Title: The Evolution and Dynamics of Electronic Health Record Systems (EHRSs)

 

Abstract

Objectives

The aim of this study is to review the transformation process involved in converting the current manual medical records (MMR) into electronic health record systems (EHRSs). The study also illustrates a life case study conducted by the author as stage one of implementation of the center for Medicare and Medicaid services (CMMS) electronic health record (EHR) incentive program (Cohen et al., 2015). The third objective is to thematically highlight the prevalence, achievements, challenges and prognosis of implementing EHRSs.

Setting

The study is focused on global, regional and national geopolitical systems. A group of select industrial countries in North America, Oceanic, East Asia, and Scandinavia is used to illustrate the dynamics and transformation system of medical records from manual to electronic. India is also included.

Methodology

The methodology that is used analyzes the global, regional and the national implementation rates of the electronic health records systems. The review is made based on the different governments’ role in making sure that the system is a success without compromising the quality of service. Also physicians’ attitudes towards the system were used as part of the review process. A comprehensive analysis of the whole EHRSs ecosystems is performed.

Findings

The findings in the study were that the implemented EHRSs are faced with a lot of challenges even if there are some subsequent benefits (Delbanco, 2008; Phillips et al., 2009). The systems are prone to transcribing errors that the user may not understand and address (Phillips et al., 2009). The errors maybe transferred to the patient’s medical results: a process that is likely to compromises the patient’s safety and quality of service. There is also the likelihood that people using the system may not fully embrace it (Davis & Stoots, 2013). According to study findings, while significant efforts have been made by various governments to encourage EHRSs, enormous challenges (standardization, programming glitches, system failures, vulnerability of patient records, confidentiality, other internal and external factors) continue to slow down the process. There is a global absence of instituting an effective and inclusive team to contribute in the design and development of EHRSs. Inadequate oversight has also impacted implementation processes. Denmark remains a trailblazer in efforts to computerize manual medical records.

Discussion

Innovations come with relative risks. The MMRs are no exception and in this case, the challenges are even more exacerbated by the involvement of different players at the various stages of the transformation process. Potential setbacks range from human errors, to computer system breakdown to uncontrolled external factors and sometimes, internal factors. While caution remains a key mantra, stakeholders (government, doctors, patients, service provider etc.) need to balance the benefits of implementation against risks of failure and the degree of vulnerability. And in general, when such initiatives succeed the rest is history.

According to the research findings, various countries have implementation rates based on the degree of government support and involvement (Davis & Stoots, 2013). For example, in the year two thousand and nine, the U.S had the lowest conversion rates as compared to other industrialized countries. This was due to the lack of government participation including incentives encouraging institutions to participate in converting their respective manual systems into electronic ones. This outlook changed in 2012 when the U.S government became more actively involved: an initiative that has seen an improvement in the conversion rate (Balgorsky, 2014).

Conclusion

In general and as expected, the implementation of an EHRS has made various achievements such as reducing the bulkiness that comes with paper work, the patient’s records cannot be easily misplaced and patient record access has improved significantly. The preceding remarks notwithstanding the likelihood of compromising patient records, though lower remains a major concern (Phillips et al., 2009). A compelling complementary and invaluable safeguard is the introduction of strict quality control guidelines. For example, cases where wrong medications are issued to patients and that have fatal effects. An effective and continuously monitoring framework will go a long way in mitigating patient vulnerability. And in general, given the current evolving dynamics, the benefits significantly outweigh the risks especially in circumstances where all the bugs in the systems have been corrected. While a successful implementation is plausible, stakeholders need to be reminded that provision for operating parallel system (manual and electronic simultaneous) for substantial amount of time remains unavoidable. Adapting such a process will guarantee continuity and sustainability.

 

(Key Words: EHRSs, Prevalence, Achievements, Prognosis, Challenges, Dynamics, CMMS, Global, Regional, National, and Quality of Service)