Electronic Health Record Systems in Healthcare (Essay Sample)

Electronic Health Record Systems in Healthcare Author’s Name Department/University Course number Course name Instructor’s Name Electronic Health Record Systems in Healthcare The case of providing wrong medicines to patients or medication error (ME) is increasing day by day everywhere in the world. According to Shea et al. (2018), a significant number of patients in the United States receive the wrong medicines. Assiri et al. (2016) mentioned that approximately $177.4 billion is spent annually on drug-related morbidities and mortalities including ME in the United States. The experiences of patients in other developed, developing, and underdeveloped countries are not much different from that in the United States. One of the major reasons for ME incidents is the problems in keeping or maintaining adequate health records by the hospitals. Traditionally, health records are maintained on paper. However, the arrival of computers and other IT technologies helped hospitals to keep or store medical records electronically. It was expected earlier that Electronic Health Records (EHRs) would reduce ME incidents considerably and improve the efficiency of hospitals to a larger extent. It is believed that EHRs can improve coordination among healthcare workers, improve care, and decrease healthcare costs. However, studies have shown that EHR can bring benefits as well as challenges in the healthcare sector. The purpose of this paper is to discuss the problems associated with the usage of EHRs. Unintended Consequences for An Electronic Health Record (EHR) Some of the major unintended consequences associated with EHRs are increased workloads for clinicians, unanticipated workflow changes, and frequent system changes or upgrades (Wiedemann, 2012). For example, system changes and software upgrades force healthcare workers to learn many new complex technical skills. The difficulty in learning such complex skills would force these workers to revert back to the maintenance of paper-based health records. At the same time, technically savvy healthcare workers may be more comfortable in maintaining and using EHRs. In short, the possibility of the creation of a division or clash among healthcare workers cannot be ruled out as part of the development and implementation of EHRs. Imagine an instance in which a hospital has a lab system that produces abnormal values. While checking these values, the physicians may recognize the mistakes and make some corrections in the lab report before prescribing medicines for a patient. At the same time, he may be forgotten about correcting the mistakes in the lab report electronically. In such cases, the hospital may be forced to maintain a wrong health record for that patient. When the patient visits the hospital again later, the physician will use the wrong EHR for the assessment of his condition. The increased workloads developed for physicians as part of the maintenance of EHR would force some physicians to enter vital patient data into the systems using the services of a clerk or a data entry operator. It is not necessary that the clerk or the operator may recognize complex medical terms properly. He may enter the wrong details into the system because of his unawareness of medical terms. As a result, EHRs can produce additional risks to patient care and unintended consequences later when the patient returns for further medical help. One of the major benefits cited for EHRs is the speeding up of the flow of communication between different healthcare workers. While using EHRs, any number of healthcare workers can access the information of a particular patient at the same time. On the other hand, while using paper records, only one healthcare worker can access the patient's information at a time. At the same time, the entry of patient information into the system is a time-consuming process for many healthcare workers. Imagine a situation in which a physician is forced to enter the patient information into the system at the time of consulting a patient. Such a scenario will force the physician to spend more time for the consultation of every patient. When a physician takes more time for the consultation, the waiting patients may develop frustrations and agonies. How Does the EHR Affect the Integrity of The System? According to Bowman (2013), improper use of EHRs as well as the poor designing of the system would jeopardize the integrity of the information in the EHR. Medication errors will be increased and patient safety and the quality of care will be decreased if the EHRs designed and used improperly. The attraction of legal complications as part of the improper use of EHRs cannot be ruled out. Since the introduction of EHRs, a lot of unfortunate incidents reported in various parts of the United States. For example, Singer (2010) reported an incident in which a patient's treatment for cancer was delayed for several years because of an error in EHR that changed the more recent abnormal results to an old normal Pap test result. It should be noted that cancer treatments are more effective when they are administered at the beginning stage itself. However, the above-mentioned patient failed to receive treatment for cancer at the beginning because of the errors in her EHR. Information Week (2011) reported another incident in which a baby died from a massive drug overdose because of errors in the EHR. In this case, the data entry operator made a mistake while entering the handwritten prescription into the computer system. The two incidents mentioned above indicate the potential of EHRs in affecting the integrity of the healthcare system in a negative manner. Is the Information in the EHR Compromised Due to Unintended Consequences? In some cases, healthcare workers may manipulate the information in the EHRs because of the fear of unintended consequences. The manipulation occurs mainly to escape from legal problems. If a patient dies because of the wrong administration of medicine or ME, his healthcare records can be manipulated or altered to avoid further legal complications. It is difficult to identify such electronic manipulations unless the investigating authorities seek the services of computer forensics. As noted by Colicchio et al. (2019), some of the most prominent unintended consequences of EHRs are physician burnout and data obfuscation. The lack of clarity regarding the patient data and the over workload forces physicians to make a decision to avoid unintended consequences by altering the data obtained from EHRs. Information overload is one of the major problems faced by modern physicians. Information overload may results increase in the errors committed by physicians. The increase in cognitive load would reduce the quality of decisions taken by physicians. As pointed out by Nijor et al. (2022), EHRs may contain many clinically irrelevant information. It will be difficult for a physician to go through a bunch of information and decide which of the information presented in the EHRs is clinically relevant and irrelevant. As a result, many physicians go through the information in the EHRs passively and make judgments. It is better to highlight the major points in the EHRs to help physicians make decisions quickly. How is Quality Affected by The Use of The EHR In the Clinical Setting? EHRs can improve physicians’ ability to diagnose diseases properly. Better diagnosis will bring better patient outcomes. While using paper records, doctors and nurses will have struggled to locate a piece of patient information that may be entered a couple of years before. On the other hand, EHRs can help them locate such information instantly with the help of a keyword search. A study by Yanamadala et al. (2016) found that patients with full EHR had the lowest rates of inpatient mortality, readmissions, and Patient Safety compared to patients with partial EHR or no EHR. EHRs were developed mainly for billing purposes initially. However, the medical community has realized its importance in other areas lately. Paper records can provide patient information in written form only. On the other hand, EHRs can provide such information not only in electronic forms but also in graphical forms. It will be easy for physicians to assess the progress of a patient if gets data in the form of charts or graphs. For example, physicians can go through the cholesterol levels of a patient more easily if these data are provided in a graphical format. On the other hand, the physician needs to take too much time to go through each piece of data if the entire data is provided in written form. One of the biggest misunderstandings in the healthcare industry is that the services and skills of doctors and nurses are what ultimately determine how well healthcare is delivered. The delivery of high-quality healthcare can only be done in part by competent doctors and nurses. For instance, when a patient is admitted, a doctor may prescribe medication, which the nurses then obtain from the pharmacy and provide to the patient. The efforts of the doctors and nurses are all unsuccessful if the pharmacists make a mistake when dispensing the medication. The coordination and communication among different healthcare professionals can be improved significantly if the health records are provided in electronic format. Does EHR Help or Hurt Healthcare Providers? If used properly, EHRs can help healthcare providers in areas like healthcare delivery, healthcare documentation, quick access to patient information, etc. Imagine a situation in which a patient admitted to a hospital needs the services of a specialist working in a distant hospital. In such a case, it is possible for the hospital authorities to show the health records electronically to that doctor and receive help from him. Thus, it is possible for patients staying in any part of the world to get support from specialists staying in another part of the world. EHRs have a...