Electronic Medical Records for the Military
Introduction
The Military wants to get rid of medical records in the typical book format that the members or doctors can manually refer to and have all medical records scanned and transferred to computer programs. This process is fast becoming used in many health care systems, in what is called as electronic health or medical records. This paper will attempt to discuss electronic medical records as applied to the military. Its advantage and disadvantages will be discussed. Additionally, this paper will also present a selected planning or evaluation issue and present a short discussion of the key issues as presented by recognized scholars in the field.
Development of electronically linked patient records or Electronic Medical Record schemes (EMRs) is a priority for governments in many countries as part of a vision for future health care services using call centers, web-based patient information and telehealth. Scientific knowledge and technology related to health care are rapidly increasing. Rapid advancements in science and technology, along with investor dollars, have created major advances in medical care. These emerging technologies in medicine, which were increasingly housed in hospitals and physicians’ offices laid the groundwork for the coming shift in the way health care was delivered. The world of healthcare everywhere is increasingly reliant on information technology (IT). Information technology can contribute significantly to quality improvements in healthcare institutions. There are difficulties associated with implementing information technologies, but they are not insurmountable.
Many health care organizations around the world are using electronic medical records in storing patient data. Based on literature, the reason for this increasing use is that it saves cost and patient data is easier to access. International standards organizations and the electronic medical record advocates recognize the need for each healthcare profession to capture its data/documentation electronically (, 2004).
The original vision of the electronic medical records encompassed a mainly virtual, computer-based medical record that would include all information, clinical and administrative, and would cover all practitioners involved in a person’s healthcare over that patient’s lifetime, including all medical specialties and even prenatal and post-mortem information. Such a vision would require standards of full interoperability consisting of complex system interoperability, terminology and architecture, in addition to a number of functional requirements (, 2004). The most important benefit of electronic medical records systems is to minimize those healthcare encounters where practitioners are uninformed about a patient’s history and recent treatment.
Plan
Implementing information systems in healthcare organizations poses a series of challenges. These include complexity, human acceptance of IT, data security, and data quality and standards. In light of these challenges, some argue that no other industry invests as little in IT as the healthcare industry. Most hospitals and physicians still rely on outmoded paper records organized by visual color codes, alphabet and number ( & , 1998).
However, comprehensive electronic patient records are finally becoming reality, helping providers reduce costs, expand accessibility, and promote quality health care. For this reason alone, the military should use electronic medical records instead of the usual book records. Basically, data captured from medical equipment is integrated with IT systems to give health care professionals real-time access to lab results, pharmaceutical information, patient histories, test results, medical images, and all other pertinent clinical data anytime, anywhere (, 2001). Certainly, patients will see the efficiency of not having to give their name and date of birth five times to five different people on the same day in one hospital.
One of the great improvements in practice that an EMR enables and which could be useful for the military is that of its the ability to manage chronic illness in a proactive, organized fashion. Many physicians and health care professionals without EMRs take a passive approach: They wait for patients who are chronically ill to show up at their practice with an acute problem, and then they address any chronic disease issues at that time or reschedule the patient for another visit dedicated to the chronic illness. This approach has several disadvantages when thinking of a patient population as a whole, say for example the whole military. It neglects patients who rarely visit the practice and delays chronic disease management until the patient arrives at your doorstep (, 2006).
In order to facilitate the international development of standards in health informatics, the electronic medical record has been defined very broadly as “a health record in computer processable form.” Despite the recognition of differences between national and regional health systems and of different healthcare contexts and disciplines the International Standards Organisation (ISO) recommends a generic electronic health record reference model for all healthcare disciplines (, 2004).
For electronic medical records systems, a critical consideration is how to provide patient care when the electronic medical records –or portions of the data–is unavailable to those who need to make medical decisions. If a clinician must make a decision in an emergency care situation without all the facts, how will this affect the way medicine is practiced? Certain tools can be made available in physical form or perhaps in an “offline” mode. For example, practitioners can rely on reference books if available, but they lose access to automated features that rapidly correlate drug therapies or interactions with a specific patient’s existing medications or allergies when electronic systems are down (, 2006).
The increasing use of IT in the healthcare systems also has drawbacks. Ensuring the integrity and confidentiality of patient-related data is a major requirement of healthcare information networking strategies. The availability of easy and rapid electronic transmission of patient information to various organizations at different locations increases the risk of violating confidentiality. Because of convenience and efficiency, staff may forget to consider the privacy implications. Rather than improving healthcare quality, IT could reduce patient satisfaction and the quality of care. Confidentiality is especially problematic in the management of suspected child abuse cases, psychiatric cases and for patients with AIDS ( & , 1998).
Patient records constitute an essential building block for health care’s information management capabilities. Unfortunately, patient records vary widely in form and availability, offer varying degrees of quality, and have not yet reached their full potential. Although genuine progress is being made, most patient records do not meet the current information needs of health care professionals. In this era of health care reform and in this information age, the inadequacies of current patient records (both paper and electronic) are all the more pronounced, as even greater information management demands loom on the horizon and better technologies are within our grasp (, 1994).
Evaluation
Patient record systems will support the information needs of the full range of legitimate users (including physicians, nurses, and other caregivers; patients; administrators; third-party payers; and researchers) and will become the core of health information systems both within and beyond health care organizations (e.g., regional health databases or information systems) to the advantage of groups such as the military.
If patient records and record systems cannot meet the needs of all users in terms of content and function through direct access or linkages to other information systems, everyone will continue to experience expensive proliferation of redundant information systems and wasteful duplication of data gathering and entry. Connectivity, data format, and data content standards must be met for systems to meet the needs of all users.
Moreover, in the planning and implementation, users must understand that the patient record is a resource for improving the effectiveness and efficiency of clinical processes and procedures, that complete and accurate data offers benefits well beyond the individual patient, and that information management (including record-keeping) is a critical component of the health care delivery process (, 1994).
Electronic health records, and in particular those that are shared outside their creation boundary, need to be retained for the lifetime, and possibly beyond the life of the patient to provide healthcare continuity and accountability. In fact, current electronic health record models refer to the “longitudinal” record that can be either a single encounter or any length of time. Any loss of accessibility to, and intelligibility of, the records and the loss of the original functionality of the data during transfer to a new technology or accidental loss due to media failure affects the integrity of the records and must be minimized (, 2004).
Electronic medical records systems make it far easier for users to review the digital information in real-time and to take advantage of automated diagnostic tools that help practitioners to quickly pinpoint irregularities. When planning for disasters or failures, those charged with this responsibility need to consider those who electronically access medical histories and test results and the levels of efficiency, productivity and the quality of patient care they need to provide (, 2006).
Conclusion
Electronic communication is widely used nowadays. The growth of electronic communication options presents both opportunities and challenges. E-mail and secure web-based portals offer busy patients like the military better access both to their physician and to applications where they can review their medications and correct errors, request prescription refills, make appointments, retrieve laboratory results and view radiology images. Literature specific to the relationship between the use of electronic medical records and outcomes in the military and its patients is scarce. Based on existing literature by far, there is no evidence that points out directly that the use of electronic medical records can improve the lives and health outcomes of patients from the military. Perhaps it can speed up things but it does not necessarily mean that patient outcome will be better. Perhaps the quality of care could be better too but the health of the military patient who is critically would still not improve depending on the electronic medical records. It would still be dependent on the drugs and therapy suited for the patient.
REFERENCES
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