hci

Introduction

Health care information need to be collected correctly, and stored in a manner which abides by the principled of confidentiality, integrity and accessibility (Kaushal et al., 2009).

A good health information management system should also ensure ease retrieval of data wherever needed. A doctor or medical practitioner shouldn’t find it hard to get data on a patient when in the process of treatment.

Medical records refers to the documentation of a patient’s medical/health history and care over a period of time within a particular health care provider’s geographical coverage (Jha (a) et al., 2009).

Telehealth is defined as exchanging medical information electronically

from one site to another with the purpose of improving patients’ health

Telehealth is used between clinician to clinician, clinician to patients as well as

patient to mobile health technology.

The increasing global health spending has enabled healthcare organizations to adopt emerging health technology for chronic disease management and cost-effectively provide customized and preventive treatment.

Introduction

Electronic Medical Records (EMR) also referred to as electronic health records (EHR) or simply health charts ensures digital collection, storage and retrieval of patients medical records.

The EMR gives a real-time information concerning a patient’s interaction with a specific health care provider. With the holistic approach offered by EMR, practitioners can prescribe the best medical attention to a patient as per the data at their disposal.

Patient data is medical information held about an individual patient. Access to a particular patient’s health history greatly determines the type of medical attention such a patient gets.

Although global health expenditures are expected to grow to $18.28 trillion by 2040, the future of Healthcare organizations' is poised to utilize developments in Telehealth technology and big data analytics to provide preventive medicine and customized healthcare through value-based treatment models.

Although Telehealth and technology aspects have existed for decades, the Covid-19 pandemic has taken Telehealth to the mainstream in the face of a worldwide crisis that is demolishing health facilities.

Telehealth enables patients to be tracked remotely and their condition development controlled through constant evaluation; whereas Big Data Analytics integrates data obtained from Telehealth modality covering both objective data (e.g. vital signs, ambient environment) and subjective detail (e.g. symptoms and patient behavior).

Related Work

While Cedars-Sinai has a good reputation in medical innovation, their EMR implementation was a failure which is often used as Cautionary to anyone intending to acquire an EMR platform.

Much of the failure was associated with the introduction of many decisions support mechanisms way after the actual deployment. Pre implementation planning was poorly done thus such important support functionalities had been left out. Much of the drugs and prescription module had been left out. Insufficient training and lack of system testing also attributed to the failed implementation at Cedars-Sinai facility. More critically, a phased approach wasn’t used as always recommended for such systems which hugely turned out to be a costly mistake.

Related Work

Veterans Administration (VA) implemented a national EMR system called VistA in 1999 which was a success. The success was majorly attributed to its comprehensive roll out plan for the system. Careful planning and collaboration with IT personnel, subject matter experts and end users was critical to the success as it led to creation of a workable system. The system’s 24/7 technical support and timely feedback sessions were highlights of the success story. Buy-in was achieved at all levels throughout the organization prior to implementation (Sameer & Krista, 2010).

Features of an Effective epic EMR System?

Patient portal. This forms the initial point of contact between service provider and the patients. It give the doctor a 360-degree view about the patient thus allowing for conscious decision making in addition to greatly saving time (Mostashari et al., 2009).

Patient history recordings. The stored information should be synchronous in that one can have a view of the patient in terms of allergies, previous procedures, treated ailments, any lab tests and even payment information

E-Prescribing. This feature gives automatic and instant notifications on drugs and any allergies as stored in the system database regarding the specific patient (Barbara & Ken, 2010).

Medical Billing Dashboards. Billing forms part of medical care process. A system which will be able to correctly and accurately accumulate and project all charges across the various treatment processes such as consultancy fee, lab fees and pharmacy fees is effective.

Telehealth has great potential to expand the capacity of healthcare to reduce risks, improve physicians-patients and patients-patients communication, and reveal unseen patterns or sensory features in a ubiquitous, personalized and continuous manner.

Continuation

Order Entry. This allows medical practitioner to enter, save and transmit a patient’s order compromising of prescription, medical tests and any other service offered.

Lab integration. Lab tests forms part of medical attention. Doctors will need to have access to lab tests results to give the right prescription. An EMR should therefore have a directly link to the laboratory where as results are updated, the doctor can view them without having to go through paper work filled by laboratory team.

Documents management. Documents should be easily managed and shared through the EMR without having to physically move the documents from on place to another.

Centralized Communication. Customer experience in key in care delivery. A good EMR should have an easy patient-doctor interaction. This should be management at a central point to ensure no unattended queries and also to enhance accountability.

The factors such as Patient-centered barriers, including inadequate mobility and regional distance, operating hours and missing appointments, can lead to appointment nonattendance followed by increased rate of deaths around the world. Additional obstacles to healthcare that can obstruct access to standard FTF services including administrative negligence, inadequate access to clinic facilities, restricted parking and undesirable clinic operating hours.

Through telehealth services one could facilitate and sustain lifestyle changes by managing shift in eating habits and are adjustable in time and location, with the ability to deliver comprehensive treatments that may not be possible for conventional treatment models.

Barriers to epic EMR Adoption

High capital costs and insufficient returns on investment. Good Electronic Medical Records systems are not cheap to acquire. Other overhead costs such as training, support costs and integration technicalities drives the cost even higher.

Underestimation of the change management required. More than often organizations fail to plan enough for deployment of an EMR platform as a result of overlooking the change management required.

Lack of alignment between clinical process and workflow to the EMR system. When effectively implement, an electronic Medical Records system should take over all processes in a facility dictating the work flow.

Continuation...

Concern that systems will become obsolete. EMR costs are high thus a fear in investing. With technology changing very fast, some facilities might feel in no time the technology will be irrelevant thus loosing the system as a whole.

Lack of skilled resources for implementation and support. EMR will need trained staff from deployment to its support. Many facilities lack enough staff with technical knowledge on supporting systems thus fail to adopt.

Concern regarding negative unintended consequences of technology. Organizations are always in fear of negative consequences brought about by new technology and systems.

Epic Implementation Plan

Establishment of project team - this will comprise of project manager (to lead team and own the project), the project sponsor, two (2) representatives from each unit; lab, pharmacy, accounts, 2 nurses, 2 physicians/doctors, 2 IT support staff, application developers and early adopters (test patients).

Formulate implementation Roadmap – this will be a blueprint plan on various steps in the epic EMR implementation.

Determine goals and timelines - the project team to come up with the overall success strategy and timelines for key milestones.

Post implementation support - IT team to offer support to users and ensure epic uptime.

Epic Implementation Roadmap