Evolution of IS and IT in Healthcare: EHRs and Beyond - Essay Sample

Introduction

Information system (IS) and information technology (IT) have evolved over the years to become a key element in the delivery of quality healthcare. This evolution can be traced to the 1960s when large hospitals developed systems to store financial and administrative systems and also centralize data processing (Wager et al., 2017). Today, IS and IT are widely used by different constituent groups, including patients, providers, government, payers, among others. Electronic health record (EHR) systems have also been adopted, various EHR products have been certified, and the use of mobile health apps is on the rise (Wager et al., 2017). The adoption of EHR has been informed by the need to enhance patient safety and increase accountability within the country's healthcare system. Its implementation has also been supported by various legislations such as the Affordable Care Act (ACA), which aims to improve the quality of healthcare and also reduce the costs. This paper seeks to discuss EHR implementation strategies for health organizations, as well as how EHR improves patient safety. The mandate of EHR, its goals and implementation in a healthcare facility, as well as its meaningful use, will also be addressed. Lastly, the paper will address the issue of patient confidentiality under EHR, probable threats, as well as its link to HIPAA regulations.

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Electronic Health Records

Generally, EHR refers to a digital chart that captures patients' records in real-time and avails it to authorized users. Information contained in EHR includes the patient's medical history, diagnoses, as well as treatment plans. Various evidence-based tools are also incorporated in EHR to help in making decisions about the patient's care. Besides, EHR streamlines workflow, hence increasing efficiency. Patient safety is one of the primary aims of EHR. This goal is achieved in various ways. First, use of EHR helps reduce the dependence on handwritten medical orders, which are prone to errors (Kimmel & Sensmeier, 2002). Secondly, EHR ensures that healthcare providers have access to accurate information, and hence diagnostics and patient outcomes are improved. Also, EHR improves care coordination between the different care teams, thus enhancing the patient's safety and outcomes.

The electronic health record mandate is a section of the healthcare IT for Economic and Clinical Health Act, which is a fragment of the United States Recovery and Reinvestment Act signed by President Obama in 2009. The EHR incentive was also launched at the same time. The laws were part of Obama's plan to reform the healthcare system. In the same stride, the ACA was enacted to ensure accountability by paying for the patient's outcomes, and this was monitored using EHR. Hence, all the healthcare institutions were required to implement the EHR effectively and efficiently demonstrate meaningful use.

The objective of the EHR mandate is to center the patient care and ensure overall health for the entire population. However, it is essential to note that the Federal Health Information Tactical Plan has a precise objective and goals to monitor the EHR (Office of the National Coordinator for Health Information Technology, 2014). One of the purposes is to expand the adoption of health care information technology. It also seeks to advance interoperable and secure patient information as well as guarantee technical security and privacy of data. Additionally, the EHR is employed to expand on the wellbeing of the persons and the community at large, empower health engagement, as well as promote public health and management. Lastly, it seeks to encourage research, advance scientific knowledge, and creativity.

Depending on the size, needs, and resources available to a health organization, various strategies can be employed for the successful implementation of EHR. However, strong leadership and targeted training are generally required. Strong leadership helps navigate the organization through the change, and multiple training options must be offered to enhance in-house capacity (Liu & Edye, 2019). The focus of the system should be on outcomes, and the entire project should be clinically driven. It should also be tested thoroughly and made flexible enough to cater for future transformations.

The Facility's Plans

Owing to the legislation discussed above, the company I worked for had to replace the system used previously with EHR. To ensure success, the implementation process was carried out systematically. Ultimately, the new system was implemented and has been hugely beneficial for the organization. First, the organization's practice readiness and preparedness for changes were assessed, its current needs evaluated, and areas that needed improvement determined.

The information gathered in the planning step was used to develop an implementation plan. It included a schedule of duties and the timelines for the implementation. The implementation of EHR was to be carried in phases to monitor the effectiveness and the learning capabilities. This step was tactical since the employees could learn in the process.

After meeting the required technological capability, security requirements, and functionality, the organization's system was upgraded to a certified EHR. The information gathered in the first two steps was critical in choosing the right EHR.

Training was also an important step in the process. Since the facility adopted MedTech, it was essential to train its staff on the use of the new system. The training was conducted in four sections. Out of the facility training and the practice days on a MedTech training module ensured that the employees had gained sufficient expertise by the time the system was operationalized.

Assessing what was learned from the system helped the organization determine the meaningful use of adopting the EHR. Through the use of MedTech, the company has significantly improved on the services offered to the patients. The reduction of paper use has made it more effective and, most importantly, reduced the incidence of errors, which, in turn, improved patient safety (Kimmel & Sensmeier, 2002).

Following the implementation of the system and achievement of meaningful use, the company established procedures to evaluate and also improve EHR continuously. For instance, the goals and needs of the organization are continually revisited. The workflows are also frequently refined to enhance patient outcomes.

Meaningful Use

According to the U.S. Department of Health & Human Services (2014), meaningful use is the effective utilization of the EHR to improve the safety of the patient, enhance the quality of care given, increase efficiency, as well as reduce health disparities. Additionally, it defined the different ways in which the patients' families can be involved in the treatment process, as well as measures to protect the confidentiality of the patient information and that of the care providers. Following a successful implementation of EHR at the facility, meaningful use has been achieved. The quality and safety of care have been enhanced and the security and privacy of the patient's data improved. However, the organization needs to do more to enhance population and public health. This goal can be achieved by empowering the patients and their families, as well as collaboration with external partners.

Patient's Confidentiality And EHR

While EHR has drastically transformed the country's healthcare system, it threatens the confidentiality and security of patients' information, since the system allows access by different individuals and from different locations. The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 to address this threat (Edemekong & Haydel, 2019). It requires that healthcare facilities or providers should protect the confidentiality of the patient's information and also develop tactical plans to ensure that the patient information is protected (Edemekong & Haydel, 2019). Violations of the provisions of HIPAA bear adverse effects on a health organization. Therefore, the facility has taken several measures to avoid HIPAA violations. Other than the establishment of secure and encrypted networks, the organization has implemented other computer procedures to protect patient's information such as investment in software to enable tracking of authorization expirations. Employees are prohibited from disclosing passwords or sharing login credentials. It is also required that computers and other gadgets should be logged out when not in use.

Conclusion

Driven by the enactment of various laws over the years, as well as the need to enhance patient safety and accountability, the adoption of EHR in health organizations has been on the rise. Strategies and steps to be followed in the implementation of EHR have been developed, as seen in the case of the facility I used to work in. While the system has several advantages, it also endangers the privacy and safety of patients' information. HIPAA was passed to address this challenge, and violation of its provisions leads to various adverse effects on the organization. Thus, as shown in the paper, organizations must develop various measures to avoid violations. When EHR is successfully implemented, meaningful use is gained. Ultimately, the quality of care given to patients improves.

References

Edemekong, P. F., & Haydel, M. J. (2019). Health Insurance Portability and Accountability Act (HIPAA). StatPearls, StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK500019/

Kimmel, K. C., & Sensmeier, J. (2002). A technological approach to enhancing patient safety. Healthcare Information and Management Systems Society.

Liu, Z. Y., & Edye, M. (2019). Implementation of electronic health records systems in surgical units and its impact on performance. ANZ journal of surgery. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/ans.15350

Office of the National Coordinator for Health Information Technology. (2014). Federal Health IT Strategic Plan 2015–2020.

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). History and Evolution of Health Care Information Systems.

In K. A. Wager, F. W. Lee, & J. P. Glaser, Health Care Information Systems: A Practical Approach for Healthcare Management (3rd ed., pp. 104-128). San Francisco: John Wiley & Sons.