Burton, Anderson and Kues (2004), who were all affiliated with the national program called the Partnership for Solutions: Better Lives for People with Chronic Conditions, which is a founded national program, discussed how the adoption of electronic health records help in the coordinated care of patients in health care institutions (Burton, Anderson & Kues, 2004). Electronic health records reportedly help various providers, which include medical centers, community hospitals, and health agencies, in linking their information to improve the delivery of health care services.
Other institutional providers, such as insurers, disease management companies, and federal initiatives actually develop and use their own information systems. Thus, all of these stakeholders would benefit from the integration of information systems through electronic health records. Ultimately, all such efforts would boil down to the development of better health care (Burton, Anderson & Kues, 2004). Physicians’ Perception. One relevant issue pertaining to the adoption of electronic health records in hospitals and various health institutions involves the question of extent of actual use by physicians and other health professionals.
In an article written by Conn (2006), the results and findings of a survey posted on the website of the New England Journal of Medicine were discussed and presented. The survey, which is reputed to be “most comprehensive survey to date of physician adoption of electronic health-record systems,” deals with questions on the number of physicians who have access and who actually use electronic health records in hospitals. This survey provides a “definitive base line” from which future progress on the use of electronic health records may be compared (Conn, 2006).
Unfortunately, the survey results show as of 2006, only a meager seventeen percent of physicians in ambulatory care have access to electronic health records. This means that more than eighty percent of physicians cannot even access these records. Moreover, physicians who do have access to electronic health records use them with limited functionality. These findings are relevant, considering that this low adoption rate shows that electronic health records are not being exploited to their full potential.
Looking at the findings on a brighter side, the survey serves as a benchmark that must be exceeded in the future (Conn, 2006). The Healthcare Financial Management Association (2006) likewise provided data on the prevalence of use by hospitals of electronic health records. The association’s article discussed the general progress by hospitals in the adoption of electronic health records systems. Nurses’ Perception. Aside from physicians, nurses are also part of the target population for the adoption of electronic health records.
Dahm and Wadensten (2008) discussed how nurses view standardized care plans in electronic health record. It also looks into the nurses’ views on quality standards for clinical practice (Dahm & Wadensten, 2008), considering that there was little literature on the opinions of nurses on standardized care plans. Dahm and Wadensten (2008) reported the details of a quantitative and descriptive study that was conducted through a survey on nurses to determine the above-mentioned information.
The said study yielded relevant results, considering that nurses are one of the best sources of information on the matter since they are the ones actively interacting with patients and dealing with records. The participants in the study are generally of the opinion that standardized care plans would be very useful in documentation, particularly with the advent of electronic health records (Dahm & Wadensten, 2008). Progress report. Based on the report of the Healthcare Financial Management Association (2006), there is still a long road ahead of hospitals in terms of adoption of electronic health records.
In particular, there were specific functions of electronic health records where hospitals and similar institutions have fared well, and there were other functions were adoption took a less favorable turn (Healthcare Financial Management Association, 2006). It appears that hospitals did not find it overly difficult to adopt certain electronic health records functions, such as order entry, results management, electronic health information/data capture, and administrative processes. All of these functions garnered twenty-three to thirty-eight percent of progress among hospitals (Healthcare Financial Management Association, 2006).
Unfortunately, most hospitals did not easily adopt to electronic health records in terms of patient access, health outcomes reporting, and clinical decision support. All of these functions received only two to thirteen percent of progress (Healthcare Financial Management Association, 2006). It is noted that the progress of hospitals seems to depend on the size of the institution, considering that “larger hospitals were further along in EHR adoption than were mid-sized or small hospitals.
” It was also observed that the socio-economic status of hospitals was a factor, as “nonrural hospitals were slightly further along than were rural hospitals” (Healthcare Financial Management Association, 2006). Policy issues. While many, especially those who belong in the medical profession, would attest to the utility and practicability of maintaining and using electronic health records in hospitals and other health facilities, it cannot be denied that there are also significant considerations on the other side of the fence.
For example, there are many and varied policy implications that should b addressed in relation to the adoption of electronic health records (Gray, 1989). One of the foremost policy concerns on the use of electronic health records, and understandably so, is the protection of confidential information. This concern is especially crucial since electronic databases could be more intrusive than the traditional systems. This concern is sought to be addressed by independent authorities that could be trusted to control the data.
Thus, both Western Europe and the United States deemed it wise to draw certain limitations in the access to information. These limitations concern the accuracy of the data accessed and protection of the data from unnecessary disclosure (Gray, 1989). Barriers to Full Adoption. The Healthcare Financial Management Association (2006) discussed the top barriers that prevent a full-blown adoption in American hospitals and the solutions to these barriers Significant barriers to full adoption of systems of electronic health records were identified through the conduct of a survey.
Barriers identified include lack of national information, funding, “concern about physician usage” and “lack of interoperability. ” These factors rated at a range of fifty to sixty-two percent as barriers to adoption (Healthcare Financial Management Association, 2006). Approaches in Removing Barriers to Adoption. According to the Healthcare Financial Management Association (2006), the various barriers to full adoption of electronic health records could be addressed from a holistic perspective. Different stakeholders could help by performing their respective roles in promoting the full adoption of the system.
For example, it is suggested that the government plays a big role in making adoption to electronic records easier. The government could help in addressing barriers to full adoption of electronic health records by providing grant funding, among others, in order to give opportunities for hospitals to attempt their adoption of the new system. Another option for the government is to provide payment incentives and simply the Medicare payment system (Healthcare Financial Management Association, 2006). The government could also accelerate investment in regional networks to encourage adoption of electronic health records.
Finally, the government could spearhead and facilitate the development of standard codes and national standards that could guide the implementation and adoption of electronic health records (Healthcare Financial Management Association, 2006). Aside from the government, hospitals should be at the forefront of all efforts in addressing the barriers to full adoption of electronic health records. Thus, hospitals are advised to participate in regional information networks to gather more information that could help in addressing the barriers.
They could also collaborate with other healthcare organizations to address problems relating to cost. Participation is also encouraged, particularly with respect to vendors, since these are the primary stakeholders who could provide information with respect to “connectivity and financing solutions” (Healthcare Financial Management Association, 2006). Conclusion. In sum, electronic health records offer a lot of advantages. Stakeholders such as the government, the individual patients, hospitals and other health care providers would all benefit from the increased access to information brought about by such a system.
Nurses would likewise benefit from the easier access to information allowed by electronic health records. However, electronic health records cannot be fully adopted without great difficulty. Up to the present, few hospitals have managed to adopt this system. Thus, there is a continuing need for all stakeholders, including the nursing profession, to continue with efforts to addressing the different barriers to full adoption of electronic health records so that this system could reach its full potential.
References
Burton, L. C. , Anderson, G. F. & Kues, I. W. (2004). Using Electronic Health Records to Help Coordinate Care. The Milbank Quarterly 82(3), 457-481. Conn, J. (2006). Ambulatory EHR use low: study. Modern Healthcare 38(25), 14. Dahm, M. F. & Wadensten, B. (2008, August). Nurses’ experiences of and opinions about using standardised care plans in electronic health records – a questionnaire study. Journal of Clinical Nursing 17(16), 2137-2145. Gray, S. H. (1989). Electronic Data Bases and Privacy: Policy for the 1990s.
Science, Technology, & Human Values 14(3), 242-257. Healthcare Financial Management Association. (2006, February). Overcoming Barriers to Electronic Health Record Adoption. Retrieved July 26, 2008, from http://www. hhs. gov/healthit/ahic/materials/meeting03/ehr/HFMA_OvercomingBar riers. pdf Key Capabilities of an Electronic Health Record System. (2003). Washington DC: Institute of Medicine. Williams, M. E. (1985). Electronic Databases. Science, New Series 228(4698), 445-456. Retrieved July 26, 2008, from http://www. jstor. org/stable/1694720