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Permalink Reply by Chris Paton on February 4, 2012 at 9:30pm

Hi Mike,

Welcome to the forum. I think this is a great question. Large EHR systems have malfunctioned in the past and backup systems and paper replacements have had to be implemented. So the question really is: with todays technology and despite the risk of system outages, are patients served better by investing in EHR technology (rather than investing in something else, say, more nurses)?

The answer to this question is probably different for different healthcare systems and different individual hospitals and clinics. Changing over to electronic records probably makes sense for a hospital that has already organised its clinical workflow, that has a high level of buy in from the clinical and administrative staff, and has sufficient funds to implement the systems properly. For another hospital, they might be struggling with a reluctant workforce, or have other, more urgent, priorities for the money.

If you look to the academic literature for the answer to this question, you'll find a mixed bag of results which probably reflects the fact that EHRs have been introduced into some systems that are ready and some that are not. The fact that we are having some success does indicate that, in the right circumstances, EHRs can be a tool to cost-effectively improve patient care.

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Permalink Reply by Cindy Jimenez on February 16, 2012 at 5:37pm

http://www.youtube.com/watch?v=OmX-N4_Ks2U&feature=player_embedded

Here is a video of the goal of EHRs from 2009.

Hi Chris, I do think that patients are served better by the investment in EHR. The reason for this is that it makes data more accessible. When a nurse or doctor have a complete medical record of the patient they can give appropriate care. This also protects the patient and decreases medical errors due to drug interactions. A patient who is capable of having a complete medical record can receive faster appropriate care. It decreases the guess to what medications the patient is currently taking, who is the primary phycian and health history.

Hi Mike, I had similar questions in my  forum regarding backup of files.

One thing that I know is that hospital have generators. After an electrical outage the generator kicks in automaticaly. This will give time for the staff to print the necessary information of their patient.

I have notice with electronic script that before you open the message that it has a warning message. The fax does too. This what I found on google.

"What precautions should be taken when faxing patient information? It is recommended that you avoid routinely faxing patient information to attorneys, insurance companies, or other non-healthcare entities if it can be sent by mail.  The best practice is to only fax information if it is needed for an immediate patient encounter.  Information regarding mental health, HIV/AIDS, substance abuse, and sexually transmitted diseases should never be faxed.  Faxed information should include a cover sheet with the name of the intended recipient and a disclaimer advising anyone who receives the fax in error to destroy the documents.  If the documents are particularly sensitive and must be faxed, you may want to call the recipient to advise the fax is on the way so they can be standing by the fax machine."

 

 

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Permalink Reply by Emily Hoehn on February 10, 2012 at 7:06am

I agree that computers provide a lot of benefits when it comes to health care. They speed things up and allow all the records to be stored in one place making it easy to access and find what you're looking for. It also allows for easy transmission to other areas or different offices if needed in a timely and organized fashion. Instead of having to try to decipher the  Doctor's handwriting, most times now you can look up what they wrote in the computer in a neatly typed font. It seems that the advantages far outweigh the disadvantages thus far. 

However, as you said, we rely greatly on computers and we would come across major issues if the computer system malfunctioned or something went wrong with the electricity or anything like that. Files could be unprotected on the internet or left open on the computer for people to see 

I think that computerized medical record keeping is a good idea if the right precautions are met. There needs to be security and passwords used to be able to log onto the computer as well as a back up plan. A lot of companies moving towards paperless charting make sure that their system is backed up incase anything happens or it crashes. This is probably not fool proof and challenges could still occur but it's a start. Companies need to take all the precautions they can to make sure that their records are secure and safe. It would be a huge mess if all of sudden they lost them all. 

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Permalink Reply by Dana Lykins on February 10, 2012 at 8:39am

I think one of the big things is to make sure all your nurses know how to chart and document by paper in case your computers did crash. Im currently a BSN student and one of our professors was telling us how the newer nurses in the hospital only know how to chart by computer and when they have crashes or computer problems, none of them know what to do. I think its really important to educate everyone on what to do and how to make things work incase your computers do crash. Emily Hoehn had a good point, you do need to make sure precautions are met and passwords are used and kept to yourself for privacy issues.

 I do think the benefits outweigh the negatives and it could really help with care, and it could also be benefitial to the hospital because if they could more easily document every care provided, they could be better reimbursed for the care they provided. It is quicker and more efficient to document by computers but I do think it takes away having prescence with them. As long as you make sure when your done with the computer, setting asside and really tuning into the patient, I think it is benefitial. Computers do malfunction which is why I think there should be some type of back up system or plan in place in case that were to happen.

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Permalink Reply by Morgan on February 13, 2012 at 3:46pm

I believe that at this time, computerized medical record keeping a good idea.  Paperless documentation makes everything go a lot more smoothly.  With less, there is prevention of losing or misplacing papers.  Computerized medical records are very accessible and it is pretty easy to find the information you are looking for.  Everything is also very organized, which makes finding specific information fairly easy.

You do bring up a good point about all the problems that can occur with using computerized medical records.  I'm assuming there's probably some kind of back up for when problems like the power going out occurs or if the computers malfunction because I'm sure that it has probably happened to them before and they need to prepare for the worst.

I would have to say that I am a firm believer the benefits of computerized medical record keeping definitely outweigh the negatives that could occur. 

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Permalink Reply by Muhammod-Rabiu SALIHU on February 20, 2012 at 11:04pm

What you have rightly observed are some of issues being addressed in adoption of EMR/EHR, various data security measures are being developed and put in place to ensure data integrity, safety, confidentiality and security. We have to continue to embrace electronic health records (EHR) inorder to meet up with emerging trends in eHealth and also be able to determine the suitability of various data security measures being developed in IT world. Backup is an essential part of adoption of EHR which is separately kept from the main system, in case the system brakes down or malfunction the backup will be there to keep the activities going. Electronic Medical Recors is a challenge of our time and all hands must be on desks to make it succeed for the benefits of both healthcare seekers and providers. 

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Permalink Reply by Riley Oneal on March 29, 2012 at 12:22pm

I think that you can go around and around with this discussion however in modern healthcare we are going to see computers more and more. There are so many possibilities when healthcare & IT come together. There really shouldn't be concern over what may happen is a computer malfunctions or power failures as IT is so much more advanced then that. Any modern Healthcare IT person would have an IT system in place that should alleviate any of these issues. I completely understand the thought process behind your concern but not to worry the IT world will keep all these "what ifs" from happening, they are an understanding group of tech savvy people that will undoubtably understand the confidential &  critical information that they have in their hands. Hope this helps! 

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