Measuring Improvements in Patient Safety Term Paper

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Gonzalez (2007), discusses the company WellPoint Inc. that provides its members with the capability to develop their own personal health records, an option to receive test results online, provide a limited set of records to their providers and to allow other family members access to the information. In terms of security safeguards, WellPoint tracks who accesses information and has staff members to monitor the systems for potential breaches. This in turn offers users a certain level of security and quality in services rendered.

As pay-for-performance programs flourish, there is a fear that many EHRs cannot accurately capture the data that is required to participate. The biggest obstacles for software makers are the sheer volume of performance measures and the lack of standardization among them. One pressing issue is that some EHR systems are still text-based and are therefore not as powerful for reporting and extracting information. (McKinney, 2007)

Wilson (2007), explains that since Michael Murphy became the top executive at San Diego-based Sharp Healthcare in June 1996, he has utilized a consensus-building style that continually led seven hospitals (four acute-care facilities and three specialized operations) and 2,600 affiliated physicians to leverage information systems to improve patient care. In addition to the physician-practice EMR, Murphy supported a difficult decision to deploy a single-product, inpatient EMR, severing decades-old relationships with a number of other vendors. Murphy says it is an important tool of a program he launched six years ago called "The Sharp Experience," which strives to improve patient, employee and physician satisfaction with the health system using Six Sigma, a systematic, data-driven approach to continuous quality improvement originally developed at Motorola.

Burda (2007), explains that many hospitals have been using the legal uncertainty over it subsidies to physicians as a reason not to provide practitioner with the funds to digitize their practices, clinics, and outpatient surgery and diagnostic centers. Under the federal tax code, the charitable assets of tax-exempt organizations such as not-for-profit hospitals cannot be used to benefit private individuals, including physicians. Hospitals that violate that code could face special excise taxes or even risk losing their tax-exempt status. This is a strong enough reason to not give funding so freely that would allow practitioners to acquire, install, and implement it in order to connect their practices to the hospitals where they admit and treat patients.

Leaders of both the hospital and physician communities as well as it advocates reported that such a connection is essential to improving patient care. Better coordination of data will in return bring about better coordination of care, safer patient care, and better clinical outcomes. However, until now, it was up to each side-hospitals and physicians-to buy their own it systems and hope they work together. Most often, it is the capital-deep hospital or hospital system with the state-of-the-art it system cajoling the capital-shallow physician or group practice to buy a similarly fancy it system. Study after study over the past few years has quantified the low penetration of various it systems in the physician sector.(Burda, 2007)

Burda (2007), concludes that there was a shift in the paradigm when it was reported that not-for-profits could give money to doctors to buy electronic health records systems without jeopardizing the hospitals' tax-exempt status. The IRS said such subsidies are permissible as long as the hospital-physician it arrangements do not violate any other federal laws. To avoid violating any other federal regulations like the anti-kickback statutes, which bar any form of remuneration to induce Medicare or Medicaid patient referrals, hospitals, must make the same it goods and services and the same level of subsidy available to all physicians on staff.

As healthcare stakeholders advance toward the President's vision of providing every American with an electronic medical record by the year 2014, a growing number are taking the intermediary step of creating personal health records (PHR). PHRs maintained by health plans are based on aggregated claims data. Plan-sponsored PHRs provide a broad range of information and enable patients to track their medical encounters across multiple providers. (Reese, 2007)

Use of it in health care is intensifying rapidly, with President George W. Bush calling for widespread adoption of electronic medical records (EMRs) within the next ten years. In addition to digitizing the information that providers use to care for their patients within organizations, clinicians, patients, and policymakers are looking ahead to sharing appropriate information electronically among organizations. To explore the qualitative and economic implications of health care information exchange and interoperability (HIEI), the researchers studied the value of electronic data flow between providers (hospitals and medical group practices) and other providers, and between providers and five stakeholders with which they exchange information most commonly: independent laboratories, radiology centers, pharmacies, payers, and public health departments. Results indicated that a fully standardized HIEI could yield a net value of $77.8 billion per year once fully implemented. Non-standardized HIEI offers smaller positive financial returns. (Walker, Pan, Johnston, Adler-Milstein, & et al., 2005)

Freudenheim (2005),continues to reiterate the words of other researchers regarding electric records. In particular, the writer considers the significance of information shared online by different doctors and hospitals, and the fact that the exchange of information can and will improve the quality and safety of patient care by reducing errors that kill tens of thousands of patients each year. He further confirms that this is why big organizations like Kaiser Permanente, the Mayo Clinic and many medical centers across the country are spending billions to convert to electronic records.

Freudenheim (2005), further affirms that after Hurricane Katrina the government and private health care officials were hurrying to build an electronic database of prescription drug records for hundreds of thousands of people who lost their records in the storm. In addition the revolution are private insurers, Medicare and some employers, which are paying incentives to medical providers that can achieve better efficiency and patient care through improved information management. However, smaller medical practices were typically ineligible for bonuses because the doctors lack the computerized records that help them qualify. The hurdles typically include up-front costs as high as $30,000 for each doctor, and the need for support and training. As a result, fewer than 5% of physicians nationally were using a computerized system as part of patient care. For most doctors who work in groups of five or fewer, the portion is probably 3% or less. A Web-based, central database approach means that doctors need little more than a few standard PC's, a high-speed Internet connection and the willingness to pay a monthly subscription fee of $500 to $600, eliminating the initial outlay of tens of thousands of dollars.

It is evident that not only were Electronic health records a necessary step toward advancing in a more efficient and high quality method of data collection and admittance, it appears to be the only true next step. However ever advancement is not without its issues as stated throughout the research and interviews conducted. It is also evident that methods are in place and being tested regularly to further straighten electronic data methods security and quality. It has come a long way yet still has need and room for improvement. In a day and age viruses, and electronic corruption it is comforting to know that issues including these are regularly considered and researched in order to insure the security and accuracy of medical health records, this makes the future look more comforting.


Burda, D. (2007, June 4). Hey, you asked for it. Modern Healthcare, 37(23), p.25.

Cavolo, D.J. (2007, July). Electronic medical record system: know the cost of ownership. Nursing Homes, 56(7), pp. 17-19.

Evans, M. (2007, July 30). Push for Quality Starts with it. Modern Healthcare, 37(30), pp.22,24,28.

Freudenheim, M. (2005, September 19). Doctors collaborate to find less costly way to add electronic medical records. New York Times, p. C4.

Gebhart, F. (2007, June 18). Open Source Spurs E-Record. Drug Topics, 151(12), p.35.

Gonzalez, G. (2007, July 2). Secure personal health records improve quality of care. Business Insurance, 41(27), p.6.

Lager, M. (2007, August). Critical Care for Health Records. Customer Relationship Management, 11(8), p.42.

Lazar, K. (2006, May 4). City's Doctors on Cutting Edge with Computer-Based Records. Boston Globe, (3rd Ed.), GN1.

Lowes, R. (2007, July 6). Two monitors are better than one. Medical Economics, 84(13), p.26.

Lowes, R. (2007, May 4). Migrating paper to an EHR. Medical Economics, 84(9), pp.26,29.

McKinney, M. (2007, July). EHR Hiinder Participation in Pay for Performance. Hospitals & Health Networks, 81(7), p.20.

Reese, S. (2007, June). The value of PHRs depends on the quality of data inputs. Managed Healthcare Executive, 17(6), pp.48-49.

Robeznieks, a. (2007, July 30). No quality boost?. Modern Healthcare, 37(30), p.44.

Rosenbloom, S. (2007, August). Leading the Charge to Efficiency. Health Management Technology, 28(8), pp.28-31.…[continue]

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