Electronic Health Records Use in Small Healthcare Practices Essay

In a healthcare world that operates on stringent budgets and margins, we begin to see the need for a higher capacity healthcare delivery system. This in turn puts pressure on the healthcare organizations to ensure higher standards of patient care, and compliance with the reform provisions. However, these are the harsh realities of today’s healthcare environment, a setting in which value does not always equal quality. The use of technology can help to amend some of this by providing higher capacity care without compromising quality; this can be done with the use of such technology as electronic health records (EHRs). This paper will aim to address how EHRs influence healthcare today by expanding upon topics such as funding sources, reimbursement methods, economic factors, socioeconomic factors, business influences, and cost containment.

Equally impressive is the implementation of Computerized Physician/provider Order Entry or CPOE. CPOE is known as one of three key patient safety initiatives by Leapfrog Group, a conglomeration of non-health care Fortune 500 company leaders committed to modernizing the current healthcare system (Huston, 2014; The Leapfrog Group, 2013). CPOE is a type of software designed to reduce errors in transcription due to illegible physician handwritings or wrongly placed decimals in dosage and strengths of medications. CPOE also gives the clinician access to Clinical Decision Support, or CDS, which is a database to assist clinicians and providers to health related information for certain patient diagnosis with care planning assistance and direction. (Huston, 2014; The Leapfrog Group, 2013). CPOE and CDS will likely be streamlined and commonly used in healthcare in the next decade which appears will likely improve patient safety as well as vastly reduce medication and

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

This affects the delivery of healthcare in that the information needed by providers, physicians, medical staff, and the patients themselves, may not be delivered correctly, timely, and of course securely. Various systems will be discussed and each how they affect healthcare delivery, in particular Electronic Health Record (EHR), Electronic Medical Records (EMR) and Computerized Physician Order Entry (CPOE) (also sometimes referred to as Computerized Provider Order Entry).

Over the previous eight years, there has been a significant investment of private and public funds to upsurge the adoption of Electronic health records (EHRs) across the nation. The extensive adoption and “meaningful use” of electronic health records is a national priority. EHRs come in various forms and can be utilized in distinct organizations, as interoperating systems in allied health care units, on a regional level, or nationwide. The benefit of utilizing an EHR depends heavily on provider’s uptake on technology. Benefits related to electronic health records are numerous and may have clinical, organizational and societal outcomes. However, challenges in implementing electronic health records has attained some attention, the implementation

Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014, October 1). Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? Perspectives in Health Information Management, 11(Fall): 1b Retrieved from http://perspectives.ahima.org/can-utilizing-a-computerized-provider-order-entry-cpoe-system-prevent-hospital-medical-errors-and-adverse-drug-events/#.Vpg-Q_krLIU

An Electronic Health Record is a computerized form of a patient’s medical chart. These records allow information to be readily available to authorized providers during a patient’s encounter with the healthcare system. These systems do not only contain medical histories, current medications and insurance information, they also track patients’ diagnoses, treatment plans, immunization dates, allergies, radiology images and lab tests/results (source). The fundamental aspect of EHRs is that they are able to share a patient’s information quickly across service lines and even between different healthcare organizations. Information is at the fingertips of lab techs, primary care physicians, pharmacies, clinics, etc. The

Therefore, several authors share some of the same ideas as to what some of the barriers faced during the transition to Electronic Health Records (EHRs) and if these barriers still exist once the transition to a full EHR system is complete. Herrick, et al., 2010, states that currently, there is no hard-core evidence to support the argument that Electronic Health Record (EHRs) and Health Information Technology is the best route for health organizations to prevent errors. In fact, the use of such technology could potentially lead to errors if information incorrectly entered in the system and Haupt, 2011, statement that smart software could help to prevent life-threatening errors better when administering medicines. Whereas, Boonstra & Broekhuis, 2010, states from a physician point a view need the understanding of the possible barriers that faced during implementation of EHRs because there a tremendous amount of literature on the obstacles but no suggestion on how to resolve these barriers have not been viewed. Barriers such as, financial on great startup and ongoing cost, technical and time to train staff and how much knowledge do they have with computer skills and psychological when support needed from vendors, etc. It suggests that once those barriers have been ironed out and a plan has set in place, then the transition from paper documentation to Electronic Health Records (EHRs) may go a lot easier for the healthcare arena physician, nurses and administrative

Clinical decision support is a system designed with capabilities to enhance physician and other health care provider in the clinical decision task. It enable the physician to have more knowledge of the patient that they are provided with care, more advance knowledge of the type of illness that the patient is going through so that appropriate clinical decision would be included in the patient treatment plan (PTP) ("What is Clinical Decision Support (CDS)? | Policy Researchers & Implementers | HealthIT.gov," 2013)

Since small practices provide care for the majority of the population in the United States, according to Begum et al. (2013), it is important to set goals as to improving its assets in healthcare delivery. This paper is going to delve into the status of Electronic Health Records (EHRs) in small, non-hospital settings, as well as policies that can help relieve current burdens. First and foremost, the definition and purpose of EHRs should be defined. It is a system of computerized patient health records that can be conveniently updated and instantly accessed by authorized personnel. This system is a worthy asset because it enhances patient information consolidation,

The Clinical Decision Support System (CDSS) is used by health professionals to help and improve the process of enhancing health care decisions to improve the quality of patient care. Under the approval of American Recovery and Reinvestment, there are many healthcare technologies are being into use such as Electronic Health Record (EHR) and Computerized Physician Order Entry (CPOE). CDSS is often integrated into EHR systems to manage clinical data and assist with clinical decision making with pertinent clinical knowledge and information and a variety of CDSS tools such as alerts for drug interactions, patient allergies and reminders for preventive care in the clinical work flow. CDSS are expanding in the health care setting and have been integrated with Computerized Physician Order Entry (CPOE). Both work to integrate advanced clinical decision support.

Computerized Physician Order Entry (CPOE) is a process that both improves the quality and safety of care by using a standardized method. In combination with even the most rudimentary clinical decision support systems (CDSS) will decrease the number of adverse events simply by eliminating legibility issues in translation alone, while improving care. More importantly, an interactive system that responds to inputs of conditions, medications, and patient history will improve the diagnostic skills of the user by actively searching a vast knowledge base for the most current information and providing it to the provider in real time. When presented with the information, the provider can then use the advice or proceed in another direction, in either scenario the provider has information to make the best clinical decision. Of course, the goal would be to present recommended guidelines that the practitioner can use in specific disease states to improve clinical performance and patient outcomes.

Clinical decision support system(CDSS) provides assistance to healthcare providers in a clinical settings regarding patient care. A CDSS can assist by providing up to date information regarding a drug, alerts for drug interactions and other health problem regarding a patient which may have been labeled by the computer system. Computerized physician order entry(CPOE), it allows the healthcare providers to enter drug, laboratory tests via computer. The use of

Clinical decision-support systems (CDSS) apply best-known medical knowledge to patient data for the purpose of generating case-specific decision-support advice. CDSS forms the cornerstone of health informatics research and practice. It is an embedded concept in almost all major clinical information systems and plays an instrumental role in helping health care achieve its ultimate goal: providing high quality patient care while, at the same time, assuring patient safety and reducing costs. This computer based systems designed to impact clinician decision making about individual patients at the point in time that these decisions are made. If used properly, CDSS have the potential to change the way medicine has been taught and

Transcription errors such as a misplaced decimal point and illegible handwriting were major causes of error. Incomplete orders were a problem that caused additional steps in the nursing workflow. The implementation of software systems, like CPOE, helps to eradicate these problems. According to Yui et al., (2012), CPOE is a component of the larger electronic health record (EHR) system which enables practitioners to enter orders directly into a computer then transmits orders to the order management system for processing. CPOE is designed to allow clinicians to enter a variety of orders, such as medications, dietary services, consults, admission and discharge orders, nursing orders, lab requisitions, and other diagnostic tests, via computer. The idea behind CPOE was for prescribers, such as physicians, dentists, osteopathic doctors, anesthesiologists, nurse practitioners, and physician assistants, to enter orders directly into the computer. During the ordering process, alerts, such as drug allergy warnings, and other decision support rules should be available to assist health care providers. Once an order is entered, the CPOE system interfaces or integrated with other EHR components, such as a laboratory or pharmacy system, to process the order. In fact, the term “order entry” can be misleading, as CPOE is truly an order management system that allows orders to be