BB102

Business Information System

CASE STUDY 4: Are Electronic Medical Records a Cure for Health Care?
(Chapter 13, Pg.546)
1.

What management, organization, and technology factors are responsible for

the difficulties in building electronic medical record systems? Explain your answer.
Electronic medical systems typically cost around $30,000 to $50,000 per doctor.
The expenditure of overhauling recordkeeping systems represents a significant increase
in the short-term budgets and workloads of smaller health care provides.
Many smaller practices are finding it difficult to afford the costs and time
commitment for upgrading their recordkeeping systems. In 2008, 80 percent of
physicians and 90 percent of hospitals in the United States are still using paper medical
records.
Many issues with sharing of medical data between different systems in different
health care providers. While the majority of EMR systems are likely to satisfy the
specified criteria of reporting data electronically to governmental agencies, they may not
be able to report the same data to one another, a key requirement for a nation-wide
system.
2.

What stages of system building will be the most difficult when creating

electronic medical record systems? Explain your answer.

The system being developed and implemented will be the most difficult when
creating electronic medical record systems because jeopardizing the goal of a national
system where all health care providers can share information. Besides, there are many
other smaller obstacles that health care providers, health IT developers, and insurance
companies need to overcome for electronic health records to catch on nationally,
including patients privacy concerns, data quality issues, and resistance from health care
workers.
Moreover, many smaller practices are finding it difficult to afford the costs and
time commitment for upgrading their recordkeeping systems. In 2008, 80 percent of
physicians and 90 percent of hospitals in the United States are still using paper medical
records.

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3.

What is the business and social impact of not digitizing medical records (to

individual physicians, hospitals, insures, patients)?

Some of the disadvantages include such items as the startup costs, which can be
excessive. At a time when healthcare organizations need to reduce their costs, allocating
capital to information systems is still a challenge (Dick, Steen, and Detmer 16).
However, some believe that an EHR can not only reduce costs but also improve quality
of care through better-informed healthcare providers and patients, the elimination of
duplicate testing, and better coordination of treatment by more than one healthcare
provider (Dick, Steen, and Detmer 15). One example of cost savings resulting from an
EHR involves antineoplastic agents. Out-of-range lab values, which instantly appear at a
pharmacy workstation and the chemotherapy in fusion center, can prevent the mixing of
expensive antineoplastic agents should the patients counts prevent infusion on that day
Although providers are concerned with return on investment, they realize that the gains
from EHRs are in patient safety and efficiencies rather than in tangible and measurable
financial terms (Waegemann 3).
Another disadvantage to an EHR is that there is a substantial learning curve and it
is helpful if the users have some type of technical knowledge. Today, clinicians are the
primary users of EHRs as opposed to the main users of the past, which where clerks. One
of the more challenging issues confronting EHRs is the fact that physicians must be the
users of the system, performing data entry (e.g., orders, progress notes) as well as
information retrieval, if they are to realize the benefits of interactive on-line decision
support (Dick, Steen, and Detmer12). Young recognizes that usability (106) can be a
major obstacle affecting the implementation of an EHR. The designers of EHR systems
have only just begun to consider the needs of the users. There must be tools to enable the
clinicians to retrieve and understand data relevant to their decision-making tasks
(Young 106). In other words, systems must be user friendly; otherwise these systems will
not be easily accepted, nor will they be used to their fullest capacity. While putting
down the pen and picking up the mouse involves a cultural shift, clinicians soon realize
the benefits of a readily available, organized patient database, enhanced communication
among staff, improved risk management, and instantaneous outcome tracking and
reporting capabilities (Wellen, Bouchard, and Houston 3).

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Confidentiality and security issues are concerns associated with both the paper
health record and the EHR. There has been much discussion about this topic and although
the patient record must be protected, the patient must also remember that the record has
to be accessible to the professionals who use the records to provide medical care. Laws
must not be so stringent as to prohibit access to those with a legitimate right to
information (Young 107). There are several security technologies available that will
help prevent unauthorized access to protected health information. Some of these
technologies include firewalls, passwords and properly designed and monitored audit
trails can enhance user accountability by detecting and recording unauthorized access to
confidential information (Dick, Steen, and Detmer 14). System designs must consider
how individually identifiable medical information will be protected and also meet
regulatory requirements. Whereas stringent security measures should be applied to
protect the confidentiality of patient information, it is also in the patients best interest for
the [EHR] to be accessible for appropriate, legitimate uses by authorized users (Dick,
Steen, and Detmer 15).
Placement of hardware is an issue and decisions regarding the portability of the
equipment must also be considered. Since workflow will change after the implementation
of an EHR, decisions must be made to determine who enters the data and documentation
forms must be revised in order to accommodate the changes.
4.

What are the business and social benefits of digitizing medical recordkeeping?
The benefits of digitizing medical recordkeeping is improve quality of care such

as nurse scan tags for patients and medications to ensure that the correct dosages of
medicines are going to the correct patients. This feature reduces medication errors, which
is one of the most common and costly types of medical errors, and speeds up treatment as
well.
Patient also report that the report that the process of being treated at the Veterans
Affairs (VA) system is effortless compared to paper-based providers because instant
processing of claims and payments are among the benefits of EMR systems.

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Electronic systems hold the promise of immediate processing, or real-time claims

adjudication, just like when you pay using a credit card. Claim data would be sent
immediately, and diagnostic and procedure code information are automatically entered.
5.

Name two important information requirements for physicians, two for

patients, and two for hospitals that should be addressed by electronic medical
records systems.
Two important information requirements for physicians are demonstrating
meaningful use by the EMR deadline in 2015 and the ability to write at least 40 percent
of their total prescriptions electronically, an EMR system contains patients vital medical
data and a full medical history and cost around $30,000 to $50,000 per doctor for
hospitals requirement.
6.

Diagram the as-is and to-be processes for prescribing a medication for a

patient before and after an EMR system is implemented.

After EMR system is implemented, EMR system replaces the inefficiency
inherent in paper-based recordkeeping. Electronic records will reduce medical errors and
improve care, create less paperwork, and provide quicker service, all of which will lead
to dramatic saving in the futures.
The examples of EMR system is the Veterans Affairs (AV) system of doctors and
hospitals. A typical VistA record list a patients health problems, weight and blood
pressure since beginning treatment at the VA, images of the patients X-rays, lab results
and other test results, lists of medications, and reminders about upcoming appointments.
VistA also has many features that improve quality of care such as nurse scan tags
for patients and medications to ensure that the correct dosages of medicines are going to
the correct patients. This feature reduces medication errors, which is one of the most
common and costly types of medical errors, and speeds up treatment as well.