Answer

Adopting a new EHR System

Issues in the 4 Interviews

The four interviews highlighted a number of issues with the current health record systems and that would possibly be resolved through the adoption of a new electronic health record (EHR) system. The interview with the CIO identified accessibility as one of the problems with the current records systems. The health records are only mostly accessible from terminals that are centralized all across the Hospital for instance in the nurse’s stations but not from other facilities within which critical care is still just as necessary like the ambulatory services or even within Urgent Care. This creates the problem of inconsistent records from one facility to the other. The CNO on the other hand noted a problem with communication and documentation. In the process of transcribing information from the paper formats and charts to the electronic ones, the patient may fail to communicate well, or the nurse may not hear the information correctly. When there is no double-checking, even typographical errors can prove costly.

 The Chief Administrator, hesitant about adopting an entirely new system, cited insecurity and privacy of information as his chief concerns. The new system would be susceptible to hacks and thus jeopardising the security of patients that ought to be the primary concern. The CFO noted in the interview that there are long-term financial implication of the current system in terms of maintenance costs, operation and marginal costs. Because the new system would be maintained by a separate entity, this would help save costs.

Comparison

In terms of costs, the current system has high set-up costs, and even though it did not have to incur the costs of having a terminal in every patient room, it still needed an expensive new server. The new system would not need set-up costs, but the staff training costs would almost be equal to the ones used with the current system. Accessibility in the current system is much more centralized, where information can only be accessed at designated positions like the nurse stations. The proposed system would have a wider accessibility, covering up to the ambulatory and urgent care services by establishing terminals in all patient rooms.

In terms of the administrative functions, the old system provided a way of tracing and identifying those responsible for clinical errors, coupled with controlled access. The proposed system would also have such functions, but the cloud storage and internet use would make patient privacy a matter of concern. When it comes to the ease of use, the old system was complemented by paper trails, and even if these are vital for retrieving lost information, transferring the data to the electronic sources is often tedious and it can lead to typographical mistakes or those that set in as a result of fatigue.

Recommendation

A new system ought to be adopted. The first justification for this is in line with the accessibility of information. In many instances, patient safety has been compromised because the patient information could not be accessed following the remoteness of locations or the sheer capability of the current system. Centralising the information within the healthcare facility limits the provision of health services and leaves no room for the success of innovations such as telehealth (Kruse et al. 2017). Ambulatory services and those in need of urgent care need their information accessed. This calls for the adoption of a new system.

Secondly, the patient privacy and retrieval of information would be more streamlined with a new system (Kruse et al. 2017). The new system brings on board a number of privacy features whereby the storage of information is a vital factor of consideration and only controlled access leads to the reaching of private patient data. In addition, this information, stored and backed up right, would easily be retrieved when needed.

The final factor concerns the safety of the patient whose information is stored. Within the current system, the paper data is to be transferred to the digital format. The transfer of this data is compounded by a number of challenges. The nurse may fail to correctly hear what the patient says, leading to entry of wrong information, or the mistake may result from the fatigue and subsequent inability to read charts right and make sense of this data (Xiao et al. 2018). Adoption of a new electronic system would limit the number of medical errors that result from such situations thus promoting the safety of the patients.

References

Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for the electronic health records. Journal of medical systems, 41(8), 1-9.

Xiao, C., Choi, E., & Sun, J. (2018). Opportunities and challenges in developing deep learning models using electronic health records data: a systematic review. Journal of the American Medical Informatics Association, 25(10), 1419-1428.