Introduction
The healthcare industry has undergone significant improvements with the technological revolution of the 21st century. Innovations in this sector have huge impacts on people’s health. One of the important inventions in this industry is electronic health records (EHR). While earlier innovations focused on drugs and equipment, EHR has revolutionized the patient’s experience in healthcare provision. EHR is an electronic system that captures patients’ key administrative clinical data and stores it for reference. Such data can be accessed and shared remotely among different healthcare providers. EHR has replaced the traditional paper-based system, which has numerous drawbacks. Initially, this system was developed for billing services. However, with time, different functionalities were added, and thus EHR now covers most functions in diverse set-ups of healthcare provision. This paper explores Cerner, which is one of the most used EHR systems in healthcare provision. The paper will also discuss how the EHR system can be used to improve organizations’ efficiency and patient outcomes.
Cerner EHR System
Cerner Powerchart® is one of the popular EHR systems that have been adopted by different healthcare providers. The system’s common functional features include appointment management, charting, e-prescribing, evaluation and management coding, patient portal, voice recognition, patient education resources, detailed scheduling, auto texting, and other dynamic clinical documentation tools (Cerner, 2018). Additionally, the system is compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). It is also Meaningful Use certified, and NC-ATCB certified. Cerner Powerchart® supports over 50 health system specialties, including acute care, cardiovascular, critical care, and emergency department, among others (Cerner, 2018).
The documentation functionality of Cerner Powerchart® is dynamic, and it prevents the doubling of charting information. Users can transfer charting data automatically into different areas of health records of any patient. Additionally, the system allows users to apply different imputing methods, including code and structured words, voice recognition, and free text. Users can apply the auto-texting feature to access pre-completed information automatically using triggers. As such, physicians and other users save valuable time that could otherwise be lost because of long documentation processes. Moreover, users can connect with different pharmacies, thus facilitating fast medication prescription refills. The system also facilitates the delivery of lab results in real-time. The patient portal lets users book appointments, update information, send files, request refills, and view clinical information, among others.
The system has two deployment options, as it can be cloud-based or on-premise. Additionally, it can be used with the common operating systems, including Windows, Macintosh, Linux, and iOS for mobile interface. The PowerChart Touch is the mobile app that allows users to access the system through mobile devices and tablets. The system uses three different pricing models. The perpetual license model is for on-premise applications where clients purchase the system (Cerner, 2018). Other costs associated with this model include installation and customization charges. The subscription model requires users to make monthly payments, and they access the system over the Internet. Finally, the commercial open source allows users to acquire the software at zero cost. However, one is not connected to any vendor solutions. Therefore, the user is responsible for maintenance, upgrading, troubleshooting, and customization, among other requirements that are needed for the system to function effectively. According to Choi, Lee, and Rhee (2013), cloud-based usage is the most cost-effective approach to EHR systems for small organizations. Cerner charges $25 per user per month. However, in large organizations, the perpetual licensing model is cost-effective, especially considering the long-term total cost of ownership. Therefore, regardless of the size of an organization, Cerner offers viable alternatives for the acquisition and usage of its EHR system.
Maximizing Organizational Efficiency
The success of any organization depends on the effectiveness with which service is delivered. In the healthcare sector, patients seek timely and quality services, and thus providers have been working on this area to come up with improvement strategies. However, with the entry of EHR systems, healthcare providers are now in a position to improve efficiency in care services to patients.
EHR systems are associated with lowering operational costs for healthcare providers (Alpert, 2016). For instance, with such a system, office supplies are reduced together with paper-based expenses. Additionally, minimal labor requirements imply that healthcare providers can save money to be utilized in other areas to improve efficiency. Initially, most healthcare institutions depended on third parties to process insurance claims. These players would levy considerable amounts on what a patient is charged for services offered. Therefore, hospitals and other set-ups would lose money through this avenue. However, EHR platforms have created a way through which the processing of claims can be effected without the involvement of third parties. Similarly, healthcare providers had to coordinate with different players in the industry, like pharmacies and laboratories, which would cost resources and time (Campanella et al., 2016). EHR offers a platform that connects all players in the industry, including insurance companies, laboratories, and pharmacies, among others. Ultimately, hospitals cut costs associated with such activities. On the other hand, by improving efficiency in healthcare institutions, EHR increases the profitability of different players in the industry. Therefore, if the gained profits are used appropriately, healthcare institutions can expand their services and improve efficiency in different ways.
Nevertheless, critics of the cost-saving nature of EHR argue that the system is expensive to acquire, and thus counterproductive. However, eligible health care providers get financial incentives to procure the needed equipment, hire qualified personnel to implement the system, and train existing workers on how to use it (Alpert, 2016). The incentives are offered through the Medicaid EHR Incentive Program and the Medicare EHR Incentive Program. As such, the cost of implementation is reduced significantly. On the other hand, different providers of EHR systems like Cerner and others have created different pricing models that can be used based on one’s needs. The subscription model is useful for small organizations and individual physicians. Ultimately, barriers to the acquisition and implementation of electronic medical records systems have been removed through different strategies (Hoover, 2017). In light of this understanding, the cost-benefit analysis of having an EHR system shows that organizations will benefit immensely by implementing this system.
One of the areas where healthcare providers have experienced remarkable efficiency improvement by using EHR is the elimination of paper-based patient records. Initially, patient records were captured on papers, which meant storage and retrieval of such information was tedious and time-consuming (Hoover, 2017). For instance, a hardcopy document containing patient information had to go through different individuals from the storage room to the area of application. As such, time would be wasted, and the probability of making an error increased tremendously. However, with EHR, patient data is captured and stored in a system where it can be accessed remotely. Therefore, the need for filing and physical transportation is eliminated, thus increasing efficiency. Healthcare providers now allocate time and resources to improving service provision.
With the instant availability of patient data via EHR systems, doctors can now offer timely services to patients. Normally, a typical patient visits different doctors for diverse reasons (Palabindala, Pamarthy, & Jonnalagadda, 2016). However, with every visit, new information is captured, and it has to be added to the patient’s file. Under the traditional paper-based system, this procedure would take time to be completed for different patients. Moreover, having disparate people update the patients’ information leads to further confusion of the data captured. This aspect may lead to costly mistakes as a patient may get the wrong prescription due to erroneous information. Additionally, doctors had to communicate with one another to understand the patients’ medical history in a bid to make informed medical decisions. However, EHR offers a better way of obtaining, recording, storing, and distributing patient information amongst healthcare providers (Campanella et al., 2016). For instance, if a patient visits a physician for a given reason, the doctor will retrieve the client’s data instantly using the EHR system. As such, the physician will access the patient’s history regardless of the hospital or healthcare facility that had been visited previously. The doctor then makes an evidence-based medical decision within a short time, and thus the patient receives timely service. This aspect increases organizational efficiency in service delivery significantly.
EHR systems also remove communication barriers that were presented by the traditional approach to healthcare provision. Through the integrated texting functionality, doctors and patients can be in constant communication on different health-related issues. Additionally, eliminating numerous paper works allows doctors to spend more time delivering care to patients as opposed to focusing on administrative duties. According to Palabindala et al. (2016), traditionally, an average doctor would spend 8 hours in a week handling paperwork. However, EHR now allows healthcare providers to dedicate more time to duties directly associated with patient care. For instance, with the new system, nurses have reported improved patient care as they spend around 30 percent more time monitoring patients (Palabindala et al., 2016). Ultimately, patient outcomes are improved as healthcare organizations become more effective in service delivery, as discussed in the next section.
Improving Patient Outcomes
In the provision of healthcare, convenience, accuracy, and quality are important factors that healthcare providers should consider during the execution of their duties. EHR systems allow the provision of quality care in different aspects. First, doctors make accurate medical decisions. While in some professions, people may get away with wrong decisions, healthcare providers cannot afford to make mistakes. Therefore, doctors have to be keen because a wrong decision may mean life or death for a patient. Unfortunately, doctors have to use patients’ medical history, which is captured in different systems. Under the paper-based system, this information is contained in hard copies, which have to be filed and retrieved on demand (Yanamadala, Morrison, Curtin, McDonald, & Hernandez-Boussard, 2016).
However, the involvement of different individuals in the capturing, storage, and retrieval process, human error is bound to happen. This assertion explains why medical errors are the third leading cause of death in the United States after cardiovascular diseases and cancer (James, 2013). Such deaths should not happen because they are preventable. According to James (2013), over 400,000 preventable deaths occur in the United States annually, and the majority of them are associated with medical errors. However, with EHR, doctors are now in a position to make evidence-based decisions after accessing real-time information concerning the patients’ history. James (2013) notes that hospitals using EHR experience close to 4 percent lower mortality rates as compared to their counterparts using the conventional paper-based system.
Additionally, EHR improves the overall patient experience when receiving care, which underscores the aspect of convenience. With this system, patients get timely services. For instance, patients can schedule an appointment from homes using their mobile devices (Yanamadala et al., 2016). As such, they do not need to travel to hospitals or make unnecessary calls to book an appointment. Once they get to healthcare facilities, the registration process is seamless as the system facilitates the same. After entering a physician’s room, the patient’s history is retrieved instantaneously. The doctor then makes an evidence-based medical decision, which reduces the chances of the occurrence of wrong decisions. Ultimately, the patient receives quality care within a short period. However, under the conventional system, a patient has to travel to the hospital and book an appointment. On a material day, one has to travel again to the hospital where he or she will be subjected to a long process of registration. Files will have to be retrieved from the storage room before being forwarded to the doctor. Even then, the doctor will not be in a position to access the patient’s history that has been captured in different hospitals. As such, chances of making misdiagnosis are high, and thus the quality of care is poor.
EHR has integrated real-time communication channels between patients and doctors. Patients can easily get information concerning their medicine through e-prescription (Yanamadala et al., 2016). Additionally, prescribers are warmed of potential allergic reactions, and physicians are alerted of the availability of certain drugs or generic alternatives. Moreover, e-prescribing reduces the number of errors in dispensing medicine, which is associated with illegible faxes or bad handwriting. According to Da Silva and Krishnamurthy (2016), prescription errors contribute to over 80 percent of preventable deaths associated with mistakes made by healthcare providers. The issue of prescription errors can occur when nurses are administering medicine according to the physicians’ directives or during dispensing at pharmacies. This aspect leads to negative patient outcomes. However, with EHR, the physicians’ instructions are clear and concise, and the probability of making an error reduces significantly.
Another aspect of EHR is the capacity to avail of information to patients. While the field of medicine has evolved over the years, its principles have not changed. For instance, a preventive approach to health is better than medication. EHR allows patients to access their medical information, and this aspect can have a huge impact on health outcomes (Yanamadala et al., 2016). Health and wellbeing are, in large part, a personal issue. For instance, the majority of lifestyle diseases can be prevented through healthy living. However, one of the challenges has been personalizing health information for different individuals. However, EHR provides people with personal health data. Therefore, individuals are encouraged to take charge of their health status by making evidence-based decisions concerning their lifestyles. Ultimately, patients’ health outcomes improve significantly. Some EHR platforms like Cerner have health resources that patients can access and gain knowledge on different issues.
EHR systems offer invaluable and diverse data on patients, which can be useful in different ways. First, the continuous collection of information can allow healthcare providers to offer more personalized care. As such, given the history of a patient, preventive approaches can be adopted to improve health outcomes in the future (Yanamadala et al., 2016). Additionally, policymaking is one of the determinants of a healthy nation in terms of accessibility and the quality of health provided to different populations. For instance, the Affordable Care Act allows millions of Americans to access healthcare services, among other benefits. In the context of EHR, the data collected can be an important tool in making health-related policies to improve patient outcomes (Ross, Wei, & Ohno-Machado, 2014).
The evidence-based policy allows for the setting of realistic and achievable objectives. In addition, using “big data” analytics, the information collected through EHR can be aggregated to understand health trends in different populations (Ross et al., 2014). As such, potential outbreaks can be identified to come up with preventive and treatment measures to address the situation. For instance, influenza is a seasonal epidemic in the United States, especially during winter and fall. One of the problems with influenza is that different strains keep on emerging, and thus handling the problem becomes complicated. However, with data collected through EHR, the occurrence of these incidences can be monitored to come up with appropriate response measures. Changes occurring in the influenza strains can be studied to address the issue in a better way. Ultimately, the impact of different diseases can be studied using data collected from EHR. As such, health outcomes can improve significantly.
The ultimate goal of EHR is to offer better patient care (Alpert, 2016). Even the efficiency benefits experienced at organizational levels are geared towards improving patient experience in care delivery. As such, the scope of patient outcomes extends to education and research. For a functional healthcare system, the people involved in service provision, including doctors, nurses, and pharmacists, among others, should be trained on evidence-based practices. Therefore, data collected through EHR can be useful in coming up with learning curricula that address patient needs based on evidence. Ultimately, transferring theory to practice will be straightforward without many drawbacks. According to Hussein and Osuji (2016), one of the challenges facing healthcare provision globally is the inability to transfer theory to practice. There are gaps between what is learned in theory and what happens in practice. This problem is majorly attributed to curricula not based on practice realities. Therefore, data from EHR can play an important role in bridging this gap. Ultimately, health practitioners will be prepared to offer quality services upon entering the workforce, thus improving patient outcomes.
Conclusion
EHR has revolutionized the way healthcare providers deliver care together with how patients experience it. Even though the system was meant for billing purposes, it has evolved to cover almost all facets of healthcare provision. Healthcare institutions now function efficiently by offering timely, quality, and convenient services. The interoperability of EHR systems allows healthcare practitioners to coordinate different aspects, especially in sharing patient data for improved medical decision-making. The number of preventable deaths is going down due to the precision with which care is delivered and medicine administered. People have taken charge of their health statuses by accessing personal information through the system. EHR plays an important role in ensuring public health by availing data that can be used to study disease patterns to come up with appropriate response measures. Data from these systems are being used in policymaking and curricula development, which are all geared towards improving patient outcomes.
References
Alpert, J. (2016). The electronic medical record in 2016: Advantages and disadvantages. Digital Medicine, 2(2), 48-51.
Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, L. (2016). The impact of electronic health records on healthcare quality: A systematic review and meta-analysis. European Journal of Public Health, 26(1), 60-64.
Cerner. (2018). Electronic medical record. Web.
Choi, J. S., Lee, W. B., & Rhee, P. -L. (2013). Cost-benefit analysis of electronic medical record system at a tertiary care hospital. Healthcare Informatics Research, 19(3), 205–214.
Da Silva, B. A., & Krishnamurthy, M. (2016). The alarming reality of medication error: A patient case and review of Pennsylvania and National data. Journal of Community Hospital Internal Medicine Perspectives, 6(4), 1-6. Web.
Hoover, R. (2017). Benefits of using an electronic health record. Nursing Critical Care, 12(1), 9-10.
James, J. (2013). A new, evidence-based estimate of patient harms associated with hospital care. Journal of Patient Safety, 9(3), 122-128.
Palabindala, V., Pamarthy, A., & Jonnalagadda, N. R. (2016). Adoption of electronic health records and barriers. Journal of Community Hospital Internal Medicine Perspectives, 6(5), 1-3. Web.
Ross, K., Wei, W., & Ohno-Machado, L. (2014). “Big data” and the electronic health record. Yearbook of Medical Informatics, 9(1), 97–104.
Yanamadala, S., Morrison, D., Curtin, C., McDonald, K., & Hernandez-Boussard, T. (2016). Electronic health records and quality of care: An observational study modeling impact on mortality, readmissions, and complications. Medicine, 95(19), 1-6. Web.