UNIVERSITY OF CAPE COAST

COLLEGE OF HEALTH AND ALLIED SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES
DEPARTMENT OF HEALTH INFORMATION MANAGEMENT

ASSIGNMENT ONE
COURSE CODE: HIM 303
COURSE NAME: HEALTHCARE SYSTEMS: IMPLEMENTATION AND INTEGRATION
INDEX NUMBER: AH/HIM/18/0016

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1.Explain how electronic health records will affect existing jobs in Allied Health as well as create
new jobs.
The advent of EHR systems would have far-reaching workplace implications. This segment will discuss
the effect of the electronic health record on the work of both workers and allied health care practitioners.
In periods of recession, employees may be especially worried, recognizing that financial strains make
staff with health conditions particularly unattractive to employers. To decide which people are likely to be
high-risk and high-cost employees, employers or their hired experts may build complex scoring
algorithms based on EHRs.
Employers might be irritated by the need to maintain EHRs, which they might find far more complex and
challenging to understand than paper records. EHR printouts or PDFs may provide a misleading image of
the medical chart and are difficult to understand for lay employers. They may be both large and
incomplete, with data that is poorly structured, presented awkwardly, or scattered in the text, all of which
would make it difficult for an employer to decide if an applicant or employee has a disability that would
prohibit her from performing important job tasks.
In the field of job research, the computerization of medical records may have varying implications. Some
employees may feel more at ease reading EHRs than conventional paper records with illegible
handwriting or summary dictation, and may find them more informative. Some may opt to retain experts
who provide record screening services, interpret EHRs, provide the employer with summaries or scores.
Other employers can misunderstand perplexing EHRs, incorrectly assuming that individuals have serious
medical issues, and denying employees employment opportunities. Others may prefer to forego using
EHRs in lieu of putting workers through actual medical testing. Employers will receive greater privacy
rights if employers do not require access to EHR records, but some may dislike receiving physical tests or
mistrust company doctors who are charged with performing them.
In many other ways, EHR systems can also impact employers. While workers are likely to be worried
about the security of their electronic health records, employers should be equally concerned about their
ability to keep digitized information secure. Employer-held health records can be subject to hacking,
fraud, or unwise disclosure by colleagues. Employers may be prosecuted under state common law or
statutory privacy causes of action if confidential health information is illegally leaked or revealed. EHR
programs would also have an impact on medical expenses, which will have an impact on employer
spending.
Electronic searches of medical files may be possible with EHR programs, allowing important information
to be identified easily and with minimal effort. With the introduction of the EHR scheme, health care
providers will face essential changes. EHR systems can enhance physicians' ability to fulfill patient needs
and increase their satisfaction at work. They will allow doctors to interact more with patients, study
patient information more easily, find suitable medical literature easily, and enjoy other benefits.
In addition, many clinicians may find that the time they need to spend on paperwork is increased by EHR
systems, reducing the time they have for patient notes and EHR systems require various information that
providers may not otherwise record.

2. Why are some healthcare professions resisting the use of Electronic Health Record?
LACK OF FINANCE:
The "Financial" group of obstacles includes those relating to the financial aspects of EMR
implementation. A significant consideration for many physicians was the monetary element. The
questions that doctors usually face are whether the costs of introducing and maintaining an EMR system

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are sustainable and whether they will benefit financially from it. You should split the costs of an EMR
system into two: start-up costs and ongoing costs. The start-up costs include all the expenditure needed to
get an EMR system working in the physician's practice, such as the purchase of hardware and software,
selecting and contracting costs and installation expense. The implementation of an EMR system involves
extensive dedication to system management, monitoring, maintenance and support, in addition to start-up
costs, in order to keep it running effectively and efficiently. These costs would include major long-term
monitoring, updating, upgrading and maintaining costs for EMRs. In addition, vendors charge a high fee
for after-sales support. All these expected expenses render doctors unable to follow EMR.

LACK OF COMPUTER SKILLS BY PHYSICIANS:

In order to deal with EMRs, doctors have inadequate professional knowledge and skills, and that results
in resistance. Prior to the implementation of IT services, the majority of physicians earned their
instruction. The level of programming skills needed by doctors tends to be underestimated by EMR
providers, while the system is not only seen as very difficult to use by these doctors, but also in practice.
In addition, strong typing abilities are required to enter into the EMRs with patient medical records, notes
and prescriptions, and some doctors lack them. Furthermore, not only doctors, but also other members of
the medical staff, lack sufficient computer skills. The broad adoption of EMRs is impeded by this general
lack of skills.

LACK OF RELIABILITY:
Reliability is the dependability of the technology systems that comprise the EMRs. High reliability is very
important for a system dealing with patient information, and many physicians are concerned about the
temporary loss of access to patient records if computers crash, viruses attack or the power fails.
Furthermore, others are worried about the risk of data loss due to an unexplained technological error in
the system. Moreover, reliability concerns will result in financial losses, such as a rise in ongoing costs.

STANDARDIZATION:
EMR hardware and software cannot be used "right out of the box"; it must be connected to other devices
that "complement" the EMR system and assist in producing benefits. Such interconnectivity issues are a
well-recognized obstacle to the broad adoption of EMRs by doctors in medical practices that have
adopted EMRs. In essence, in order to provide an integrated system like EMR, EMRs are not compatible
with the current practice systems, and physicians are unwilling to get rid of usable systems. In addition,
more than 264 separate types of implementations of EHR/EMR software are in use. The data format
differs between various software packages and systems, mainly due to the lack of consistent data
specifications within the industry, making it difficult, if not impossible, to share data between systems.
Because of the relative lack of organizational capital such as skills and experience, this issue is more
severe in small practices than in larger ones.

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INTERFERENCE WITH DOCTOR-PATIENT RELATIONSHIP:
The majority of doctors claimed that using an EMR impaired contact with their patients. During the
meeting, doctors must turn to the computer to complete electronic forms, and this can be time-consuming,
especially when they suffer from limited computer skills. Some doctors say they avoid using EMRs
because looking for menus and buttons interrupts the clinical experience. According to Shachak et al.,
using EMRs raises physicians' average screen gaze time from 25% to 55% of the consultation session,
resulting in less eye contact and less conversation with the patient. Alternatively, doctors have to give
more time per patient in the "Time" group, which comes up against a barrier. In addition, because some
EMRs are patient-accessible, they may also distort the clinical experience with more patient intervention
and distractions. As a result, EMRs will modify the conventional doctor-patient relationship. Whether this
is really a problem for doctors and patients, however, needs more empirical study, as most studies have so
far largely ignored this issue.
3. Discuss some of the economic pressures forcing changes in the healthcare
A. DISSATISFIED CONSUMERS:
According to a study conducted by Prophet and GE Healthcare Camden Group, 81 percent of customers
in the healthcare environment are unsatisfied with their healthcare experience. Consumer issues include
rising prescription drug prices and lengthy wait times at the doctor's office.

B. INCREASED COST SHARING:

Employees' out-of-pocket medical costs have doubled in the last five years. As a result, according to a
2015 survey by PwC, the number of consumers rejecting medical care has risen to 40%. When skeptics
reject medical treatment, their employers and healthcare providers suffer as a result.
C. SKYROCKETING PRESCRIPTION DRUG COST:
According to a 2013 report from CVS Health, specialty drug prices will quadruple by 2020, from $87
billion to $420 billion. These skyrocketing costs will have a cascading impact in the future. They won't
buy them if people can't afford the drugs, which means hospitals won't carry them. You have
pharmaceutical firms at the end of the chain, limiting how much they can invest on research and
development of new drugs.

D. HEALTHCARE COMPLEXITY:
According to the Consumer Financial Security Bureau, 43 million Americans have outstanding medical
debt on their credit records, and medical debt accounts for more than half of all debt collections.
Healthcare billing can easily become unnecessarily complex when dealing with medical facilities,
physicians, insurers, and pharmaceutical firms. Consumers often have no idea who they owe money to or
for what.

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4. Describe the role of government in bringing about changes in the healthcare system in general.

HEALTH CARE FINANCING:

Governments play a significant role in health care funding through mobilizing resources through public
budgets and other contributing processes, pooling resources allocated to health growth, directing resource
distribution, and purchasing health services from a range of providers. The Ministries of Health are tasked
with safeguarding access equity by strengthening the security of financial risks, reducing financial
barriers to access for the poor and disadvantaged in particular, and ensuring that the funding of health
care by all income groups is equal. Health-care funding is becoming a more critical role of health-care
systems as access inequities within and within countries expand due to financial barriers and a lack of
sufficient social security.

HUMAN RESOURCE DEVELOPMENT:

Governments are responsible for designing appropriate policies for human resource development aimed at
meeting the real needs of populations, securing appropriate skills mix, improving equity in human
resource distribution, managing them properly, and monitoring and evaluating the national health
workforce, as human resources are the main inputs and assets in health systems. Governments create
national standards for the training of health workers and develop accreditation programs for training
institutions. The degree of cross-sectoral cooperation between the ministries of health and the ministries
of education and other relevant departments depends on effective policies and strategies for the
production of human capital. Often the lack of coordination among various stakeholders leads to
duplication and inefficient production of the health workforce.

HEALTH SERVICE DELIVERY:

Governments also play a role in directing overall health growth by establishing health policies and
programs, maintaining basic public health functions, and controlling health service delivery.
Governments include health care services in most countries, including public goods like promotion and
prevention services as well as medical care. Although private hospitals are increasingly playing a role in
care delivery in these countries, public hospitals remain the gold standard for quality standards, service
rates, quality health professional training, and health and medical research in a number of fields. Health
ministries are responsible for the protection of health and assume that responsibility by carrying out
essential public health functions, including surveillance systems and the provision of public goods, such
as mass immunization programmes, protection of the environment, fortification of foodstuffs, food safety,
etc. The delivery of essential public health functions is becoming complicated in view of increased
globalization and its impact on changing lifestyles, including eating habits and the rapid increases in
international travel and communication technology. In order to fulfil its public health functions and to
protect national health security, governments, through ministries of health, are responsible for the
provision of necessary medicines and vaccines and supporting laboratory networks. Access to quality and
affordable vaccines used in national immunization programmes faces several challenges, including

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limited financial resources, inappropriate supply systems and lack of effective national regulatory
authorities to implement quality and safety standards. Strategic decisions have to be made by
governments in terms of national investment in developing self-reliance and self-sufficiency in medical
technology, including medicines and vaccines. Governments are also involved in the provision of clinical
services at primary, secondary and tertiary levels of health systems. These services are provided in
communities, work settings and public institutions including health centres, investigation networks and
hospitals.

5. Discuss what happens when a patient data is leaked or hacked to unauthorized users of the
EHR?
FINANCIAL LOSS:
Undoubtedly, one of the most immediate and hard-hitting consequences that companies would have to
contend with is the financial effect of a data breach. Costs can include compensating impacted clients,
setting up incident management efforts, investigating the breach, investing in new protection measures,
legal fees, not to mention the eye-watering administrative fines that can be levied for failure to comply
with the GDPR (General Data Protection Regulation) A violation can also influence the share price and
value of a company significantly.

REPUTATIONAL DAMAGE
A data breach's reputational impact can be detrimental to a company's credibility. Research has shown
that up to a third of retail, financial and healthcare consumers would stop doing business with broken
organizations. News travels fast and organisations can become a global news story within a matter of
hours of a breach being disclosed. This negative press coupled with a loss in consumer trust can cause
irreparable damage to the breached company.

Consumers are all too aware of the importance of their data and they will actually quit and go to a
competitor who takes protection more seriously if organizations do not prove that they have taken all the
appropriate measures to protect this information.
Reputational damage is long-lasting and will also impact an organisation’s ability to attract new
customers, future investment and new employees to the company.

LOSS OF SENSITIVE DATA:

The implications can be catastrophic if a data breach has resulted in the loss of confidential personal data.
Any information that can be used to directly or indirectly identify an individual is referred to as personal
data. Anything from a name to an email address, an IP address, and photos will be included in this. It also
involves sensitive personal data which could be processed to identify an individual, such as biometric
data or genetic data. The fact is that if a vital patient has their medical records removed in a data breach,
there might be a major knock-on effect on their medical condition and possibly their lives. To
cybercriminals, biometric data is also highly useful and worth much more than basic credit card

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information and email addresses. The fallout from breaches that expose this data can be disastrous and
exceed any financial and reputational challenge. In today's evolving Cyber Security environment, there is
no space for complacency, regardless of how well-prepared the business is for a data breach. You must
have in place a coordinated security policy that protects confidential data, eliminates risks and safeguards
the credibility of your brand.

LEGAL ACTION:
Organizations are legally required by data security laws to show that they have taken all the appropriate
measures to safeguard personal data. If this information is breached, whether it's deliberate or not, people
will take legal action to demand compensation. In both the United States and the United Kingdom, class
action cases have risen dramatically as plaintiffs demand monetary compensation for the loss of their
records. More cases will be taken to court as the frequency and severity of violations continues to
increase.

REFERENCES
1 . “Impact of Electronic Health Records Systems on Information Integrity: Quality and Safety
Implications”
(https://www.researchgate.net/publication/2580448801_Impact_of_Electronic_Health_Record-
Systems_on_Information_Integrity_Quality_and_Safety_Implications, n.d.)
2. 5 Damaging Consequences Of A Data Breach | MetaCompliance
(https://www.metacompliance.com/blog/5-damaging-consequences-of-a-data-breach/, n.d.)
3. Hoffman, Sharona, “Employing E-Health: The Impact of Electronic Health Records on the
Workplace”(2010). Faculty Publications. 10.
(https://scholarlycommons.laws.case.edu/faculty_publications/10, n.d.)
4. “The Potential Damages and Consequences of Medical Identity Theft and Healthcare Data Breaches”
(https://www.experian.com/databreach, n.d.)

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