Ghabarou et al., 2013).

In spite of these benefits poised, there are many setbacks which have slowed acquiring these systems over the years. Previously, less than 18 percent of the united states health providers have been using the system with only around 5 percent of American hospitals acquiring them (Tsai & Bond, 2008). In small ambulatory care providers, the rate was even lower. This, however, has changed, and in a span of a very short time, that is since 2007, the number of hospitals adopting this new system has dramatically increased (Lehmann & Kim, 2006). For instance, in 2008, when the program started, only about 8% of the number of hospitals had surged the importance of this system and started using (Hydari, Telang & Marella, 2014).

Towards the end of the Obama administration, around 2015, nearly 84% of hospitals were using the system as per records of the federal data. Despite that, the first step to fully harness the power of this electronic systems is to adopt. After that, there will be a need for using them when all health institutions have seen the need of having it (Kern et al., 2012).  

Therefore, the research is meant to investigate on how well these improved systems will improve patient’s standards. Also, the research is meant to identify how costs are cut by the help of the new systems. Doctors have always had a hard time in bookkeeping and recording patient activities. With the help of the newly introduced systems, the study will establish how this will help reduce such instances among others (Lehmann & Kim, 2006).

The significance of the study

            Electronic health records systems come with a lot of advantages. Studying these advantages might change the way some of the hospitals perceive about it. Also, the study will show how the system will improve the quality of care and increase patient output on a daily basis. According to one of the health practitioners, the maximum value of this system entirely lies on how institutions are able to support its progress (Hydari, Telang & Marella, 2014). For that reason, whatever will be found in this research will be very useful. First, it will significantly aid in investments in the health information technology which are being made by the healthcare team, states and the federal government (Tsai & Bond, 2008).

Thus, this will be a big blow to the government, in a way that they will have discovered new forms of treatment and making work more comfortable (Kern et al., 2012). To the health institutions, there will be a reduced work and made work easier issue while the economic status of the country will greatly improve. The following are few of the issue that will be solved upon completion of the study.

  1. Safety concerns are unique to the electronic health record systems.

Having a device failing whether it is naturally made of human-made is entirely inevitable. Upon using these systems, it is so obvious that at one point they may fail. This can arise when multiple systems have been deployed to a larger geographic area (Lehmann & Kim, 2006). The consequences have also become increasing despite scientists sorting ways in which they can correct the issues. This has led to hospitals not being able to justify the use of such systems. For instance, take an example of a situation that happened in Rhode islands.

This was in April 2010 when a third of hospitals around there were by default forced to postpone surgeries and divert life threatening issues to hospitals that were not affected (Carli-Ghabarou et al., 2013). This was as a result of an antivirus update which meant that the systems had multiple and endless restarts which also caused a loss of network functionality. This really reduced the institution's activities and even made patients lose their trust in such institutions (Xu, 2016).

Also, miscommunication between the components of an EHR system can lead to compromised safety. For instance, data tables could have a mismatch in the data fields. This, in turn, may affect the orders by introducing changes which are in advent and cannot be detected by machines. Therefore, through the study, one can tell such problems and avoid them from happening in future (Kern et al., 2012).

  1. Mitigation of safety issue that arises from system failures.

One major concern with regard to the widespread use of this systems is that certain harms can be reduced when they are properly used. For example, transfer of information can be facilitated by using ERHs which standardize how information is passed between different providers (Longhurst et al., 2010). This helps close the errors in communication which may result when there are negative feedbacks. Another thing is about how systems embedded to the ERHs are prone to human error thus have a cognitive constraint.

Periodically, decisions must be evaluated particularly those related to the clinical decision support (Krenn & Schlossman, 2017). Lastly, even though there is an intensification in the safety which is associated with incorporating free text, radiographic images, dictated reports among other tests dealing with the ERHs, most institutions are yet to code critical data needed for maximization of safety.  This prevents users from getting feedback. Thus, to ensure full maximization of the system, the study will detail on how to realize the full benefits of having a secure network (Carli-Ghabarou et al., 2013).

  1. Monitoring and improving patient safety by using the system.

Many national initiatives have always had a goal of improving the patient safety and facilitate the prevention of safety measures. In the near future, electronic data might be used and can be used to manage, detect and learn from probable safety (Kenneally & Dittrich, 2012). The stakeholders involved here include the joint commission, the agency for healthcare research and quality and the partnership for patients which was not formed long ago. Current ways of measuring safety rely mostly on incident reports which can only detect a very small portion of events (Hydari, Telang & Marella, 2014).

The newly formularized systems have a program which easily recognizes undermined and overlooked errors. In addition, the electronic system could pay attention to improving the infrastructure that exists in reporting to patient safety organizations (Campbell & Ryan, 2012). This can be done by generating data which describes specific safety events. Thus, detection and reporting would be more efficient and help reduce the amount of resources spent towards investigating and acting upon (Tsai & Bond, 2008).

Contribution to the field and beneficiaries.

            Professionally, doctors will benefit more. Since this is their field of work, they will find everything easier. Also, targets will get reached in a way that there will be a maximum number of patients being attended to (Krenn & Schlossman, 2017). Largely, the entire team from low, middle to high profiled workers will benefit. Through the study, there will be an increased medical knowledge both for the researcher and the entire healthcare fraternity. Generally, the study is meant to benefit the whole nation. The people will be aware of the new systems hence it will not be a problem in trying to explain what it entails (Xu, 2016). To the patients, they will find service delivery improved, and there will also be an increased number of healthcare issue solved due to the improvised systems. Also, it is through the study that one will be able to know the flaws of previous systems and correct the mistakes making it a better one. Lastly, for the team, their work will be easier particularly in areas of keeping records (Krenn & Schlossman, 2017).

Identifying key variables.

To respond to the research questions given earlier, the most appropriate methods to instill would be by qualitative analysis. Also, using questionnaires would be used in this case. Before that, one should ensure that they are aware of the variables that they are going to use. In this case, the study is about improving the medical sector and the way patients are treated. For that case, variables here are the patients, the electronic system, and the entire fraternity of the health care. First, by using qualitative research, it will be easy to know how medical staff relates to the patients.

This will be helpful as to know how fast or slow the practitioners will be keying information regarding their patients (Carli-Ghabarou et al., 2013). For this case, a non-random sample will be carried. To be precise, purposive sample procedures would be appropriate. This will help in engaging the patients into knowing how they relate to their doctors and other staff members. The results gathered will be necessary for knowing how well the medical staff will be ready and willing to educate their patients and make them calm about the new systems (Jha & Classen, 2011).

Secondly, practitioners will be given questionnaires. The questions will be to determine how they best view the new system (Harrington, Kennerly & Johnson, 2011). Also, they will indicate their previous relationship with the other system they had and how well they will see this new system help them. This information will help in knowing the cons and the pros of the electronic systems. After that, it will be then given the go-ahead on whether to be used or to be ignored.

Upon the respondents’ agreement to take part in the study, the researcher begins with the patients. This comes after they have selected few of the patients who will participate. However, one disadvantage is that one will never find the same patients in a hospital each time they are there (Jha & Classen, 2011). This means that patients will be selected on the day when the research will take place. A good relationship needs to be built between the researcher and the patients so that they can give them reliable information (Martín, Larrea & Jiménez, 2009). Comparison of stories then takes place and depending on the level of similarity; results are drawn as either positive or negative. When through with the first stage, the researcher administers the questionnaires to the medical staff. This also will be gauged with the similarity in answers since the questions are purely the same. Judgment is made and results tabulated.

Critical thinking skills.

            Previously, the study has been conducted to establish how well these systems can be integrated and used in the current society. Results have always been positive despite some few hitches which have always been improved (Ridelberg, Roback & Nilsen, 2017). Also, lack of enough funds has always made it impossible for the implementation of the program. For instance, look at the research done in 2008 by some scientist from the health information technology evaluation collaborative. They came up with data of about 500pyhsicians from 5 different institutions and nearly 75000 patients.

The idea of having different health plans was a great strengthener in that particular research (Phansalkar et al., 2013). According to them, about 56 percent of the doctors who used the electronic system provided excellent care that those who used paper records. Also, the investigation showed how well the EHRs led to a better patient care system. However, the research was not complete as they were not able to establish the negative sides of using the system. Despite that, the likes of Commonwealth and New York state department of health were able to approve the results (Amiri, Rahimi & Khalkhali, 2018).

            Towards empowering this system, we can see that the Obama passed the law and the system has been examining the issue for quite a long time. Healthcare has improved across the entire united states. However, the other manual system of keeping records has not been neglected since it is inevitable for such circumstances to happen. However, it is still not clear how long it will take for the systems to get renovated and new systems to be integrated. Over time, research of the same is expected to take place to solve issues before it is late (Phansalkar et al., 2012). 

References

Amiri, P., Rahimi, B., & Khalkhali, H. (2018). Determinant of successful implementation of Computerized Provider Order Entry (CPOE) system from physicians’ perspective: Feasibility study prior to implementation. Electronic Physician, 10(1), 

Campbell, P., & Ryan, J. (2012). Diuretic Dosing in Acute Decompensated Heart Failure: Lessons from DOSE. Current Heart Failure Reports, 9(3), 260-265.

Carli-Ghabarou, D., Seidling, H., Bonnabry, P., & Lovis, C. (2013). A survey-based inventory of clinical decision support systems in computerized provider order entry in Swiss hospitals. Swiss Medical Weekly. 

Harrington, L., Kennerly, D., & Johnson, C. (2011). Safety Issues Related to the Electronic Medical Record (EMR): Synthesis of the Literature from the Last Decade, 2000-2009. Journal of Healthcare Management, 56(1), 31-44. 

Hydari, M., Telang, R., & Marella, W. (2014). Saving Patient Ryan Can Advanced Electronic Medical Records Make Patient Care Safer? SSRN Electronic Journal. 

Jha, A., & Classen, D. (2011). Getting Moving on Patient Safety — Harnessing Electronic Data for Safer Care. New England Journal of Medicine, 365(19), 1756-1758.

Kenneally, E., & Dittrich, D. (2012). The Menlo Report: Ethical Principles Guiding Information and Communication Technology Research. SSRN Electronic Journal.

Kern, L., Barrón, Y., Dhopeshwarkar, R., Edwards, A., & Kaushal, R. (2012). Electronic Health Records and Ambulatory Quality of Care. Journal of General Internal Medicine, 28(4), 496-503. 

Krenn, L., & Schlossman, D. (2017). Have Electronic Health Records Improved the Quality of Patient Care? PM&R, 9(5), S41-S50.

Lehmann, C., & Kim, G. (2006). Computerized Provider Order Entry and Patient Safety. Pediatric Clinics of North America, 53(6), 1169-1184. 

Longhurst, C., Parast, L., Sandborg, C., Widen, E., Sullivan, J., & Hahn, J. et al. (2010). Decrease in Hospital-wide Mortality Rate After Implementation of a Commercially Sold Computerized Physician Order Entry System. PEDIATRICS, 126(1), 14-21. 

Martín, C., Larrea, M., & Jiménez, E. (2009). Implementing the Omega failure detector in the crash-recovery failure model. Journal of Computer and System Sciences, 75(3), 178-189. 

Phansalkar, S., Desai, A., Bell, D., Yoshida, E., Doole, J., & Czochanski, M. et al. (2012). High-priority drug-drug interactions for use in electronic health records. Journal of The American Medical Informatics Association, 19(5), 735-743. 

Phansalkar, S., Desai, A., Choksi, A., Yoshida, E., Doole, J., & Czochanski, M. et al. (2013). Criteria for assessing high-priority drug-drug interactions for clinical decision support in electronic health records. BMC Medical Informatics and Decision Making, 13(1)

Qiao, Y., Asan, O., & Montague, E. (2015). Factors associated with patient trust in electronic health records used in primary care settings. Health Policy and Technology, 4(4), 357-363.

Ridelberg, M., Roback, K., & Nilsen, P. (2017). How Can Safer Care Be Achieved? Patient Safety Officers’ Perceptions of Factors Influencing Patient Safety in Sweden. Journal of Patient Safety, 1. http://dx.doi.org/10.1097/pts.0000000000000262

Tsai, J., & Bond, G. (2008). A comparison of electronic records to paper records in mental health centers. International Journal for Quality in Health Care, 20(2), 136-143.

Xu, R. (2016). Electronic Health Records: Patient Care Quality. Revue Interdisciplinaire Des Sciences De La Santé - Interdisciplinary Journal of Health Sciences, 5(1), 27. 

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