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Introduction
Health care information technology and systems are now major topics for health care reform but were rarely mentioned in the early 1990s. Almost $20 billion was allocated in the economic stimulus package for these systems (Olin, 2010).
Health information system quality
Paper medical records still dominate most medical practices. A national survey estimates only 4 percent of physicians have fully functional electronic health records (EHRs) with an additional 13 percent having some basic HER (Olin, 2010).
Paper Work Inefficiency
Paper records are incomplete and reflect treatment only by a specific physician or organization: the records are not uniform, isolated, and inert- inert in the sense that they can not be processed interactively by other health care applications.
Features of a Complete HER
All these features enhance interoperability which is a standard process by which different health information systems can communicate with each other so that a physician in one health care organization can access a patients information even if the patient normally uses a different health care organization.
The Way Forward
Personal health records (PHR) a variation being considered and would be maintained and controlled by the patient (or by a third party such as Microsoft or another vendor) rather than a health care organization. The PHR however raises questions of privacy. Given the difficulty of having a single, physical EHR spanning multiple health care organizations, interoperability, and regional health information networks are ways to allow health care organizations to share EMRs/EHRs when needed. These networks are subject to appropriate privacy and security considerations. They also facilitate sharing patient information when needed (Mettler, Rohner & Baacke, n.d.).
Improvement of Health Information Quality
An EPS can automatically check for drug interactions with the other medications the patient is taking, and for dosage guidelines. These systems would also eliminate the confusion and errors caused by illegible prescriptions. Clinical Decision Support Systems can make suggestions and alert the physician to new research or guidelines for care. Health information system advocates are not suggesting that these systems take over care, or make decisions, for the physicians. These systems are enablers that can help improve the clinical decision process. However, without the data from an EHR, these advanced applications are impossible or useless.
Benefits of Health Information Systems
Health information systems can automatically check for potential adverse drug interactions, recommended dosage guidelines, and specific patient drug allergies when the prescription is written. This is important because adverse drug events (ADEs) are the most common cause of medical errors in hospitalized patients and can add 20 percent to the cost of the hospital stay. Additionally, emergency rooms treat 700,000 patients each year for ADEs.
Computerized analysis of medical images can allow more sophisticated analyses and result in better diagnoses. When combined with telemedicine, it allows diagnoses and treatment plans to be developed by specialists who are often not available locally, especially in rural and underserved areas.
Challenges of Health Information Systems
The initial high costs of investing in health information technology, the ongoing maintenance required in all information systems, and short-term loss of productivity because staff need to adapt to new systems. Many worries that if HIT follows adoption patterns of other new medical technologies, these advances may have limited reach, disadvantaging underserved and vulnerable patient populations and increasing or perpetuating disparities in access to and quality of care (Robert Wood Foundation, 2006).
Challenges facing Health Information Systems
Legal barriers to adoption include concerns about newly-created potential legal liabilities and concern over the actual or perceived legal burden of compliance with regulations regarding privacy and other factors. Technology-related barriers include concerns about ease of use and obsolescence of particular EHRs. Technology-related barriers include concerns about ease of use and obsolescence of particular EHRs.
Conclusion
Group practice and hospital EHR adoption surveys may have to be approached in more than one phase, with initial surveys to identify appropriate respondents followed by the second phase of surveys to gather data from those respondents. It is also likely that critical information will need to be elicited from more than one knowledgeable respondent within a practice or organization. Health information systems have the potential to upgrade the quality of health care (Miles, 2009).
References
Mettler, T., Rohner, P & Baacke, L. (n.d.). Improving Data Quality of Health Information System-A Holistic Design-Oriented Approach. Web.
Miles, P. (2009). Health Information System and Physician Quality: Role if the American Board of Pediatrics Maintenance of Certification in Improving Children Health Care. Pediatrics 123(2), pp. 108-109.
Olin, B. (2010). Health Care Information Technology: A Key to Quality and Cost Issues. Web.
Robert Wood Foundation. (2006). Health Information Technology in the United States: The Information Base for Progress. Web.
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