Sample Capstone Project Paper on Impact of Transitioning Into the New Healthcare Market Rules

Introduction

The dramatic growth of the health market has refocused all the stakeholders on one message; that the current trend is not sustainable. In response to this, a majority of stakeholders is now pursuing strategies that will enhance their individual positions in the sector; this has included the introduction of new market rules that have been implemented to bring change. The introduction of new market rules in the health sector is a comprehensive task that is comprised of many facets with different levels of outcomes, the cardinal aspect, being the transition part.  One of the major significant rules in the healthcare market has been the inception of electronic medical records (EMR) which basically involves the extensive utilization of technology in healthcare. The main aim of this paper is to analyze the impact of transitioning into new health care market rules, to accomplish this objective; the paper will focus on electronic records as a new market rule, and describe the positive as well as the negative impacts that the transition have on the healthcare market.

Background

Increasing life expectancy, improving survival of people who have acute and long-term conditions and a greater array of available treatment options are gradually combining, to a place on the increasing burden, on the healthcare systems on earth (Shi & Singh, 2013). This is evident in a majority of the developed nations, where the main concern is the salaries for the healthcare professionals and the immense public expectations. Similar practices are now being seen in economic transitions of developing nations  (Shi & Singh, 2013). There is a huge amount of research, both domestic as well as international that is identifying some of the major shortcomings in the current provision of healthcare.

Several drawbacks have contributed immensely to the high death rates, mortality, and misappropriation of healthcare finances (Crosson, Ohmann, & Hahn, 2009). Despite the many challenges that are being observed, significant steps have been made in the information technology. This has presented substantial development in IT and software capabilities in the last few years. There is considerable potential to utilize technological developments in respect to various aspects of healthcare (Chaudry, Jerome, & Shinyi, 2011). Of particular interest is the requirement to develop and, deploy an array of e-health applications, with the view to improve the quality, safety, and efficiency of the healthcare delivery.

Making the transition to EMR

As business grow, it is important to accommodate to the implementation of new technology. The health care consortium is a unique type of venture that should take full advantage of the advanced technologies (Grady & Edgar, 2001). In the U.S, the health care industry boasts for being one of the largest employers and a giant contributor to the GDP. Health care is an industry in which many people have dependence. The establishment of a modern healthcare system is vital for a nation like the U.S. The electronic medical records are vital as they can assist in recording a patient’s information, not only does an EMR contain vital information about a patient it also has tests, results, doctors notes and insurance information (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). The law does not stipulate the exact contents of an electronic record.

Impact of transitioning electronic records
Positive impacts
  1. Increased coherence and production

The main objective of transitioning from paper records to EMR is to improve coherence and production in the market (Chaudry, Jerome, & Shinyi, 2011). The use of an electronic methodology will ensure the retrieval of different results in a more rapid manner; this will ensure the right appropriation of both time as well as money. Electronic records are important because they reduce the redundant paper work; they have the power to integrate with a billing program, which is used to submit claims electronically (Chaudry, Jerome, & Shinyi, 2011). The use of electronic record methodology guarantees productivity because records allow for point as well as click histories.

  1. Quality of care and safety

As noted above, electronic health records improve patient safety through many ways, for example, the improvement of the legibility of the clinical records, improved access anywhere and anytime, decreased duplication of the records (Chaudry, Jerome, & Shinyi, 2011). Despite the mentioned benefits, a study that was carried out by Garrido failed to show the benefits that are associated with electronic health records in the Kaiser Permanente system. There is only one study that has acknowledged the benefit of utilizing electronic systems to decrease mortality (Travers & Downs, 2011). This study utilized a disease management module, which was fashioned for use by the renal dialysis patients, which could provide more specific medical frameworks and better data retrieval to improve medical care (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). The study propounded that the mortality rates were low in comparison with pre-implementation periods and when compared to a national renal dialysis registry. Using the internal data, the Kaiser Permanente consortium learned that drug Vioxx was causing an increased risk of cardiovascular problems, before the data was published in regards to its own internal data (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013). In a similar manner, Cleveland clinic involved its electronic records to see the patients who were using the drug, within a time span of seven hours, the hospital had already deactivated the prescriptions and made the physicians aware by sending emails.

  1. Utilizing passwords

A majority of systems are solely dependent on passwords. Passwords are utilized as the first line of defense again unauthorized access (Chaudry, Jerome, & Shinyi, 2011). The strong logs in passwords are usually characterized by absence of dictionary words, combination of letters as well as numbers and symbols. It is important for all the staff in the organization to be made aware of the threats that is presented by the use of weak passwords, especially the ones that cannot be changed easily (Crosson, Ohmann, & Hahn, 2009). Users should be aware that it is possible to hack into strong passwords using software.

  1. Utilizing portable instruments

The conversion of electronic health systems will make it possible to transfer data in the records to mobile devices (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).  The main advantage with these devices is that they are readily available and can be carried easily; physicians can carry them outside the workplace. As a result of the high incidences of loss or theft of the mobile devices, for example, the laptops and the computers, doctors will need to limit the amount of information that they share on the portable storage media (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). The individual health data, which is kept on the mobile device, will have to be coded. When encryption is done in the right way, the personal health information will be safe from disclosure. The presence of encryption will make it very easy to safeguard the electronic records of the personal health information.

Negative impacts
  1. Extensive use of resources

The transition to electronic records is an affair that costs millions of dollars for the big hospitals. For example, a Southern Carolina provider is spending over $40million on the implementation of the system (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). The healthcare providers can spend from $25,000 to $60,000 per physician on the implementation of the systems. The cardinal costs are not in any way limited to the software and the hardware. It is paramount for healthcare providers to plan for consulting, training as well as the most effective software to use in the system (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). Several glitches can disrupt several processes, for example, billing, this can result to painful cash problems. In the transition to electronic records, it is important for organizations to consider the aspects of decreased productivity as well as loss of revenue.

  1. Need for Training

Many physicians want to spend a great amount of their time dealing with the health of their patients; many doctors do not want to spend their time learning about new computer systems. This is a major challenge in the transition (Crosson, Ohmann, & Hahn, 2009). If physicians lack time to learn about systems, it will be hard for them to master the requirements. Transition demands that schedules be made for the sole reason of making room for training. In numerous instances, this aspect is not popular with a majority of physicians (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007).

One of the major challenges faced by healthcare providers is the fact that many physicians who are above fifty years old do not know how to type. Old doctors are mainly dependent on dictation (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). Despite the fact that the speech recognition devices have the power to digitize data, they do not have the power to structure it the way that EMRs need to have it structured. For the physicians who cannot type and need to hunt and peck, a productivity decrease will be the result of the transition.

Training is a vital component in successful transition of electronic medical records (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013). It is imperative to achieve order to reach the highest levels of utilization in EMR systems. Some major concerns during the transitioning, which should be taken into consideration includes, the patient comfort as well as recognition. EMR are aimed at improving the records of patients; however, despite this objective, there is a concern about the patient provider link. Through the transition, patient provider connection is likely to improve (Shi & Singh, 2013).

  1. Productivity Hit

The transition to electronic records is similar to the other information technology implementations, after an electronic record is implemented productivity drops and then it gradually increases (Crosson, Ohmann, & Hahn, 2009). Experience has indicated that the rebound is different in various organizations. For some healthcare consortiums, it can take one full year to go back to full productivity. It is significant for the healthcare organizations to know that the electronic records benefit emanates from better documentation, the improved accuracy as well as safer patient care (Grady & Edgar, 2001). The price of all this advantages can be manifested in forms of lost productivity.

  1. Updating the written information practices

The transitioning of systems of the electronic records may necessitate changes to the physician’s information practices (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). For example, the physicians will be required to modify the administrative, technical and physical safeguards as well as practices which are maintained with respect to the personal health information in making the transition to the electronic healthy records. In regards to the introduction of the electronic records, the physicians will be required to come up with new methods for the purpose of enabling the patients to access and correct the records of their own personal health information (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).

Ethical outcomes of transitioning to electronic health records

Despite the fact that the use of electronic records has many benefits, several concerns have been raised concerning the present risks and the different barriers (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). There are different risks that have been linked to the implementation of the electronic records; the primary risks are linked with patient privacy and the security data breaches, others are linked to the costs, system implementation, data inaccuracies and the associated reliability.

  1. Privacy and security breaches

All patients in a hospital have the right to care, custody and the control their health record whether on paper or in the electronic format (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013). Adult patients should be granted an opportunity to form decisions that concerns their healthcare. This can include the type of information that should be shared with the healthcare providers. If certain factors, for example, age, limit a patient from doing various activities then a legal representative should be given the right to make decisions on behalf of the patient (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).

In regards to the electronic record, it has been hard to determine the person who is responsible for protecting the records and making various decisions about the release of a patient’s healthcare information (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013). A majority of people understand the negative consequences that are linked with data leakage. The security contravention threatens the privacy of patients when delicate information is given to another party. Despite the presence of firewalls to guard sensitive data, it is possible for data to be compromised in specific situations. Records that are stored in files that are not password protected can be easily obtained (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013). When data is stores in multiple sites, it is likely to be hacked. Unauthorized access to information affects the victim with his family members, for example, a leaked patient history may reveals immense information  about his/her family, this can make the whole family subjects of stigmatization or even discrimination (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008).

EMR have safety measures in place for the purpose of protecting privacy of patient and enhancing security. To share information to the third parties, it is imperative for patients together with their legal representative to consent by signing (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). The user’s entry is monitored and supervised. There are several policies as well as procedures that protect the patients from this kind of acts, for example, the employees in the organizations are expected to utilize their id’s to log to a patient account, the employees should always log of when they are leaving a terminal.

  1. Costs

The development of an electronic record system is immensely expensive, for this reasons; many donors depend on the demonstration of meaningful use of the funds (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). To be able to meet the meaningful use criteria, the healthcare organizations are required to demonstrate their compliance with the already established criteria which is designed to allow the move to an ERS is a strategic manner.

  1. System implementations

In case there are two systems that are being integrated, it is possible to have interface issues. Interface issues are a major problem because they are not initially visible until their impacts are felt (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). It is important to maintain and test the interface on a regular basis so as to control the major risks.

  1. Data inaccuracies

Even though the use of digital records is perceived as a mechanism to improve the patient safety through the reduction of healthcare errors, many people have been concerned due to various factors (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). There are many concerns that have been raised regarding the quality of accuracy and the reliability of the data that is entered into the record. Since the records are longitudinal by nature, it is likely that they integrate information which is not current or even significant (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).

Data inaccuracy can result in many undesirable consequences, for example, misrepresentation of the patient’s current condition as well as treatment (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). Each year, the healthcare organizations experiences extensive fraud. Fraudulent activities that have been perpetrated by a small number of professionals include falsification of diagnosis, exaggeration of a patient’s condition and lack of billing services. Acts of fraud have become prevalent in many institutions today; this had led the federal government to come up with laws for the purpose of detecting fraud (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007).

  1. Research and initiatives

Despite the fact that the electronic records have offered improved quality care and patient satisfaction, it is significant to have more research to confirm the expectations (Crosson, Ohmann, & Hahn, 2009). In an evaluation of literatures from 1950 to 2007, it was confirmed that specific areas, for example, function evaluation, adoption, as well as attitudes provide significant opportunities that can be used for the purpose of research.  The data that is found in the electronic records can be utilized for the purpose for the purpose of supporting quality improvements initiatives that include the evaluation of nurse care through the nursing documentation (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).

Conclusion

As highlighted in this report, there are both negative and positive impacts when it comes to the transition into new market rules. This paper focused on the transition of electronic health records as a new market rule, the report analyzed both the negative and positive impacts. According to the report some of the positive impacts of electronic health records include; Increased efficiency and productivity. The use of EMR will ensure that several medical results are retrieved in a rapid manner. Improving the quality of care and patient safety; as noted, the electronic health records improve the safety of patients through many ways, for example, the improvement of the legibility of the clinical records as well as decreased duplication of the records. EMR utilize passwords to guard records; passwords are utilized as the first lines of defense to guard against the unauthorized access. Today, it is possible to utilize portable devices; the transformation to EMR will make it possible to transfer information on records to portable devices. The prevalent negative impacts include; extensive use of resources; Need for Training; productivity hit and Updating the written information practices.

Recommendations

To achieve favorable outcomes in the transition, it is advisable to assess the appropriateness and the feasibility of carrying out a PIA. This is in order to determine the actual as well as the actual threats that the new information may have on people’s privacy and to come up with ways in which the risks can be mitigated in the best way possible (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013). It is important for the physicians to ensure that they have the sufficient human resources as well as technical expertise for the purpose of implementing the new technology and to record the personal health information into the new systems. It is advisable to equip staff with knowledge; they should be trained extensively and educated on new systems (Kralewski, Dowd, Cole, Gans, Malakar, & Elson, 2008). It is worth noting that in some cases, the physician may lack the resources or even the technical expertise to make the right transition, in this case, it is advisable for them to seek assistance from the third parties.

The access to the records should be limited to the medical as well as the administrative staff, this should be on a need to know basis, for the purpose of carrying out all their job functions (Dagroso, Williams, Chesney, Lee, & Theoharis, 2007). All the staff in the organization should be required to construct, use as well as protect strong passwords which should be updated on a regular basis. The transmission of personal health information, by using email should be highly discouraged; it should be only encouraged in cases where information is encrypted. Transferring information using portable devices ought to be highly discouraged, in a similar manner, the wireless technologies should not be used for the purpose of transmitting medical information (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).

When the transition has been made, the physicians should retain, transfer, or even dispose of the paper records in a secure way. The records should not be destroyed until authorization has been given by the relevant departments (Murphy, 2015). Since privacy breaches appear to be inevitable, the physicians should ensure that they have a privacy breach protocol in place for the purpose of managing the breaches that may occur. Despite the fact that the systems pose many threats in the protection of the health information, it is possible to effectively address some of the challenges (Linder, Schnipper, Tsurikova, Melnikas, Volk, & Middleton, 2013).

References

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