Abstract
This paper reviewed the pros and cons of electronic medical records to advocate for the transition towards the use of electronic medical records. The pros of EMRs discussed in the essay are: the elimination of medical errors, enhanced security and safety, and cost efficiency because of data consolidation. The cons of EMRs are possible privacy threats, lack of standardization since EMR is an emerging concept, enormous implementation costs, and loss of human oversight. A critical review of the pros and cons pointed out that even with the apparent drawbacks, the move from the paper records to electronic records are likely to increase the efficiency and safety of patient record management and enhance the quality of healthcare delivery. The identified resolutions on the issue include the participation and sufficient training of medical personnel on EMRs and reducing the cost of implementation in order to sensitize healthcare organizations to adopt EMRs.
Electronic Medical Records (EMR)
Introduction
For centuries, healthcare systems have relied on paper-based records, and the gradual transition towards computerized systems has been taking place for at least two decades in western healthcare systems. Nevertheless, the use of computerized systems in healthcare has not been widespread as the case of other sectors such as transportation, finance, retail industries and manufacturing. In addition, computerized systems implemented in healthcare systems have been used primarily for administrative functions instead of clinical practices. Deltev & Berner (2007) considers Electronic Medical Records (EMR) as a significant prerequisite for the implementation of computerized health information systems. Deltev & Berner (2007) define EMRs as a form of computerized medical record implemented to facilitate health care delivery. EMRs are a component of an independent health information system that allows medical personnel to store, retrieve, and modify health records. According to Greenhalgh et al. (2009), EMRs are central towards the effective implementation of computerized health information systems and modern technologies in healthcare such as decision support systems. Irrespective of the potential benefits of using EMRs, paper-based records are still the prevalent means of recording patient data in most healthcare institutions and practices in the United States. This paper outlines the pros and cons of EMRs and takes a personal position on the issue that EMRs are required to enhance the quality of medical care. In addition, the paper outlines a resolution to the issue and implications for master’s prepared nurses.
Pros and Cons of EMRs
With numerous healthcare and medical firms migrating towards paperless record keeping, reviewing the pros and cons of EMRs is one of the most efficient methods of evaluating the ideal solution to the issue of safe and efficient management and keeping medical records. Healthcare institutions are increasingly adopting EMRs over the traditional paper-based record keeping. Nevertheless, most healthcare institutions have adopted EMR are still using paper based records. As a result, there is the need for healthcare practices to evaluate the pros and cons of EMR to decide on whether or not to implement this form of records management system.
EMRs have numerous advantages including accessibility. Milewski & Anurag (2009) affirm that EMRs are the preferred record management system because they guarantee effective coordination of patient care by healthcare personnel. Accessibility of electronic records is relatively easier and faster than the traditional paper records. Milewski & Anurag (2009) point out that this helps in speeding up doctor collaborations, which in turn improves the quality of healthcare administered to patients. The second advantage of EMRs is that it helps in reducing human errors. A study conducted by Dwight, Nichol & Perlin (2006) reported that poor legibility associated with traditional paper-based records contributed significantly to medical errors; however, the use of electronic records facilitated legibility because of standardization of forms and data input, which in turn helped in reducing the prevalence of medical errors and improving reliability of medical records. The study reported that the adoption of electronic medical records eliminated unsecure storage and inaccurate filling, which in turn removed the numerous layers of human contact that can lead to costly mistakes. The third advantage of electronic medical records is the high degree of safety and security. Deltev & Berner (2007) argue that paper records are likely to be damaged, lost, stolen, or damaged by natural disasters; on the contrary, EMRs evade these scenarios with higher degrees of safeguards. Electronic records are safer than the traditional paper records in terms of physical security. The fourth advantage of EMRs is that they are cost efficient, which is achieved through data consolidation. A study by Dwight, Nichol & Perlin (2006) concluded that EMRs are cost-efficient because they get rid of costs associated with office supplies, paper and printing. Himmelstein, Wright & Woolhandler (2009) estimate that EMRs enhance overall efficient by approximately 6 percent annually, and that the monthly costs associated with EMRs can be compensated by the costs of a few tests and admissions. The study also reported that EMRs are cost-efficient because they create a centralized location for storing electronic medical data, which helps in reducing the duplication of documents, and increases the speed of access and information exchange. Himmelstein, Wright & Woolhandler (2009) point out that electronic health records cut labor costs and improve operational efficiency, which enhances productivity by allowing high transaction volumes.
Irrespective of the numerous advantages, EMRs have some drawbacks. The first significant drawback of EMRs is the high costs. Deltev & Berner (2007) reports that electronic record management systems are extremely costly to acquire, and is this is the significant barrier for implementing EMRs on clinical practices. The second disadvantage of electronic health records is the potential privacy threat. The high levels of accessibility and portability of EMRs also tend to increase the risk of unauthorized access or data theft. Nevertheless, the Health Information and Accessibility Act requires that healthcare institutions to adopt adequate security measures to guarantee information of security of patient data. The third disadvantage of EMRs is the potential loss of human oversight. Greenhalgh et al. (2009) believes that technology advancements, especially in automation, serve to eliminate human intervention and management among medical personnel. However, it is evident that well-trained personnel have the responsibility of overseeing and ensuring that EMRs are functioning optimally. Another drawback of EMRs is the potential lack of standardization (Deltev & Berner, 2007). This is because EMRs are still a new concept, implying that standardization in terms of efficiency, productivity and quality are not yet feasible. However, the continuous advancements in technology and service levels will eliminate the concerns associated with this issue.
Position on the Issue
Paper-based record management systems also have their advantages; however, it is anticipated that healthcare practices will continually migrate from paper-based systems towards electronic medical records. In summarizing the aforementioned pros and cons of EMRs, it is essential to take into account the following critical points. The pros of EMRs include elimination of medical errors, enhanced security and safety, and cost efficiency because of data consolidation. The cons of EMRs include potential privacy threats, lack of standardization because EMR is a new concept, enormous implementation costs, and loss of human oversight. A critical analysis of the pros and cons reveals that even with the perceived drawbacks, the migration from the paper-based records towards electronic records are likely to increase the efficiency and safety of patient record management and enhance the quality of healthcare delivery. Therefore, EMRs will guarantee both doctor productivity and patient safety. In addition, the implementation of electronic health records paves way for the adoption of other modern technologies in healthcare. Milewski & Anurag (2009) assert that medicine is a field comprising of wide knowledge base and electronic health records comes in handy as an effective method of storing and offering instant access to medical data. The use of EMR goes beyond mere storage and retrieval of clinical data to facilitate other clinical practices such as diagnosis of patients and examining the body tissues, and monitoring the patient progress and response to medication. All these point out the significance of incorporating electronic records in healthcare practices.
Resolution on the Issue
It is apparent that the transition towards the use of electronic medical records is beneficial towards the dissemination of healthcare services. Therefore, there is the need to deploy appropriate strategies to address barriers of effective implementation of EMR. Effective and systematic transition towards electronic records require the involvement and adequate training of healthcare personnel when implementing EMRs in order to eliminate the disappointments and difficulties of using EMRs among medical personnel (Deltev & Berner, 2007). The second resolution is to guarantee effective implementation of EMRs is to reduce the cost of implementing EMRs and sensitize healthcare institutions on the importance of electronic medical records in ensuring quality healthcare delivery (Dwight, Nichol & Perlin, 2006).
Implications for Master’s Prepared Nurses
It is evident that one’s position on the issue has profound effects on the roles of advanced nursing practice. First, advocating EMRs has a significant effect on the advanced nursing practice as a teacher. In this capacity, the nurse teacher adopts an informative stand to educate on the benefits of EMRs and administer effective training towards the usage of the same. Second, in the capacity of a researcher, the aforementioned position of advocating for EMRs will have an effect on the nursing roles because data obtained from such systems can be helpful in undertaking studies to devise methods of improving healthcare quality and efficiency.
Conclusion
The paper has identified and discussed the pros and cons of electronic medical records. The pros of EMRs include elimination of medical errors, enhanced security and safety, and cost efficiency because of data consolidation. The cons of EMR include potential privacy threats, lack of standardization because EMR is a new concept, enormous implementation costs, and loss of human oversight. The manuscript makes a case for the utilization of EMRs to guarantee patient safety and productivity of medical personnel, which in turn translates to high quality healthcare delivery. The resolutions on the issue include the involvement and adequate training of medical personnel about EMRs and reducing the cost of implementation in order to sensitize healthcare organizations to adopt EMRs.
References
Deltev, S. B. (2007). The executive’s guide to electronic health records. New York: Health Administration Press.
Dwight, E., Nichol, P., & Perlin, J. (2006). Effect of the implementation of an enterprise-wide electronic health record on productivity in the veterans health administration. Health Econ Policy and Law , 1 (2), 163-169.
Greenhalgh, T., Wongs, G., Potts, H., Bark, P., & Swinglehurst, D. (2009). Tensions and paradoxes in electronic patient record research: A systematic literature review using the meta-narrative method. Milbank Quarterly , 87 (4), 729-788.
Himmelstein, D., Wright, A., & Woolhandler, S. (2009). Hospital computing and the costs and quality of care: A National study. The American Journal of Medcine , 1-7.
Milewski, R. J., & Anurag, G. (2009). Automatic recognition of handwritten medical forms for search engines. International Journal of Document Analysis and Recognition (IJDAR) , 11 (4), 203–218.
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