Reference no: EM133977168
Chapter 5: Technology and Its Effects
The interoperability of clinical data is a primary goal of health service organizations and federal health policy. D'Amore et al. (2015) thoughtfully define interoperability as the ability of two entities, human or machine, to exchange digital data and information with each other spontaneously while maintaining the format and its original meaning.
An electronic health record (EHR) is a digital version of a patients' paper medical chart that meets national standards for interoperability across all health services and health care delivery organizations. EHRs streamline and automate clinical workflows such as capturing, measuring and monitoring clinical documentation and patient information. For example, EHRs enable clinical staff to capture patient vital signs and pain level with improved timeliness, validity, and accuracy (Office of the National Coordinator for Health Information Technology, 2015). Such data are often early indicators of disease and are helpful in chronic disease management.
Case Report
Lack of interoperability in medical clinics and health care organizations can obstruct the exchange of important health care data and lead to a number of problems for both organizations and patients, such as increased health care costs from duplicate testing and procedures and fatal medication errors. Thus, industry decision makers are working to modernize data collection and management to improve efficiencies in care. According to Zhao and Xia (2014), achieving meaningful interoperability requires internal capacity building and external readiness assessments.
Health care delivery systems are harnessing the functionality of EHRs to improve quality care to their patients and ensure interoperability. For example, Banner Health, a nonprofit health system with 28 hospitals in six states based out of Phoenix, Arizona, has switched EHR vendors in an effort to capture clinical efficiencies and synergies such as interoperability across the entire health system (Cohen-Kim, 2018).
However, despite the best efforts to implement technology to improve patient care, issues such as access to treatment, systems glitches, and redundancy persist. For example, in late 2017, Banner hospitals began the switch-over from its old EHR system, Epic, to the new Cerner EHR system (Cohen-Kim, 2018). Cerner and Epic are the top two hospital-based EHR vendors, and both software applications have broad nationwide adoption in large health systems across the country. Banner Health's decision to switch software vendors was an internal decision based on the organization's objectives and goals. In the case of Banner Health, the technology change-over reduced the availability of appointment slots for medical providers and long delays for prescription drug fulfillment, resulting in an outcry of complaints to the state of Arizona (Cohen-Kim, 2018). Synergies created by technology will help to lower costs and increase care continuity in the long-term; however, the short-term consequences of a technology upgrade gone bad can invite a host of unintended and unexcepted events. Arizona's Department of Health Services investigated a plethora of complaints since the EHR rollout began, and technology-related issues continued to plague the Banner Health system (Cohen-Kim, 2018).
Patients' desire to access their electronic health information has created the demand for health systems to both use and share this data in meaningful ways. For example, in a purely interoperable environment, the continuity of care delivery means patients health information is transmitted electronically among the hospital, specialists, and primary care providers. Health care organizations will continue to leverage technology to achieve healthier outcomes. Although the broad-scale implementation and adoption of EHR technology can lead to clinical synergies and efficiencies, it can also lead to dissatisfied patients and other short-term setbacks. Overcoming these adverse effects will require a concerted effort from all stakeholders, both internal and external. Clinical delivery systems ought to be nimble, agile, and scalable to accommodate future technological advances (Wager, Lee, and Glaser, 2013).
Questions
1. What proactive measure can managers and vendors use to mitigate the risk from technology projects such as EHR and other interoperability implementation?
2. What role do patients play in technology implementation projects, given their desire for access to digitized information and state-of-the-art medical treatment?
3. Discuss the pros and cons of technology and its effect on each of the following stakeholders: patients, providers, and state or federal agencies.