History, Current Status and Future of Electronic Health Records (Research Paper Sample)

History, Current Status and Future of Electronic Health Records
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Electronic Health Record (EHR) is simply a digital patient's paper chart. EHRs are patient centered systems that that with patient's consent the information is securely availed to authorized users (HealthIT). Not only are EHRs designed to accommodate a patient's medical history, but also include a broad view of a patient's data. Among the information contained in the EHR include; patients' history, immunization dates, laboratory results, allergies, diagnoses, treatment plans and medications. EHRs can also allow access to tools used to make crucial decisions in regards to patients' care. It is apparent that this is one the greatest technological advancement in the field of medicine and public health, and, therefore, understanding of its history, current status and future prospects can be vital to making EHRs are global interest and seducing many countries and individuals to embrace the technology.
The History of EHRs
EHRs are believed to have been developed in late 1960's in response to doctors' concerns that critical information about some of their patients was not fully accessible especially during complex medical situations (Fig, 2012). EHRs were developed with software programs with a capacity to store vast information, provide prompt access and store updated and accurate data. The first attempt to develop systems similar to EHRs were in 1967 when a logical programming software called HELP was developed in Latter Day Saints Hospital to aid decision support. This could assist in evaluation tests. The following year Dr. L. Weed published an article that enlightened the need to use Problem structured medical records to keep patients' records. In 1969, The Medical Record (TMR), a software design to store medical records was developed in Duke University while Computer Stored Ambulatory Record (COSTAR) was developed in Harvard Medical School.
In 1970, El Camino Hospital (California) used Technicon Medical Information Management System (TDS), and this led to the development of computerized Provider order entry program, and consequently improved systems (Fig, 2012). Judith Faulkner established Human Services Computing Company wholes role was to carry out data analysis for UW- Madison hospital and U. S. government. Judith Faulkner also founded epic systems (Fig, 2012). It is apparent that EHRs software evolved from academic experiment, and has continued to evolve into feeder systems that can organize and store, and extrapolate requested medical records in large numbers. In 1980's Decentralized Computer Hospital software which is used up to date was developed. This was first implemented in the Veterans Administration. Cadence was launched in 1985 by Epic systems and its major task was scheduling patient's medical information. In 1988, the state of U. S. acknowledged the power in EHR technology and accorded the Department of Defense financial support of $ 1.02 billion. This was directed to Science Applications International Corporation (SAIC) health care system. The support was meant for all the States and military health centers. This has remained the foundation of an EHR system in the Department of Defense (Fig, 2012).
In 1992 Epic systems released operating system based health records software. In 1998 software that could prescribe solutions for doctors was developed by Allscripts. When the Institute of Medicine (IOM) approved EHRs, there was a widespread adoption of these systems as they represent a bright future in health care. IOM even went ahead to encourage providers to consider serious implementation.
The relationship of EHR to the PCEHR (Personally Controlled Electronic Health Record)
The advancements made in EHRs has led to the development of PCEHR, which are personalized for individual control (Shoniregun & Dube, 2010). A PCEHR is an electronic system in which personal medical records are stored and shared among networks and are accessible to the person in question and any other authorized personnel. PCEHRs allow a person to have access to crucial medical records that can assist in medical advice and aid in the decision making. EHRs are quite broad and shared among hospitals while PCEHR is personal records. PCEHR is advantageous in that the Australian government will benefit in that they will be left with infrastructure and legislation that will lead to improvement in e-health projects. Of interest is a system that can have health care records for all people in Australia and health-care providers. One more benefit of the system is that it can dictate communicate in a network and determine the way people using the system will be authenticated. From an e-health perspective, PCEHR will revolutionalise health care in Australia. This will enable the government to manage the patients' wellbeing and health through increased collaboration between the patients and care providers by use of shared health records.
The current strategy, use and implementation status of EHR/PCEHR
According to Shoniregun and Dube (2010), the discussion about the implementation of PCEHR involved the government and the patients but left out non-patients citizens. He further argues that the needs of non-patient citizens were overlooked, and that is a potential hindrance to the implementation of the system (ICWMNTPH, 2013). The project has many critics and doubters. The Australian Medical Association (AMA) and the Medical Software Industry of Australia (MSIA) are among some of the organizations with weak faith in this system (Brisbane). Complaints range from privacy issues, applicability of the system and governance and liability issues. It is worth noting that even the critics agree that EHRs have large potential usefulness in increasing efficiency of health record even though there is very little evidence to prove that EHRs can improve the quality of health care.
After some period after the implementation of PCEHRs, there is the need for modification as studied by different health and technology professionals. Professor Enrico Coiera the (University of New South Wales) argues that summary records e.g. PCEHR have very little clinical value. In comparison to United Kingdom, the system that was adopted in Australia required arduous verification process while signing up. As such, there was a low level of acceptance of the system. So "opt-in" systems are difficult to solicit adoption as compared to opt-out systems.
Since this technology was first implemented in UK, records from there can point to what trends to expect in Australia. HealthSpace of UK reported that there were 172,950 registration from 2007 to 2010. Many people perceived HealthSpace as of little use to them. Another negative progress in the implementation of the technology came recently when Google shut down its EHR, Google Health. The company argued that it was challenging to engage the small audience of fitness fanatics and technology savvy patients that the technology attracted. Research has shown that the merits of the system determine the number of users who will buy the system. Issues such as privacy are even overlooked when there are benefits, but PCEHR has so few benefits that issues such as privacy become disincentives to the application of the system.
. A web-based EHR has been developed by both the University of Western Australia and Kimberly Aboriginal Medical Services (icrar). This is the system used in the Kimberly region Western Australia (Government of Western Australia, 2013). In this system, all medications, care plans and communication regarding patients are electronic. Patients must be consulted before their records are shared with hospitals, mental health professionals and even visiting professionals. This system is different from PCEHR in that all concerned people work off in the same record. Medical practitioners have to work in close collaboration as any changes in made on the record are visible to all people involved in the care plan. In addition to telehealth services the Department of Health, the private sector and KAMSC can ensure the consistence of the care plan. Because of its uniqueness, this project was reviewed in OECD's global e-health projects. Another critical concern when implementing PCE...