Paper Example on Comprehensive Solution: EMR to Improve Patient Data Accessibility

Introduction

Patient data must always be available, and when requested by the patient or their legal representative, authentic copies of the information are required. Most hospitals use paper records and these have many disadvantages, they can be misplaced, data is exposed to breach of confidentiality, and there is need to be redone with each new doctor the patient consults with causing the information to be incomplete or omitted. The electronic medical record (EMR) eliminates all these problems in a practical and efficient manner. An EMR is one of the technological innovations that bring more safety and quality in diagnosis for patients.

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An EMR brings so many benefits to a hospital setting. The electronic medical record modality ensures that patient data can be effectively and quickly shared by the entire patient care team, and this exchange is possible even over long distances. It is the basis of information for consultation and referral, reduces the misuse of equipment and services, avoiding unnecessary repetition of examinations and procedures, allowing at any time an accurate knowledge of the treatment done and the result achieved (Ben-Assuli, 2015). This tool eliminates a common problem in clinical practice: the illegibility of handwritten information by professionals in paper records, a fact that may generate misinterpretations of clinical data. Moreover, the computerized medical record system allows information to be stored for much longer, ensuring greater security for the patient and family, and facilitating the use of data in possible epidemiological studies (Haskew et al., 2015). The processing of these data enables the verification of health trends in a given population, previously drawing the attention of health professionals and managers to possible epidemics, thus triggering immediate control measures (Entzeridou, Markopoulou, & Mollaki, 2018). Thus, the implementation of an EMR would be a great step toward improving the quality of care provided to patients, as it generates ease, agility, and safety for health professionals and public health would become more complete and accurate.

Implementation Plan

The implementation of an EMR system is an important moment for health institutions, but it should pay attention to some points, such as: does the solution meet the current needs of the unit? Can it help in patient safety? Is it suitable for structure and size? Is it authorized? The implementation of this project will require the help of computer technicians for the installation of the program on computers and the training of health professionals of the unit. It would also require the cost of new equipment and free internet access. Its implementation may take a few months, thus requiring planning and extensive dialogue between managers of the Health entity, IT department and the technical team, in order to avoid communication failures that compromise the project. There is also an infrastructure demand for the tool, such as computers and network connections that meet minimum requirements.

The activities carried out in the EMR implementation project are aimed at achieving the objectives set while minimizing possible inconveniences for internal users (employees) and external users (patients). As regards the methods for implementing an EMR, there is evidence to support the progressive implementation of the modules that make up an EMR (Howe, Adams, Hettinger, & Ratwani, 2018). This approach seems to guarantee better results for the following reasons: Progressive cultural growth of the personnel involved and greater involvement in the implementation process. Secondly, enhances the possibility to gradually test the data-sharing methods between diagnostic departments and services and to refine the technical and organizational solutions to be adopted. The implementation process will follow the outlined steps below:

Seeking Authorization

The first step will involve seeking authorization from the relevant authorities. EMR deals with patient's data which has to be protected and any activity dealing with that data requires authorization regarding the digitization and use of computerized systems for the storage and handling of medical records, including authorizing the elimination of paper and the exchange of identified health information (Sligo, Gauld, Roberts, & Villa, 2017). The digitization must comply with requirements laid down in regulation. Original documents may be destroyed upon digitization, but must be subject to mandatory review by a standing document review and review committee specifically created for this purpose. They must verify the integrity of the originals and then warrant final disposal. Documents of historical value, identified by the commission, shall be preserved in accordance with archival law.

Validating the Data

Once the certificate is requested, a registration authority must be found to validate the data. Such a procedure is important for the safety of patients and that of the hospital. This step ensures that important steps are established to prevent fraud.

Choosing a Management System

EMR will be managed by a specific system and it is important that this system has tools that become true facilitators in the clinic routine. Its interface is user-friendly - greatly assisting the adoption process by requiring less training time by employees (Scott, Rundall, Vogt, & Hsu, 2018). Additionally, the information collected can be safely stored in the cloud, ensuring that professionals have access to real-time data even outside healthcare facilities.

Migration

Depending on the size of the hospital, full data migration may take time. A survey will be needed to record all patient information in the system. So that important data is not lost, it is essential to maintain the organization during this phase. The client-server technology, programmed in PowerBuilder, with Sybase databases will be used for the design of the EMR system (Scott, Rundall, Vogt, & Hsu, 2018). In the offices, PC/Intel computers will be installed, with a Windows operating system, and the EMR application will be installed in each one along with the database access tools.

Security Phase

Information security within EMR is the biggest challenge in EMR management. It refers to digital data protection measures to prevent unauthorized access to medical records, computers, and databases. Access and access policies to EMRs need to be carefully regulated due to the accessibility of patient information by all medical personnel and health staff (Ben-Assuli, 2015). Policies relating to the control of confidentiality such as the use of Password/Access Level Policies need to be strengthened and streamlined as well as the development of information intrusion technologies such as hackers' threats (Adler-Milstein et al., 2015). Data security will be enhanced through passwords and a firewall system. The use of login and password is the most traditional and common method of authentication. It requires a person to be previously registered, a username to be registered and a password entered. These permissions will follow strict company policy and will be based on the access hierarchy, requiring users with higher permissions to approve changes from their subordinates (Cucciniello, Lapsley, Nasi, & Pagliari, 2015). This will prevent unauthorized people from accessing medical records. It also prevents unqualified professionals from viewing patient data. A firewall is a tool that controls device access to the local network of health facilities. This way, an unknown device will be prevented from accessing servers, systems, and computers registered to the network.

Training Phase

These training will include the use of the computer system, changes in operating processes and the merging of the two. Training will also involve educating the users about cyber threats and how to detect and report them. During this stage, reports will be made highlighting the strengths and weaknesses of trained employees, with a view to redistributing employees more easily to help others (Haskew, Ro, Saito, Turner, Odhiambo, Wamae, & Sugishita, 2015). The EMR system is also exposed to technical problems such as ICT hardware failure, network and electrical disruption due to unforeseen factors such as fire, flood, earthquake, lightning, and others. Therefore, EMR maintenance needs to be managed well and data backup planning is implemented properly to ensure that the EMR process is not interrupted during patient care.

Legal and Ethical Aspects of the Implemented EMR

Document retention time. The paper record must be kept by the institution for a minimum of 20 years from the patient's last interaction with the clinic, hospital or laboratory and the electronic record must be kept indefinitely.

Information Privacy. Maintaining the confidentiality, privacy, and security of patient information is one of the highest duties of the physician and other professionals who serve the patient (Scott et al., 2018). There will be a strict control and record of access made by professionals, and the possibility of auditing actions performed by system users. In addition, all changed medical records will be backed up daily every 24 hours. These copies will be stored on devices other than those used by the system.

Information to public and judicial bodies. The access to the electronic medical record will be done after the identification of the professional, via a digital certificate. If the access is improper, the professional can be held legally responsible for the action.

Evaluation of the Project

To establish whether the project is successful or not, some tests will be carried out. The first test will be an accessibility test which will compare the search speed of record through timekeeping between a physician using an EMR system and the other one using traditional paper. The average time taken by the physicians to find the requested information will then be recorded and compared (Ben-Assuli, 2015). An observation test will also be carried out to establish whether there has been a decrease in the repetition of exams and the accuracy of the return control to the emergency room. A work map will be used to synthesize the nursing map and it will show, every thirty employees, which employees have medication hours for that interval.

The capability maturity model (CMM) will be used to evaluate software process, quality models. CMM is a certification granted by the Software Engineering Institute (SEI) of Carnegie Mellon University (USA), which measures the degree of maturity in the software development process. CMM focuses on processes, which consider the production factor with the greatest potential for short-term improvement (Baumann, Baker, & Elshaug, 2018). Other factors, such as technology and people, are addressed by CMM as they interact with processes. It sets a standard against which to repeatedly judge the maturity of an organization's software process. It is an application of the principles of total quality and project management in the software world. Pursuing this goal of maturity, the company will create a Micromed deployment methodology, which arises from the need to carry out this rigorous control in the systems deployment processes, prioritizing the standardized technical documentation, through the developed and homologated instruments.

Steps To Take If the EMR Is Not Successfully Launched

Implementing an EMR system is a challenge since it entails substantial difficulties that require the adaptation of processes and systems of care for better registration and quality of care. With low investment in health management policies, it is difficult to invest in integrated systems such as electronic medical records to ensure a wide range of health servic...