Barriers of Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Barriers

Barriers of Electronic Medical Record Systems EHR System implementation are another issues that should be analyzed. They include technological and organizational barriers. The following are some of the barriers stated by Lewis and Mitchell.

Technological and Cost Barriers of Electronic Medical Record Systems EHR System

• Lack of sufficiently powered computer systems.
• Lack of affordable computer systems and/or workstations.
• Lack of adequate system security.
• Lack of data exchange standards.
• System inflexibility.

Organizational Barriers of Electronic Medical Record Systems EHR System

• Lack of a clear definition and objective of an Electronic Medical Record Systems EHR System should be.
• Lack of clear objectives for the development of the Electronic Medical Record Systems EHR System.
• Unclear legal ramifications of electronic data.
• Social concern regarding the patient's right to privacy.
• Lack of information system staff skills necessary to develop an Electronic Medical Record Systems EHR System, and
• Staff acceptance and implementation issues.

Laws and Legal Issues for Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Laws and Legal Issues

In order to implement and EHR system or Electronic Medical Record Systems EHR System in the country successfully, a number of laws need to be enacted to protect patient records. The laws should focus on two main issues: right of privacy and right of access to health records, as discussed below.

The Right of Privacy for Electronic Medical Record Systems EHR System

Growing demanded for information contained in patient records pose an ever increasing threat to patient privacy. When information from patient records or from Electronic Medical Record Systems EHR System is disclosed by a provider, it is extremely difficult to control re-disclosure of the information effectively. The lack of protection of patient privacy may hinder full development of computer-based patient record systems.

Thus, the government has to enact privacy legislation to assure that the patient information from the Electronic Medical Record Systems EHR System will not be disclosed to third parties without the patient's consent, except under defined circumstances.

Right of Access to Health Records for the Electronic Medical Record Systems EHR System

Rights of access to health records from Electronic Medical Record Systems EHR System maintained by physicians and other individual health care providers should be clear. According to a researcher, in the USA, several statutes contain special provisions concerning a patient's access to particular portions of his or her record, such as X-Rays. In the absence of regulation, some courts have recognized a provider's common-law duty to allow a patient limited access to his or her records in the Electronic Medical Record Systems EHR System. The government has to enact a regulation to clear the right of access to patient records.

Another information, in addition, in the United States, there are numerous laws governing the provacy of personal information, including medical records in Electronic Medical Record Systems EHR System. Many of these laws also mandate that the security of records is also ensured.

Privacy of The Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Privacy

Privacy is another major issues connected to the electronic medical record systems, such as the use of medical database, and the adequacy of current privacy protection law. This section will analyse impacts of the lack of privacy measures in the EHRs or Electronic Medical Record Systems EHR System, such as discrimination and damage to reputation. Recommendation for protection of Electronic Medical Record Systems EHR System privacy will also discussed.

Discrimination for Electronic Medical Record Systems EHR System

Discrimination by employers and insurers is a major concern. In 2000, a survey showed that more than 200 cases in which individuals with a genetic predisposition to certain diseases reported a range of discriminatory actions made by insurance companies, employers, and other on the basis of genetic information.

Damage to Reputation of Electronic Medical Record Systems EHR System

Release of patient's personal and sensitive information, such as mental health problems, HIV-positive status, a history of substance abuse, and existence of debilitating illness, can have a devastating impact on an individual's reputation, affecting all aspects of his or her life. In addition, medical records may be used to persecute patients, by allowing the perpetration of malicious pranks, fraud, or other unlawful activity.

Protecting Patient Privacy for Electronic Medical Record Systems EHR System

In order to protect patient's privacy, a number of policies as discussed below should be applied in the Electronic Medical Record Systems EHR System organization.

• Patients should be advised as to who has access to their Electronic Medical Record Systems EHR System and the level of access permitted should be specifically identified.
• Patients should be able to specify what information should not be disseminated via Electronic Medical Record Systems EHR System. Patients, however, will not have total control over their records. For example, public health and law enforcement may obtain patient's information without consent through means prescribed by law.
• Stringent security procedures should be in place to prevent unauthorized access to computer-based patient records and confidential data should be encrypted whenever patient information is transmitted electronically from on location to another.

Security Technologies for the Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Security Technologies

Today a number of security technologies have been developed to solve the security problem. The major security technologies will be discussed below.

Electronic / Digital Signatures - An electronic record or Electronic Medical Record Systems EHR System can be signed electronically to identify and individual person. Digital signatures employ powerful cryptographic techniques that not only make signatures unforgettable, but also explicitly bound to a particular document.

Firewalls - Firewalls are systems of computers and switches that restrict to approved locations the destination or source of data entering or leaving the hospital. Firewalls are a good option for improving both the confidentiality of communications and authentication users. According to Greenstein and Feinman, functionality of firewalls - such as packet filtering, application-level proxies, and real-time monitoring-have been employed.

Encryption - Encryption is the process of encoding or scrambling a message so that the meaning of the message is not clear to unauthorized persons. It is one of the strongest measures used to improve communications security, particularly for Electronic Medical Record Systems EHR System. Two types of cryptographic mechanisms can be used to provide and encryption capability: symmetric cryptography where entities share a common secret key; and asymmetric cryptography or public key cryptography where each communicating entity has a unique key pair.

Biometric Identifiers - Biometrics require some physically unique characteristics of the user be used for identification. Biometric identifiers include retinal scans or fingerprints that can identify authorized users. Lewis state that these techniques are rarely used in health care institutions or Electronic Medical Record Systems EHR System because currently they require very costly equipment.

Network Security of Electronic Medical Record Systems EHR System

The Electronic Medical Record Systems EHR System's Network Security

Network data security relates to the security of data on a network. To ensure that the data of Electronic Medical Record Systems EHR System is useful and secure, systems must allow for interconnection between providers, such as hospitals, and interoperability.

Network Security Issues for the Electronic Medical Record Systems EHR System

• Interoperability - The ability of data to operate across networks under the same security arrangements.
• Integrity - The consistency and accuracy of the data stored and transmitted in computer-based systems over a given time period. The Electronic Medical Record Systems EHR System data should be received unchanged from when it was sent.
• Additions - The Electronic Medical Record Systems EHR System should have rigorous rules that allow information to be added as an addendum to the encounter buy will not allow the user to delete or alter the record.
• Authentication - The identify of the person accessing the record. The Electronic Medical Record Systems EHR System database should have a table with an encrypted password that the user must enter before accessing the Electronic Medical Record Systems EHR System.

Security Issue - International External Users

The Electronic Medical Record Systems EHR System's Security Issues for Users

To enhance security of patient's information within an organization, many policies should be applied. For internal users, for example, only authorized user should have access. The organization should define a hierarchy of users and create an authorization table to link users with the hierarchy. In addition, the organization should create security for the authorization table.

For external users, confidentiality agreements with external users should be signed. The organization has to implement hardware and software security systems, such as keys, passwords, and protocols. Special security to restrict mass copying or output of records should be used strictly as well.

Issue Analysis - Security of the Electronic Medical Record Systems EHR System

Electronic Medical Record Systems EHR System's Security

In implementing the Electronic Medical Record Systems EHR System, one of the major issues of concern is security of the Electronic Medical Record Systems EHR System and patient's information. The following are main concerns regarding the security:

• Access to patient's information by unauthorized users
• Inappropriate access to patient record information by authorized users
• Inadequate data security protection on the Internet
• Inadequate standards for data security
• Limited data security functionality in vendor systems

The suitable levels of privacy, confidentiality and security for achieving the Electronic Medical Record Systems EHR System may vary depending on the institutional environment and the use of the information. A balance between confidentiality and convenience must be achieved. This subsection will exam the security issues related to users, network, security technology, and strategies.

Public Key Infrastructure (PKI) for Electronic Medical Record Systems EHRs

The Electronic Medical Record Systems EHRs - Public Key Infrastructure (PKI)

According to security concern, Public Key Infrastructure (PKI) technology i s one of technological solutions to meet the security requirements of the health insurance portability. PKI technology provides functions for access control, authentication, confidentiality, message integrity, and non-repudiation. Using the PKI technology for Electronic Medical Record Systems EHRs, healthcare organizations will be able to establish privileges to access the network, change, or transmit patients' information.

Although PKI for Electronic Medical Record Systems EHRs, seems to be the answer to solve the concerns, there are still challenges to consider. The PKI may be difficult to customize, challenging to manage, and costly to implement. However, the PKI for Electronic Medical Record Systems EHRs seems to be the most promising technology available today.

According to a top researcher, some company from alliance to enhance security solutions for the Internet business. They companies have utilized PKI technology to enhance the safety and integrity of transactions over the Internet. This will secure online application, which includes online Electronic Medical Record Systems EHRs.

Document Imaging Technology for the Electronic Medical Record Systems EHRs

Electronic Medical Record Systems EHRs - Document Imaging Technology

Another technology that can be applied for healthcare service system, Electronic Medical Record Systems EHRs, is the Document Imaging System (DIS). It is an information system that typically captures information stored on paper documents and provides immediate, simultaneous access to the information contained in the patient or business record. In healthcare services, Electronic Medical Record Systems EHRs, document images are kept on optical disks, typically WORM (write once, read many) disks, which serve as an efficient long-term mass storage medium.

In the country, the DIS technology may be appropriate. It should be applied for paper conversion in the first stage of the Electronic Medical Record Systems EHRs.

Technologies for the EHRs

Technologies for the Electronic Medical Record Systems

Web-based Electronic Medical Record Systems EHRs, Document Imaging, and Public Key Infrastructure (PKI) will be discussed. Some examples of users will also provided.

Web-Based Electronic Medical Record Systems EHRs

In the information age, the Internet and web-based technology have been applied in business, education, and government dramatically. In healthcare services today the web-based technology also is used for improving th equality of health services. It is easy to customize application softwares and costly. One of the research states that, in the United States, about one-third of the nation's health systems have installed some form of electronic records. Most large system vendors offer web-based medical record systems.

All patients, for example, in the University of Washington system have an electronic web-based Electronic Medical Record Systems EHRs. The Electronic Medical Record Systems EHRs record allow measurement of most clinical process measures and outcomes. Physician satisfaction, in addition, will be measured by survey.

In addition, the web-based medical record system or Electronic Medical Record Systems EHRs, called the Patient Clinical Information System (PatCIS), has been implemented in the New York Hospital.

Electronic Medical Record Systems EHRs Disadvantages

Disadvantages of Electronic Medical Record Systems EHRs

Although Electronic Medical Record Systems EHRs offers many advantages of health care services, the Electronic Medical Record Systems EHRs also has some disadvantages. The computerized medical record, for example, can be quite costly to institute. In addition, due to a lack of privacy policies, patient information may not be protected. The information may be changed because of a telecommunication error or lack of security measures.

More disadvantages of the Electronic Medical Record Systems EHRs will be discussed later.

Electronic Medical Record Systems EHRs Advantages

Advantages of Electronic Medical Record Systems EHRs

The potential advantages of Electronic Medical Record Systems EHRs are widespred. Some of these advantages are shown below.

Information access

• Rapid and convenient access to online health information.
• Reduce the problems of distance for remote health services.

Clinical improvements

• Timely information access for clinical decision making.
• Readily available, multidisciplinary health information.

Epidemiological benefits

• Vast quantities of health data to draw on for research purposes.

Increased administrative and management efficiency

• Optimization of record management.
• Security and controlled access by authorized users.
• Elimination of information duplication.

Financial savings

• Minimization of record storage space and paper costs.
• Streamlining of administrative and management functions.

Improved healthcare quality

• Increased access to information crucial to determining health outcomes.
• The organization's operations will become more transparent making it easier to monitor and evaluate organizational activities.

There are more advantages of Electronic Medical Record Systems EHRs which will be discussed later.

Electronic Medical Record Systems Implications for Third Parties

Electronic Medical Record Systems Implications for Government Agencies

The government agencies have varying degrees of interest in and authority to influence Electronic Medical Record Systems EHRs development and implementation. The agencies will be able to provide substantial funding for research and development of EHRs Electronic Medical Record Systems technology. In addition, the government can support standards development through funding or a regulatory mandate.

Electronic Medical Record Systems Implications for Educational Institutes and Research Centers

The efficiency and effectiveness of medical research are directly linked to the accessibility, validity, and completeness of necessary medical data. With the EHRs Electronic Medical Record Systems, researches will be able to identify quickly a study population of records that meet certain eligibility criteria. The Electronic Medical Record Systems EHRs can facilitate more valid and precise research because a larger sample of patient records can be studied.

Electronic Medical Record Systems Advantages

The Electronic Medical Record Systems EHRs system, in addition, offers several advantages for education. According to Dick, Steen and Detmer, for example, professional schools (i.e., schools of medicine, nursing, and dentistry) would be able to use the Electronic Medical Record Systems EHRs information to teach healcare professions students and organize conferences and presentations.

Electronic Medical Record Systems Concerns

However, Ball and Collen stated that there were some concerns relating to the ease of use, completeness and accuracy of data, data confidentiality, and system security. Thus, development of the Electronic Medical Record Systems EHRs should focus on the human interface such that the Electronic Medical Record Systems responds quickly and easy to use.

Electronic Medical Record Systems Implications for Medical Professionals

Electronic Medical Record Systems Implications and Impacts for Medical Professionals

The implications of the Electronic Medical Record Systems for medical professionals are they have to learn to use a new technology, and have to change their behavior. Some physicians or nurses may view the Electronic Medical Record Systems or EHRs as a threat to their professional roles and resist implementation of Electronic Medical Record Systems.

Alternatively, professionals may support the development of the Electronic Medical Record Systems by participating in planning and influencing their peers. In addition, the medical professionals will be able to improve efficiency and quality of healthcare services using the Electronic Medical Record Systems.

Electronic Medical Record Systems Implications and Impacts

This section will discuss implications and impacts of the Electronic Medical Record Systems related to patients, medical professionals, and the third parties, such as the government agencies, insurance companies, and educational and research institutes.

Electronic Medical Record Systems Implications and Impacts for Patients

In regards to the decision of the government to implement the electronic health record systems or Electronic Medical Record Systems, there are a number of benefits for patients. For example, the patients will be able to manage their own healthcare by themselves. They will also be able to verify their billing. However, the patients still have concerns about the privacy of their personal information, and the security of Electronic Medical Record Systems.

In addition, patients are no more likely than health care professionals to use or understand the computer. Patients may distrust the Electronic Medical Record Systems and may select healthcare provides on the basis of the use of an Electronic Medical Record Systems.

Electronic Medical Record Systems Background

Current, the government announced that the country is to become the leader to put medical records on an electronic database or Electronic Medical Record Systems (EMR). The new Electronic Medical Record Systems will replace paper records within two years.

Because of the Electronic Medical Record Systems, many people have concerned about patients' privacy and security of the system. They recommended that the government should legislate privacy and security safeguards to guarantee the patients' information or the Electronic Medical Record information.

Introduction to Electronic Medical Record Systems

Electronic Medical Record (EMR) Systems Introduction

We will analyze an issue that involves the decision of the new government to implement the Electronic Medical Record Systems (EMR System) in the country. Wewill discuss the Electronic Medical Record Systems implication and impact for patients, medical professionals, and other related agencies. The Electronic Medical Record Systems technology related to security will also be examined. Finally, we will provide a set of the Electronic Medical Record Systems strategies and recommendation.

Four Main Systems related for the Electronic Medical Record Systems

1. Computerized Patient Records (CPRs)
2. Electronic Medical Records (EMRs)
3. Electronic Patient Records (EPRs)
4. Electronic Health Records (EHRs)

We will use the Electronic Medical Records (EMRs) in this report.