Essay on "Health Care Situation: Medical Error"

Essay 6 pages (2468 words) Sources: 4

[EXCERPT] . . . .

Autonomous patients will argue that they the rightful owners of the intimate information contained in the EHRs. Conversely, individual health care providers and hospitals might argue for ownership of this information. hese obvious conflicts between economic and personal value, professional and patient autonomy, and business interest must be rectified before introducing EHRs (Mercuri, John J. (15 January 2010), p. 1. The integrated data storage of an HER system also creates several potential harms as described by Mandl, Szolovits, and Kohane (3 February 2001, p. 1): Potential risks for confidentiality and privacy of patient data. Such concerns seem justified when one considers that, under current laws and practices, identifiable medical data are routinely shared with insurance companies, government, researchers, employers, state bureaus of vital statistics, pharmacy benefit managers (companies that track doctors' drug prescriptions), local retail pharmacies, and others. Medical records contain some of the most sensitive information about an individual. The confidentiality of a patient's medical information is sacred in the healthcare profession. Unauthorized disclosure of such information result in anything from minor embarrassment to the loss of insurance or employment (Mercuri (15 January 2010). Patients therefore should have a right to decide who can examine and alter what part of their electronic medical records (Mandl, D.K. & Szolovits, P. & Kohane, I.S. (3 February 2001, p. 3).

No matter how sophisticated security systems become, people will always manage to defeat them (Mandl & Szolovits & Kohane ibid). One of the most difficult issues for a computerized medical records system's officer is to make sure that secure authentication tools, such as voice identification and/or so called "strong identification" tools are part of the system. Unlike most industries where a single login gets you complete access to applications and databases, health care systems require levels of authentication. For example, not everyone within a clinical institution has the authority or privilege to write a prescription. A good electronic health record (EHR) implementation will have authentication levels based on roles so only an authorized physician can write a prescription. This means that when physicians log into an EMR their authentication provides them access to a restricted area of code that allows the processing of a prescription. That is what is sometimes referred to as "role-based authentication."

Recommend how you would change the structure, governance, culture or focus on social responsibility to prevent this situation in the future.

I would recommend the following measures to create changes in the structure, governance and medical/hospital culture to ease the implementation of an electronic health recording system: The HER system must be fast, intuitive and easy to use for the physician. They should be built with well-designed hardware and software (Mercuri ibid, p. 1). If training is required it should be as minimal as possible in order to prevent (additional) time loss for the doctor. The implementation, as in most successful IT market launches, should have the support of a hospital's top management and the buy-in of the physicians and staff who will be using it. The personnel should be informed about the manifold medical impacts that a physician's bad handwriting may have on the patient's well-being. There should also be constant awareness training on the legal implications of illegible medical records: Medical malpractice suits of patients and relatives against the treating doctor and the employer hospital based on a theory of negligence; rising medical malpractice insurance rates for doctors and hospitals. As with many issues involving behavior, change comes slowly. A rapid, forced implementation should be avoided at any cost. A "big bang" approach is very likely to cause frustration, anger and resistance (see Gibson, Stan. (10 February 2010), p. 2). The implementation of EMR in a hospital should be gradual and persistent. As expressed by many non-medical and medical experts in the EMR field, the key to a successful implementation is "to keep at it. The longer the EMR is in, and the more data builds up, is when the physicians realize they can't live without it" (see citation by Gibson ibid).

I would imagine that the installation of an EMR system will initially lead to a decrease of doctor productivity at first. Nevertheless, the overall benefits will pay back the time and technology investment many times. Even if the individual doctor in a hospital will not be as efficient as hoped for when the implementation process was initiated, there certainly will be increased efficiency in the way different departments of a hospital are interconnected with each other. his will lead eventually lead to better patient treatment and a better, e.g. more economic utilization of the personnel and technical capacities of hospitals.

List of References

Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.

Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.

1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.

Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.

Gibson, Stan (10 February 2010). Implementing HER technology is easy: physician buy-in can be hard.1-4. searchhealthit.techtarget.com/.../Implementing-EHR-technology-is-e..., accessed 24 August 2011.

Glondys, Barbara. (2003). "Ensuring Legibility of Patient Records (AHIMA Practice Brief)." Journal of AHIMA 74, No. 5 (May 2003). 1-7.

library.ahima.org/.../idcplg?, accessed 22 August 2011.

Johnson, Lee J. (21 May 2005). Legibility, accuracy, specifity vital in records. 1-3.

www.modernmedicine.com/.../Legibility...vital...records/.../675856, accessed 21 August 2011.

Leingang, Matt. (14 May 2003). "Seminar Will Coach Medical Pros on Penmanship."

health.groups.yahoo.com/group/iatrogenic/message/954.

Mandl, Kenneth D. & Szolovits, Peter & Kohane, Isaac S. (3 February 2001). Public standards and patients' control: how to keep electronic medical records accessible but private. 1-8.

www.bmj.com/content/322/7281/283.fullSimilar-

BMJ 322: 283 doi: 10.1136/bmj.322.7281.283,

accessed 24 August 2011.

Mercury, John J. (15 January… READ MORE

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