|
The application and challenges involved with implementing an Electronic Health Record (EHR) system for a private family medicine practice |
Abstract
The importance of creating purchasing EHR (electronic health records), practice management systems (PMS), and health information technology (HIT).systems is that they are meant to enhance the interoperability of an organization. The primary reason entail ensuring that each system had a unified communication. As a result, the outcome of this integration can be said to have enhanced the general improvement in quality and speed of health care, improving data sharing accuracy within the two systems, increasing productivity, and boosting the positive shift of the physician time spent in providing quality health care as compared to data entry.
I. INTRODUCTIONAccording to the modern research, the development and the expansion of the electronic health record (EHR) is one of the main factors that revolutionized the development of health information technology (HIT). On the other hand, the generalization of the use of the HIT mainly incorporates the transformations PHI (protected health information) and paper patient charts into electronic forms [1]. The same rationale is based on the essence of transforming other forms that that modernize the use of HIT.
A. EHR Functionalities
According to the modem research, it is stipulated that the electronic health records comprises of multiple core components including result management, decision support, patient support, physical order management, patient health data, administrative procedure and reporting, electronic connectivity and communication, population health and reporting requirements [2]. The table below can be used to visualize these components alongside with other available options of the EHR.
B. Integration of Practice Management System
According to research, practice management systems (PMSs) comprises of different integration levels with EHR systems. Despite that, there are several challenges that are encountered at each level. The integration levels of PMS ranges from the full sharing of information introduced into the system to selection of pending information that is required by the organization for integrating one system with others. In order to have the potential of distinguishing these systems, it is imperative to take into account the role of the physicians’ office for instance insurance verification, billing profiles, dissemination of appointment reminders, and appointment scheduling [3]. Furthermore, the general coordination of these systems is considered to be the primary challenge because of the development and revolution of several HER products. For instance, although an organization can have the potential of developing PMS software and new EHR systems, the extent of integrating the two is challenging.
II. advantages in using the ehr- Access to timely and accurate information – with the use of the EHR, both clerical information and PHI can be accessed easily by individuals who are seeking improved means for reviewing data. In return, there is also an improvement in workflow. Such an improvements are beneficial to provider since it increases the quality of health care for patients in the practice. Likewise, providers are given the opportunity of having instant access to health information.
- Offering prescription capabilities - The general refilling and administration of drug prescriptions can be performed electronically which in return assist in increasing the process of interaction with pharmacies. The filling of claims with insurance organizations for prescriptions can be conducted more efficiently because the PMS and EHR systems have the potential of verifying coverage electronically [1]. Furthermore, the implementation of EHR system assist in keeping a track of medical prescriptions by private family practice group. In return, it is easier for such a group to understand how government regulations and rules are becoming stricter with respect with contemporary opioid epidemic.
- Reducing expenses – controlling expenses is one of the primary objectives of the private medical groups. Often, the reimbursement rates of the Center for Medicare and Medicaid insurance do decrease annually. Furthermore, private insurers do follow the same rationale by taking into account the reimbursement rates to private hospitals. Because of that, the implementation of the EHR system is said to have the potential of allowing private practices to have the likelihood of marginalizing expenses through avoiding mistakes and duplications which absolutely minimizes profits.
- Limiting medical errors - The implementation of EHR system has the potential of utilizing real time certification and is updated continuously with patient visits thus availing reorganized data for each counter [1]. Because of that, physicians are able to access accurate and detailed information when conducting clinical diagnosis as well as reviewing diagnostic results. As a result, it limits the number of medical mistakes made.
- Expense and return investments – the presence of limited resources to invest in the EHR system and the lack of returns from such an investment is considered to hinder its implementation. Typically, the loss of the money invested in this system mainly include the transition period from the paper work to the EHR. Therefore, such a transition ultimately represents the general loss of revenues during the implementation of this system which will continue rising if it is corrected as required. At times, the implementation of this system does not guarantee to be beneficial because small practices can end up becoming overwhelmed by annual fees and licensing fees lined with its implementation [4]. Thus, this makes such an investment to be too risky.
- Willingness and physical capabilities – it is imperative for clinical staff, physicians, and other health care providers to be willing to change their medical practices so as to accommodate and embrace changes. Despite that, in case such efforts are not made towards enhancing transition into the EHR system, it means that the system will fail thus costing a substantial amount of money and other associated resources [5]. Furthermore, in case the medical staff lacks the capacity of adapting quickly to this system, the money invested will be lost. Technical skills ought to be developed quickly which can be challenging to small practice
A. Project Planning and Management
The implementation and the management of the EHR project can be completed within five phases namely initiation, planning, execution, control, and closing. The initiation stage will be concerned will educating the staff members about the goals of the project, collecting their feedbacks about their skill set of IT, identifying missing skills, and the pieces of data required to move the project into the next phase. Secondly, the planning stage will depend on the project team members chosen to facilitate the success of the remaining phases. In this phase, the project team selected will be given the task of managing project schedule including time, risks, costs, and communicating the issues that might arise to the project manager [1]. The team will also assist in developing budget for all the resources needed, vendor selection, verification of hardware and software installation, and authentication of training schedules. The execution and control phase will occur simultaneously. The execution phase deals with activities such as management of ongoing activities, measuring milestones of the project, and risk identification. The control phase deals with monitoring log and risks that arises, tracking performance and accomplishment percentage, measuring reporting of timesheets, tracking subcontractor and vendor reports, and cost control of documents [5] Finally, the closing phase deals with activities such as signing out subcontractor and vendor documents, closing out monetary obligations, presenting final reports to project executives and potential stakeholders, and reviewing the project to ascertain the lessons learned.
IV. Technology ConsiderationsWhether paper or electronic form, EHR implementation do not change the rules of the PHI governed by HIPAA (health insurance portability and accountability). Although EHRs have the potential of saving money, it is evident that the costs incurred in making EHRs might end up exceeding the savings from this system [6]. In return, this is the main reason as to why securing this system has proven to be a difficult task.
A. Strategies for Disaster Recovery
To have the potential of preventing breaches in the EHRs, organizations and vendors have created their hardware and software so as to make them as flawless as much as possible. The same strategy is aimed at ensuring that breaches in HIPAA and PHI have been prevented. However, the tradeoff in security is the general access and thus the primary function of the EHRs entail providing access to data which poses a difficult situation to both EHR developers and vendors [6]. The main considerations given to technology security entail publishing definitions and standards regarding what constitutes violations
B. Cloud Computing Considerations
Furthermore, they include the establishment of system levels that offers negative reinforcements and warnings so as to assist in preventing the violation of these standards. Encouraging internal compliance from all workers through signed agreement partnered with education and training also assist in securing these conditions. Auditing encryption software and recording system assist in tacking and locking accessible PHI with the objective of preventing further HIPAA violation from undesired breaches [6]. The underlying reason for that is because the cloud computing system ultimately requires little installation requirements during its implementation stages.
V. Final Recommendation based upon DataConsidering this case, provided with $150,000 upfront expenditures indicates that the at least $120,000 would be utilized as $ 40,000 per an individual physician. From this computations, it means that the organization will remain with $ 30,000. Therefore, with $ 60,000, it implies that there will be $ 1,650 left per a physician. As a result of that, it implies that the implementation of the EHR systems will have to be based on its operators so that to ensure that could have extremely declined as compared to its competitors [6].
VI. ConclusionThe development or growth of the EHR has not only brought several advantages but also disadvantages in the implementation of the HIT world. Furthermore, the ability of the electronic systems to safely save, record, and integrate with others is the one that has expanded the global use of HIT. Furthermore, it is evident that the electronic health record (HER) is highly detailed as compared to digitized patient records. The underlying reason for that is because they have the potential of providing multiple functions ranging from supporting administrative functions to patient care as well as the functions of information infrastructure. As a result of that, it assists the clinical staff to carry out their clinical tasks more efficiently
References
- Menachemi, N., Ford, E. W., Beitsch, L. M., & Brooks, R. G. (2020). Incomplete EHR adoption: late uptake of patient safety and cost control functions. American Journal of Medical Quality, 22(5), 319-326.
- Davis, D. C. (2021). Perceived Level of Benefits and Risks of Core Functionalities of an EHR System. In Medical Informatics: Concepts, Methodologies, Tools, and Applications (pp. 1112-1124). IGI Global.
- Hristov, I., Appolloni, A., Chirico, A., & Cheng, W. (2021). The role of the environmental dimension in the Performance Management System: A systematic review and conceptual framework. Journal of Cleaner Production, 126075
- Xie, W., Mehta, N., & Palvia, P. (2020). Value co-creation dimensions and challenges in EHR systems. Journal of Information Technology Case and Application Research, 22(3), 188-215.
- Reeves, J. J., Longhurst, C. A., San Miguel, S. J., Juarez, R., Behymer, J., Ramotar, K. M., ... & Millen, M. (2020). Bringing student health and Well-Being onto a health system EHR: the benefits of integration in the COVID-19 era. Journal of American College Health, 1-7.
- Williams, K., & Colomb, P. (2020). Important Considerations for the Institutional Review Board When Granting Health Insurance Portability and Accountability Act Authorization Waivers. Ochsner Journal, 20(1), 95-97.
