Sample Paper on Healthcare Informatics Research and Innovation

Healthcare Informatics Research and Innovation

Technology and technological innovation are increasingly changing the way different sectors handle their activities. The health care sector is not an exception, where technological advancements are finding their way in health care record keeping, management, and retrieval. The passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 has especially had a great impact on electronic health records (EHR), which has experienced a dramatic increase in technological advancements. While initially a requirement from the Act, health care practitioners are increasingly adopting EHR given the benefits that it brings to the health care setting. Although the widespread adoption of EHR faces challenges including lack of computer skills, high cost for implementation, and patient information security concerns; its implementation presents the potential to reap the benefits including legibility, improved patient outcome, and timely reporting and sharing of patient information among health care providers.

HITECH introduced compulsory EHR among health care providers in 2009. Before its (HITECH) passage EHR was largely implemented at the discretion of health care providers. Most providers relied on physicians’ notes, lab reports, and pharmacy prescriptions, which meant that patients’ information was widely fragmented at best. HITECH introduced EHR as a means of collating patient information in such a way that it would be easily retrieved, shared, and read, in addition to giving patients a better look and control over their treatment. To encourage the adoption of EHR, the Act included incentives such as reimbursements to providers that implement certified EHR technology, while meeting the expressive use threshold (Hoover, 2016). The idea of the incentives is to generate greater momentum in the adoption of EHR, and in doing so reap the benefits that accrue from the implementation.

Implementing EHR hinges on the fundamental goal of improving health as the overarching premise. However, under this premise are specificities, that cover patients and care providers. One such goal is access to health data. EHR allows patients to access and own their health data, retrieve and manage it at their convenience from wherever they are. The goal also covers health care providers, who can easily retrieve patient data, essentially increasing efficiency. EHR essentially allows both patients and medical practitioners to access the requisite information, in addition to allowing real-time updates of the patient’s information through a connected system.

The second goal of EHR is the improvement of consultation outcomes. The goal covers both the patient and the medical practitioner. For patients, access to their medical history enables them to prepare further and relevant information before a consultation, especially if they are changing physicians. As aforementioned, having access to patent information gives the practitioner the full medical history of the patient. The information helps better understand the patient during the consultation period.

Another goal of EHR is to present accurate and timely information, especially for patients. The purpose of providing this information is to involve the patients in their care and help them better understand their situation. Having access to such information allows the patient to self-manage their health situation. The idea here is to empower the patient with as much information as possible, to allow them to make informed decisions where there is a need, in addition to understanding the problem and discovering possible remediation.

One of the first benefits of EHR is legibility. Gann (2015) informs that death due to medication errors ranked eighth among the causes of mortality in the U.S. in 1999. The majority of the errors were due to illegible handwriting in physician notes. Hoover (2016) informs that in an investigation on the sources of medication errors, 60% of the errors in health care facilities could be traced to poor handwriting. Thanks to the implementation of electronic health records among other nursing informatics and technology, there has been a marked improvement in patient safety and clarity of information among health care providers.

EHR has greatly improved patient outcomes over the years since the passage of the Act.  According to Hoover (2016) since the passage of the Act and the beginning of its implementation by health care providers, there has been a 52% decrease in adverse drug events. Moreover, advances in EHR technologies have improved in that the technology integrates with bar code scanning. Gann (2015) explains that with such integration, wrong medication scans initiate alerts, which point to the problem. The technology essentially minimizes the chances of dispensing wrong medication due to error consequently improving patient outcomes.

Data entered in the EHR system is usually available to all specialists with access to the system instantly. Through such an instantaneous sharing of patient information across the system, critical lab and other values can be reported to the health care providers on time (Hoover, 2016). Physicians and other specialists in the health care setting, therefore, get patient information at their convenience. Moreover, the fact that patient information and history remain in the system improves treatment and overall efficiency by avoiding duplicate tests.

Since the passing of HITECH in 2009, hospitals and health care facilities have increasingly adopted and implemented the use of EHR. Data from the Office of the National Coordinator for Health Information Technology (ONC) shows increased uptake of EHR within the health care sector. According to ONC (2019), more than 95 percent of hospitals possess some form of EHR. Hospitals in possession of the technology use it for several reasons including capturing patient information, monitoring patient progress, and patient billing. The hospitals additionally use the system to inform clinical practice. ONC’s data additionally informs that 82% of the hospitals in the study used EHR for supporting quality improvements, 81% for monitoring patient safety, and 77% for measuring organizational performance. Ideally, the data shows an increase in the use of EHR among hospitals, jumping from 87% of hospitals in 2015 to 94% of the hospitals in 2017 (ONC, 2019). The jump in the uptake and use of EHR can only be attributed to the benefits that come with the implementation of the systems within the health care setting.

Additional data on EHR shows the cost-saving property of the system; a reason that perhaps fuels its implementation. The cost-saving properties of EHR cut across the board for both patients and care providers. Reis et al. (2017) inform that studies into EHR show marked savings for patients, whose costs are $731 (9.66%) less when treated in hospitals with EHR in comparison with those without EHR. For hospitals, cost-saving comes in the form of reduced errors which traditionally cost the organizations billions.  Reis et al. (2017) intimate that hospitals lost $19 million in 2008 alone due to medical errors. EHR, therefore, provides a safety net in cost saving by reducing errors while increasing the efficiency of the staff in any health care setting.

Although EHR has great potential it remains a challenge within the health care setting. Both clinicians and patients reap the benefits of EHR, while nurses are unhappy with the implementation. Hoover (2016) states that most nurses (92%) lament the implementation of EHR. The nurses point out that EHR is time-consuming, keeping them away from their core duty—patient care. Nurses additionally lament on the incompetence of the IT department as well as the administrators, who leave them out of EHR discussions before its introduction and implementation. Moreover, the nurses state that they do not get enough training on the workings of the systems, which then presents challenges. As a solution, Hoover (2016) argues that facilities should involve informatics nurses from the onset, give them enough training and education before the change process instead of the traditional information overload once the system is in place. Additionally, the training should involve all the staff members within the facilities before launching. Facilities should also provide continuous support and refresher training any time there is a change in the system, as is customary of information systems.

Since HITECH came into force in 2009, hospitals and medical practitioners have been keen on implementing EHR. In general, the goal of EHR is to improve health. It allows both patients and medical practitioners to access health information and make informed decisions. The uptake and implementation of EHR have been phenomenal as both patients reap the benefits of the system. Although the cost of implementation remains one of the biggest challenges for its full implementation across the health sector, EHR has shown promise with a great potential of improving the health care sector for goo

References

Gann, M. (2015). How informatics nurses use bar code technology to reduce medication errors. Nursing 45(3), 60-66.

Hoover, R. (2016). Benefits of using an electronic health record. Nursing46(7), 21–22. doi: 10.1097/01.nurse.0000484036.85939.06

ONC. Hospitals’ use of electronic health records data, 2015-2017. ONC Data Brief, 19(47), 1-13.

Reis, Z., Maia, T. A., Marcolino, M. S., Becerra-Posada, F., Novillo-Ortiz, D., & Ribeiro, A. (2017). Is there evidence of cost benefits of electronic medical records, standards, or interoperability in hospital information systems? Overview of systematic reviews. JMIR medical informatics5(3), e26. doi.org/10.2196/medinform.7400.