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What is Already Known about this Subject?
Electronic Health Records (EHRs) are currently one of the major developing fields in health informatics and quality improvement within healthcare organizations. Many hospitals worldwide have implemented EHRs for better healthcare delivery, however that comes with many challenges which some have seized to succeed.
What Does this Study Add?
Despite all the benefits proposed by EHRs, the efficacy of implementation of such systems is a controversial topic and the literature needs more evidence on their effect on clinical end points. This study explores the use of EHRs and their effect on the performance and quality of care provided in the EMS in a tertiary Hospital. The Emergency Medical Services (EMS) has a complex patient presentation and challenging conditions for providing quality healthcare services due to the time limitations, high cognitive load and large number of patients.
How Might this Impact on Clinical Practice or Future Developments?
EHRs offer a better access to clinical data, encourage evidence-based practice, and improved coordination of care between departments allowing a swift clinical decision to be made amongst healthcare providers, thus, a great improvement in patients’ quality of life
Background
Electronic Health Records (EHRs) are currently one of the major developing fields in health informatics and quality improvement within healthcare organizations (Hayrinen, Saranto, & Nykanen, 2008; Use of Electronic Health Record Data for Quality Reporting, 2017). The Health Information Management Systems Society (HIMSS) defines EHRs as a “longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (HIMSS, 2019). EHRs automate the workflow and information from patient’s arrival to the hospital to their discharge. Information can include all the patient’s demographics, vital signs, past medical history, immunization history, progress notes, medication, laboratory results, and radiology reports (HIMSS, 2019; Gesulga, Berjame, Moquiala, & Galido, 2017). An EHR enables physicians to provide a consultation remotely, improves monitoring of post-operational physiological and mental status (Choi, Saberito, Tyagaraj, & Tyagaraj, 2014), reduces the use of medication, reduces mortality rate (Li, et al., 2013), and provides greater accuracy in diagnosis (Faisal, Parveen, Badsha, Sarwar, & Reza, 2013).
Many hospitals worldwide have implemented EHRs for better healthcare delivery, however that comes with many challenges which some have seized to overcome (Gesulga, Berjame, Moquiala, & Galido, 2017). The main reason for failure of these systems are staff resistance and opposition to convert to a paperless environment as people generally find it difficult to accept drastic change in their routine (EHRinPractice, 2019). Another major challenge to EHR implementation is data migration, the existing data is sensitive and private information about patients that needs to be migrated to the new system carefully and accurately to ensure maintaining confidentiality with continuous high quality of patient care. Data migration is a time and resources consuming process. The most recent patient data must be migrated to the new system first then a decision has to be made on how far back data should be uploaded (EHRinPractice, 2019). Other obstacles that might face EHR implementation would be organization readiness (Khoja, et al., 2007), lack of resources such as technology and funding, lack of pre-implementation activities (Biruk, Yilma, Andualem, & Tilahun, 2014) and personnel technical skills (Ajami, Ketabi, Isfahani, & Heidari, 2011).