Electronic health records (EHRs) refer to the digital version of the patients former paper chart. They are perceived as easier to read. They allow for a broader health care. Designing is done in a way that allows sharing of information among all specialist contributing to patients care. The patient’s paper chart contains health information collected from all health specialists concerned with the patients care (Katra & Ingram, 2006). This ranges from the nursing care, laboratory results, pharmacists, gynecologist, physiotherapist and nutrition reports among others. With that information flow is fast since each health specialist is able to discern what has been said about the patient regarding several attribute and therefore accord maximum care. It aligns with the great health care principle that health care is solely a team effort (Sullivan, 2010). Information sharing as seen in EHRs supports this effort.
The nature of the computer charting is that documentation takes place as the health specialist interacts with the patient. The health care providers therefore have to strike balance between interacting with the patients and documenting. As a result, most of the health care providers end up focusing more on the screens than interacting with the patients which raises concern. Patient care is therefore suffering following the implementation of EHRs (Sullivan, 2010). For instance, a study seeking to assess the impact of EHRs on healthcare established that one of the cons is the damage in the patient-provider relationship. The study pointed out that doctors and other health care providers spend a considerable time on the screen. This impairs communication between the provider and the patient. While focusing on the screen, the providers often miss on key non-verbal impressions expressed by the patients which is of great significance especially in behavioral health. This may negatively impact on the patient’s experience. Some patients may develop the feeling that the providers are less concerned about their emotional needs (Sullivan, 2010). Some patients may also not be in a position to relate the providers focus on the screen with documentation hence the feeling that the providers focus is more on technology that it is in interacting with them. The negative perceptions towards health care providers by the patients may turn out to be detrimental. For instance, such a patient may get reluctant in returning for later appointments and this could be challenging mostly in chronic conditions.
The charting in EHRs is often characterized by clicking boxes. This mode of data collection normally allows the collection of specific types of data leaving out others that may be of great importance in the provision of health care. For instance, EHR system often leaves out data on medical histories. Medical histories provide a basis for understanding a patients past medical situation, that is, past medical conditions, treatment plans undergone and any conditions that the patient is at risk of. In cases of co-morbidities, medical history is particularly important. A patient may present with a certain condition which may be related to a chronic condition that the patient has had in a long time (Katra & Ingram, 2006). For instance, a patient may present with a renal disease which is a consequent complication of diabetes which they have had in the past. In such a scenario, collection of data and consequent treatment may miss out on the diabetes and focus on the renal issue which may be problematic in the long run. In the event a law suit is involved, the health care providers may land in a compromised situation. On the other hand, if the health care provider collecting the medical data is incompetent, they may fail to question on certain aspects of health concern which may be missed out by other specialist who rely on the initial medical report. Failure to document certain data may also compound the issue.
Common data types tracked by organizations include administrative, clinical and task based systems. Financial data in the health systems is also important. Financial data seeks to track revenues as well as billing. Revenue is particularly important to the government whereas billing is highly significant in insurance companies. Health systems are always in the process of growth. Consequently, the data volume also grows to accommodate the expansion. This data is usually critical to different organizations and there tracking is necessary to ensure that the best data is released (Schneider et al., 1999). Financial data is important to track following various reasons. Firstly, future standards and improvements are determined on the basis of current health records. In order to promote efficiency, tracking is required to ensure that quality health records are maintained. Secondly, poor accounting principles and absence of standard financial reporting are characteristics of health systems which calls for financial tracking. Another reason for financial tracking is the need to allow for a fee-based care which when coupled with value helps in improving patient outcomes.
The organization tasked with tracking financial data is the government policy makers. The policy makers make decisions regarding programs in the health care. Any health claim is often submitted to them for analysis and thereafter make decisions regarding the claims. The policy makers do so by making use of the financial data within the health records to evaluate the health situation. Ethical concerns usually arise when outside organizations are involved in tracking data. The organizations tracking health data aim at accomplishing different missions. The electronic health records usually permit these organizations to access the patients’ health records. Privacy and confidentiality are ethical issues that patients have a right to. An individual has the right to be protected from interference by other persons or organizations. The information regarding a patient can only be shared with others if they give permission to do so (Schneider, 1999). Other instances when the patient’s information can be shared is when the law allows. Electronic health records permit organizations such as research centers, accreditation organizations, government policy makers, insurance companies among others to access health records which raises ethical concern in regard to the patient’s privacy and confidentiality. An example is a research individual accessing health records to accomplish a given study. The hospital may permit this individual but fail to engage the patients whose details are being used. This is a breach to their privacy.
In conclusion, electronic health records have made information more available to the health care providers. They have also permitted information sharing which ensures team effort. EHRs are associated with many advantages towards improving health care. Just like any technology, they have also raised various concerns. One major concern is the communication barrier it brings out when the health care providers focus more on the screen than on their interaction with the patients. Another concern is associated with permitting outside organizations to access the health systems to get data for achieving their missions. This often breaches patient’s privacy and confidentiality which is a great ethical concern.
Sullivan, M. (2010). Playing catch-up in health care technology. Journal of Health Care Compliance, 12(3), 25-30.
Kalra, D., & Ingram, D. (2006). Electronic health records. In Information technology solutions for healthcare (pp. 135-181). Springer, London.
Schneider, E. C., Riehl, V., Courte-Wienecke, S., Eddy, D. M., & Sennett, C. (1999). Enhancing performance measurement: NCQA’s road map for a health information framework. Jama, 282(12), 1184-1190.
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