A study in electronic medical records for a community health center Part 1

A Study in Electronic Medical Records part 1
Introduction
Information technology has profoundly changed the way many businesses operate. Data is now available at the click of a mouse button; this data can be used to compile valuable information for almost any industry. The shift to electronic data management creates many procedural changes for any organization (Back, 1995). The health care industry is no different and has been changed by the surge in information technology. The retrieval and manipulation of data, once performed with paper and pen, shifts to sophisticated database tables and management applications. A practice management system that includes electronic medical records is an automated clinical application that archives data which includes patient medical history, demographics, provider notes, drug information and even facilitates the issuance of electronic prescriptions (Surti, 2002). The implementation of a new system will create changes that require careful research and preparation before actual implementation. The selection and research process has begun at RCHC for a new practice management system that implements the use of electronic medical records.

Purpose of the study
This study identifies the obstacles associated with the research, selection and implementation of electronic medical records in a community health care environment. Thorough research is important in the selection of electronic medical records and is especially important when considering the needs of a federally qualified health center. Bad decisions can cost a health clinic hundreds of thousands of dollars in equipment and lost productivity and this money comes from tax payers in the form of federal grants such as the American recovery and reinvestment act of 2009, otherwise know as the economic stimulus plan (LeBlanc, 2009). The stimulus plan has allotted just over $500,000 for federally qualified health care centers for use in information technology and infrastructure (iHealthbeat, 2009). The goal of this study is to outline the steps needed to effectively implement a practice management system with the addition of an electronic medical records application with the least amount of wasted resources and time.

Significance to the writer
This study is significant to the writer and to anyone in the IT/medical industry. The trend within the industry is moving toward paperless offices and electronic records (Gates, 2007). This technology is not new but it is not yet widely used. Many staff members in the medical industry are not versed in technological lingo yet they still wish to utilize technology to the fullest. For this reason, it is necessary to employ staff members who are dedicated to technological advancement (Gates, 2007). These members of the staff can stay abreast to new systems and practices within the IT/medical community. Our near future will see an explosion of electronic medical record use and it is up to knowledgeable members of the staff to bring these technologies to light for the benefit of the business as a whole.

Significance of the study
The emergence of electronic medical record systems has created a rush by vendors who now offer over 300 systems for health care centers to select from (Venkatraman, 2008). This selection process can be cumbersome when trying to meet the specific needs of a clinic. For this reason, many clinics have formed consulting networks that aid other clinics through the entire process. A valuable resource to a health clinic can be provided by these networks of individuals who have already experienced this process and have already identified the pitfalls associated with this daunting task.

Many professionals in the medical industry are not trained or familiar with the level of technology required to perform this system implementation, this is why a consulting firm can be very useful (Jacobson, 2005). It is up to the technical support staff to understand and maintain any new system. Each member of management is required to be involved in this selection and implementation. Without everyone’s involvement this project could easily flounder under the extreme changes that a new system will bring. Each person in the organization will have direct contact with this new system and should be thoroughly trained and comfortable manipulating the new system. It is the responsibility of management to ensure that all users are able to properly use this system. Failure to properly use a new electronic medical record system can cause loss of productivity, security vulnerabilities and even unnecessary stress to members of the staff.

Significance to the health clinic
The implementation of an electronic medical record system should be well planned and well executed. The information within an electronic medical record system is too valuable and a practice is much too busy to take the implementation of a new system lightly. Loss of data and down time can be very costly to a practice. It is possible to purchase an excellent system but proceed with implementation in an ineffective manner causing many problems along the way. It is also possible to purchase an inferior system and have completely smooth implementation. The quality of the system is not an issue during implantation. A good implementation plan will keep the project manageable, not difficult or overwhelming.

Why should a medical facility consider the purchase of an electronic medical record system? The introduction of a new system, if implemented properly, can improve the organization bottom line, improve patient care and increase staff job satisfaction (Gonzalez, 2008). The organizational bottom line can be improved in many ways. First, the obvious cost of paper charts will be greatly reduced. Along with the reduction of paper charts comes a reduction in the number of staff members required to support a paper chart system. With the elimination of charts, staff members will spend less time faxing documents for quicker and easier digital transmission methods such as email. Costs related to organizing and storing paper charts will also be eliminated with the introduction of electronic medical records. An electronic record system will also decrease the time and cost associated with medical transcription.

Significance to the patients
Patient care will be increased with the addition of electronic medical records. The elimination of the gap in time currently required to enter encounter data into the system will decrease possible documentation errors. Missing or lost charts will be a thing of the past with all records accessible through a central database. An electronic medical record system will also bring issues to the forefront that may be currently overlooked such as patient allergies. It is easy to overlook things such as allergies and an electronic system will guarantee that these things are brought to the attention of providers during each encounter.

Organizational overview
RCHC operates without the use of any electronic medical records. Traditional charts and folders are used to record patient medical information. However, patient information does end up as data within the health center’s current practice management system. During the clinical encounter the information is gathered and recorded as hard copy on physical pieces of paper then placed within folders. The information from the folders is then entered in the current practice management system. This practice management system serves as an electronic database to store patient demographic, encounter and billing information. This system also automates the billing process and streamlines the practice scheduling for the entire health center.

The addition of electronic medical records to this system would expand the database to allow for complete digital records of patient medical information, not just demographic, billing and sometimes cryptic encounter information. The creation of physical patient folders and charts would now exist entirely within an electronic environment. Providers will be able to directly add information into the system during encounters decreasing data entry errors related to the delay in data entry. This new system will create procedural changes that affect the entire health center. A large portion of data entry time will occur within the exam rooms and in turn change the time required for an office visit, patient information will be shared with other providers electronically under HIPPA compliant methods and an entire medical records office and staff will be transformed. What once were a department consisting of two large rooms that stored rows of paper charts and a staff of five people, in time, will be a few computers and staff members integrated into the office environment.