Meaningful Use and the HITECH Act

EHR Pros and Cons

EHR stands for Electronic Health Record. This is an electronic version of a patient's medical history, which is maintained by the healthcare provider over time. The record may include all the key administrative clinical data that is relevant to the patient's care under a particular health provider (Tiwari, Thakur, & Tiwari, 2018). It also includes demographics, problems, progress notes, vital signs, medications, immunizations, past medical history, laboratory, and radiology reports. An EHR automates access to patient information and it has the potential to streamline a physician's workflow. The electronic records can be shared across different health care settings, which benefits the patient as they do not have to undergo the same tests that have been done before. An EHR is designed to store data accurately and it captures the state of a patient across time.

Pros

Cons

Improvement in the quality of care.

When an EHR is used properly there will be increased improvement in the quality of care delivered to patients. It is the goal of each health institution to better the lives of its patients and clients. Using EHR this is possible since communication is improved, patient information is easily accessible, and there is no risk of loss of data or lost papers. There is also a seamless sharing of information between providers in the same organization (Harle et al., 2016). This ensures that a provider does not need to wait for a file to come from one location to his or her office for them to attend to the patient. This feature reduces the time patients spend waiting. Clinical decision-making tools can be integrated and this will assist physicians to make the correct diagnosis.

EHR hinders patient-clinician engagement.

It has been noted that physicians are spending a considerable amount of time entering data into the system instead of interacting with the patient (Harle et al., 2016). This interferes with the patient-provider relationship. Clinicians have indicated that they find EHR to be taking away valuable patient time and the clinicians are spending time interacting with the patient. EHR increases the amount of data that the clinician has to enter. Clinicians are now required to enter much more documentation as compared to the past (Casalino & Chenven, 2017).

Improved accessibility to data.

EHRs ensure that there is no need for physical paperwork to be filled for each patient. With electronic storage all the physical files are eliminated and all the data can be easily accessed with the touch of a button (Tiwari et al., 2018). The loss of patient records is eliminated too. In the past it was not unusual for some of the patient charts to be unavailable at a given time. This delayed attendance to the patient and care was impacted. With EHR a physician can even access patient records remotely. The amount of space needed to store physical files is reduced and this space can be used for other purposes (Tiwari et al., 2018).

Clinician burnout due to EHR

This arises from the increased demands in the clinician to enter data into the EHR system (Downing, Bates, & Longhurst, 2018). This decreases job satisfaction as one spend more time entering data and less time interacting with the patients. There are increased data entry demands on the clinician since they have to ensure that they have filled out all the fields when they are attending to a patient. It has been noted that using a EHR has detracted most clinicians from their professional satisfaction and contributed to their burnout (Casalino & Chenven, 2017).

Computerized physician order.

This allows physicians to enter lab and imaging requests, prescriptions, and other notices electronically, which reduces the errors of hand writing (Harle et al., 2016). With this model the amount of errors is reduced as the orders can be visibly read and acted upon. Other physicians within the organization who are attending to the patient have access to the data and the chances of them duplicating orders is reduced (Tiwari et al., 2018).

Poor Return On Investment

In the push for EHR the government and other stakeholders encourage its adoption with the claim that the organization will improve its efficiency and its revenues will increase too (Downing et al., 2018). This will offset the initial investment costs that are linked to adopting EHR. However, as time passes most organizations are discovering that the ROI gains promised are not feasible or did not materialize. Many practices have discovered this the hard way.

Meaningful Use and the HITECH Act

Engage patients and families in their health

As an APN this role will demand more interaction with the patients. There is a need to engage with the patient not only to establish what their ailment is but to also establish if they have the support system needed outside the healthcare facility. Understanding patient background and health needs are vital as this ensures that one can have a holistic view of the patient's health environment (Tiase, Hull, Troseth, & Schnall, 2018). It also improves patient education, which is vital for the patient as they will better understand what is required of them and how best they can care for themselves. There is a limited amount of time that one can spend with an individual patient and this objective will be hard to maintain as some patients might not be effective communicators. Therefore, one should ensure that they do not lose focus on what is vital even if they have spent too much time with the patient. The most important thing is to ensure that the patient is satisfied and he or she has understood the treatment plan and how to care for his or her health.

Improve care coordination

Using an EHR it is now much easy to coordinate the care of patients. As an APN one needs to log into the EHR system and check on the status of patients and the recommended treatment plans. There will be information regarding what prescriptions have been administered and what has not been done. This way the possibility of errors is reduced and patient care is improved (Marek, Stetzer, Adams, & Kelly, 2018). Providers can also share information about a patient within the same organization and the information is accessible instantly. With proper coordination, a nurse in one department will get the information needed to continue caring for a patient who has come from a different department. Patient errors are reduced as all information is located in a central location and one can see what medications have been administered and the time they were administered.