Do you want to know electronic health records the good the bad and the ugly? If your answer is yes then this blog provides you all information regarding this.
Electronic health records have been widely embraced throughout healthcare institutions large and small as part of the Patient Protection and Affordable Healthcare Act. While EHRs offer numerous advantages, such as improved access to patient data, increased charge capture, and improved preventative health, they also come with a number of drawbacks.
The processes that an EHR enables determine how effective it is. Hospitals may invest in difficult and expensive technologies if the technology is not supported by well-thought-out processes, which will add to the waste in an already inefficient system.
To ensure beneficial outcomes before making substantial investments in new technology, suppliers and healthcare providers must identify and eliminate waste in processes that include the use of EHRs from the early phases of EHR design. In healthcare, lean management is a useful tool for achieving this goal since it teaches hospital administrators, clinicians, and staff how to identify and reduce waste.
Unnecessary waste is frequently eliminated when an EHR is used. If the system is broken, however, introducing new technology might exacerbate the situation, with “poor” or “ugly” outcomes. Healthcare executives must be aware of the benefits and drawbacks of electronic health records (EHRs), as well as what can be done to avoid them.
Let’s start on a positive one by looking at what “excellent” EHRs may provide for practices and health systems. The six key advantages are mentioned below based on my personal experience.
The positive aspects
1. Data accessibility has been improved
Prior to EHRs, getting access to medical records necessitated a lot of physical effort. When a patient came to the office or hospital, for example, their file had to be physically removed from a storage location, transported, delivered (batch processing), stamped, and sorted all in one visit. Because of this back-and-forth, there was a higher risk of human mistakes, and charts might occasionally be missing information or be out of order chronologically. It was not uncommon for five out of fifteen charts for a clinic day to be unavailable at any given moment in my experience, resulting in lost time, space, motion, and frequent care errors.
2. Order entry by a doctor using a computer
CPOE allows physicians to electronically place lab and imaging orders, prescriptions, and other notices, decreasing the risk of human mistakes and allowing access to the order by the patient’s other physicians in the EHR network. If a patient’s cardiologist prescribes a medicine, the primary care physician will have access to the prescribing information if they are both on the same EHR. This not only saves time, but it also cuts down on mistakes like duplicate prescriptions and drug interactions, as well as potential patient harm.
The capture of the Charge
Healthcare organizations keep track of a patient’s use of hospital resources such as equipment, medical supplies, diagnostic testing, medication, and hospital staff (“capture”). Patients and third-party payers are billed for these charges. It is common to overlook the use of a resource. Because the process of “charge capture” might be complicated, it’s critical to have a system in place that captures charges entirely and correctly, maximizing revenue reimbursement.
4. Health Promotion
Preventative health checks can be prompted using EHRs. The physician gets access to preventive health records in one place for a normal doctor or urgent care visits. If a cancer screening (such as a mammogram or colonoscopy) or blood pressure testing is due, the doctor can easily look it up in the EHR system and make an appointment for the patient.
Furthermore, EHRs enable data analysts to search the entire system for, for example, all diabetic patients who haven’t had their hemoglobin A1C and cholesterol checked in the previous year. The analysts can then send a list to the physician, allowing practice management to contact the patients and schedule these preventative health appointments. Paper records cannot be used for this form of data mining.
PAs and NPs should be able to sign off with ease.
Physician assistants and nurse practitioners are normally obliged to have their notes approved and signed off on by their supervising physician, though state laws vary. Instead of physically moving and signing paper, EHRs allow note modification and cosigning to take place electronically.
6. Provider-to-provider e-messaging
Telephone tag between providers, as any physician can attest, is a common occurrence that wastes a lot of time. Physicians can send e-mails to one another using EHR software. Referrals are one circumstance where e-mail comes in handy. Instead of calling to book an appointment, the physician sends an electronic message.
1. An absence of compatibility between information technologies and electronic health records (EHRs).
With more accountable care organizations springing up around the United States, technology is becoming increasingly important in the development of an ACO, allowing primary care physicians to track and follow patients’ progress across the healthcare system. The necessity to connect EHRs across the health system and communicate data with a network of referring hospitals was one of the driving forces behind the strategy. However, it is not always possible to provide information. The success of the project depends on finding a hospital partner who is prepared to communicate openly. For example, Atrius Health, a Simpler Consulting customer, collaborated with Beth Israel Deaconess Medical Center and Epic Systems to establish a web gateway that allows the two provider organizations to access each other’s EHR systems for shared patients. 1 Communication can become a severe problem if this planning and integration is not done, resulting in more follow-up, effort, and waste.
2. The price of installation and upkeep
EHRs are typically prohibitively expensive. The provider must pay for not just the physical hardware and/or software, but also for setup, maintenance, training, IT support, and system updates. The cost of effectively implementing and maintaining the system is prohibitive for many smaller practices with limited cash flow.
3. The ability to produce
In the early stages of the EMR’s introduction, research conducted by the University of California-Davis discovered a 25-33 percent decrease in physician productivity.
While the ultimate goal is to boost office or hospital productivity, expect a considerable loss in productivity, and ultimately income, in the first few weeks, if not months.
4. Documentation backlogs
EHRs actually increase physician workload, which may come as a surprise to many. Written notes tended to be more succinct and to the point than oral notes. Physicians now have to document much more before, during, and after patient visits because to EHRs. There are advantages and disadvantages to this approach. More comprehensive documentation, for example, provides additional information to coders that may justify billing for a higher level of service. On the downside, it can lead to additional delays and errors because physicians frequently wait until the end of the day, or even days later, to close notes. As a result, people rely on their memories to submit accurate data. Furthermore, if a patient sees a different physician, others will not be able to see the updated information until the note is closed.
5. Provider-to-provider e-messaging
While e-mailing has its advantages, it may also be a disadvantage because it eliminates face-to-face or phone-to-phone communication. There are no give-and-take discussions or question-and-answer scenarios with electronic health records (EHRs). There are no means of expressing emotion, subtlety or voicing your concerns or fears. Rather, doctors must believe that the information they’re giving us exactly what the other doctor wants, that it’s being understood correctly and that it’s being read. It isn’t always the case, though.
6. Constant updates are required, but no one is held accountable for delivering them.
Every job, big or small, necessitates an update in the EHR system, whether it’s a routine health visit, a diagnostic, a procedure, a treatment, or a prescription. For example, if a patient has an active “problem list” (e.g., diabetes, hypertension, high cholesterol, etc. ), someone must be in charge of changing the patient’s prescription and keeping the problem list up to date.
The Horrible One
Violations of HIPAA
There is a higher danger of privacy infractions with EHRs since they make sensitive information more accessible. These can be deliberate “snooping” or unintentional, such as when security measures are inadequate. Many systems, thankfully, include a forensics component that tracks when and by whom files are accessed.
2. Data fields that aren’t filled with any information
Many EHR systems allow for auto-population of data for new records, which differs depending on the proprietary nature of the system being used. While these shortcuts save the physician time and effort, they may result in erroneous new records if the preceding auto-populated record is out of date. If a patient had surgery in June and it was not or inadequately documented, a “no data available” empty data field error message or, worse, false information could be presented. To avoid an issue like this, it’s crucial to create standard work and manage to those standards.
The most obnoxious of all EHR flaws is copy and paste. Because EHRs need additional documentation, physicians may use the copy and paste tool to save time, especially during routine or follow-up visits. While this may save the physician time, it jeopardizes the patient’s safety and lowers the quality of care because updates or changes between visits may be omitted or improperly reported.
To Sum Up
EHRs offer significant benefits to doctors, hospitals, and doctors’ offices, as well as patients. However, the “bad” and “ugly” frequently outnumber the “good.” To avoid these problems, hospitals and healthcare systems must evaluate the EHR system thoroughly before purchasing and implementing it. Regrettably, this is a stage that many people ignore. Indeed, according to the above-mentioned Black Book Rankings survey, 79 percent of the 17,000 people polled said they did not adequately assess their needs before choosing an EHR system. 3
Before implementing a new EHR system, taking the time to evaluate new technology and implement a new process, such as Lean management, to evaluate workflows and identify and eliminate waste will aid in implementation, foster communication, reduce non-value-added work, and ultimately increase adoption.
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