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Executive summary
Josephine McMurray, Elizabeth Hicks, Helen Johnson, Jacobi Elliott, Kerry Byrne, and Paul Stolee authored the article, Trying to find information is like hating yourself every day: The collision of electronic information systems in transition with patients in transition, which was published in the Journal of Health Informatics.
The article examines the implication of electronic medical records (EMR) coupled with parallel paper medical records on continuity of information in healthcare facilities. In conducting the research, ethnographic field study was deployed as the main methodology for gathering data.
The article draws its inferences from results of three main case studies involving older patients having hip fracture and transitioning within healthcare settings (McMurray et al., 2012, p.218).
The focus of the article is on the implication of the electronic information systems (EIS) interoperability on the capacity of healthcare providers to communicate amongst themselves and the implication of digital records on transformation of information handling and processing systems within healthcare facilities.
According to the article, enhancement of continuity is an important outcome for healthcare information system. In this context, healthcare records are pivotal in enabling care providers to exchange patients’ clinical coupled with demographic information, which is necessary to effect appropriate treatment (McMurray et al., 2012, p.218).
Records also aid in accountability transfers, regulatory compliance, and provide means for following up quality of the healthcare delivered. While the authors find documentation important in this extent, they argue that documentation culture consumes 25 percent of the caregivers’ time in a healthcare facility (McMurray et al., 2012, p.218).
Improving the documentation process can aid in improvising of more accurate, better quality, secure, and speedy, and even well coordinated healthcare.
According to the authors, the above qualities cannot be achieved via paper-based approaches to documentation of healthcare information. This assertion underlines the importance of transitioning to EMR healthcare information systems.
However, the authors report low adoption rates of the EMRs in clinical settings in Canada. They also argue that care providers encounter challenges in sending and receiving information that has been digitized. Consequently, “the adoption of digitized documentation is inconsistent across healthcare sectors and interoperability between information systems is limited” (McMurray et al., 2012, p.220).
Based on this realization, the researchers found it sound to conduct a research to investigate the effects of electronic and paper information parallel system in fostering efforts of communication exchange during the process of transitioning of patient within the healthcare continuum.
The authors present two main viewpoints. First, “partial interoperability between electronic information systems has complicated not eased the ability to communicate across settings and disciplines” (McMurray et al., 2012, p.223).
The authors note that during the period, which the research was conducted, Canada had strategically focused on investment in EMRs. Nevertheless, most cases studied showed that transitional information was transferred through paper-based means of communication.
Despite the availability of EMRs in the three cases considered in the research, healthcare providers exchanged transitional information through fax or transportation of paper-based information during transferring of the patient across the care continuum. In particular, the authors exemplify this view point by claiming that in the case involving Mrs.
Robertson, two facilities sharing ownership cared for her, but even though EMR was available to the two care facilities, “staff continued to fax requests for admission and discharge documentation to each other and maintained separate paper charts” (McMurray et al., 2012, p.224).
Indeed, clinical care workers entered Mrs. Robertson’s information manually to an external database in each of the care facilities. For long-term care facilities, none of them deployed EMRs.
Documentation of information is meant to ensure ease of accessibility and retrieval of information. However, in the second viewpoint of the authors, “while some information is more accessible and communications streamlined, parallel paper and electronic systems have added to the front line providers burden, not eased it” (McMurray et al., 2012, p.224).
In this context, the article findings indicate that even if information were recorded previously in the EMR system, front care providers raised concerns that they encountered challenges in accessing and retrieving the information. These challenges were attributed to poor user interfaces and unavailability of records’ summaries.
However, physicians argued that although it was difficult to retrieve and access information from their places of residence in the EMR system, when such information was retrieved, it helped them in cross communication.
As part of analysis of the article, it is important to note that transition from one information system to another involves organizational change. Before people can learn and acquire experience in the use of new information system, confusions and problems are anticipated. Therefore, it is not surprising that people would deploy paper-based approaches in the documentation process while EMRs were available.
From the context of the second viewpoint of the authors, any digital information system has challenges articulated to its design. Some of these challenges include poor design of user interfaces and interactivity. When such challenges are encountered, the solution encompasses system redesign and improvement to meet user requirements, but not scraping it.
In my opinion, the article is relevant to management information systems for Public and Health Administration. It provides possible area of improving EMRs to meet the needs of the users and deliver the outcomes for which the system is installed within a healthcare facility.
Reference
McMurray, J., Hicks, E., Johnson, H., Elliott, J., Byrne, K., & Stolee, P. (2012). Trying to find information is like hating yourself every day: The collision of electronic information systems in transition with patients in transition. Health Informatics Journal, 19(3), 218-232.
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