Abstract Electronic health records (EHR) is more and more being utilized in organizations offering healthcare to enhance the quality and safety of care. Understanding the advantages and disadvantaging of EHR is essential in the nursing profession as nurses would learn its strengths and weaknesses. This would help the nursing profession know how to deal with the weak areas of the system. The topic on advantages and disadvantages of EHR has been widely researched on with different researchers coming up with different opinions.
Nurses ought to have knowledge on the advantages and disadvantages of EHR systems for them to use systems efficiently. This would transform the operations of health systems and benefit patients with quality service. The advantage and disadvantage of Electronic Health Records Electronic health records are designed for offering national access to selected information amassed from data found in medical records created by various providers irrespective of whether providers are in a similar healthcare system or in the event of patients of accident in a different healthcare facility (Devine, Hansen, Wilson-Norton, et al 2010).
EHR is essential to nurses because it increases their efficiency hence undertake their mandate to offer care to patients effectively. Recently most of the sectors have made heavy investments in computerization of their services. The nursing practice is impacted significantly by the use EHR systems. There are both positive and negative impacts in the use of EHR systems. Some researchers have associated EHR with increased efficiency and high quality of care while others cite negative effects like high start of cost and confidentiality of health information.
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Understanding the advantages of EHR encourages nurses to make greater use of them, while understanding their disadvantages enables nurses to determine areas in which they ought to take caution when using them. Advantages of Electronic Health Records EHR and organizational outcomes These organizational outcomes of EHR are mostly comprised of increased revenue and cost containment, together with other less tangible benefits like enhanced regulatory and legal compliance, increased job satisfaction, and improved ability to undertake research. Various authors have made the ssertion that EHRs help care givers in capturing patient charges accurately and at the right time (Devine, Hansen, Wilson-Norton, et al, 2010). Use of EHR ensures elimination of billing errors together with erroneous coding; this in turn increases the cash flow of the provider and enhancement of revenue. Appointment reminders by EHR to patients increases visits by these patients hence increasing revenue. Majority of averted costs linked to EHRs result from efficiencies which result from storing the information of patients electronically (Fleming, Culler, McCorkle, et al. 2011).
These comprise of increased test utilization, reduction in resources of staff used in management of patients, reduction of cost of supplies required for maintenance of paper folders decrease in cost of transcription and costs linked to pulling of charts. Other less tangible benefits include that there is increased operational performance and compliance to legal and regulatory requirements is improved. Additionally, researchers who use EHR experience less malpractice claims. EHRs Clinical outcomes The majority of clinical outcomes been focused relate to care quality and safety of patient.
Care quality is defined as doing the appropriate action to the right person at the right time and in the appropriate manner and obtaining optimal results. Similarly safety of the patient is defined as avoiding injuries to patients from care aimed at helping them. Most of the research on EHR is focused on efficiency, effectiveness and patient safety. Weinger, (2010) made the assertion that computerized alerts directed at physicians enhanced the use of prophylactic care for patients hospitalized with the condition of deep vein thrombosis.
There was a 19 percent increase in use of anticoagulation prophylaxis when computer alerts are used. This meant that there was 41 percent reduction in the risk of pulmonary embolism or deep vein thrombosis ninety days following discharge. In addition, researchers have established that there is a relation between efficiency and EHRs in the delivery of healthcare. EHRs societal benefits Improved ability to conduct research is another less tangible benefit associated with EHR.
When the data for patients is electronically stored, makes the data easily accessible hence more quantitative analysis can be undertaken for identification of evidence-based best practices with ease. In addition, public health researchers use electronic clinical data more actively which have been amassed from a huge population hence coming up with research that benefits the society (Mitka, 2011). Clinical data availability is limited but this form of data will increase. Probable EHRs disadvantages
Irrespective of the findings regarding the advantages of various functionalities of EHRs, some probable drawbacks on EHR have been identified by researchers. These comprise of financial concerns, temporal loss in productivity linked with adoption of EHR, change in workflow, security and confidentiality concerns and several unintentional consequences. Financial concerns comprise of costs of adoption and implementation, cost of maintenance, revenue loss due to temporal low productivity, and revenue declination. These factors act as deterrent for physicians together with hospitals in adopting and implementing an EHR.
The purchase and installation of software and hardware, conversion of paper files to electronic forms and training of end-users are major costs. Irrespective of the associated costs, EHR technology has become common recently, as the cost has gone down significantly. The cost of maintenance for EHR can as well be high; there ought to be replacement of hardware and upgrading of software regularly. Other costs include fees for support, vendor software maintenance, external contractors’ payments and information systems staff payment.
The majority of EHR financial benefits are not linked with the provider, but to the payers of third party in form of averted errors, and enhanced efficiencies; these translate into reduced payment of claims (DesRoches, Campbell, Vogeli, et al. 2010). Poor alignment of incentives for healthcare organizations and towering direct costs are an obstacle. Another probable disadvantage is the risk of violating the privacy of patients. Some of these concerns have been relieved by having policy makers take actions to ensure that patient data privacy is maintained (DesRoches, Campbell, Vogeli, et al. 2010). Recent legislation enforces stringent requirements which prevent unauthorized entities from accessing the data. Topic availability The topic on advantages and disadvantages of EHR is widely available both online and on printed sources. Searching the topic online a wide range of information was obtained. Google search engine had considerable information on the topic. In the search the keywords used were ‘Electronic Health Records’ and ‘EHR. ’ With these keywords, the information obtained was on general knowledge on electronic health records.
On adding advantages and disadvantages to the EHR, more refined results on the positive and negative impacts of EHR were obtained. On adding ‘EHR effect on nursing’ the results obtained showed how EHR has positively and negatively affected the functionality of the healthcare system and nursing profession. Nursing and medical journals were mostly used to get this information. In the search, online libraries like EBCOHOST and Apollo library were used. When conducting the search only peer reviewed materials were chosen by selecting that option and the sources selected were not older than five years.
For this case sources were chosen to be from 2010 up to 2013. On EBSCOHOST, with the above mentioned criteria and keywords the search results were 485. Apollo online library had search results of 502. This indicates that the topic is widely researched and there is adequate information online to be used for research and practical nursing practice. This search criterion was also used on Google scholar and relevant information was obtained. Information availability On conducting search online with various search engines, information was accessible in various formats.
The information obtained showed articles written by researchers regarding the advantages and disadvantages of electronic health records. While some articles presented challenges, others presented benefits of the EHR system. Files were found in PDF PowerPoint and Word document formats. The obtained results on this topic could be used for a wide range of reasons. Some on the information touched on how professionals could use this information in their work. For instance, the information on the benefits of using EHRs could help nurses determine how well they can use the EHR systems to enhance efficiency in their operations.
Professionals can also get the information of some of the negative impacts of electronic health records. As nurses get to understand this information, it can form basis for their research to unearth what has not yet been found. Some sections of information were useful for patients who want to know about the efficiency and privacy of the system. The administration would find the information useful because it shows ways in which the hospital will benefit as well as how it will be affected negatively by the EHR system.
For instance, the administration of the health care facilities will ensure increase in efficiency in the provision of services and billing process would be improved (Otto & Nevo, 2013). Understanding these benefits would encourage healthcare administrators to make decisions on whether to adopt EHR systems. Personal views In the nursing practice, this technology of electronic health records poses some challenges that need to be addressed before it is adopted. The major concern of this topic is the security issue, whereby the confidentiality of the information stored in these systems is under question (Weinger, 2010).
It is felt that unauthorized people may get access to this information and use it maliciously. Patients wouldn’t be willing to use this system unless they are assured that their information is secure. In addition, some nurses may have inadequate skills in using the system and can easily make errors that can put patients in danger. Therefore, the nurses should be adequately trained on the use of EHR systems. Failure to do so may put patients at risk and lower the quality of the care provided which would be contrary to the intentions of EHR. Though there are cons to using the system, the pros outweigh them. Conclusion
This paper has discussed the topic on advantages and disadvantages related with adoption of EHR. EHR is widely believed to ensure that there is improved efficiency in provision of healthcare, cost is contained and that accuracy is maintained by reducing medical errors. Through adoption of EHR, it will be easy to conduct research as medical data of the required population would be readily available. Some of the drawbacks associated with use of EHR are financial concerns, temporal loss in productivity linked with adoption of EHR, change in workflow, security and confidentiality concerns and several unintentional consequences.
Despite having many unintentional consequences of EHR on balancing the benefits with the drawbacks, EHRs are beneficial specifically at social level. Information on this topic is readily available and can be used as a basis for deciding whether to adopt the system or not. References DesRoches, C. M. , Campbell, E. G. , Vogeli, C. , et al. (2010). Electronic health records’ limited successes suggest more targeted uses. Health Aff (Millwood) 29(4), 639–646. Devine E. B. , Hansen R. N. , Wilson-Norton J. L, et al. (2010). The impact of computerized provider order entry on medication errors in a multispecialty group practice.
J Am Med Inform Assoc. 17(1):78–84. Fleming NS, Culler SD, McCorkle R, et al. (2011). The financial and nonfinancial costs of implementing electronic health records in primary care practices. Health Aff (Millwood) 30(3), 481–489. Mitka, M. (2011). Electronic health records, The Journal of the American Medical Association, 305(14), p1402 Otto, P. & Nevo, D. (2013). Electronic health records, Journal of enterprise informationmanagement, 26(1/2), 165-182 Weinger, M. B. (2010). Electronic health records, The New England journal of medicine, 363(24), 2372-2374
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