Scholars argue that if one is to discuss something, they first need to define it. An electronic medical record can be defined as a software program part or complete medical record of a patient kept in a computer (Angst & Agarwal, 2009). It is the electronic version of the traditional paper record, that stores information such as, patient demographics, past and current medication, medical history, surgery, progress notes, laboratory test results etc. Change to the electronic health record involves significant financial investment in various fields such as equipment, maintenance and replacement costs. Even though the cost is high, the benefits are huge which set a promising course for the future. The use of electronic records offers a platform in the medical field which makes various functions possible (Hillestad et al., 2005).
The EMR have been in existence for many years (Reid, 2010; Stead, 2009) from as early as the year 1958 but it has not been fully explored (Grams, 2009; Stead, 2009). Institute of Medicine endorsed the execution of the EMR usage according to the U.S Department of Health which had strategized on improving the services in the healthcare sector via the use of IT which is based on healthcare only (Layman, 2008; Simon et al., 2009). According to Simon et al. (2009), IOM comprises of medical experts and service providers who assess medical practice for a better future while still providing the best of services to the patients of the United States. The incorporation of equipment that is technologically advanced improves any health-providing institutions’ capability to cater for their patients with excellent treatment adequately and as well as maximize on efficiency (Venkatraman et al., 2008).
EMR is a system containing computerized information which is either single or multiple useful at the different stages during a patient-doctor visit. The EMR systems offer a number of benefits in a medical facility such as assisting in lab analysis, expediting samples from patients so that they can be analysed and the results discussed with the patients during visits (Hsiao et al., 2009). The ability of the system to test, analyze, record and store information can eliminate the unnecessary visits to the hospitals and also detect diseases earlier. This capability has proven to be beneficial to improving patient services (Anderson & Bowers, 2008).
However, just like any other information system, for the EMR system to work more efficiently, the users need to involve in every step of implementation where possible. Discussions will help the users understand its core basics and design for efficient implementation. In developing countries, the EMR has greatly helped in providing accurate results and cost saving (Blaya et al., 2010). Besides, the success of the system lies in its proper implementation. For the implementation of the system to beneficial, organizations need to have adequate resources for example infrastructure, computer literate staff, computers and tactical strategies (Mohammed-Rajput et al., 2011).
Despite the advantages, it is important to note that EMRs have some cons which include heavy investment in the system and its maintenance, security issues among others (Weitzman et al., 2012). It was discovered that some of the practitioners prefer noting down on a piece paper in the place of entering data since it is perceived as slow and tedious and at times it derails communication with the patient (Mazzolini, 2013). However, a study that was conducted showed that spending time on data entry on the EMR can give time to the patients to ask more questions regarding their health. This is viewed as a positive effect of the system (McGrath et al., 2007). In the execution of the system, there are some challenges encountered since the medical care facilities are complex (Scholl et al., 2011). If the methods are not fully and carefully bin corporates, then the implementation will be difficult. Minimum research has been conducted on the proper design strategies for the EMR system.
General poor and inadequate resources lead to an increase in expenditure which creates a resistance towards the EMR technology (Khalifa, 2013). Today, there is a new field in information science, health informatics which is mainly based on the management of data in the healthcare sector by utilizing technologies (Hoyt et al., 2012). Inadequate technical experts and financial difficulties were some of the challenges that were identified by WHO regarding the incorporation of the system (Boonstra & Broekhuis, 2010). The involvement of patients in the EMR system through the access of personal individual healthcare record not only does it offer better healthcare services but also reduce the costs of visiting the doctor on a regular basis both at a private practice level as well as the national level (Tang et al., 2006). The benefited accrued in the adaption of a computerized system which provides all the information needed are manifold especially in developing countries (Williams and Boren, 2008). The enactment of the EMR system has shown a vast improvement specifically in tracking the medical history of those patients and those of patients who avoid medical treatment.
Analysis of previous studies
As a result of a reduction in medical errors, operations in the EMR system have been related with enhanced care, diminished expenses, guaranteeing of social insurance staff approach – an institutionalized arrangement of data and expanded productivity as to staff workload assignments (Lau et al., 2012). Studies led in the U.S demonstrated that the social insurance framework is as of now confronting an assortment of difficulties, including the need to convey amazing patient care while limiting expenses (Dixon (2007).
Ayatollahi et al., (2009) believes that the United States is rather behindhand compared to other different nations when it comes to receiving wellbeing EMR system. To survey the level of safety on EMR execution in the United States, Poon and his colleagues contemplated on utilization of IT among eight partners (2006). The gatherings of the eight partners involved incorporated conveyance marketplaces; network remains solitary doctor’s facilities, gifted nursing offices/recovery clinics, doctor hones, home wellbeing organizations, drug stores, reference research centers, and outsider payers. Their examination focused on the utilizations of EMR and the effects on wellbeing, social insurance quality, and hierarchical effectiveness.
In light of start to finish gatherings with accomplices and a leading group of authorities, Poon and his partners contemplated that, irrespective of the rising excitement for the wellbeing of the IT systems in refining security, reception in these areas was especially low as a result of worries with respect to cost and profitability (2006). Jha et al., in audit review on EMR adaptation through 2005, realized that a quarter of the specialist utilized EMR structures in portable mobile phones (2009). Besides, Hillestad et al. uncovered that around 47% of service providers around the United States, together with specialists and other non-specialists, had previously executed HIS, broadly not precisely in various nations (2005).
Data from the country wide Ambulatory hospital treatment Survey (NAMCS) revealed that experts completion price on EMR and HER frameworks have continuously extended with 25.2% and 43.nine% respectively (Hing and Burt, 2009; Hing and Hsiao, 2010); anyhow, there has been no simple alternate beginning now and into the foreseeable future. Schoen et al. (2009) drove an expansive diagram of approximately 10,000 simple care experts within the United States of America and 10 particular nations, such as Australia, Germany among others, addressing a mix of human administrations systems. The revelations exhibited America waiting substantially at the back of numerous international locations to the quantity of HIS utilization. Schoen et al. (2009) found that selective 46% of U.S. experts used critical EMR limits, differentiated and about the comprehensive use that is more than 90% in Australia, Netherlands, Sweden, Italy, New Zealand, Norway, and the UK.
The American Recovery and Reinvestment Act of 2009 (ARRA) provided the answer for the U.S’ slack in actualizing EMR frameworks since it included $19 billion in jolt stipends to help in the advancement of HIS program. The prerequisites of the PPAHCA and the jolt stipends offered in ARRA made a wellspring of finances for the execution of the EMR frameworks in 2014. Regardless of the above support, Angst and his partner directed an investigation of doctors and healing center heads that discovered that budgetary motivators alone did not offer adequate power to empower the execution of EMR frameworks, or to diminish the opposition infesting the business (2009). Along these lines, it has turned out to be important to test exactly different components that might add to this opposition of EMR frameworks among human services experts.
Comparing the USA and the UK, the UK is far much ahead in the adoption of the EMR. Johnson and colleagues reported that the UK is achieving almost 100% adoption rate of the EMR when the US is at a 10-30% rate. The gap is attributed to the fact that the UK government invested heavily on the implementation of the EMR (2014). The estimated cost of investment was approximately $7 million for every hospital with 200 beds but it would save the government around $200 billion annually (Venkatraman, Bala, Venkatesh & Bates, 2008). Aside from the cost saved, the investment in EMR incorporation was reported to reduce errors and increase efficiency.
Recently, the major EHR primary care vendor in the UK such as the TPP SystmOne and EMIS expanded to incorporate the community as well as the hospitals for a longstanding care system that offers the British solutions to link primary care and secondary care (Johnson et al., 2014). A study conducted under the NHS the ophthalmology units all around the UK showed that 45.3% of all the units were already using the EMR and 26.4% had plans to implement the system in a period of 2 years. 37.5% of the clinicians had access to the EMR and approximately 56.3% of records were entered in the system. 46.7% of all service providers had access to the system in one hospital and over 71.1% of the providers strongly agreed on the implementation of the system to other medical centres (Lim et al., 2014). From the statistics above, it is evident that the system is able to overcome a number of limitations such as sharing of patient’s data in ophthalmology which increase efficiency and the quality of patient care offered.
EMRs are relied upon to enhance the nature of care, the proficiency of the care procedure, and diminish human services costs (Chaudhry et al., 2006). Most assessment ponders concentrated on process markers, and dispositions of clients or patients, instead of expenses and patient results (Blaya et al., 2010). Assessment investigations of EMR frameworks in creating nations have revealed a few advantages to wellbeing administrations. Change in the exactness and fulfillment of information is one of the distinguished advantages (Blaya et al., 2010) which is credited to approvals of the EMRs at the season of information section and additionally having continuous information passage which takes out translation mistakes and permits prompt confirmation of the information while the patient/customer is as yet present (on the same page.) Chaudhry et al. (2006) likewise demonstrate that EMR frameworks can influence the facility to staff to pick up learning and experience, and mindfulness on information quality, in this way adding to changes in the information quality.
Studies have likewise revealed the impacts on productivity regarding time spared in finding and understanding data and in delivering month to month reports; lessened time sitting for patients and diminished time for the supplier per visit (Fraser et al., 2005). A report by Blaya et al. (2010) uncovered that the utilization of different mark and standardized identification scanners diminish time used in finding records. Automation of a few capacities, for example, computation of drugs and arrangement of schedules were likewise measured to expand the productivity of therapeutic services arrangement (Schoen et al., 2009). In any case, a few instances likewise announced an expansion in workload and span of counsel time because of presentation of EMRs.
Another beneficial outcome of EMR frameworks distinguished in actual writing it’s diminished solution arrange mistakes and expanded adherence to human services conventions (Fraser et al., 2005; Douglas et al., 2010). This is related with choice help works inside EMRs, for example, PC cautions or suggestions to endorse drugs, regulate immunizations, and to ask for lab orders; admonitions on tranquilizing measurement, medicate contrary qualities, irregular lab comes about and other hazard factors. Moreover, the capacity to track patients to distinguish chance components, complexities, and non-attendants, and to screen and help patients to remember therapeutic services needs or treatment are other EMR capacities considered to have a constructive outcome in enhancing the nature of care (Blaya et al., 2010). The apparent impacts of the EMR frameworks included expanded customer participation since PCs were related to a propelled facility (Thompson et al., 2010); and diminishment in inoculation drop-out rates as EMR gives an account of vaccination drop-outs were utilized by wellbeing laborers to convey wellbeing data to the network (Singh et al., 1997).
Hing et al., (2007) directed an investigation that took a gander at the sociological part of EHR frameworks and how it influenced the nature of care with respect to chiropractic mind. This examination gave understanding into the specialist PC tolerant relationship, with the PC requesting more consideration than the patient. The PC intercession brought about the specialist missing nonverbal patient correspondence, bringing about a negative impact on the nature of care. The reports looked at the general EHR framework use rate and gave a review of the pattern. In his investigation, normal subjects noted all through the articles surveyed were challenges in use of the considerable number of highlights of the new programming, nosy change in the work process, money related limitations on little office spending plans, and burden in the specialist patient relationship, which frequently prompted disappointment practically speaking. There was conflicting covering the impacts of EHRs on changes like care.
An investigation of the usage reports showed an expansion in human services use of EHRs in recent years. Hing et al., (2014) announced that the national wellbeing insights showed approximately 34% use was by office-based doctors. The statistic demonstrated an expansion of over 90% compared to the 2001 statistics. The usage expanded from approximately 33% to 77% on office-based doctors in the year 2013. Bates (2008) saw that electronic wellbeing record change from paper documents expanded in recent years.
The American Recovery and Reinvestment Act additionally guided wellbeing data innovation to advance enhanced quality and proficiency of care and to decrease therapeutic mistakes. Doctor’s facilities embraced EHRs, with 97% revealing ownership of an ensured EHR and 76% having received it in 2014 (Goetz et al., 2012). Smaller expert workplaces were slower in adoption (Goetz et al., 2012 and Valdes et al., 2004) In 2008, the American Medical Association (AMA) detailed an even lower figure than the national wellbeing insights, with just 17% of office-based doctors using EHRs in some frame, and just 4% of these were completely utilitarian in the office (Belletti et al., 2010). In 2014, the AMA announced just 2% of office-based doctors meeting all requirements for arranging two important uses. It gives the idea that regardless of the motivators to cultivate EHR utilizes, genuine usage was slower in the free workplaces, and full-highlight capacities were not actualized.
The AMA – a medicine institute, and numerous charitable and expert associations elevated expanded selection to enhance general wellbeing, tolerant security, quality, restorative obligation safeguard, and research (Berko, 2002). Performance plan payment advanced utilization of EMRs and EHRs as a feature of their estimation for the nature of mind objectives. This plan was fortified in 2016 early November by Medicare which aimed at advancing a legitimacy based motivation instalment framework through the affirmed EHR technology (Centres for Medicare). The Agency for Healthcare Research and Quality detailed that utilization of EHRs bolstered a good quality of care over the country (Agency for Healthcare and social care)
Schuler, (2010), contends that atomic information that can be examined as an EMR encourages the computerisation of information passage to accomplish intelligible documentation. The capacity to inquire fine-grained information components (Chen 2009) gives the possibility for the assessment of the medical information which progressively illuminates on clinical strategies and program (Paneth-Pollak et al. 2010). Likewise, it accommodates dynamic choice help since the institutionalization of information components and data models to guarantee semantic interoperability empowering the execution of dynamic choice help (Beale et al. 2007).
As per Christensen et al. 2009; Fickenscher 2009 Emr has various advantages which incorporate
- the development of exact clinical procedures utilizing proof based pharmaceutical driven by the need to give mastery at the purpose of care.
- Adoption of plans of action in view of clinical procedures and estimated by clinical quality marker by supporting business work processes to computerize and streamline forms,
- access to solidified information, data and therapeutic aptitude that enable clinical choices to be influenced free of area, to time and setting where the EMR replaces the conventional paper restorative record
- preservation of medicinal services experts’ certain information of patient security and offers devices that give choice help, for example, cautions for irresistible illnesses or sensitivities.
- adoption of clinical conventions in light of key hazard inclined procedures (Rotter et al. 2010) that counteract unfavorable occasions by urging endeavors to drive efficiencies in forms that are very inclined to mistakes
- Accessibility to solidified information, data and restorative mastery at the purpose of care through better utilization of economical advances, for example, cell phones This diminishes medicinal services cost by anticipating duplication of information, and supports neighborhood responsibility through down-up execution estimation
- provision of an apparatus for supervisors, administrators, and examiners to quantify healing center execution in light of essential source information by offering access to nuclear-organized data progressively (instead of, for instance, filtered reports). This significantly diminishes the time between the gathering of information and the investigation of key execution markers and offers unparalleled wealth and permeability of operational exercises from the purpose of care
- automatic situation of patients at the focal point of care conveyance and supports a Personally Controlled Electronic Health Record (PCEHR). PCEHR gives a focal store to clinically pertinent data, bolsters information gathering utilized for auxiliary uses for instance, look into, underpins viable execution of general wellbeing systems and enhances capacity to react to significant episode/calamity needs in the network.
Hopper et al., (2009) demonstrated that the execution and utilization of an EMR as a device to enhance the results for sepsis treatment had critical outcomes. Their investigation at the Methodist North Hospital demonstrated that LOS ‘for patients treated by sepsis difficulties tumbled to 13 days from 16 days. This diminishment is likened to ‘a positive monetary effect of almost [USD] $2 million in view of efficiencies in mind conveyance and documentation of serious sepsis’.
The significance of tending to fundamental reasons for unfriendly occasions to lessen the LOS is shown in an examination by Hauck and his partner Zhao (2011). They performed their examination on VAED information between 2005 and 2006 and demonstrates that a clinic stay conveys a 5.5 for each penny danger of unfavorable medication response, 17.6 for every penny danger of contamination and 3.1 for every penny danger of ulcer for a normal scene. Further to this, they found that each extra night in healing facility expands the hazard by 0.5 for each penny for antagonistic medication responses, 1.6 for every penny for contaminations, and 0.5 for each penny for ulcers.
The approval of medical pathways for a scene of care has been believed to lessen the LOS by advancing confirmation based treatment alternatives to target preventable and avoidable episodes of disease (Rotter et al. 2010). Presenting wellbeing information and communication technology arrangements that display the main characteristics of an EMR framework will make medical paths all the more effectively created, executed and improved. The reception of an EMR-based framework can lessen this LOS by empowering prior recognition and finding of the confusions, thus diminish and now and again dispense with) the requirement for expanded medications.
Berg et al., (2003) investigated on the interrelation amongst innovation and its social condition, and means to expand comprehension of how data frameworks are produced, presented and progressed toward becoming the piece of social practices. In the investigation, sociotechnical approaches were used inquiring about the way specialized and social measurements transform after some time. The measurements that might be contemplated incorporate execution techniques, mentalities and encounters of people, hierarchical results, and effect on nature of care. There are different hypothetical structures utilized as a part of sociotechnical assessments, for example, the hypothesis of Diffusion of Innovations; Human, Organization and Technology-fit variables; and Social Shaping of Technology (Cresswell and Sheik, 2014).
Similarly, Vikkelsø (2005) contends that the presentation of the system EMR influences medical practices in terms of work undertakings, hierarchical consideration, and dangers. Concerning work assignments and duties, he shows that some work undertakings may vanish while others rise. A portion of these new errands is formally perceived though others are left as undetectable work. Besides, the workload isn’t similarly dispersed among staff. In connection to authoritative consideration, she contends that consideration may debilitate on a few parts of care and increment the emphasis on different zones. As far as dangers, Vikkelsø (2005) contends that while EMRs are expected to decrease infamous dangers of blunders in understanding treatment, they may likewise present different dangers for patients, for example, conflicting therapeutic data crosswise over records.
Thus, it may not be evident that the presentation of EMRs has brought about work strategies ending up better or more effective with everything taken into account. Or maybe, it brings about an alternate sort of medicinal practice with another dispersion of work, obligations, abilities, consideration, and dangers. Thus, the impacts of presenting EMRs ought to be estimated as far as changed work rehearses, refocused hierarchical consideration and new sorts of dangers.
Various studies exhibited that in case the EMR did not bolster the work process of providers, it would not be utilized legitimately or productively (Bar-Lev and Harrison, 2006; Lee, 2006; Saleem et al., 2005). The expression “workaround” was utilized as a part of a couple of studies, alluding to casual work processes created by management to manage the boundaries of the current framework of the EMR. In a couple of the examinations, EMR architects worked together with practitioners to reconstruct the EMR for better utilization, and discover techniques on joining EMR necessities into their work processes. These practitioners included medical attendants and doctors in the study conducted by Bar-Lev and his colleague Harrison (2006), medical attendants, nurture specialists, doctors, occupants, and colleagues.
The above interpolations prompted an effective way of incorporating of EMRs into training. Poor PC framework accessibility and eminence was a noteworthy wellspring of disappointment and an obstruction to accomplishment in a few examinations (Moody et al., 2004). On the off chance that innovation foundation is deficient, utilization of the EMR is not as much as ideal. Smith et al. (2005) found that, regardless of whether diagramming quality enhances, and time for creating documents on the EMR does not expand, medical caretakers will still be disappointed if the general framework is sluggish and burdensome to utilize.
Looking at a few investigations, the topic on practitioners’ time taken for generating documents was pervasive subject. Korst et al. (2003) revealed that the EMR system does not expand nurture outlining time. Medical caretaker’s argued that the expanded time did not bring any contradictions as long as the quality of the documentation was enhanced. The expansion in time spent graphing prescriptions was credited to a more definite process of documentation (Hurley et al., 2007). The last was viewed as an accomplishment of EMR execution. Be that as it may, practitioners in the Kossman and Scheidenhelm (2008) research discovered that expanded time for documentation was forced by the EMR troublesome because of moderate PCs, inaccessibility of PCs, and framework downtime.
Medical attendants felt this brought about less time with patients, a distinct absence of achievement as far as patient care is concerned. Choi et al., (2006) realized that the EMR system spared time for creating documents in a few territories, for example, in the Intensive Care Unit where clinical information was transferred specifically from the monitors of the patients into the EMR. However, time for generating documents for Registered Nurses expanded if the PCs were moderate. Any minute spared was viewed as an advantage since medical caretakers would invest more energy beside the patient. Notwithstanding, Donati et al. (2008) discovered that, any time the EMR spared medical caretakers time, it was not converted into additional time spent with the patients. McLane (2005) revealed that extensive training and incorporation of medical caretakers in the arranging procedure translated into advanced EMR achievement. Evaluating pre-execution demeanours enabled usage pioneers to distinguish the worries of the staff and coin instructions according to the staff’s needs. Including attendants in the EMR configuration process advanced client acknowledgment, increased the chances for a successful implementation (McLane, 2005).
In general, most studies are based on the implementation and evaluation of EMR and thus leaving a gap in the effectiveness of the system.
Benefits of using EMR
The usage of EMR has numerous benefits which prove that they are effective.
- EMR use has improved the evidence-based decision-making process.
Through the use of EMR, users can easily locate past and present widespread patient information such as physicals, lab and test results other medical records and analytic images which are of great help during evidence-based decision making for patient care. Easily accessing information allows services medical practitioners to address a variety of topics during patient’s consultations to discuss their health rather than the normal follow up which usually is considered inefficient. A study conducted by the POSP (2012) revealed that the clinical support tools for decision making such as a warning mechanism to alert the specialist when results are below or above the pre-determined points were helpful during decision-making.
According to their report, 94% of the service providers gave a positive response to the use of EMR during decision making through the use of clinical support tools. Based on a progress report by Ontario, in 2015 there was a slight increment in the acceptance of EMR compared to the 2012 results which suggest that the providers are adopting the use of EMR in patient care. With this functionality, there could be further enhancements which will provide wider access to other additional sets and support tools within the system, for example, accessing guidelines for smoking cessation.
- The use of certain functionalities present in the EMR provides for health screening, promotion, and prevention.
With EMRs integrated into the medical center, searches for certain diseases and patients suffering from them have been made able and also the receiving of automated notifications and reminders. These functionalities enhance preventive patient care and pre-emptive management, for example, service providers reported that the EMR functionality of tracking patient data facilitates initial detection of disease before onset via alerts when the results are out of the health frame.
In a survey done by PWC and eHealth Ontario showed that an average of 94% of the participants agreed that the use of EMR in needs-based planning assisted in the preventive care provisions for patients such as immunization and screening (2015). Most of the reports from the participants gave out the ease of generating medical reports for preventive care services and provision of tools which auto determined the recall for patients in need of preventive services which proved the effectiveness of EMR system.
One study conducted by Tundia et al. reported that 71% of the patients in the ages between 50 – 74 had a screen test for colon cancer as compared to 56% in the previous year (2012). Additionally, it was revealed that the number of percentage of old adults to receive influenza immunization increased to 81% through the use of EMR practices. The use of EMR in preventive care has brought a significant impact in the reduction of diseases achieved through early detection. Incorporation of EHR and other agencies for enhancing particular functionalities of EMR will improve the preventive care services.
- Chronic disease management has improved through EMR functionality.
Through the use of the EMR, providers can conduct searches as well as generate the report for the specific patient’s population, receive emergency alerts and keep track of chronic diseases. For example, following trends for blood pressure or sugar levels can be noted and tracked over a period which will facilitate better assessment and management as well as making informed decisions (Pronovost, 2013).
Also, careful integration and observing of laboratory records and the progress of the treatment will help in the management of chronic diseases. A research conducted between the years of 2012 and 2014 revealed that EMR has greatly assisted in offering better services to patients with chronic diseases through; the simple generation of reports, ability to track patients’s specific information such as the conditions and lab reports, standard coding using, the ability of the system to share the data for chronic disease management with other professionals etc (Holt et al., 2014).
- Sharing of patient information has improved the safety given to patients and responses.
Incorporation of EMR to the solution reporting department such as the HRM will allow faster and secure access to sensitive information required for the making decisions for patient care which will improve safety as well as timely responses. Research conducted by the eHealth Ontario showed that the average time is taken to discharge reports after hospital visits were two weeks but with the use of EMR in the HRM it is now reduced to 30 minutes (2015).
The service providers also noted that through the use of EMR, HRM has proven to be quite competent especially in completing reports although it can vary among hospitals. Wider access to HRM among the practitioners is useful since it is online and can be accessed through the mobile phone which makes it easy for not only timely reports and replies but also communication (eHealth, 2015). The EMR has tools such as the risk calculator which is mainly used for drug combination and alerts about possible errors in adversative drug events. This tool helps the healthcare providers offer better patient care through the generation of an accurate list of medication for any specific patient.
- Communication can improve within the care teams through information sharing of the patient data and electronic planning.
The use of EMR enables members of the healthcare sector to share information including for patients as well as to coordinate the teams effectively through electronic scheduling. This is made possible through the access of all the records and information of patients to all practice healthcare members. In a report done by (Carayon et al., 2009), some of the providers disagreed with the use of EMR being effective in sharing of information and coordinating teams. Arguably, the bigger percentage of the provider strongly agreed that the system offered a suitable platform for providing quality care through effective communication and timely scheduling of the team’s activities as well as keeping tracks.
More extensive access to tolerant data in EMRs by other essential care and network-based suppliers, for example, medical attendants, drug specialists and others, is viewed as a chance to upgrade the congruity of watch over patients. Access to different suppliers will change contingent upon the essential care demonstrate took after by the training. Doctors are progressively tolerating of patient data got to by the full care group so correspondences and coordination can be completely improved, additionally supporting the requirement for EMR-to-EMR mix, and a blend of EMRs with other commonplace resources. Enhanced booking and coordination of patient visit because of EMR utilize was additionally noted to enhance access to mind.
- Inclusiveness of patient records will improve through the appropriate integration of EMR.
Study members report that critical advance has been made to bring accommodating data from various care settings into essential care EMRs. As noted already, release revealing through healing center announcing arrangements, for example, HRM, is broadly answered to enhance the stream of data from the intense to essential care setting. Diminishments in time spent sitting for release of synopses, and referrals speed up and encourage the coordination of care with the end goal that patient needs can be tended to in an opportune manner following release. For example, availability to the Ontario Laboratory Information System (OLIS) has enhanced lab administration among specialists and social insurance groups. Clinicians can download lab came about because of private and general wellbeing labs and associated doctor’s facilities to fabricate an exhaustive profile for patients to educate decision making. Suppliers additionally generally report that the referral procedure is considerably more proficient with the utilization of pre-populated information in referral frames, which would more be able to guide patients to the proper levels of care productively.
Summary of the review
EMRs in hospitals have great benefits. Not only does it decrease medical errors present in manual activities but it also provides a paperless friendly environment which improves the transfer of information amongst healthcare providers. This system allows for immediate access to a patient medical record which may be needed during the consultation I’m the case where the experts are distant. Other benefits include the elimination of credibility issues, faster methods of billing and quality storage for easier retrieval of information. Importantly, the EMR facilitates the continuity of patient care. Subsequently, the EMR assists the society as well as the organization. In managing day to day operations, the system offers a platform for smooth operations.
Some of the benefits which prove the effectiveness of the EMR system include improvement of the evidence-based decision-making process, communication between care teams, chronic disease management, promotion of patient safety and quick responses among others. All the above-discussed benefits and the numerous studies conducted in the past proof the effectiveness of the EMR and the positive impact it can have when integrated with the HRM.
Agency for Healthcare Research and Quality (2006). Agency for Healthcare Research and Quality; Rockville, MD: Practice-Based Research Networks (PBRNs) Fact Sheet. AHRQ Publication No. 01-P020
Anderson, H., & Bowers, G. (2008). Transforming care in the physician workspace through electronic data exchange. North Carolina Medical Journal, 69, 153-158.
Ayatollahi, H., Bath, P. A., & Goodacre, S. (2009). Paper-based versus computer-based records in the emergency department: Staff preferences, expectations, and concerns. Health Informatics Journal, 15(3), 199-211.
Bar-Lev, S., & Harrison, M. I. (2006). Negotiating time scripts during the implementation of an electronic medical record. Health Care Management Review, 31(1), 11-17.
Bates DW. Rockville, MD (2008) Agency for Healthcare Research & Quality: Statewide Implementation of Electronic Health Records.
Beale T, Chen R, Leslie H, Frankel H, Garde S, Sundvall E, Schuler T, van der Linden H (2007). ‘Implementing open EHR,’ Ocean Informatics. Presentation at MedInfo, 19 August 2007.
Belletti D, Zacker C, Mullins CD (2010). Perspectives on electronic medical records adoption: electronic medical records (EMR) in outcomes research. Patient Relat Outcome Meas. ;1:29–37.
Berko C (2002). Better documentation, better reimbursement. Today’s Chiropractic. 31(6):56–58.
Canada Health Infoway and PwC (2013). The emerging benefits of electronic medical record use in community-based care.
Carayon, P., Smith, P., Schoofs Hudta, A., Kuruchitthame, V., & Li, Q. (2009). Implementation of an electronic health records system in a small clinic: the viewpoint of clinic staff. Behaviour & Information Technology, 28(1): 5-20.
Centers for Medicare & Medicaid Services Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. https://www.federalregister.gov/documents/2016/11/04/2016-/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment model-apm
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., Morton, S. C. & Shekelle, P. G (2006). Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care. Annals of Internal Medicine, 144,10, 742-752.
Chen R (2009). Towards interoperable and knowledge-based electronic health records using archetype methodology. Department of Biomedical Engineering, Linköping University, Linköping.
Choi, W., Park, I., Shin, H., Joo, Y., Kim, Y., Jung, E. et al. (2006). Comparison of direct and indirect nursing-care times between physician order entry system and electronic medical records. Consumer-centered Computer-supported care for Healthy People, 288- 293.
Christensen C, Grossman J, Wang J (2009). The innovator’s prescription: a disruptive solution for health care. McGraw Hill Professional, New York
Cresswell, K. & Sheikh, A. Undertaking sociotechnical evaluations of health information technologies. Informatics in Primary Care, 21,2, 78-83.2014.
Dixon, B. E. (2007). A roadmap for the adoption of e-health. E-Service Journal, 5(3), 3- 13.
Donati, A., Gabbenelli, V., Pantanetti, S., Carletti, P., Principi, T., Marini, B., et al. (2008). The impact of a clinical information system in an intensive care unit. Journal of Clinical Monitoring and Computing, 22, 31-36.
eHealth Ontario. Connectivity Strategy for Ehealth in Ontario version 1.0 (2015) http://www.ehealthontario.on.ca/images/uploads/pages/documents/EHR_ConnectivityStrategy.pdf
eHealth Ontario. Progress Report. (2015) http://www.ehealthontario.on.ca/en/progress-report
Fickenscher K (2009). ‘Clinical transformation: turning rhetoric into reality’, presentation, Indian Institute of Health Management Research viewed 21 May 2010, <http://www.iihmrdelhi.org/health%20conclave/DR.%20KEVIN.pdf
Fraser, H. S. & Blaya, J (2010). Implementing medical information systems in developing countries, what works and what doesn’t. AMIA Annual Symposium Proceedings, 232-236.
Fredericks M, Lyons L, Kondellas B, Ross MW, Hang L, Fredericks J (2009). Chiropractic physicians: an analysis of select issues for the use of electronic medical records and the patient-practitioner relationship within the society-culture-personality model. J Chiropr Humanit. 16(1):13–20.
Goetz Goldberg D, Kuzel AJ, Feng L, DeShazo J, Lov LE (2012). EHRs in primary care practices: benefits, challenges, and successful strategies. Am J Manag Care. 18(2):e48–e54. [PubMed]
Grams, R. (2009). The “new” American electronic medical record (EMR) ─ Fantasy or fact? Journal of Medical Systems, 33, 327-328. doi:10.1007/s10916-009-9315-4
Hauck K and Zhao X. (2011). How dangerous is a day in the hospital? A model of adverse events and length of stay for medical inpatients. Imperial College London, London, UK and Monash University, Melbourne, Australia.
Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Affairs, 24(5), 1103-1117.
Hing E, Hsiao C-J. (2007). Electronic medical record use by office-based physicians and their practices: United States, Natl Health Stat Report. 2010;31(23):1–11.
Hing, E. and Burt, C. W. (2009). Are there disparities when electronic health records are adopted? Journal of Health Care for the Poor and Underserved, 20(2), 473-488.
Hopper K and Jacobs P. (2009). ‘Halting the sepsis cascade,’ The Cerner Quarterly, vol. 5, no. 1, pp. 15–23.
Hsiao C., Beaty, P.C., Hing, E. S., Woodwell, D. A., Rechtsteiner, E. A., & Sisk, J. E. (2009). Electronic Medical Records/Electronic Health Records Use by Office-Based Physicians: the United States, 2008 and Preliminary 2009. Atlanta, GA: Center for Disease Control, National Center for Health Statistics.
Hsiao CJ, Hing E. (2014). Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001-2013. NCHS Data Brief. 143:1– 8.
Hurley, A. C., Bane, A., Fotakis, S., & Duffy, M. E. (2007). Nurses’ satisfaction with medication administration point-of-care technology. The Journal of Nursing Administration, 37(7/8), 343-349.
Jha, A., DesRoches, C., Campbell, E., Donelan, K., Rao, S., Ferris, T., et al. (2009). Uses of electronic health records in U.S. hospitals. The New England Journal of Medicine, 360(16), 1628-1638.
Johnson, O. A., Fraser, H. S., Wyatt, J. C., & Walley, J. D. (2014). Electronic health records in the UK and USA. The Lancet, 384(9947), 954.
Khalifa M. (2013). “Barriers to Health Information Systems and Electronic Medical Records Implementation. A Field Study of Saudi Arabian Hospitals,” Procedia Computer Science, vol. 21, pp. 335-342.
Korst, L. M., Eusebio, A. C., Chamorro, T., Aydin, C. E., & Gregory, K. D. (2003). Nursing documentation time during implementation of an electronic medical record. Journal of Nursing Administration, 33(1), 24-30.
Kossman, S. P. & Scheidenhelm, S. L. (2008). Nurses’ perceptions of the impact of electronic health records on work and patient outcomes. CIN: Computers, Informatics, Nursing, 26(2), 69-77.
Lau, F., Price, M., Boyd, J., Partridge, C., Bell, H., & Raworth, R. (2012). Impact of electronic medical record on physician practice in office settings: A systematic review. BMC Medical Informatics & Decision Making, 12(1), 10-19.
Layman, E. (2008). Training healthcare personnel to work with healthcare data. North Carolina Medical Journal, 69(2), 159-162
Lee, T. (2006) Adopting a personal digital assistant system: application of Lewin’s change theory. Journal of Advanced Nursing, 55(4), 487-496.
Lee, T. (2008). Nurses’ experiences using a nursing information system. CIN: Computers, Informatics, Nursing, 25(5), 294-300.
Li J, Talaei-Khoei A, Seale H, Ray P, MacIntyre CR. (2013). Health care provider adoption of eHealth: systematic literature review. Interact J Med Res. ;2(1). Center for Medicare and Medicaid Services. Center for Medicare and Medicaid Services; Washington, DC: 2015. Medicare Incentive Payments. E.I. Program.
Lim, S. B., & Shahid, H. (2017). Distribution and extent of electronic medical record utilisation in eye units across the United Kingdom: a cross-sectional study of the current landscape. BMJ open, 7(5), e012682.
McLane, S. (2005). Designing an EMR planning process based on staff attitudes toward and opinions about computers in healthcare. CIN: Computers, Informatics, Nursing, 23(2), 85-92.
Moody, L. E., Slocumb, E., Berg, B., & Jackson, D. (2004). Electronic health records documentation in nursing: Nurses’ perceptions, attitudes, and preferences. CIN: Computers, Informatics, Nursing, 22(6), 337-344.
Moreno, L. (2005). Electronic health records: Synthesizing recent evidence and current policy. Mathematica Policy Research, Inc. Retrieved from http://www.mathematica-mpr.com/publications/pdfs/electronichealth.pdf
OntarioMD. (2013, January 28). Physicians EMR usage and Satisfaction Survey 2009-2012
Paneth-Pollak R, Schillinger JA, Borrelli JM, Handel S, Pathela P, Blank S (2010). ‘Using STD electronic medical record data to drive public health program decisions in New York City’. American Journal of Public Health, vol. 100, no. 4, pp. 586–90, doi:10.2105/AJPH.2009. 175349.
Poon, E. G., Jha, A. K., Christino, M., Honour, M. M., Fernandopulle, R., Middleton, B., & Kaushal, R. (2006). Assessing the level of healthcare information technology adoption in the United States: A snapshot. BMC Medical Informatics and Decision Making, 6, 1-9.
Pronovost, P. J. (2013). Enhancing physicians’ use of clinical guidelines. Jama, 310(23), 2501-2502.
Reid, C. M. (2010). Electronic health records today. E-Content, 24-29
Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J, Snow P, Kugler J. (2010), ‘Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs’. Cochrane Database of Systematic Reviews, vol. 3, art. no. CD006632, doi: 10.1002/14651858. CD006632.pub2.
Saleem, J. J., Patterson, E. S., Militello, L., Render, M. L., Orshansky, G., & Asch, S. M. (2005). Exploring barriers and facilitators to the use of computerized clinical reminders. Journal of the Medical Informatics Association, 12, 438-447.
Schoen, C., Osborn, R., Doty, M. M., Squires, D., Peugh, J., & Applebaum, S. (2009). A survey of primary care physicians in 11 countries, 2009: Perspectives on care, costs, and experience. Health Affairs, 28(6), 1171–1183.
Schuler R. (2010). ‘The smart grid: a bridge between emerging technologies, society, and the environment,’ The Bridge, vol. 40, no. 1, pp. 42–49
Simon, S. R., Soran, C. S., Kausal, R., Jenter, C. A., Volk, L. A., Burdick, E., … Bates, D. W. (2009). Physicians’ use of key functions in electronic health records from 2005 – 2007: A statewide survey. Journal of the American Medical Informatics Association, 16(4), 465-470.
Smith, K., Smith, V., Krugman, M., & Oman, K. (2005). Evaluating the impact of computerized clinical documentation. CIN: Computers, Informatics, Nursing, 23(3), 132- 138.
Stead, W. W. (2009). Electronic health records. Information Knowledge Systems Management, 8, 119-143. doi:10.3233/IKS-2009-0140
Tang P. C., et al. (2006). “Personal Health Records: Definitions, Benefits, and Strategies for Overcoming Barriers to Adoption,” Journal of the American Medical Informatics Association: JAMIA, vol. 13, pp. 121-126.
Tundia, N. L., Kelton, C. M., Cavanaugh, T. M., Guo, J. J., Hanseman, D. J., et al. (2012). The effect of the electronic medical record system sophistication on preventive healthcare for women. J Am Med Inform Assoc 2013 Mar-Apr; 20(2):268-76.
Valdes I, Kibbe DC, Tolleson G, Kunik ME, Petersen LA. (2004). Barriers to proliferation of electronic medical records. Inform Prim Care. 12(1):3–9.
Venkatraman, S., Bala, H., Venkatesh, V., & Bates, J. (2008). Six strategies for electronic medical records systems. Communications of the ACM, 51(11), 104-144.
Vikkelsø, S. (2005). Subtle Redistribution of Work, Attention and Risks: Electronic Patient Records and Organisational Consequences. Scandinavian Journal of Information Systems, 17, 1, 3-30.
Cite This Work
To export a reference to this article please select a referencing stye below:
Related ServicesView all
Related ContentAll Tags
Content relating to: "Hospitals"
A hospital is a health care institution with specialised facilities and medical equipment where doctors and nurses diagnose and treat people with illnesses or injuries.
Patient Safety Indicators for Acute Patient Hospitals: Systematic Review
SUMMARY A systematic review was conducted to identify the strategies used in the development of patient safety indicators for acute care hospitals. The data sources used were MEDLINE, EMBASE, Intern...
Strategic Management and Marketing Analysis of Kansas University Hospital
Strategic Management and Marketing Analysis – Report Introduction (organization, serviceproduct line) The organization that will be used for the marketing strategic development and analysis is ...
Changes for Implementation of a Closed Loop Infusion Therapy System into an Existing Working Paediatric Hospital
The aim of this study is to ascertain what are the changes needed to work practices in order to effectively integrate a complete closed loop medication system into an existing paediatric intensive care....
DMCA / Removal Request
If you are the original writer of this literature review and no longer wish to have your work published on the UKDiss.com website then please: