Question A: Electronic Health Record (EHR) functions in the acute care setting

There are numerous applications of EHR in a critical care setting. Some of the uses include

1. Computerized entry of physician
2. Imaging informatics system
3. Ensuring safety and security of patient information.
4. EHR also allows clinicians to use computer-based drug prescription that has proved to be more secure and helped to minimize human errors.

Description

End-user clinicians in acute care settings can use the EHR to facilitate the entry and retrieval of medical and health records through the use of a computerized entry of physician order. This system allows users to input and retrieve patient information with ease and accuracy. The computerized physician order entry is supported by the advancements in technology which is currently experienced hence the system has a significant potential to grow. The second application of the electronic health records is the imaging informatics systems. In this process, clinicians access radiological results through EHR. Other effects that can be accessed through EHR include MRI, CT, and X-ray(Langhan, Riera, Kurtz, Schaeffer, & Asnes, 2015). EHR allows the clinicians to get instant access to the radiology results as they are uploaded into the system. Thirdly, EHR ensures safety and security of patient information. The EHR system is password protected, thus only authorized clinicians and other health care providers can view patient information ensuring that the patient information is stored in a secure environment. Finally, the EHR is used by clinicians to prescribe medication. The computerized prescription is more accurate and can eliminate human errors that may occur during the regular drug prescription. This system allows the doctors to record and upload the medication prescribed. Once the details of the prescription have been uploaded on the EHR, the pharmacist can be able to access the information and provide the prescribed medication

Strategy for implementing new technology in a critical care setting

Currently, there is a continual influx of new technologies in critical care settings. Thus there is a need to develop appropriate strategies for adopting the latest innovative technologies and integrating them into the existing technologies in the critical care setting. An important strategy that can be adopted entails considering input from the current staff concerning the new technology, educating the critical care staff about the new technologies and what the technology has to offer, ensuring accessibility to the technology, and technology evaluation(Langhan et al., 2015). The process of technology evaluation is particularly very critical as it will help the staff to assess the effectiveness of the new technology and be able to make an informed decision about the technology adoption in the critical care setting. Below is the road map to the implementation of new technology in the critical care setting.

Figure 1: The strategy for adopting new technology in critical care setting

Question B: EHR functions needed by clinical end-users in the outpatient setting

1. Communication through Messaging
2. Care management
3. Analysis and reporting of population data

Description

Communication through Messaging: the EHR has the capability to facilitate instance message alert communications between the clinicians and outpatient clients. Patients can receive instant messages as soon as their laboratory results are ready for collection. Chronically ill patients on monitoring programs can also be notified via short messages when they are required to visit their clinics and follow-up schedules. Message Log is a common messaging application used in EHR. The platform enables clinicians to receive patient-specific information from laboratory and other hospital sections to improve patient care(Wilcox, Bowes, Thornton, & Narus, 2008).

The second application of EHR in outpatient is the care management which is designed to precisely manage patient conditions. For instance, the HELP-2 system is designed for longitudinal management of conditions such as allergies which can be followed longitudinally with the patient. The system has the capacity to document specific measures associated with the treatment(Wilcox et al., 2008).

Analysis and reporting of population data have been made easier through the use of EHR in the outpatient hospital department. The EHR has been applied in the identification of trends of care across various clinical encounters. This has simplified the management of population data concerning clinical care(Wilcox et al., 2008).

Question C: Comparison of two models used in Health information exchanges

Centralized model

This model is sometimes called consolidated model, and it allows all data to be stored in one centralized warehouse. All the participants submit patent data to the repository. In turn, all participants connected to the centralized warehouse can view patient data through a delivery system. This model can be adopted well in a community network, and the data is easily queried. Consolidating data in a centralized system facilitates community data analysis particularly for public health issues and research purposes(Adler-Milstein, Bates, & Jha, 2013). The layout for the centralized model has been shown in figure 2.

Figure 2: Centralized model

Decentralized model

The decentralized model is also called distributed model. A unique characteristic of this model is that all data remains at the point of service; thus there is no centralized data warehouse. The participants in the data sharing network agree to share patient data. This model features a record locator service which is unique to health information. The record locator service can locate the health information making it easier for the authorized health personnel to identify and retrieve health information(Adler-Milstein et al., 2013). An illustration of the decentralized model has been shown in figure 3.

Figure 3: Decentralized model

Benefits of developing health information exchanges

Developing health information exchange means creating capacity for sharing health information among health care professionals which is particularly important since by sharing health information, health care professionals minimize medical error. Errors are reduced by different health care professionals reviewing the health information and helping to eliminate the mistakes that may have been made. Moreover, sharing of medical records electronically helps to enhance efficiency through the elimination of the tedious paperwork(Adler-Milstein et al., 2013). Sharing medical information also help the caregivers to make critical decisions and support effective treatment and care. Some cases of redundancy in health care systems can be eliminated through health information sharing. For instance, if a patient moves from one hospital to another, there is need to share health information with the second hospital to avoid repeating the same laboratory tests which had been performed by the former hospital. Health information sharing can also help to improve public health monitoring and reporting which in turn helps to improve the quality of health care and treatment outcomes. Finally, the sharing of health information significantly reduces health care costs.

Challenges to health information exchanges

A major challenge to the widespread health information sharing is the issue of ensuring patient information safety and security. Many health care providers remain skeptical about EHR due to issues with the patient information security breach. This challenge has significantly slowed down the process of health information sharing in many health facilities. Secondly, increased workload has been witnessed in health facilities which have so far embraced health information sharing. Doctors and other health care providers are overwhelmed by the ballooning amount of data available which overburdens the limited workforce in the healthcare sector. Another barrier to health information exchange is the lack of the necessary facilities required to implement data sharing in health care setting(Adler-Milstein et al., 2013). Finally, the limited number of trained personnel able to handle health care information has significantly limited the adoption of health information sharing in health care settings.

Question D: Factors to consider while offering personal health record

Computer literacy is a key factor to consider when providing personal health record to patients. The ability to use a computer has been associated with the effective use of personal health records(Day & Gu, 2012). Thus the need to train patients on computer application before giving them personal health records. Another factor to consider is the patient’s perception of personal health records. Patients who perceive the personal health records as being convenient tend to use the PHR effectively. Finally, the cost of providing the PHR should be considered. Since patients may not be able to pay for the maintenance cost of the system, it is important for the organization to plan the source of funds to facilitate the PHR(Day & Gu, 2012)

Qualities of a personal health record

Before the implementation of any health care project including the PHR, the cost of implementing and sustaining it is paramount. The cost of the PHR must be considered before it is adopted in the health care setting. If the cost of maintaining the PHR is sustainable, then it can be adopted(Kahn, Aulakh, & Bosworth, 2009).

On the contrary, if the cost is unsustainable, it is so that such a PHR should not be adopted. The security of patient information is another critical factor to consider before adopting personal health records. A good health record should put in place measures that ensures the information contained on the system is safe, particularly in the face of increasing cases of cybersecurity breaches. Finally, the third quality of a PHR to be considered is the design of the PHR. Design shortcomings among the adopted PHR have been reported necessitating the need to examine the PHR design before adoption(Kahn et al., 2009).

References

Adler-Milstein, J., Bates, D. W., & Jha, A. K. (2013). Operational health information exchanges show substantial growth, but long-term funding remains a concern. Health Affairs, 32(8), 1486–1492.

Day, K., & Gu, Y. (2012). Influencing factors for adopting personal health record (PHR). In HIC (pp. 39–44).

Kahn, J. S., Aulakh, V., & Bosworth, A. (2009). What it takes: characteristics of the ideal personal health record. Health Affairs, 28(2), 369–376.

Langhan, M. L., Riera, A., Kurtz, J. C., Schaeffer, P., & Asnes, A. G. (2015). Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff. Journal of Medical Engineering & Technology, 39(1), 44–53. https://doi.org/10.3109/03091902.2014.973618

Wilcox, A., Bowes, W. A., Thornton, S. N., & Narus, S. P. (2008). Physician use of outpatient electronic health records to improve care. AMIA … Annual Symposium Proceedings. AMIA Symposium, 2008, 809–813. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18999307

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