Literature Review on Electronic Health Record in Healthcare

The world has radically and steadily transformed with the emergence of the digital technology. The electronic devices such as mobile phones, tablets, and other web-enabled devices have changed how we undertake our daily lives and communicate to other people. Medicine is an information filled sector, and a flow of information is paramount. The circulation of information has become accessible in the wake of the digital technology and thus, led to the development of creation of the electronic health records (Jha et.al. 2009). The electronic health record is a systematical collection of health information about patients that is put in an electronic gadget. Patient information includes medical history, vital signs, medication orders, laboratory tests, radiology reports as well as doctors and nurses notes. The electronic health records make work easy by automating the medication, exam ordering and making sure that the orders are readable, complete and to the standard. When health care providers can access accurate information, the patients are the greatest beneficiaries as they receive better medical care. Electronic Health Records influence Healthcare by improving diagnostic and quality of care cost reduction and reducing medical errors.

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Electronic health records help in improvement of diagnostic and quality of care (Campanella et al., 2015). The electronic health record many also include the decisions to support the decision support system, which provides up to date information and reminders that assist the health practitioners in making decisions. The EHR provides the health providers with the medical history, lab results, radiology and other information on the patient which is useful in giving the patient the best medical care (Campanella et al., 2015). Errors are also minimized as the health providers will have the information needed at hand and no need to look for the information in files. The EHR also guides the doctors in case the patient is brought in on and emergency case. Moreover, the EHR also expose the potential safety problems that may occur therefore helping the health providers and patients to avoid the serious problem which leads to better patient outcomes. Additionally, the electronic medical records help in identification of the correct operational problems which if were to be done on paper would waste a lot of time in fixing.

The electronic health records system can also enhance care through improvement of screening such as in diseases of breast cancer, asthma, diabetes, chlamydia and blood pressure. This way the physician can monitor the progress of the patient carefully without any errors which are also useful in ensuring the correct medication id given to the patients (Bell et al., 2010). However, there have been some disputes concerning the implementation of the electronic health records. According to Campanella et al., 2015, there were unexpected rises in the mortality rates after the implementation of the EHRs.

The electronic health records also help in reduction of the cost used in making health records. The electronic health records can significantly reduce the costs associated with medical errors (Schiff & Bates, 2010). For instance, studies have it that there are considerable cost reductions which are often achievable through improving the quality of care and reducing the harm to patients. The EHRs have a prominent impact on the way resources are utilized by helping avoid wastage of resources that occur through medical errors. The guidance adherence is promoted to reduce the inappropriate clinical practice variability and also used in ineffective therapies which in turn improve the patient outcome and enhance a cost effective care for the patients. Moreover, according to studies, the use of the electronic health records in the delivery of health care improves hospital efficiency which as a result benefits the exceeding cost of adoption and increases the patient satisfaction (Goldstein, Navar, Pencina, & Ioannidis, 2016). The EHRs are not specific to one disease and thus allowing the physician to look at different outcomes with the same data source. For instance, looking at the model of probable heart failure, readmission, and diabetes among other diseases. This makes them cost effective as much paperwork is reduced and resources saved.

The electronic health records play a significant role in reducing medical errors. The electronic prescribing has been great in reducing the rate of medication errors (Schiff & Bates, 2010). The most important part of medical care is the getting the diagnosis right. Unfortunately, diagnosis errors are most common unlike the other medical errors such as the surgical and medication errors. Through EHR, the rate of the diagnosis errors is set to reduce significantly. However, physicians claim that the method of electronic health records is time-consuming and taxing. The medical providers also argue that the electronic medical records system derails the diagnostic thinking and distracts the doctor from the patient as they focus more on the data gathering. However, experts say that the diagnostic process must be reliable, which is a thing that the electronic health records provides easily. The electronic health records minimize the medical errors in various ways.

First, the EHRs can help diminish the errors in filtering, organization and offers easy access to information (Schiff & Bates, 2010). For a physician to make a correct diagnosis on the patient they need correctly to gather information about the patient from medical histories, lab tests, and many others. Therefore, the electronic health records provide this information readily making it easier for the doctor to follow the patients past medical history and thus make the correct diagnosis. However, the information given on the EHRs can be overwhelming, making it difficult to scan through all the information from each patient. Fortunately, the medical information can be organized in various formats. The developers of the EHRs need to ensure that the patients information is displayed in selective formats to enhance rapid judgments and minimize too much work overload when reading all the medical history (Schiff & Bates, 2010).

Secondly, the EHRs can foster assessment is through bringing the clinicians, and patients together assess the document evaluations, unanswered questions, and differential diagnosis (Schiff & Bates, 2010). This evaluation will help come up with accurate capturing of the patients history and discussing the uncertainties, thus avoiding error. The documentation can be designed in such a way that the physicians and the patient discuss the problem on the same screen. This type of discussion will enhance useful and easier conversation as well as documentation, hence, problems of errors id reduced.

Thirdly, the electronic health systems facilitate the documentation of ongoing and emerging issues of the patient (Schiff & Bates, 2010). The physician is not forced to start documenting a fresh, but rather goes on from where they had last recorded. Therefore, it is imperative to ensure that the documentation is systematic to avoid confusion and mix-ups, especially for the chronic diseases. Additionally, it becomes easy to update and refine the documented information.

The documentation using the electronic health records is useful in giving patient education (Kraan et al. 2015). The clinicians may use the records to show the patient what symptoms to look out for and how to avoid certain problems. Another way to educate patients is through automated feedback that can help primarily in learning of the diagnostic errors. A decision support system can also ensure that the doctor does not leave out vital questions to the patient that assist in making a diagnosis.

The nature of effectiveness of the electronic health records system is well displayed in all the three articles. The information given clearly show the importance and benefits the electronic medical records bring forth. The electronic health records influence Healthcare by improving diagnostic and quality of care cost reduction and reducing medical errors. The records are systematically put to help ease the physicians work as they go through the patients medical history to give the best diagnosis. Improving diagnosis mean that the patient will be offered the best medical care they can get. Moreover, the physician can monitor the progress of the patient carefully, hence making sure that they receive the correct medication and reduce medication errors. The electronic health records also minimize the cost of resources needed to keep paper records. The hospital incurs a lot of costs when it comes patients records and monitoring. Therefore, the electronic health record system will minimize the cost significantly. On the other hand, reduction of the diagnosis errors is enhanced by the use of the EHRs. The doctors can follow and monitor the patients history carefully and quickly through good organization and filtering of information. The physicians can make a diagnosis based on the information displayed as well as update it without the need to start all over again.

References

Bell, L., Grundmeier, R., Localio, R., Zorc, J., Fiks, A., & Zhang, X. et al. (2010). Electronic Health Record-Based Decision Support to Improve Asthma Care: A Cluster-Randomized Trial. PEDIATRICS, 125(4), e770-e777. http://dx.doi.org/10.1542/peds.2009-1385

Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. (2015). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. Eur J Public Health, 26(1), 60-64. http://dx.doi.org/10.1093/eurpub/ckv122

Goldstein, B., Navar, A., Pencina, M., & Ioannidis, J. (2016). Opportunities and challenges in developing risk prediction models with electronic health records data: a systematic review. Journal Of The American Medical Informatics Association, ocw042. http://dx.doi.org/10.1093/jamia/ocw042

Jha, A. K., DesRoches, C. M., Campbell, E. G., Donelan, K., Rao, S. R., Ferris, T. G., ... & Blumenthal, D. (2009). Use of electronic health records in US hospitals. New England Journal of Medicine, 360(16), 1628-1638.

Kraan, C. W., Piggott, J. J. H., van der Vegt, F., & Wisse, L. (2015). Personal Health Records: Solving barriers to enhance adoption.

Schiff, G. & Bates, D. (2010). Can Electronic Clinical Documentation Help Prevent Diagnostic Errors?. New England Journal Of Medicine, 362(12), 1066-1069. http://dx.doi.org/10.1056/nejmp0911734