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Electronic Health Records: Friend or Foe?
The benefits of the electronic health records for
older adults across the continuum of care
By Catrin Brodie, RN, MN, GNC
©
mySeniorSite Feature
The patient electronic health record
(EHR) is a computerized document that includes all
of a person’s health information. In the past, this
information, was held by many different health care
workers in paper files and may not have included all
of the necessary information or health details. The
EHR provides great benefits to the complex care
needs of the older adult who are either in the
hospital, in residential care or living in the
community because it contains all of the necessary
information the doctors and nurses need to make the
best decisions for their patient.
The greying of the population will
have an incredible impact on the health care system
and their caregivers. Especially on Vancouver Island
where about 9.0% of the people are 75 years old or
older, compared to 6.9% for the province of British
Columbia. Roughly 2.7% of the population is aged 85
and over, compared to 2.0% for the province. In
addition to a growing population of seniors, baby
boomers, currently between the ages of 43 and 62;
make up approximately 31% of the population. By
2010, the first wave of baby boomers will be nearing
65, and as they age, this will put more pressure on
nearly every area of our health care system.
Background
Currently on Vancouver Island the
patient records, documentation and information are
either in a paper format stored in different
locations, such as hospitals, home care offices,
residential care facilities, physician's offices, or
via the electronic heath record or both. This paper
system being held by many different health care
providers and in many different locations is not a
good system. It increases the chance of risks for
seniors, such as repeating the same test and
medication errors due to more than one doctor
ordering different medications and because of their
complex health needs.
Therefore, in 2008, the Vancouver
Island Health Authority (VIHA) started to use the
EHR to decrease the amount of paper and to make the
patient information accessible to the responsible
health care providers. The most important reason to
make this change is due to the aging population, the
increasing need to provide care to the frail
elderly, a rising burden of illness from chronic
diseases, and advances in technology and
pharmaceuticals that are enabling new procedures and
treatments. The EHR can, therefore, improve patient
safety by having as much up to date clinical
information, “at the fingertips” or “point of care”,
as possible to assist in care delivery decision
making.
History of the EHR
The first reports of computer being
used in nursing care began to appear in literature
in the 1970s. The use of the personal computer in
the 1980s would allow for the “capture” of the
nurse’s notes and patient care plans. The
introduction of the Internet and web-based
applications in the 1990s, enabled communication
across distances and made it possible to transfer
health information. In some areas computers became
smaller and nurses could take them to the bedside or
homes as laptops or personal data assistants (PDAs).
The nurse could begin to access the patient
information at the bedside, rather than returning to
the nurse’s station. In 2000, an increased
importance was placed on computerized information to
help with decision making, quality improvement and
research. The EHR is a tool which will increase
efficiency; information gathering, and research; and
improve patient safety and patient health outcomes.
The health authority has begun to
create an EHR for every person on Vancouver Island
providing 24/7, online access to patient records and
information in the hospital and remotely at home or
from the doctor’s office. This allows for the best
care for patients because now their doctors, nurses,
hospitals and community services can share
information across the information highway.
Benefits
Using the EHR can improve population
health in the following ways; by allowing the care
givers access to x-rays, laboratory results, and
medication information right at the time they need
it, therefore assisting to speed up the time to make
their decisions. Other benefits are the ability to
write doctor’s orders, communication, care planning
and clinical notes, faster referrals between
doctors, fewer delays ordering tests and getting
results, and fewer reporting errors. There are often
many different people involved in their care and
they need to have all the information and the
ability to communicate this information between each
other. Many older adults have long term care case
managers, home care nursing, a general doctor or
specialists that are all involved in their life and
health care decisions. The increasing numbers of
the aging population of Vancouver Island, their
increased care needs and complexities, is a
significant reason why the EHR should be used.
Consent and Confidentiality
A patient entering the health care
system will be providing “presumed consent” for
their information becoming part of the EHR. This
means that they may not give their consent in
writing but the health authority will presume that
if they are in the hospital for treatment that they
are aware all of the care team has access to their
information. However, there are processes in place
to protect the privacy and confidentiality of the
patient. To protect data there are restricted login
passwords, digital signatures and encryption. As
well as policies the staff are expected to follow
that only the health care worker that is directly
responsible for that patient can access their
information. There is password protection and coded
patient identifiers to help protect patient
confidentiality; and the software automatically
locks a device after a period of inactivity.
Conclusion
Simpson stated that in 2001 that, “by
2011, computers will learn and reason better than
humans. By 2012, they’ll memorize, recognize, and
learn in a human fashion. By 2013, health care
professionals will view them as colleagues rather
than tools. Health care will finally grasp the gold
ring of precision as computers eliminate the
guesswork, eradicate the deadly errors, and usher in
the age of accuracy” (Simpson, 2001, p.14).
Do you agree that the prediction for
2011 has come true?
Over time, every British Columbian
will have a personal EHR, which will be a secure and
private lifetime record of their key health history
and care within the health system and this record
will be available electronically to their health
professionals to support high-quality care.
(This article is
published for information only. mySeniorSite does
not guarantee the accuracy of the facts or opinions
expressed herein. Reproduction of this article in
any form must have the express consent of
mySeniorSite and the author. See
terms of service for more information).
©
mySeniorSite.ca. All rights reserved.
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The greying of the population
will have an incredible impact on the health
care system and their caregivers. |
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