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The American Journal of Accountable Care September 2015
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Optimizing the Effect of Electronic Health Records for Healthcare Professionals and Consumers
Maryam Alvandi, RCT, MHS
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Optimizing the Effect of Electronic Health Records for Healthcare Professionals and Consumers

Maryam Alvandi, RCT, MHS
Electronic databases promote a safe environment for healthcare professionals by facilitating retrospective analysis of errors; however, providers should make significant changes to how they handle patient information.
Strategies to Increase Familiarization Among Healthcare Professionals
All members of a healthcare organization must feel a sense of ownership to avoid common pitfalls and to make implementation successful for themselves, their colleagues, and patients.8 Healthcare professionals must receive sufficient training to identify ways to access information and provide on-site technical support, and they must be continuously encouraged to use EHRs in their organizations. Moreover, the scope of practice must be defined, and standardized guidelines and clinical support tools must be provided. It is imperative to allow users plenty of time to use the program before going live, while providing education on the benefits of utilizing the EHR, what it contains, and how will it improve patient care.20 Organizations need to increase professional practice environments and create strategies to enhance adoption among providers that may include clinical stories, peer-to-peer training, demonstration clinics, and mentorship programs to encourage others to use EHRs.21 It is important to increase funding, which will speed up information liquidity to digitize healthcare delivery and allow for community-based physicians, clinics, and points of care to adapt and utilize EHRs in their practice.22

Strategies to Increase Familiarization Among Consumers
There is a need to educate the clients and increase public awareness about the benefits of EHRs for care. Healthcare professionals need to hold free sessions for patients who are interested in more comprehensive information, which will help them in making an informed decision and provide them with a better understanding of technology by linking with EHRs. Consumers must be provided with well-identified information to learn how this new evolving technology can help to streamline work processes. This will reduce potential obstacles and disconnects between health consumers and this complex and challenging technology. Information literacy concerns need to be addressed and methods to assist consumers in overcoming their anxiety must be identified. Consumers should be encouraged to increase their knowledge to better cope with rapid technology changes by motivating and empowering the use of this type of computer software.8,23

Strategies to Increase Acceptance Among Healthcare Professionals
It is essential to incorporate change agents into the program who will help implementers and users to effectively and meaningfully communicate with each other to address the gaps that may exist.18 The change agents will provide education sessions for healthcare professionals to promote open-mindedness toward change and the acceptance of adapting systems to existing practices. Change management agents provide invaluable assistance to healthcare organizations to better manage their resources and improve productivity through supporting resources. They troubleshoot problems and provide their input for change, acting as a catalyst to encourage active involvement in setting up a new environment.

Timely and ongoing training would allow healthcare educators, providers, and agencies to explore and examine information trends and proactively react to changes; and increasing the quantity of hardware items in practices (eg, computers, phone lines, Internet connections) will improve access to EHRs. All of these factors will help to decrease the complexity of EHR systems and increase its ease of use. All organizational members will need to participate in the use of EHRs to ensure wide acceptance.8 It is critical to provide support during the implementation phase to facilitate transition and communicate the accuracy and availability of the new electronic system. There is a need to establish continuing education and develop a communication plan with useful tools, such as newsletters and posters to increase awareness by illustrating EHRs and acquainting healthcare professionals with current research in this dynamic field.

Strategies to Increase Acceptance Among Consumers
Integration of the EHR is an essential factor to the vision of an electronic health information environment and one that can lead to the empowerment of individual patients, consumers, and healthcare professionals. In order to increase acceptance of the EHR among consumers, some of the following are necessary: education to promote technology as a means of improving health information exchange and health literacy; accessibility of computers in common public spaces (eg, libraries, community centers); and standardization around data safety, privacy, and confidentiality policies.8 Consumers need to be well informed on its effect to conveniently reduce travel time for multiple physicians’ appointments. They also need reassurance that healthcare information can only be accessed by legitimate users, and that client privacy and confidentiality are being safeguarded.

Current Status of the EHR and Future Directions
To date, no country has implemented an operational national EHR. Historically, many systems were developed locally by the information technology department of a healthcare organization. While most hospitals have some level of automation, few have accomplished a fully operational electronic environment, and many physicians’ offices, clinics, and long-term facilities still preserve manual processes. 1 Canada has made significant progress in recent years and EHR standards have evolved; however, it is behind in use and spending on health information technologies. There is no unified legislation for all jurisdictions in Canada, and the setup of provincial storage databases remains slow.24

According to a survey in 2010, only 37% of Canadian physicians use electronic records compared to 99% of physicians in the Netherlands and 97% of those in New Zealand and Norway (Table). The report indicates the lack of trust and collaboration between Canadian health authorities, which contributes to Canada’s slow progress in implementing the EHR. Additionally, a lack of government investment, inadequate involvement of physicians, and absence of flexibility and coordinated leadership all account for widespread variance in the EHR development across Canada. To promote EHRs more effectively, there should be an improvement in communication between jurisdictions and healthcare organizations, and clinicians should have stronger engagement toward adoption.25 Stronger leadership will accelerate the ehealth infrastructure and promote greater awareness of its benefits—subsequently, increasing scrutiny of additions to documentation, adequate resources, and an organizationwide commitment to information security are required.1

The United States is making substantial efforts in engagement for the promotion of EHR adoption. According to a study published by Furukawa et al,26 almost 78% of office-based physicians reported using some type of EHR system. However, physicians’ electronic health information exchange with other healthcare providers outside of their organization was limited to only 14%. Despite ample progress in EHR adoption, health information exchange and patient engagement require ongoing attention.26

The future holds tremendous potential for EHR capabilities and moves toward its implementation and adoption. From this point forward, information technology applications will become more commonplace, easier to use, and will highly extend the capabilities of healthcare providers through additional features offered. Technology will promote a safe environment for healthcare professionals by reducing negative exposure to risk and liability, and consumers will have increased accountability for the management of their own health, with tracking and benchmarking at their fingertips.1,8

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