Thursday, March 3, 2011

Health Information Technology Advantages and Disadvantages

One of the biggest issues facing our country today is that of health care reform. One way to effectively reform health care is through the use of health information technology. If implemented, a HIT system could have the potential to drastically reduce health care costs, while simultaneously increasing health care worker productivity, two major factors in reforming American health care (Cullen, Ranji, & Salganicoff, 2011). 


The addition of computers in hospitals, private practices, and clinics have allowed these establishments to function more efficiently, allowing more time to focus on patient care. While computers have already greatly improved the health care system, they are being not used to their full capacity. As aspects of medicine continue to be updated with new technology, it is clear that a paper record system is outdated and in need of improvement.). The most sensible solution to this problem lies in the prospect of a computerized HIT system that would allow significant changes in the way records are kept and maintained

While there is no set universal HIT system, there are three main components that are considered necessary: Personal Health Records (PHRs), Electronic Medical Records (EMRs), and Electronic Health Records (EHRs) (Cullen, Ranji, & Salganicoff, 2011). Public Health Records (PHRs) allow personal access to one’s own health information so that it can shared electronically with whoever they wish to see it (Cullen, Ranji, & Salganicoff, 2011). Electronic Health Records (EHRs) are electronic patient records that can be shared with various medical institutions in order to give an accurate complete medical history of the patient. (Cullen, Ranji, & Salganicoff, 2011). EHRs would be essential to patients who would have to see multiple doctors for treatment as it would allow an easy flow of patient information between physicians (Wexler 3). The most important aspect of this system is the Electronic Medical Records (EMRs), which are "an adapted version of the patient record in an electronic format primarily intended for health care providers and stored within a given institution or organization such as hospital or health delivery system" (Cullen, Ranji, & Salganicoff, 2011). EMRs, which are currently being used in some major cities, offer the benefit of having a complete and current medical history of a patient, down to the exact drug dosage and latest x-ray scans, all stored electronically in an accessible database (Halvorson 74). The use of a HIT system would greatly improve several aspects of the current health care system. Its implementation would allow "accurate and complete information about a patient’s health, the ability to better coordinate the care [given], a way to securely share information with patients and their family caregivers over the Internet, and [access] to information to help doctors diagnose health problems sooner, reduce medical errors, and provide safer care at lower costs" (The Office of the National Coordinator for Health Information Technology).

While the potential benefits of a HIT system would theoretically improve the condition of health care, "only 20% of doctors and 10% of hospitals currently use EHRs" (Cullen, Ranji, & Salganicoff, 2011). This lack of efficient technology is most likely due to the extremely high cost needed to change the paper record system to EMRs in every medical establishment in the country. Halvorson estimates the cost at being a staggering $115 billion to switch over to the new system (59). In a country facing an economic recession and a gigantic national deficit, that number seems practically impossible to obtain, causing a delay in the installation of this helpful system
Realizing the potential effect of a HIT system on health care, both the current and former president have gone to great lengths in hopes of progressing this issue into a usable, universal system. In 2004, President George W. Bush created the Office of the National Coordinator for Health Information Technology as a branch under the Department of Health and Human Services in order to drastically increase the nation’s use of HIT (Cullen, Ranji, & Salganicoff, 2011). Following his lead, President Obama "signed the Health Information Technology for Economic and Clinical Health (HITECH) Act … which has become the guiding framework for expansion of HIT in the U.S." (Cullen, Ranji, & Salganicoff, 2011). As a result of this act, several government and private funding opportunities have been created to provide the necessary capital needed to implement a HIT system (HITECH and Funding Opportunities, 2011).

As with almost any scientific improvement, there are a number of ethical concerns raised by the prospect of a HIT system. With this particular invention, though, ethical concerns go hand in hand with personal security issues. The major ethical concern of a HIT system is correct usage of access to a patient’s health record information through the use of EMRs. An open database system could potentially allow workers to unethically look up a patient’s medical reason for purposes other than what they were intended for. Sameh Saleh, a Visual Assistant for Kaiser Permanente, which has an EMR system in place, states that measures are taken in order to protect a patient’s personal health information (Saleh). While all employees have access to patient EMRs, Saleh says that "if an employee accesses a patient’s information for no apparent reason, the IT department will trace it back and disciplinary actions will be enforced" (Saleh). Furthermore, "employees are restricted from accessing any files belonging to family members, friends, or coworkers" (Saleh).
Another major ethical and security issue of HIT systems is the potential loss of data (Mick and Conners, 2011). The concern of data being lost is an issue that almost any institution using computers must face. After all, computers are not perfect and are subject to errors that could result in data loss or destruction. Kaiser Permanente uses Epic Hyperspace as their main database system that ensures a back up of all data entered into the system (Saleh). Saleh says that "any personal information entered into company computers is backed up on a daily basis, ensuring the prevention of data loss regardless of what happens to the individual computers" (Saleh). It is clear for any medical group implementing a HIT system they must realize that "there are legal as well
as ethical ramifications for the protection against loss of data, whether due to natural disasters, technical malfunctions, corporate financial complications, or intentional destruction" (Mick and Conners, 2011). As with Kaiser Permanente, these establishments must take precautionary measures to combat these ethical and security concerns.
Advantages of Using Health Information Technology:

  • Increases work efficiency
  • Reduces paper waste
  • Allows easier access to a patient's medical records
  • More complete and current medical history
Disadvantages of Using Health Information Technology:
  • Expensive to implement
  • May not be compatible everywhere
  • May require extra training
  • Raises ethical and security concern
The future of health care reform lies in the progress of a health information technology system that can be used nationwide. The potential benefits from the implementation of HIT clearly show that it is an important aspect of making our nation’s health care better. While the country has made great strides in making a nationwide HIT system possible, we still have a long way to go to achieve total medical computerization. Hopefully, as we continue to make improvements in technology, we can find a way to make an affordable HIT system that could be used in hospitals and medical practices nationwide in order to improve our nation’s health care. 



References:

Cullen, E., Ranji, U., & Salganicoff, A. (n.d.). Health Information Technology: Background Brief - KaiserEDU.org, Health Policy Education from the Henry J. Kaiser Family Foundation . Home - KaiserEDU.org, Health Policy Education from the Henry J. Kaiser Family Foundation . Retrieved February 12, 2011, from http://www.kaiseredu.org/Issue-Modules/Health-Information-Technology/Background-Brief.aspx 

Halvorson, G. C. (2007). Health care reform now!: a prescription for change. San Francisco, CA: John Wiley & Sons.  

HITECH and Funding Opportunities. (n.d.). HealthIT.hhs.gov: Home. Retrieved February 24, 2011, from http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__hitech_and_funding_opportunities/1310

Mick, M., & Conners, S. (n.d.). Ethical issues of medical records on the internet. Ethical issues of medical records on the internet. Retrieved February 20, 2011, from http://webpages.cs.luc.edu/~laufer/ethics97/papers/MickConners.html 

Saleh, Sameh. Personal interview. 25 Feb. 2011. 



 The Office of the National Coordinator for Health Information Technology. (2011, February 18). HealthIT.hhs.gov: Home. Retrieved February 20, 2011, from http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204

Wexler, B. (2005).
              Thomson/Gale.
The health care system . Farmington Hills, MI:

1 comment:

  1. Great blog and post on pros & cons of HIT Lindsey, thank you and keep it up.
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