Electronic Personal Health Record Research Paper

Nursing

Instructions Use your previous assignments to Identify a policy related to your chosen health issue and create a Prezi or PowerPoint presentation concerning your health issue, focusing on the development, needed change, or implementation related to your health issue. Policy briefs are overviews of issues that are intended to inform policy-makers.  The presentation should be […]

Electronic Personal Health Record

Healthcare professionals collect subjective and objective data on a patient to understand their health issues. Nevertheless, little of that information is presently being shared with medical consumers. According to Gagnon et al. (2016), ePHR is a set of automated devices offering patients timely access and a wide-ranging outlook of their health information, maintained and entered by them or their medical providers. As such, it enables patients to be the keepers of their data and exert a certain degree of regulation over it. It also allows them to participate, track, and manage their healthcare. Electronic Personal Health Record (ePHR) has, therefore, been adopted in the interest of patient access to their medical records. In essence, ePHR is perceived as a solution that could be advantageous to facilitate control and access to patients’ health-related data. It is also seen as a technology to enhance the effectiveness and efficiency of patient care, improve medical consumers’ safety, and promote self-management of one’s well-being.

Explanation of the Technology

Traditionally, the clinician-patient association involved the total reliance of the medical consumer on the doctor. In this regard, physicians must keep accurate record systems to store data concerning a patient and utilize the document to make recommendations and diagnoses. In that sense, the utilization of ePHR is one crucial milestone. The demand by the public for flexible access to health services and information is increasing, and the development is encouraged by policies and internet trends promoting empowerment and patient rights (Roehrs, Costa, Righi, & Oliveira, 2017). At the same time, efforts to adopt electronic health records have led to unprecedented worldwide investment in medical communication and information technologies. On the whole, the technology promises efficiency and improved quality through the availability of patient data and better maintenance.

Improved exchange of data across medical care personnel and enhanced patient-provider communication are critical to increasing the safety and quality of health care. The demand for ePHR is centered on allowing the patients some control based on the upload of data and sharing of information. The mentioned development may, in part, be due to these systems being moderately new and progressing with digital health innovation (Hemsley, Rollo, Georgiou, Balandin, & Hill, 2018). Technology distracts medical care’s moral order by giving healthcare consumers more control over their health information. Therefore, patients must know their responsibilities and roles in organizing their health, and both clinicians and patients are challenged in embracing ePHR, which encourages shared access to patient’s health information.

Benefits of the Technology

The potential advantages of capturing patients’ information in an electronic record are numerous. For example, due to the need to apply guidelines consistently and accurately, up-to-date and complete patient information, such as the ones stored in ePHR, is vital. Similarly, having data easily accessible lessens the cognitive burden on the clinician. Therefore, the released cognitive resources, due to not having to search for information, can be dedicated to better interpretation of information. In this respect, ePHR has the potential to empower patients through greater clinical outcomes, health information, personal data, and shared decision-making (Roehrs et al., 2017). Overall, the technology is likely to increase the safety of the patients by increasing the accessibility of drug or test results alerts, recording non-prescribed treatments or medicines, and exposing drug or diagnostic errors.

The ePHR is also seen to improve efficiency and continuity of care by acting as a point of record integration, especially in fragmented health systems, and reducing geographical barriers to patient care. Similarly, there have been improvements in trust and communication between medical consumers and physicians, the accuracy of records, compliance with chronic disease, and confidence in self-care (Gagnon et al., 2016). Patients specifically value online secure messaging, drug lists, trend charts, plans for disease management, laboratory results, and prescriptions. Patients with long-term conditions are those for whom the greatest benefits can be expected because they frequently use electronic personal health records. The reason, in this regard, is that such individuals have the most need to track their treatments and illness. The technology is also likely to benefit healthcare consumers who are experiencing treatments that produce new needs for communication or information or experiencing episodic periods of care. Finally, ePHR may assist in promoting collaboration between health professionals and carers through information sharing or enabling relatives to monitor the progress and care of children in hospitals or elderly parents from a distance.

Literature Review

The investigation by Alzoubi et al. (2019) has produced significant results showing that with the development and improvement in information technology, ePHR is increasingly being adopted for secondary uses, such as clinical research, clinical decision support, and safety and quality measurement. Another point of view has been discussed by Toscos et al. (2016) that those who activated or were more engaged in their care through ePHR experienced fewer medical errors and hospital readmissions. Furthermore, this population communicated better with their physicians than those who lacked the confidence, skills, and knowledge to manage their healthcare. Central to the findings by Feeney et al. (2019), ePHR provides additional benefits of improving the completeness and accuracy of the information and appears tailored for mobile and rapidly displaced populations. The study by Mathai, Shiratudin, and Sohel (2017) concurs with that of Feeney et al. (2019) that properly designed ePHR can well organize physician workflow and eliminate the need to take down transcriptions on paper, leading to increased productivity and efficiency. Therefore, technology helps medical personnel improve communication with patients, scan reports, and better exchange laboratory results.

Implementation Plan

In the US, Registered Nurses encompass the largest population of healthcare workers. For this reason, nurses have a valuable role in implementing electronic systems successfully. Arguably, the ePHR is a set of automated devices offering patients timely access and a wide-ranging outlook of their health information, maintained and entered by them or their medical providers (Gagnon et al., 2016). At the same time, one of the best sources of information on which to base the strategy of the technology is key stakeholders. For example, the board members/administration will be crucial stakeholders since they will make important operational and financial decisions concerning the implementation of ePHR. The stakeholder from the billing team will provide insight into the accuracy and speed of processing claims, as well as the performance metrics of the ePHR billing system. Office managers also play an essential role because they are liable for inputting contact, billing, and demographic information of all medical consumers coming through the healthcare practice. Lastly, clinicians are vital to a successful implementation process because they are on the front line of offering clinical services.

An Overview of Privacy, Safety, Legal, and Ethical Issues with ePHR

Many developing nations are increasingly implementing ePHR because it is cost-effective and due to its effectiveness in improving the quality of health care. Nevertheless, the safety of information in the system is a real challenge because technologies can introduce some hazards. In this respect, health personnel faces ethical issues linked to ePHR. Autonomy is jeopardized when patients’ health data are linked or shared without their knowledge (Lee, 2017). Healthcare consumers may conceal data due to a lack of confidence in the system’s security. There is also the issue of privacy and confidentiality. In ePHR, privacy and security can be seriously susceptible to worms, viruses, and hackers. In the near-term, the key legal dilemmas that must be tackled as they pertain to ePHR include the mechanisms for physicians to openly report potential safety issues with the system, the accountabilities posed by prevailing medical decisions alerts, and support warnings. Another consideration should be assessing the whole computer-accessible clinical synopsis from multiple institutions and clinicians. In brief, ePHR presents various privacy, safety, legal, and ethical issues because compliance with regulations and standards in systems is still low, and most privacy policies of the system do not offer a comprehensive depiction of the security measures utilized.

Purpose and Goals of Implementing ePHR

The landscape of healthcare practice is changing. One transformation is shifting from a paper-based practice environment to a paper-light or predominantly electronic setting. To this end, ePHR is being implemented and adopted by consumers, administrators, and providers in the medical industry (Nagykaldi, Tange, & Maeseneer, 2018). The purpose and goal of adopting the system are to ensure better clinical decision-making by incorporating improved patient data from numerous sources. The technology is also expected to lower healthcare costs and improve efficiencies by promoting improved coordination of healthcare services and preventive medicine and reducing redundant tests and waste. Similarly, ePHR is being adopted to ensure the promotion of better health. The system will inspire a healthier lifestyle in the whole population, including avoidance of behavioral risks, better nutrition, and increased physical activity. Finally, the goal and purpose of implementing ePHR are to improve components of patient care, including equity, safety, efficiency, patient-centeredness, timeliness, education, and communication.

Evaluation Plan

Assessment of the implementation of ePHR is an essential step because it ensures every system in place operates efficiently. This way, it will be possible to determine if files and data tables are loading properly and if the data gathered are stored and processed correctly. At the same time, the evaluation is critical in ensuring that the system’s interfaces work as intended. For example, it will be possible to determine if the security system is checked, the reports are produced accurately, the alerts are properly triggered, and workflows have been adjusted appropriately. Hence, the scope of the evaluation can be categorized as the assessment of training readiness, application configuration promptness, and infrastructural readiness (Aguirre, Suarez, Fuentes, & Sanchez-Gonzalez, 2019). The evaluation will also entail testing servers, printers, workstations, wireless devices, and related security measures. Moreover, this plan segment will include appraising all areas, procedures, and workflows of the clinical record design. In this part of the evaluation, training will also be included to determine the staff’s readiness to utilize the system before going “go live.”

Projected Evaluation of the Implementation Process

The anticipated assessment of the implementation process of the ePHR system consists of pre and post-go-live testing. It further includes data backup processes, a patient communication standard to include probable downtime, as well as reliability and network speed checks. More so, it includes staff scheduling and required temporary or overtime personnel, communication tools, and modification of scheduling and appointments (Aguirre et al., 2019). The objective of the projected evaluation of the implementation process is to ensure the ePHR system performs and works as expected. During this process, it is vital to ensure that the team carries out load or stress testing, conducts interface testing, conducts integration evaluation, and performs unit testing.

At the same time, the team should ensure the plans of testing covers different situations and scenarios. For example, in the implementation process, day one will start by assessing data availability and ensuring that it is usable and accessible upon demand by authorized individuals. Another activity will entail testing for data integrity and quality to ensure the information is created appropriately and accurately. On the second day, the evaluation will be for the correct and complete use of the ePHR to ensure its functionality and features are used and implemented as intended (Aguirre et al., 2019). Lastly, on day three, the assessment will be done again to improve and monitor patient safety to ensure that ongoing performance improvement and quality assurance are in place to report, detect, and monitor the safety and safe use of ePHR.

Projected Evaluation of the Benefits of Patient Care

Some of the basic advantages linked to ePHR include the elimination of poor penmanship, which has plagued the medical chart, and access to computerized records easily. Three particular functionalities of ePHR are essential in projecting the evaluation of the system’s benefits to patient care because they promise to reduce costs at the healthcare facility and improve the quality of care. The first is one is a clinical decision support (CDS) tool. It helps clinicians in making decisions concerning patient care. In a CDS system, some functionality includes alerts for various potential patient issues, such as drug interaction that is flagged by the computer and offering the latest data concerning a drug (Aldosari, 2017). The second system is computerized physician order entry (CPOE). It is a tool that enables clinicians to enter orders, such as physical therapy and laboratory tests, into a computer instead of doing so on paper. Computerization of the approach eradicates the likely dangerous medical errors resulting from the penmanship of clinicians. The last one is health information exchange (HIE). HIE can create many competencies in the provision of health care because it enables sharing of patient-level electronic health data between various institutions.

Conclusion

In summary, ePHR not only offers an approach to organizational efficiency but presents a safer way to care for medical consumers and the needed means to attain regulatory standards. Therefore, when adopting the system in a clinical setting, the implementation process is a vital step to consider. Including and selecting a suitable strategy can minimize delays and facilitate success in the rollout of the technology. Understanding the organization’s needs and becoming familiarized with the approach are detrimental steps to the success of the implementation. Utilizing the best approach, training, backup system, and strategy exponentially diminishes the likelihood of usability being compromised and increases the satisfaction of healthcare workers.

References

Alzoubi, H., Alzubi, R., Ramzan, N., West, D., Al-Hadhrami, T., & Alazab, M. (2019). A review of automatic phenotyping approaches using Electronic Health Records. Electronics8(11), 1235. doi: 10.3390/electronics8111235

Aldosari, B. (2017). Patient safety in the era of EMR/EHR automation. Informatics in Medicine Unlocked9, 230–233. doi: 10.1016/j.imu.2017.10.001

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic Health Record Implementation: A Review of Resources and Tools. Cureus. doi: 10.7759/cureus.5649

Feeney, O., Werner‐Felmayer, G., Siipi, H., Frischhut, M., Zullo, S., Barteczko, U., … Rakić, V. (2019). European Electronic Personal Health Records initiatives and vulnerable migrants: A need for greater ethical, legal and social safeguards. Developing World Bioethics. doi: 10.1111/dewb.12240

Gagnon, M.-P., Payne-Gagnon, J., Breton, E., Fortin, J.-P., Khoury, L., Dolovich, L., … Archer, N. (2016). Adoption of electronic personal health records in Canada: Perceptions of stakeholders. International Journal of Health Policy and Management5(7), 425–433. doi: 10.15171/ijhpm.2016.36

Hemsley, B., Rollo, M., Georgiou, A., Balandin, S., & Hill, S. (2018). The health literacy demands of electronic personal health records (e-PHRs): An integrative review to inform future inclusive research. Patient Education and Counseling101(1), 2–15. doi: 10.1016/j.pec.2017.07.010

Lee, L. M. (2017). Ethics and subsequent use of electronic health record data. Journal of Biomedical Informatics71, 143–146. doi: 10.1016/j.jbi.2017.05.022

Mathai, N.., Shiratudin, Mf., & Sohel, F. (2017). Electronic health record management: Expectations, issues, and challenges. Journal of Health & Medical Informatics08(03), 1-5. doi: 10.4172/2157-7420.1000265

Nagykaldi, Z. J., Tange, H., & Maeseneer, J. D. (2018). Moving from problem-oriented to goal-directed health records. The Annals of Family Medicine16(2), 155–159. doi: 10.1370/afm.2180

Roehrs, A., Costa, C. A. D., Righi, R. D. R., & Oliveira, K. S. F. D. (2017). Personal health records: A systematic literature review. Journal of Medical Internet Research19(1), e13. doi: 10.2196/jmir.5876

Toscos, T., Daley, C., Heral, L., Doshi, R., Chen, Y.-C., Eckert, G. J., … Mirro, M. J. (2016). Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: A quasi-experimental study. Journal of the American Medical Informatics Association23(1), 119–128. doi: 10.1093/jamia/ocv164

 

 


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