Thesis on "Erm There Have Been a Great"

Thesis 12 pages (3911 words) Sources: 1+ Style: APA

[EXCERPT] . . . .

ERM

There have been a great many changes in the healthcare industry in the past two decades, largely due to the globalization of the workforce and changing demographic patterns, and technological advances. It was interesting to think about the vast changes occuring in and to look at the ways in which technology, privacy laws, and stakeholder expectations have changed. The industry changed in terms of a reliance on hospital-based care to more emergency clinics, outpatient and nursing home services, and managed care. More hosptitals merged, and many doctor's have banded together to form larger, more cost-effective, speciality groups. One of the largest and most obvious changes has been in cost of healthcare. In 1990 the avereage cost of care per person was $2,800, rising in 2000 to $4,700, and then in 2010 exceeding $7,500. In 1990, 14.1% of Americans had no insurance and in 2010, and additional 50 million people, or 16.3%. Certainly these issues are concerns, but there have been incredible innovations that have changed the lives of all those involved in the healthcare industry. For example, doctors can turn their I-phones into an EKG monitor and transmit data in real time to a cardiologist, will cost less than $100, and will change the way patients interact with their physicins (Chideya, 2012).

We must also realize that the healthcare system is its own ecosystem, and as such, has different levels of dependence from a number of different departments and stakeholders. When implementing a system of medical records that is so vastly different than the norm, every single aspect of the healthcare ecosystem is involved. Many in the industry heartely support the idea of ERM systems, but are also concerned about change, the workload, accuracy, privacy, and a host of other issues that are changed when a new system is introduced. For an ERM system to be viable, it must be able to travel with the patient every step of the way in their healthcare -- from regular checkups, to eye-exams, dental-exams, tests, insurance, pscyhology, and more. It must be holistic to be valuable, for looking at only a piece of the patient's life or medical history brings us back to the previous paradigm and manner of doing things in an outmoded and rather inefficient manner. Note on Figure Y that there is a circular pattern between the patient, the provider, the community, and any other aspect of their lifestyle. Technology is a tool, and as a tool it has the potential for great good, or great error. As technology evolves, though, so do the aspects of functionality it may provide. In the holistic healthcare ecosystem, EMR should, in theory, be accessible anywhere at anytime to any patient, medical professional, or professional that has an interest in the patient and consent from the patient to view records; or, in the case of an emergency procedure, to save a life. Thus, EMR planning and implementation must be done based on strategic healthcare initiatives, not technological tactics (Knickrehm and Ficery, 2011).

Any implementation of an ideal Electronic Medical Record system would require not just a technology side within the clinic or office, but an important exteral reach to the outside providers, services and other interested parties in terms of Internet and telecommunications components. An example of this would be Tele-health, which esssentially focuses on the manner in which medical information is shared (exchanged) using electronic communication between interested parties and patients, with the overall goal of providing better, more up-to-date, medical care (Wasson, 2012; Telehealth, 2012). The clinical side of Tele-health is called telemedicine, defined by the American Telemedicine Organization as "the use of medical information exchanged from one site to another via electronic communications to improve patients' health status." Specific examples of telemedicine include video consultations, remote patient data monitoring, nursing call centers and searching for or saving personal health information online (Gray, 2011).

Tele-medicine is a global phenomenon that has benefits for individuals in all walks of life. It helps expand access to care, education, new research and technology, in particular in populations that tend to be more isolated or communities (or regions) that cannot afford to support full time clinics and have had to rely on travelling medical care. This also applies to homebound patients or patients who are chronic and can more easily (and less expensively) use email or video conferencing with specialists in any location worldwide -- benefits that would not normally be available to most populations. In addition, test results, lab studies, etc. can be available quicker, and can more easily be discussed with the patient on a more interactive basis. For the individual, so much information is now available that is vastly superior than anything they could access even a decade ago (Web.md, the Mayo Clinic, scholarly articles, support groups, etc.). An informed patient can then be more of a participant in their own health care paradigm, ask more pertinent questions, and above all, provide more details to their healthcare provider while taking more responsibility for their own participation in their personal situation (Gray).

A Robust Configuration Management Database is very much needed for this any adequate ERM implementation. The various issues inside the center can be noted by this system and suitable solutions can be formulated. It is necessary to feed all the information about the IM/it department of the center into this system and so it can work efficiently. For example, this system is used to provide complete accurate information about the people, processes and technologies that compromise the it environment. It also helps to map the performance of all the systems in this center. If there is an infrastructure problem in the center, then the center can easily find out the affected databases, servers and users. It is also very useful in implementing certain changes in the center. The use and accuracy of any EMR program may be enhanced in terms of robustness and reliability with a CMBD (Catalog and Confirmation Management) process. This technique controls hardware and software assets far better, helps diagnose issues, improves the efficiency of such issues as network management, sharing of disparate information from alternative sources, most especially in the legal and regulatory sectors. It is especially effective in helping to reduce redundancy and duplication of effort (Aeritae, 2010; Messineo, 2009).

Immediate Access to Patient Information

A clear benefit to EMR systems is their portability: healthcare personnel can easily carry a laptop or tablet to the examination room, pull up details of tests, vital signs, drugs, histories, x-rays, and more. Special software can provide potential interactions, as well as a more thorough history of what was prescribed when, and at what dose, something not all patients remember clearly. This system also alerts the physicians and the nurses if there is a difference in the details, or if healthcare has been given in different locations. . This technology helps the nurses to detect the faults made by the doctor in the treatment of the patient (Tutela, 2009).

Electronic medical records allow for easier retrieval of patient information and are typically integrated into billing systems and scheduling, thus providing clients an incentive for coming back to the particular office or clinic. A health care professional within the hospital can also access continuing education and attend seminars online, and contact specialists for disease information outside his area of expertise. They also have more control over the continued management of health intervention and knowledge of patient progress. In an interview with educators who served as telemedicine case managers for adults with diabetes, "the nurses and dietitians calling these patients reported satisfaction with both the feasibility and effectiveness of telemedicine" (Gray; Gomez, et.al., 1996). Advantages specifically named were "more frequent contact with patients, greater relaxation and information due to the ability to interact with the patients in their own homes, increased ability to reach the underserved, more timely and accurate medical monitoring, and improved management of data"(Sandberg, et.al. 2009).

More and more, increased access to information and the ease of using technology has increased collaboration between doctor and patient. This has, however, encouraged a more patient-driven medical system. Patients are less content to let the doctor prescribe or order tests without knowing more about their own condition, the medications they must take, and even costs of procedures. Nursing theory is also pushing that the patient take more responsibility for their health and healthcare, rather than being passive participants and allowing others to make decisions that will impact their lives. This change has given rise to the term "e-patient," describing someone who actively seeks out health information and communication online. Advantages include emotional support and information sharing, access to physician question and answer forums, online records to capture progress and goals and access to clinical trial databases. A sense of empowerment is the common thread running through these patient portals that connect patients to providers and to each other (Gray).

Of course, immediate and robust access to patient information brings up issues of privacy and confidentiality as well. HIPAA, or the… READ MORE

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