Converting Paper Records to a Computer Based Health Record Essay

Traditional utilization of piece of music base aesculapian records leads to the dispersion of clinical culture as a end of the heterogeneous character of hospital schemas. Due to this, the increase of a clinical information sy chaff that can integrate hospital information as well as enable cooperation amongst legacy systems became a difficult task. corpse integration as well as the development of an efficient clinical information management system was thereby dependent upon the creation of abstract and architectural tools that volition enable much(prenominal) an integration.In line with this, numerous health c ar institutions are surely seeking to establish the integration of their workstations finished the utilization of scientific tools. much(prenominal)(prenominal) tools are effective in the ar endurement of clinical matters as well as in the arrangement of administrative and financial information. clinical information systems are utilized by healthcare instituti ons in their integration of information. At this point, the utilization of electronic health check systems in healthcare delivery is evident in countries such as the join States, United Kingdom, Sweden, Hong Kong, Canada, as well as Australia.The current shift from a humanity memory based persona to a technological mental image can be traced to the recent emphasis given on health care prime(a) improvement and cost reduction. In lieu of this, policy exoneraters started to bring in health information technology such as the Electronic aesculapian Record (EMR). gibe to Tim Scott in Implementing an Electronic Medical Record System, approximately information regarding the use of EMR systems are derived from the Regenstrief Institute, Brigham and Womens Hospital, the Department of Veterans Affairs, LDS Hospital, and Kaiser Permanente.The information derived from the side by side(p) medical institutions shows the following. First, success is dependent upon the organizational to ols rather than on the type of technology used. Second, minimal changes were whole t unrivalledd in terms of increase of quality and talent as a result of the systems adaptation. Such findings thereby led to the slow adoption and implementation of EMR systems since majority of medical institutions as well as healthcare systems required the high verifiability of the systems utility.True enough, researches at bottom these institutions also showed that EMR systems increase the quality of diligent of care as it decreases medical errors, however, the economic looking at regarding its use has not been well documented leaving most medical institutions adamant regarding its implementation. In lieu of this, the paper is divided into three parts. The first part willing present the rationale behind the formation of the technology based medical substitution class.It will be formulated within the parameters of Thomas Kuhns intent of scientific revolutions. The second part present a dis cussion of the confused EMR components and the problems encountered in its implementation at Kaiser. The last part, on the other hand, will concentrate on presenting possible solutions to the problems evident in the utilization of the EMR systems within the Kaiser program while giving particular proposition emphasis on the intention of the agent in successful implementation.Thomas Kuhn, in his work authorise The Structure of Scientific Revolutions, discusses the very nature and necessity of what he calls scientific revolutions. In this particular work, Kuhn sees an apparent balance in the midst of policy-making revolutions on the one hand, and scientific revolutions on the other. Kuhn writes scientific revolutions (are) those non-cumulative developmental episodes in which an quondam(a) figure of speech is replaced in whole or in part by an unharmonious new one (2000, p. 50).On a preliminary note, paradigms are frameworks in and through which we approach phenomena, in genera l. They are models, so to speak. of course enough, polar models employ different methodologies, different methodologies in turn, generate different types of knowledge, which, consequently, have different criteria of proof or validity. Scientific development, as Kuhn contends, whitethorn appropriately be characterized by paradigm shifts and this he calls scientific revolutions.It is meaning(a) to note that scientific developments do not occur in a vacuum. For the aforementioned basis, there is a felt need to situate scientific developments in the historical context within which they are conceived, propresent and ultimately, institutionalized and combine as part of night clubs shared knowledge. This is to say that scientific revolutions are also proper objects of historical analysis and discourse in as some(prenominal) as political revolutions are.Kuhn contends that there is a parallelism between political and scientific revolutions. As pointed out earlier, it is important to n ote that he characterizes scientific revolutions as those non-cumulative developmental episodes in which an older paradigm is replaced in whole or in part by an ill-matched new one. Kuhns characterization emphasizes two important points. First, that there is a replacement of an old paradigm by a new one. Second, that the new paradigm is not merely something new it is also incompatible with the old paradigm.This is to say that the incompatibility or the irreconcilability of the new paradigm with the old paradigm serves as warrant for the necessity of such a revolution. Although there are significant differences in both scientific and political developments, Kuhn argues that one may be justified in using the judgement of revolution as a metaphor for get wording them. He writes semipolitical revolutions are inaugurated by a growing sense, often restricted to a segment of the political lodge, that existing institutions have ceased adequately to meet the problems posed by the envir onment that they have in part created.In much the same way, scientific revolutions are inaugurated by a growing sense, once again often restricted to a narrow subdivision of the scientific community that an existing paradigm has ceased to function adequately in the exploration of an aspect of nature to which that paradigm itself had previously led the way. (2000, p. 150) Kuhns parallelism is thus, founded on the idea that in both cases, a sense of malfunction (in our institutions as for the case of the political, and in our paradigms as for the case of the scientific) necessitates for the occurrence of a revolution.In semblance to this, the shift from a human memory based paradigm to the technological paradigm may be likened to a revolutionary development within the field of medical data acquisition and retention. The difference between the human memory based paradigm as opposed to the technological paradigm stems from the ascription of greater subjectivity in relation to human me mory based data as opposed to technologically hold data.As was stated in the first part of the paper, the heterogeneous feature of speech of medical institutions stems from the existence of various separate holistic systems within it. As a result of this, deriving and correlating clinical information becomes tedious. The main reason for this stems from human memory based paradigms utilization of paper based records which has a high probability of non-viability and unreliability. Examples of this are evident in evidence-based medicines non-adherence to the traditional methods of training and practice.Second, paper based records run short of their original expectations. The objective of the healthcare record is to identify problems and to understand the impact of the illness on the individual thereby enabling the betterment of the problem to the patients satisfaction, within the bounds of medical capabilities and societys resource limitations(Simpson and Robinson, 2002, p. 115). The main limitation of the paper bound records, therefore, stem from their inability of being multiply accessible to members of society.On the other hand, Scott link the reasons for the development of a technology based paradigm with the high verifiability of the positively charged results of technologically determined medical care processes. According to Scott, new technologies make it possible to evaluate and intervene to improve care in slipway not heretofore possible (2002, p. 2). In line with this, members of both the normal and private sector lobby for the accessibility of technological improvements.For the members of the private sector, this is ascribable to the inclusion of the medical industry within the business sphere. For the members of the public sector, on the hand, demands for greater answerability for health care stems from the prevailing belief that technological advancements must be made accessible to the general public. According to the IOM, information tech nologys role in the substantial improvement of the design of the healthcare system is important since it ensures the formation of a strong root word in runing efforts to reengineer care processes oordinate patient care across clinicians and settings and overtime, support multidisciplinary team functioning, and facilitate performance and outcome measurement for improvement and accountability (qtd in Scott, 2002, p. 4). The results of the success of the EMR are traceable to the developments within the field of e-Health. According to Silber, EMR serves as the fundamental building block for the development of various applications such as the use of ICT by the Primary Health Care Team.Others affect the use of ERM for validation of research or as an instrument in Continuing Medical Education. Information necessary for the functions ascribed above, in relation to the face-to-face health record, are possible since the health records functionality enables the inclusion of the following practitioner order entry, electronic patient record, document management, clinical decision support, administrative data, integrated communion support, as well as access to knowledge and resources.According to Raymonds and Dolds, the functions of each component are as follows. The electronic patient record presents the patients history. Document management, on the other hand contains the actions undertaken in relation to the patients diagnosis. Clinical decision support as compared to the later contains the alerts based on current data from the electronic medical record, evidence based practical guidelines or more complex artificial intelligence systems for diagnostic support. admission price to administrative related information such as admission and miss are contained within the section encompassing administrative data. Integrated communication support however provides the tools for the facilitation of effective and efficient communication amongst members of the patients health team. The last part enables access to other sources of information regarding the patients condition (Scott, 2007, p. 4). The Kaiser Permanente EMR implementation presented one of the main problems in relation to the utilization of the components of the technologically based paradigm.It was recognized that the problems arose due to several factors which range from the softwares lack of efficiency up to the non adherence of specific qualities of the program with the social conditions in the region as well as the teams lack of background in relation to the efficiency the program necessitates with regards to the division of the work flow as well as its dependence upon all the players within the medical institutions that the program was implemented.Scott however stated that what should be given credence with regards to the above failed project is not so much as the harm of the program but the possibilities it opened in relation to the creation and implementation of new EMR programs in t he future. Scott states, success and failure are socially negotiable judgments, not static categories (2007, p. 43). Hence if such is the case it is thereby possible to conceive of the problems noted by Hartswood et al (2003) in relation to the user-led characteristic of EMR.The social negotiability of judgments thereby ensures the possibility of reversals in judgments as soon as occasions arise wherein a sensed failure may be reconnected with an overall success. In line with this, the unvarying developments within the various EMR systems produced and implemented within the country ensures the viability and possibility of a near success and perfection within the system which in a sense also ensures the possibility of another scientific revolution in the near future whose scope may extend beyond that of the technological sphere.