Electronic Medical Record

Q. IDENTIFY AND DESCRIBE THE PROBLEM IN THIS CASE.

Management of the medical records is a major issue in the United States. Most of the records available are paper based making it difficult to access & share. This may lead to medical errors, increase complications and delay in service. The health care costs in the United States reached 2.8 trillion dollars in 2012 which is 18% of the nation’s GDP. Administrative and record keeping cost account for 13% of the health care spending. Improving medical record keeping system will not only reduce the cost but also improve efficiency and the quality of the health care.

Q. WHAT MANAGEMENT, ORGANIZATION AND TECHNOLOGY FACTORS ARE RESPONSIBLE FOR THE DIFFICULTIES IN BUILDING ELECTRONIC MEDICAL RECORD SYSTEM? EXPLAIN YOUR ANSWER.

Many health care providers are unable to afford high capital cost of electronic medical record system. Insufficient returns for smaller practices are also a cause of concern and the maintenance cost of such system is high. Government did take initiatives to promote the adoption of EMR systems in the form of economic stimulus money. However, only small amount is available upfront. The available funds may not be enough for smaller medical facilities to implement such an expensive system.

Many organizational changes have to be carried out in order to computerize medical records. Doctors and nurses have to change their way of working. New Codes and procedures have to be devised or the existing ones have to be redesigned incorporating this system. A lot of time has to be invested in upgrading the system. Necessary trainings will have to be imparted. Doctors may not have sufficient time to understand this system entirely. In some cases they may be required to enter data themselves, diverting their attention from patients. Technical support staff has to be recruited to manage these systems which a lot of hospitals cannot afford.

Many EMR systems are in place. Integrating all these systems is difficult especially when there are no regulations for sharing such information. The EMR systems are poorly designed and are not user friendly. Constant upgrading of the system is required. Patients have privacy and safety concerns. Sharing vital records of patients may lead to misuse of these data.

Q. WHAT IS BUSINESS, POLITICAL AND SOCIAL IMPACT OF NOT DIGITIZING MEDICAL RECORDS (for individual physicians, hospitals, insurers, patients and the US government)?

 A medical record system contains medical history of a patients, treatments, medications etc. Without a digital record, physicians would have to navigate through piles of papers to identify required information. Some vital information may not have been filed due to which a physician may take more time to arrive at a diagnosis or starting a treatment. Due to unmanaged medical records, doctors who already work in tight schedules would have to divert their attention from patient care to paper works. There is also a lot of room for different types of medical error due to lack of digital medical records. In extreme situation, it may even cost a doctor his license or lose credibility amongst his patients