Electronic Health Records in Hospitals and Physician Offices

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The electronic health record is growing at an alarming rate, following an infinite advancement of this technology. This advancement is aimed at reducing the barriers that hinder the intensive use of electronic health records in hospitals and physicians offices in the entire country. Some of the key barriers include the high cost of implementation and emerging concerns of information insecurity. Dean et al. (56) affirm that, despite the barriers faced with the EHR implementation, the hospitals in the United States are still implementing the electronic health record, with a high growth rate of approximately 75 %. This increase is also evident in a number of non-federal hospitals, as 15.1% have already made a point of implementing and familiarizing themselves with the basic features of the EHR. This has served a critical role in attracting a very high percent [80.8%] of the non-federal hospitals to express their interests in the EHR by application of incentive payments. As a result, 80.1% of these hospitals will apply for EHR in the course of this year or in 2012.

Likewise, since 2008, the physicians offices have also demonstrated a growth rate of 50%, with a considerable number of physicians offices [24.9%] having made a point of implementing and familiarizing themselves with the basic features of EHR (Dean et al. 106). Implementing and adapting to the EHR is increasing as we advance in years since the year 2009 recorded a higher rate of EHR adoption rate than in 2008. More so, the current literature on EHR affirms that the payment of the EHR incentives has attracted a number of physicians offices [41.1 %] into coming up with an EHR application plan in 2011and in 2012. This translates that the hospitals and physician offices positions are increasing the rate of implementing and adapting to the EHR.

Case Study Analysis

Case

Dr. Fisher is regarded as the finest family physician in his small community. He is very busy, seeing 30 patients in his office daily, delivering babies, and making house calls. He often feels overworked and would like to spend more time with his family. Today, one of the many patients in his office waiting room is 56-year-old Mrs. Rogers. The Rogers family has fondly called him their family physician for the past 25 years. He delivered and cared for both of Rogers children.

Mrs. Rogers saw Dr. Fisher four months ago with a complaint of lower back pain of one months duration. He performed only a cursory examination of her lower back, which, at the time, led him to prescribe aspirin and a heating pad for presumed arthritis. He also ordered X-rays of her lumbar-sacral spine so that he would have an objective baseline by which to evaluate the future progression of her condition. The X-ray report from the local radiologist arrived at Dr. Fishers office three and one-half months earlier but was filed away without his seeing it. Mrs. Rogers was billed by the radiologist and Dr. Fisher but never received any information concerning the X-ray findings. She reasoned that no news was good news, but she has now returned because the pain has not subsided. In fact, she is beginning to feel a new pain in her ribs.

Dr. Fisher retrieves the radiology report from his file on the way to the examining room to see Mrs. Rogers. It reads compression fracture of T-10, without evidence of significant osteopenia or arthritic changes, likely etiologies include severe trauma or neoplastic process.

He now questions her thoroughly about constitutional symptoms. She describes anorexia and a 15-pound weight loss since her last visit, as well as nighttime sweats and chills. On physical examination, Dr. Fisher finds a two-centimeter, firm breast mass, unlikely to be anything other than advanced breast cancer. Mrs. Rogers had noticed the lump just before her visit with Dr. Fisher four months ago but did not mention it to him because her back pain was of more immediate concern and he appeared to her to be very busy. She reasoned that because it never caused her any pain, she could wait to report it.

Analysis

Proper time of Dr. Fishers examination of the X-ray and radiology report

Health workers should take into account the length of time that should exist between the diagnoses and reporting of the tests, as required by the health law (Kerridge et al. 23). Dr. Fisher should have examined the radiology report shortly after the radiologist filed the report. Providing Mrs. Rogers with timely information about her health could have been achieved through defining the role of the radiologist as well as the role of Dr. Fisher with regard to patients care. This helps to enhance patients care since possible errors in information exchange and the presence of work overlap is eliminated.

Proper actions of the radiologist: Should the radiologist have called Dr. Fisher with a verbal report of the findings?

Effective patient care could have been achieved if Dr. Fisher and the radiologist improved workflow as well as health service delivery outcomes by focusing on organizational culture, improving their relations, and defining the role of each one of them. The radiologist should have called Dr. Fisher with a verbal report of the findings even though verbal reporting could have been faced with the limitation that emanates from work overload from the diverse family members, thus hindering efficient and effective communication exchange. Verbal communication, however, is of paramount importance since it provides immediate connectivity between the radiologist and Dr. Fisher.

Does the radiologists failure to do so constitute negligence?

The radiologists failure to report findings constitutes negligence since this health care facility fails to give timely information to Mrs. Rogers concerning the record of her diagnosis tests. The heath practitioners ethical principle of autonomy states that appropriate information should be granted to patients concerning their health status and the kind of treatment that should follow the diagnoses tests (Kerridge et al. 49).

More so, failure to report the findings also constitute negligence since it fails to provide the patient with timely treatment after the diagnosis test. The ethical principle of beneficence points out that health care practitioners have a responsibility of assisting and taking the best action that fits the patients welfare so that whatever is done or said must be for the well being of the patient (Kerridge et al. 52).

References

Dean, BB, J Lam, JL Natoli, Q Butler, D Aguilar, and RJ Nordyke. Review: Use of Electronic Medical Records for Health Outcomes Research: a Literature Review. Medical Care Research and Review: Mcrr. 66.6 (2009): 611-38. Print.

Kerridge, Ian, Michael Lowe, and John McPhee. Ethics and Law for the Health Professions. Annandale, N.S.W: Federation Press, 2005. Print.

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