NURBN1005 Introduction to Research & Evidence-Based Practice Essay

Better treatment and more customer-oriented services are what today healthcare organisations are aiming at (AHIMA, 2011). To provide better services, quality of care is the need of the hour which requires high-quality information at the right time (Sittig, and Singh, 2011). Paper-based records have certain limitations and hence, fails to provide the required data at the time of need. Health information systems therefore becomes of utmost important providing the health history of a patient at any point of time (Gartee, 2007). This will not only make medical information of patients easily available but also the format of health records will change, thus changing healthcare. This essay evaluates whether digital health record is an important aspect and shall be implemented for all patients or not.  

Seymour et al. (2012) defines Electronic Health Records (EHR) as an electronic version of healthcare records of patients which gathers, creates and stores information of patients’ health electronically. The information system collects information from birth to death which are certified and can be shared by different healthcare providers. Various forms like voice recognition, barcodes, order sets, images and documentation templates are used to feed data (Iv et al., 2011). EHR thus helps in improving the quality of care by improving clinical documentation, healthcare utilization tracking and healthcare efficiencies. Moreover, billing and coding, better safety, lower healthcare and portability of health records becomes easy (Seymour et al., 2012; Valdes et al., 2004). 

The need for EHR cannot be ignored. Gartee (2017) states the importance of health safety that can be derived through the proper use of EHR. Only in USA every year till 2010, lakh people die in hospital because of medical errors. This is because of the fragmented and decentralized nature of the healthcare delivery system. Moreover, patients seeing multiple providers who did not had complete information access tend to take wrong decisions. Additionally, health costs for employers were increasing due to absence of proper order entry system in ambulatory settings (Gartee, 2017). Apart from this, the changing society and living patterns have made the paper medical records outdated. The society is increasingly becoming mobile, people relocated and patients change doctors frequently. Moreover, not a single doctor provides the full healthcare service to a patient. Hence different specialists and testing facilities should be shared (Gartee, 2017).

Ayatollahi et al. (2014) explains how EHR helps facilitates the use of electronic health and are complex information system. EHR system depends on other information systems in the healthcare highly for accessibility, availability and accuracy of data. Being a central database of information, it will be advantageous in several ways. EHR will therefore help in providing a holistic view of overall health of a patient (over the patient’s lifetime) for better diagnosis and treatment (Ayatollahi et al., 2014). Digital records also helps in better coordination and track the patient’s care across facilities and practices. Interoperability too becomes important and hence information must be shared across specialties, disciplines, hospitals, pharmacies and emergency teams for timely decision making. Integrated communication systems further allow greater efficiency and minimizes administrative costs among different stakeholders (Wu et al., 2017). 

Apart from keeping the patient’s records of medications and allergies, a qualified HER also has the ability to check for the problems automatically when any new medication is prescribed, thus alerting clinicians of arising conflicts. It also tells about life-threatening allergies in case of emergencies. The quick and systematic identification and correction of problems of patients becomes much easier in an EHR as compared to a paper-based setting, thus easing the overall process and providing better solutions to the patients (HealthIT.gov, 2019). 

Patients are demanding to increase accessibility to their data for their more personal use. They have started taking an active role to manage their medical data (Baudendistel, 2015). Patient-centered-care enables clinicians to understand personal healthcare preferences as patients can add important personal stories that are both medical as well non-medical (Buckley and Fox, 2015). Moreover, family health histories are also updated into EHR systems. They help in understanding the risks of diseases and provide insights whether diseases are inherited or derived from social factors. In addition to family and patient health benefits, value of public health in EHRs has also increased. To detect events of public health significance, biosurveillance systems are linked to such health record systems. This will help in providing the possibility of advances in public health policies (Evans, 2016). Also, EHR systems help researchers in gathering data in areas like smoking, heart disease and delivery of preventive services (Parkin, 2016). 

EHR data has been increasing enormously and its availability has let many new opportunities to develop new knowledge about diseases. Big-data and text mining has enabled identification of diseases associations (Chen and Sarkar, 2014). Such technology helps in large-scale EHR data analysis of patterns, correlations, outcomes and temporal trends. These analytics will use data and let several information from description and reporting to predictive modeling, forecasting and decision optimization (Evans, 2016). 

Many countries are adopting such health record system and creating a single national EHR system (Dark Daily, 2018). Many countries like UK, USA, New Zealand, Australia, and France have been successfully implementing it.  However, Australia allows its EHR consumers to control their digital health information at a greater level than any other country. The country has more than six million already registered with the system and around 14000 healthcare professional organizations including hospitals, diagnostic imaging, pharmacies, pathology practices and general practices are connected (Osman, 2018). The market size of EHR system in Australia in 2018 was valued at US $526.3 million which is expected to grow exponentially at the rate of 8.5%. The report by Global Market Insights also shows that Australia has necessary infrastructure with ease of internet being accessed to most of the patients as well as healthcare practioners (Osman, 2019). Although such remarkable achievements, 9 lakh Australians opted out of the healthcare record program and 20,000 on the first day (Dark Daily, 2018). Only 6 million out of 25 million got registered in the EHR program (Duckett, 2018). 

Now the question arises that despite having so many advantages of the EHR system, why do people roll out of such programs for which government comes forward. Privacy and security are the main reason for which people in Australia preferred not to get registered in such programs (Dark Daily, 2018). This means that their personal data is more vulnerable than their health records. Unauthorized disclosure of diagnosis, medical conditions or other sensitive information can impact an individual’s personal as well as professional negatively. These can be maliciously or accidentally transferred to insurance companies or employers or sold to a third party which can jeopardize public trust in the system (Perera, 2011). 

Privacy, information security and confidentiality are at risks with such systems and needs to be balanced with the value of health records (Dornan et al., 2019).  For instance, patient’s consent is needed to access medical information. But patients with mental issues may be reluctant to share such information as these are sensitive cases and it can be potentially damaging if there is breach in privacy. Hence, until they are assured of confidentiality, they would fear to share their data (Clemens, 2012). Similarly, behavioral health data similarly becomes more complicated as there are different laws in different states and countries (Evans, 2016). Therefore creating and using EHRs is rather difficult and involves several barriers involving both technical and non-technical issues. Lack of training and education, lack of awareness, lack of experts, user resistance are primary barriers in implementing such systems. High costs with needed skills and infrastructure is also a serious issue (Ayatollahi et al., 2014). Moreover, lack of IT equipment and facilities and interoperability becomes a major hurdle while implantation (Gesulga et al., 2017).

To conclude, Electronic Health Record (EHR) systems are very useful for both consumers as well as healthcare providers and have numerous advantages. These include convenience, better coordination of care among several healthcare providers, reduced duplication of diagnostic tests, reduced hospital admissions, better informed decisions on healthcare involving both patients and providers and fewer adverse drug events. Apart from this, the family as a whole gets its benefits. Researchers and governments understand the patterns and causes of diseases in a better way thus enabling better healthcare policies and predicting future diseases. 

However, implementing such systems involves privacy, security and confidentiality issues which makes patients distrust such systems and they step back to provide their personal details. No doubt, data is the new wealth and various organizations can misuse these data. Nevertheless, the data recorded, gathered and stored at a single place enables easy and quality delivery of health systems and cannot be ignored. Hence, it is necessary that EHR system is implemented on all the patients as it would enable in a better healthcare infrastructure providing better services to the patients. The Government, however, should come up with better legislations regarding computer crimes and data security so that the data is safe and people start trusting the system. They can allow patients to restrict data to be accessed by other parties until receiving their consent. Imposing to become a part of EHR system may not be right, however, mandating inclusion of all patients should be done when the Government comes up with a better, safe and secure system.