Introduction

The Baptist Hospital in Miami is a facility that has adopted an electronic health record system in its operations. This hospital has embraced a system known as Net Access. Net Access has also been adopted by numerous hospitals in Florida and across the US. Essentially, it enables medical staff to easily record the patients data in a digital format. The hospital has moved on from a paper-based system that it was using previously. According to the hospitals CEO, whom I interviewed for this report, the system was first adopted in 2007. The major factor that led to its development was the convenience and ease that it introduces to the problem of health records management. The system of electronic health records at the Baptist Hospital has been operational for nine years. This essay presents a comprehensive discussion of the electronic health records management system adopted by the Baptist Hospital. It highlights some of the issues that the hospital had experienced during the design process and during the process of systems implementation.

Electronic Documentation System

Net Access is used for managing a wide range of information regarding the hospitals patients, including the information pertaining to insurance. With the help of this system, a physician is able to quickly determine whether a patient is insured and what type of insurance cover does a patient have. Also, Net Access allows practitioners to gain insights into a patients medical history and all of the treatment that a patient has received in the past. Net Access system is dynamic and quite flexible, which allows it to accommodate more information than what the staff at the hospital could have previously. The additional capacity makes the system future-proof, as the hospital does not expect to implement a new system to address any possible future changes.

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The development, installation and management of electronic health records require efforts from all of the stakeholders. At the Baptist Hospital, the IT department is primarily responsible for the management of the electronic documentation system. This unit resolves any problems that may occur with the system and it also works together with other departments in order to ensure that the system operates optimally. Besides, the hospital has set up a committee which brings together representatives from various critical professional fields. Government agencies and private insurers have representatives on the committee. The primary function of the committee is to monitor the operation of the system. Particularly, the committee ensures that all of the patients information is handled with utmost confidentiality. The confidentiality of patient information is prioritized in the management of most electronic health record systems (Bernat, 2013). The committee takes its members from various medical, technical, financial and regulatory professions. Thus, there are frequent conflicts between the members, who pursue different interests. For instance, insurers often demand that physicians provide certain sensitive and confidential information about their patients, which often would result in a breach of the principle of doctor-patient confidentiality.

There are numerous systems of health records management on the market. Therefore, the selection of a system of electronic health records (EHR) requires a medical institution that plans to implement such a system to consider various factors, which include the specific needs of the organization, cost of acquisition, and costs of managing the system (Hendricks, 2012). These are the primary factors that the leadership of Baptist Hospital has considered before they acquired Net Access system of electronic health records. After some research, they found out that the system was cheaper than most of the alternatives and that it was easier to manage. Besides, the management observed that the system would adequately meet its needs of records management.

The nursing community plays a very significant role in the process of managing the systems of electronic health record (Nguyen, Bellucci, and Nguyen, 2014). At the Baptist Hospital, the nurses have an important role, as they form the largest group that is actively involved in the management and utilization of the system. They oversee it, report any problems that arise, and consult nursing practitioners in order to gain insights into how the organization can improve itself in order to match their existing and upcoming needs.

Design Process

The Baptist Hospital acquired Net Access system from a third-party vendor that specializes in development of electronic records systems. The vendor integrated other supporting systems, such as a system of customized nursing documentation in order to enhance the main systems functionality. Net Access enables nurses to input patients details and retrieve this information from a central server. Some of the data that nurses use in the documentation system include patients personal data, the diagnoses that they make, as well as the prescriptions issued by the physicians. Moreover, the nurses handle other types of information, such as the patients levels of income and their social environment. These details enable the nurses to gain a comprehensive understanding of the physical and social health of their patients.

The EHR system was designed is such a way as to allow it users to access the system from different devices. Therefore, devices such as automated machines for recording financial transactions are linked to it in order to achieve inter-operability. While the hospital has strived to develop standard tools for users from all over the hospital, some departments use rather unique devices. These devices are connected to the system, but often they actually hinder real-time sharing of information. Despite the fact that it is a dynamic system, it does not allow the physicians to make order inputs. However, it does permit practitioners to use smart devices. The hospital has partnered with an electronic device manufacturer that supplies the hospital with special smartphones, which facilitate communication among the staff and support collaboration in the provision of patient care.

Ongoing System Management

The head of the IT department has the responsibility of ensuring a continuous evaluation of the records systems operation. Consequently, the IT department acts in an expeditious manner as to correct any detected flaws in the course of operation. Defects in the records system may create loopholes that may in turn expose confidential information to third parties through unauthorized access. One of the important functions that electronic health record systems offer is that they facilitate decision making support (Rothman, Leonard, and Vigoda, 2012). The system has enhanced the decision-making capacity of the hospitals nursing staff. The ease of access to the patients insurance information allows nurses to advise the patients on the best and most suitable treatments options and plans. Overall, the system has enabled nurses to make decisions that safeguard the health of patients in the best way possible.

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However, the EHR system is still open to abuse. Unscrupulous practitioners could use the system for a selfish gain. Consequently, the IT department restricts and monitors access to the system in order to ensure that it is used only for the meaningful and planned purposes. It department creates different levels of user access for different people, depending on their roles and assigns them unique login credentials, which they are prompted to change with the first login and on a regular basis. These credentials allow the hospital employees to access the system, and the IT department can monitor user activity of the system. These measures ensure that the users of the system access it only for work-related activities.

One of the risks that all of the electronic health records systems face is security breaches and failures. There have been cases where medical facilities have lost massive amounts of data as a result of a system failure (Cunningham, 2015). The IT department of the Baptist Hospital has adopted various measures in order to prevent a possible system failure. The hospital has a remote data center that backs up the information used in the system. The hospital recognizes the need to safeguard the confidentiality of the patients information; thus, it only allows authorized users to access the system. Furthermore, the hospitals IT policy requires that authorized users should only access patients information for work-related reasons. Moreover, it forbids users from sharing such information with third-parties, unless in those cases where it may be legally mandated. Besides, the policy prohibits the display of personal and sensitive patients information in unit areas. It points out that only the generic information, from which one cannot identify a patient, may be displayed.

The Net Access system was developed in order to allow healthcare practitioners easily access and share the patients information. Access to the EHR system has been expanded to include external parties, who often facilitate the provision of healthcare services. Consequently, insurers, suppliers, and regulators have different kinds of access to relevant information in the system. Moreover, some patients, especially frequent international travelers, can access their personal information through a web portal. Such a patient requires only an internet connection and a supported device for access to his/her information.

Challenges with the System

Net Access system has experienced various problems in its course of operations. Maintenance of this EHR system has proved to be quite costly. The electricity expenses that the hospital incurs have risen rather sharply. This spike is primarily due to high level of electricity consumption by the equipment needed to sustain Net Access system and its support systems. The IT department needs to ensure that the system is operational at all times. However, the hospitals management feels that the high costs of electricity are necessary, if the hospital whishes to continue enjoying the benefits that the system offers.

One of the hospitals first challenges related to the system was the lack of competent staff to launch and fully operate the system. Therefore, during the initial stages of implementation, most users experienced some difficulties with using the system. However, the hospital was able to utilize some training programs that were facilitated by the systems vendor and in-house IT professionals, which led to a considerable improvement in the employees competencies. Consequently, the medical facility has been able to fully realize the benefits that they system presents. The hospitals administration is aware that it must maintain a high level of competence of its workforce should it maintain the degree of effectiveness that is provided by the EHR system (DesRoches, et al., 2013). Therefore, the hospital collaborates with the systems vendor in order to develop and implement continuous training sessions that cover system improvements and other emerging needs for the employees.

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Some of the hospitals employees demonstrated apathy regarding their willingness to abandon the old paper-based system for the new fully digital system. However, this kind of reaction is common in similar projects, which are associated with significant changes to the routine tasks. Despite the overwhelming evidence that suggests that systems of electronic management of health records boost the quality of services offered by the medical facilities, some practitioners still asserts that the paper-based systems should not be entirely abandoned and point out the possible faults in the integrity of electronic systems (Nguyen, Bellucci, and Nguyen, 2014). The Baptist Hospital experienced a similar situation and had to put in place certain measures in order to ensure that the provision of healthcare services was not affected. Departmental heads took up the responsibility of sensitizing the staff working under their command about the importance of implementing the system by highlighting the specific benefits that a systems presents to their departments.

The Baptist Hospital has also experienced occasional slowdowns in its course of operations following the adoption of Net Access system. Over-reliance on the system has compromised service delivery in times of breakdown, since virtually all patient records reside in the electronic system. Consequently, hospital operations come to a halt whenever unavoidable technical failures occur. These slowdowns raise concerns as they place patients health in significant danger. Additionally, they result in a cost implication on the patients as they opt to visit other hospitals whose systems have not suffered slowdowns. Furthermore, they spark frustration within the nursing because it is difficult for them to perform their functions when they are unable to access patient information.

Despite the challenges, hospital administration is committed to making sure that the security of patient records is never compromised. This commitment is demonstrated by their conduct when confronted with a challenging situation. Instead of using workarounds, the staff refers any concerns to the IT department to restore the system, which boosts confidence in the system. Most users believe that the IT department can resolve any issues that arise. The hospital has been able to utilize the EHR system in its operations and enhance the delivery of care.

Conclusion

It is possible to establish that a majority of users have confidence in Net Access as the hospitals main EHR system from the interaction with the system. The hospital administration attributes the adoption of the electronic documentation system to the alleviation of challenges that it previously had with its paper-based records system. Net Access has improved the management of patient records and enhanced decision-making by different medical practitioners. Consequently, the quality of health care provided at the hospital has improved significantly. In general, the management of medical records through an electronic system has assisted the Baptist Hospital in meeting organizational, staff, and patient needs. Therefore, other health care institutions in Florida should adopt similar systems to improve the effectiveness of the health care delivery systems.

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