Electronic medical records have been around for more than 30 years, but since 2010 they have become widely adopted throughout the healthcare industry. Electronic health records (EHRs) are comprised of many components that work together to “automates access to information and has the potential to streamline the clinician's workflow” (“Electronic Health Record,” 2012). The system allows more efficient and accurate patient care while reducing costs in the long term for healthcare practices. Small healthcare practices have moved slowly in adopting electronic health record (EHRs) systems for their practices, their lack of readiness will cause the organizations problems in transitioning to the implementation of EHRs. This research paper will discuss why we need electronic health records (EHRs), the advantages of EHRs and some factors associated with rolling out successful electronic health records (EHRs) systems. Implementing electronic health record (EHRs) systems can help small healthcare practices reduce costs and increase the efficiency of treatment for patients.
Why do we need EHRs
Electronic Health Records (EHRs) are electronic versions of patient health information that is generated and managed by health information management systems. Patient health records include patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports (“Electronic Health Record,” 2012). Electronic health records allow: easy backup of information, patient records to be accessed remotely, easy storage of information, reduction in office space, and many other capabilities. According to Menachemi and Collum (2011), “three particular functionalities hold great promise...
... middle of paper ...
...print book)
Electronic Health Records. (2012). Centers for Medicare & Medicaid Services. Retrieved from http://cms.hhs.gov/Medicare/E-Health/EHealthRecords (Corporate author; Technical report; Published on the Internet)
Henricks, S.G. (2011). “Meaningful use” of electronic health records and its relevance to laboratories and Pathologists. Journal of Pathology Informatics. 2:7. doi: 10.4103/2153-3539.76733
Menachemi, N., & Collum, T. (2011). Benefits and drawbacks of electronic health record systems. Risk Management Healthcare Policy. 4: 47–55 doi: 10.2147/RMHP.S12985.
Rao, S.R., DesRoches, C.M., Donelan, K., Campbell, E.G., Miralles, P.D. (2011) Electronic health records in small physician practices: Availability, use, and perceived benefits. Journal of the American Medical Informatics Association. 18:271e275. doi:10.1136/amiajnl-2010-000010.
For years now, the healthcare system in the United States have managed patient’s health records through paper charting, this has since changed for the better with the introduction of an electronic medical record (EMR) system. This type of system has helped healthcare providers, hospitals and other ambulatory institutions extract data from a patient’s chart to help expedite clinical diagnosis and providing necessary care. Although this form of technology shows great promise, studies have shown that this system is just a foundation to the next evolution of health technology. The transformation of EMR to electronic heath record system (EHR) is the ultimate goal of the federal government.
Historically, physicians and nurses documented patients’ health information using paper and pencil. This documentation created numerous errors in patients’ medical records. Patient information became lost or destroyed, medication errors occur daily because of illegible handwriting, and patients had to wait long periods to have access to their medical records. Since then technology has changed the way nurses and health care providers care for their patients. Documentation of patient care has moved to an electronic heath care system in which facilities around the world implement electronic health care systems. Electronic health records (EHR) is defined as a longitudinal electronic record of
The case study by Elizabeth Layman (2011) is a very comprehensive compilation of the implementation of electronic health records, in relation to the Health Information Services Departments. Through this study Layman documents the conditions to be implemented to achieve satisfactory application of the change-over from the conventional pen and ledger system to computer documentation of patient’s records maintained by health networks.
It was just yesterday when Electronic health records was just introduced in healthcare industry. People were not ready to accept it due to higher cost and consumption of time associated in training people and adopting new technology. Despite of all this criticism, use of Internet and Electronic Health records are now gaining its popularity among health care professionals, as it is the most effective way to communicate with patient and colleagues. More and more hospitals and clinics are getting rid of paper base filling system and investing in cloud base storage.
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
Healthcare professionals associated with medical billing and coding know the progress the technology has made so far. In the last few decades, medical billing and coding has switched from being a paper-based system to a computerized format. Under HIPAA laws, medical practitioners had to develop new software in order to send out electronic bills. With the advent of electronic medical records (EMR), with one touch of a button, doctors, Nurse Practitioners and PAs can gain access to all the care a patient has ever received from every healthcare facility the patients visited previously and can figure out possible illnesses. This enables statistical documentation of the population as a whole as well. EMR can also make the healthcare system more transparent and allow integration with reimbursement data. As the healthcare system changes, this will prevent unnecessary costs and make it easier to get the reimbursements needed to treat a patient.
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
In this paper you will find that the transition from paper health records to electronic medical record is a transition that requires a lot of time and precise preparation and planning. Looking through the paper you will see that there are factors that need to be implemented. You first definitely have to have your medical records. Next you have to know the role that HIPPA will play in your transition because of regulation and violations. Then, you have to prepare for potential problems that you could possibly face. Next, you will see there are several things to evaluate from how long it will take to cost. You will see prices for workstation and the number of staff that you need to carry out your plan of action.
This paper will identify the use of Electronic Health Records and how nursing plays an important role. Emerging in the early 2000’s, utilizing Electronic Health Records have quickly become a part of normal practice. An EHR could help prevent dangerous medical mistakes, decrease in medical costs, and an overall improvement in medical care. Patients are often taking multiple medications, forget to mention important procedures/diagnoses to providers, and at times fail to follow up with providers. Maintaining an EHR could help tack data, identify patients who are due for preventative screenings and visits, monitor VS, & improve overall quality of care in a practice. Nurse informaticists play an important role in the adaptation, utilization, and functionality of an EHR. The impact the EHR could have on a general population is invaluable; therefore, it needs special attention from a trained professional.
Over the years, healthcare facilities have acted like a storehouse for patients’ medical records, uninterested and unable to distribute clinical data to anyone beyond their organization. The EHR, started in the 1960s under the name of "computerized-based patient record" (CPR), became known as "electronic medical records" (EMR) in the 1990s and today it is known as electronic health record (EHR).The target of the Department of Health and Human Services (HHS) is to incorporate the EHR and use it in a "meaningful" way to improve the quality, efficiency, and safety of patient care delivery; to engage patients in their personal health record; and to improve care coordination. Equally important, the "meaningful use" of the EHR system intends to build a bridge to other systems by creating an interoperability of health information while implementing quality care throughout. However, this interoperability can only be accomplished when the receiving system and the user fully understand how to apply these exchanges.
In the 2004 State of the Union Address, President George W. Bush stated “within the next 10 years, Electronic Health Records (EHRs) will ensure that complete health care information is available for most Americans at the time and place of care (U.S. Government)”. In order to encourage the widespread implementation of EHRs and to overcome the financial barrier to doing so, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 set aside $27 billion in incentives to be distributed over a ten-year period for hospitals and healthcare providers to adopt the meaningful use of EHRs (Encinosa, 2013). In 2011, the Centers for Medicaid and Medicare Services (CMS) implemented the Meaningful Use (MU) Incentive Program. In order to qualify for incentive payments under MU, providers must attest to meeting specific quality measures thresholds each year consisting of three stages with increasing requirement at each stage.
The purpose of this paper is to discuss how Electronic Medical Records (EMR), affects healthcare delivery. I will discuss the positives and negatives this issue has on healthcare and how it effects the cost and quality for healthcare services. In addition, I will identify any potential trade-offs to cost or quality. Lastly, I will discuss how the EMR affects my job as well as any challenges or opportunities this issue presents.
Over the last several years, electronic medical records are becoming more prominent in health care facilities, replacing traditional written records. As many electronics are becoming more prevalent with the invention of numerous smartphones and tablet devices, it seems that making medical records available electronically would be appropriate for the evolving times. Even though they have been in use to some extent for many years, the “Health Information Technology for Economic and Clinical Health section of the American Recovery and Reinvestment Act has brought paperless documentation into the spotlight” (Eisenberg, 2010, p. 8). The systems of electronic medical records mainly consist of clinical note taking, prescription and medication documentation,
The implementation of electronic health records (EHR) continues to make an impact on nursing and patient care throughout the country. As a part of the American Recovery and Reinvestment Act of 2009, all public and private healthcare providers were required to implement electronic health records in their facilities by January 1, 2014. By demonstrating “meaningful use” of the electronic medical record, facilities are able to maintain Medicaid and Medicare reimbursement levels. Providers who show that they are meeting the “meaningful use” criteria during EHR use will receive an incentive payment from Medicare and Medicaid. “Meaningful use” is “using certified technology in EHR implementation to improve quality, safety, efficiency, and reduce health disparities; engage patients and families; improve care coordination; and maintain privacy and security of patient health information” (Centers for Medicare & Medicaid Services, 2013).
Our clinical knowledge is expanding. The researcher has first proposed the concept of electronic health record (EHR) to gather and analyze every clinical outcome. By late 1990s computer-based patient record (CPR) replaced with the term EHR (Wager et al., 2009). The process of implementing EHR occurs over a number of years. An electronic record of health-related information on individual conforms interoperability standards can create, manage and consult with the authorized health professionals (Wager et al., 2009). This information technology system electronically gather and store patient data, and supply that information as needed to the healthcare professionals, as well as a caregiver can also access, edit or input new information; this system function as a decision support tools to the health professionals. Every healthcare organization is increasingly aware of the importance of adopting EHR to improve the patient satisfaction, safety, and lowering the medical costs.