One doesn’t need a crystal ball to determine the direction that EHRs will take over the next several years. As providers move quickly to embrace EHRs, which are designed to store and share information from all providers involved in a patient’s care, health informatics specialists will continue to be in high demand as healthcare facilities implement new systems, upgrade existing databases and work toward achieving the three stages of “meaningful use.” The potent force shaping that direction will be the Meaningful Use criteria of the EHR Incentive Programs. So far the agencies have closely followed Health Information Technology Policy Committee’s recommendations, and it is likely that they will continue to do so in the future. Office of the National Coordinator, in turn, is accountable for forming the EHR certification criteria which safeguards that EHRs can perform to specifications that allow for Meaningful Use.
Electronic Health Record Systems have the potential to transform the healthcare system from a mostly paper-based industry to one that utilizes clinical and other pieces of information to assist providers in delivering a higher quality of care to their patients. The Health Information Technology for Economic and Clinical Health Act of 2009, which is part of the American Recovery and Reinvestment Act , was signed into law with an explicit purpose of incentivizing providers (e.g. hospitals and physicians) to adopt EHR systems. Healthcare Information and Communication Technology in the health sector can improve the quality of care, managerial efficiency, and cost savings. Many countries, including members of the Organization for Economic Development and Cooperation have been interested in ICT in the health sector and the dispersion of ICT into the healthcare industry. The HITECH Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative that is designed to encourage the use of electronic health records.
US healthcare spending far exceeds than that of other countries, yet the healthcare system fails to deliver high-quality healthcare regularly. The quality of healthcare across the continuum depends on the integrity, reliability, and accuracy of health information. Adoption of the Health Information Technology, including Electronic Health Records, is essential for the transformation of the current healthcare system into one which is more efficient, consistently delivers high-quality care, and is safer.
Ethical Concerns in the Use of Electronic Medical Records
A medical record in the past was information documented on paper for research, clinical, administrative and financial purposes. Its major drawback was regarding accessibility, and it was available to one user at a time. The use of electronic medical record systems raises important ethical concerns about patient privacy and confidentiality, medical errors, expectations of structured data entry by clinicians, documentation integrity, and provider-patient interaction. Clinicians and health care organizations need to define best practices and policies in the use of EMR systems to improve quality and maintain clinician efficiency without compromising patient welfare and safety.
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In spite of the initial slow acceptance of EHRs by healthcare organizations and clinicians, they continue to flourish and advance over time. Electronic health records have been transformational for large organizations, but the genuineness is that medicine in countries is mostly practiced by small medical groups, with limited finances and IT support. As a new trend, some outpatient clinicians opt to re-engineer their business model based on an EHR. Their goal is to reduce overhead by having fewer support staff and to focus on seeing fewer patients per day but with more time consumed per patient. When this is combined with secure messaging, e-visits and e-prescribing, the goal of the e-office is attainable. Buyers have a wide choice of features and cost to choose from. At this time cost is a major obstacle as well as the lack of high-quality economic studies demonstrating reasonable return on investment.
