Advantages
EHRs, particularly those equipped with Clinical Decision Support (CDS) capabilities, have been experimentally related to greater compliance to evidence-based medical recommendations and improved care. Despite the best intentions of physicians, patient interactions may not comply with the best management recommendations due to several issues. Some explanations for this noncompliance include physicians’ unfamiliarity with the rules, clinicians’ failure to recognize that a particular criterion corresponds to a specific client, and practitioners’ insufficient time during the consultation session. EHR systems attempt to overcome these challenges, and investigators have examined how EHRs can enhance adherence rates by focusing on preventive treatments, such as vaccine administration. For instance, Nanah and Bayoumi (2020) discovered that automated caregiver notifications raised influenza and pneumococcal inoculation rates for inpatients from 0% to 35% and 50%, respectively.
Rationale: From the standpoint of society’s public wellness, following these standards keep people healthy and reduces the danger of epidemics in populations.
EHR permits clinicians to not only deliver more precise diagnosis and management but also to save time. They expedite meetings and physician visits without jeopardizing a patient-centered methodology, allowing healthcare providers to see more clients daily. EHRs include templates clinicians use to capture typical patient and visitor concerns or complaints. These designs are frequently adapted to certain specializations or adjustable to meet each physician’s specific requirements. As Artificial Intelligence (AI) makes breakthroughs in EHR networks, it supports clinicians with screening patients and interpreting patient medical records. A few organizations have also implemented voice assistants so operators can interact with systems through speech.
Rationale: In a life-or-death emergency, every minute counts; thus, hospitals rely on precision timekeeping. Doctors and nurses are legally obligated to document every minute of client treatment to prevent potentially catastrophic outcomes. Therefore, EHRs are essential, as the administration of medications in hospitals requires precise timing.
When health information is digitally accessible to clinicians, EHRs make it easier for patients to provide their data through HIE. HIE is the method of sharing electronic medical records at the patient level between various institutions and can significantly improve the efficiency with which healthcare is provided (Shen et al., 2019). In many places where individuals receive treatment, documentation about them is generally preserved. Therefore, this can therefore include their family practice doctor’s office, as well as other medical offices, a pharmacy or chemists, and other places including hospitals and emergency rooms. An enormous amount of data amasses over the course of a lifetime and is kept in silos everywhere. It has been customary for vendors to fax or mail important information to one another, making it challenging to retrieve it immediately when and where it is required (Shen et al., 2019). HIE makes it easier to share this data via EHRs, leading to far better, more affordable, and higher-quality healthcare.
Rationale: HIE can cut down on expensive duplicate tests requested because one caregiver lacks accessibility to the clinical data kept at the site of another physician by enabling the encrypted and possibly real-time interchange of client information.
Disadvantages
Hospitals and clinicians are discouraged from adopting and implementing an EHR due to financial factors, such as incorporation and deployment expenses, maintenance costs, drop in revenue due to sudden loss of productivity, and income decreases. Costs associated with EHR integration include acquiring and installing gear and software, converting paper maps to digital ones, and end-user instruction. Numerous studies have highlighted the expenses related to inpatient and outpatient care. In a 2002 research conducted by Nagasubramanian et al. (2020) at a hospital with 280 acute care beds, the total expected cost of a seven-year EHR implementation project was around $19 million. 47 In the outpatient scenario, earlier studies predicted that the typical starting cost per specialist in a three-physician practice would be between $50,000 and $70,000. (Nagasubramanian et al., 2020). There is also the expense of implementing and converting to an entirely new health information system, which, even at competitive costs, is not inexpensive. Luckily, as more and more competitors enter the marketplace for EHR systems, pricing competition is intensifying.
Rationale: The higher cost of implementation and execution hinders the effectiveness of medical practitioners to efficiently perform their tasks as much time is taken when using a physical record to attend to patients.
Another potential disadvantage of EHRs is the possibility of client privacy breaches, a growing issue for individuals due to the rising volume of EHI transmission. To alleviate some of these worries, legislators have taken steps to safeguard the security and confidentiality of patient information. Proposed laws have, for instance, enforced laws pertaining exclusively to the electronic sharing of patient records, which improve the current Health Insurance Portability and Accountability Act privacy and security regulations. Although little digital information is 100% protected, the latest policy’s stringent criteria make it far more challenging for unauthorized internet-based data. For instance, all EHR networks are mandated to provide an oversight function that enables system administrators to identify every user who visited every part of a medical file. Numerous hospitals and physicians have implemented zero-tolerance policies for staff who improperly examine documents. Although privacy and confidentiality will continue to be an issue, lawmakers and institutions are taking numerous steps to guarantee that EHRs adhere to the stringent guidelines designed to protect the confidentiality of healthcare data.
Rationale: Since privacy and confidentiality will continue to be an issue, lawmakers and institutions must take numerous steps to guarantee that EHRs adhere to the stringent guidelines designed to protect the confidentiality of healthcare data.
EHRs may result in several undesirable effects, such as an exponential rise in medical errors, destructive emotions, alterations in the power structure, and technological dependency. End-users of an EHR may have intense emotional reactions as they attempt to adjust to innovation and operational disturbances. Modifications in an institution’s hierarchical framework may also result from the introduction of an EHR. For instance, a practitioner may lose sovereignty in patient decision-making if an EHR prevents the prescription of specific tests or treatments. As caregivers become dependent upon technology, it may become a problem for them to become too dependent on it. Healthcare organizations should guarantee that essential medical care can continue to be administered without innovation, especially during significant system outages.
Rationale: Unintended consequences are detrimental to the efficient functioning of a hospital, and thus health facilities must ensure that the appropriate process to change is followed for an effective HER system.
Concludion
The following two objectives would impact my role as an APN in clinical practice as described herein. The first aim is that eligible professionals or hospitals give patients the ability to access online, download, and submit their health data created during a visit within 24 hours and check that patients are utilizing the capabilities. This goal would give me access to clients’ medical information, provide self-care, and improve the standard of healthcare, and wellness and patient-centered results. The second objective is that qualified practitioners and approved healthcare facilities receive provider-requested, digitally transmitted patient-generated medical information through either the EHR or the HIE (at the provider’s discretion). Since EHRs accelerate consultations and clinician visits without risking a patient-centered approach, the objective will enable me to see more customers daily. In addition, because EHRs contain templates for documenting typical client and visitor problems and concerns, achieving this objective would assist me in offering adequate patient care.
References
Kanwal, T., Anjum, A., & Khan, A. (2021). Privacy preservation in e-health cloud: taxonomy, privacy requirements, feasibility analysis, and opportunities. Cluster Computing, 24(1), 293-317.
Nagasubramanian, G., Sakthivel, R. K., Patan, R., Gandomi, A. H., Sankayya, M., & Balusamy, B. (2020). Securing e-health records using keyless signature infrastructure blockchain technology in the cloud. Neural Computing and Applications, 32(3), 639-647.
Nanah, A., & Bayoumi, A. B. (2020). The pros and cons of digital health communication tools in neurosurgery: A systematic review of literature. Neurosurgical Review, 43(3), 835-846.
Shen, N., Bernier, T., Sequeira, L., Strauss, J., Silver, M. P., Carter-Langford, A., & Wiljer, D. (2019). Understanding the patient privacy perspective on health information exchange: a systematic review. International Journal of Medical Informatics, 125, 1-12.