Disparity in Electronic Health Record systems

1. I wrote the paper outline already. I need the paper to be re-written keeping the initial outline and main idea. Please rewrite the final paper based on the provided outline and instructors feedback I have provided as uploaded files. Please includes abstracts and reformulate topic statement as needed.Introduction

Risk is inherent to any human endeavor. To conduct their activities even routine ones in almost any known field or discipline known to mankind, human take some risk. This is the reason why there are bodies of knowledge such as risk mitigation/management, occupational safety, quality assurance/control to help reduce risks, safety, and quality in every trade and craft. The health care industry is no exception this problem. Meant to enhance quality of life by enhancing health itself, healthcare in its entirety, and the different processes, methods, and means it uses to function can also pose risks or become unsafety to the very patients it pretends to care for. One such component of healthcare delivery or better yet, a resource originally meant to provide higher quality and safer care for patients while creating tangible enhancements for healthcare organizations is the now famous Electronic Health record (EHRs). However, disparities in HER systems and the lack of interoperability among them can seriously affect in a negative way patient safety and quality of care. This is what we set out to investigate and proof in this piece. We are going to tackle this taskin three different sections Section I will deal with a brief history of Electronic Health Records systems in the United States to include its guiding and underlying policies, challenges faced by theses system, who is affected, where do we find those affected by these modern era apparatus, and why are we interested in these issues. The second section is going to be the analysis of the current status, root causes, financial and human implications of EHRs, as well as key stakeholders of these systems which sometimes affect patients’ health quality and become a liability to health safety.In a third and final section, we are going to think of both non-technical and technical solutions to the issues of disparities and lack of interoperability in EHR systems resulting in health safety issues as well as negatively affecting quality of care. In this final section, we will also investigate other considerations to include things like cost and funding supports, risk mitigation measures, and ethical considerations. Last, but not least we will examine possible outcomes to the proposed solutions, how long they will take to deliver expected results, and finally what evidence-based methods are we going to use in order to measure obtained results?

1. Statement of the Topic

As we already mentioned in the introduction of this piece, healthcare in general and its different processes, and methods, are intended to enhance quality of life through delivery of health. However, on the flip side, some of the industry’s components can turn out be unsafe for patients in some respects, and even negatively affect the overall quality of care. Many studies have indicated that disparities in EHR systems and the lack of interoperability among them can seriously affect in a negative way patient safety and quality of care.

1. Brief History of the Topic

The Affordable Care Act (aka ACA) signed Into Law on March 23, 2010 aimed to make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike… (HHS.gov, 2016). Included in the Affordable Care Act are policies that are geared toward the innovation and development of Health Information Technology Industry resulting in Integrated Health Systems. This in turn resulted in the formation by physicians of what is known as “Accountable Care Organizations” (ACOs) These new entities allow doctors to better coordinate patient care thus, improving the quality of care, helping prevent disease and illness and reducing unnecessary hospital admissions.

1. When did this problem begin?

It is in the wake of Integrated Health Systems that Electronic Health Records system developed as well and become more of a norm than exceptions for last five years or so. As EHRs are being more and more utilized in hospitals and physicians practices, a host of problems arose along but, in this piece we are only focusing on disparities of the systems and their lack of interoperability which cause safety to patients’ health and negatively impact the quality of health rendered to those same patients.

1. Has it gotten worse?

Although it has been reported and recognized by many sources that the rapid deployment of EHRs systems either commercially off the shelf (COT) offered or privately developed by healthcare entities, resulted in a lot of disparity and interoperability related to Health Information Exchange systems, the problem is being addressed by developers in the sector and has not gotten worse. Regardless of the statuswhich is not regarded as a major public health issue, we still need to look at the issue with a safeguarding approach.

1. What is the location most affected by this issue?
2. a) Health safety and health quality issuesas consequences of EHRs implementation are observed nationwide because EHR systems are mandated by the Affordable Care Act, a federal regulation. This can be categorized as a national public health issue because it affects all 50 states and other U.S territories with EHR capabilities.
3. Who is affected by the disparity and lack of interoperability in EHR system?
4. a) Victims of EHRs disparity and lack of interoperability are found among the United States general population. It can be anyone who seeks medical care after becoming ill or just a routine health checkup.
5. Health care delivery entities themselves can become victims of disparities and lack of interoperability in EHR systems because they can be sued by their customers.
6. Why is this topic important to you?
7. a) I am a strong believer of safety measures and implementation in everything we do. The science and art of medicine exist to preserve human life and foster human well-being, but at the same without safety precautions medicine can cause more damage to human life and human well-being.

b.) I am not personally a victim of EHR/EMR systems failures but, I want to be an advocate for safer applications of Information Technology to preserve human life and improve patients’ care.

1. Analysis of the Current State
2. Causes of EHR disparities and lack of interoperability
3. Policies, standards, frameworks, and good practice exist to help safe operations of EMR systems but because the underlying technology is always changing or improving, end-users cannot keep up.
4. Healthcare facilities must make sure they keep up with new development in the field.
5. Low cost, rapid adoption and training of EMR end users can prevent issues with substantial financial impact.
6. Financial costs/Implications of EHR/EMR systems disparities and lack of Interoperability

There sure are incalculable financial costs to failures of EHR/EMR systems. These costs are the result of lawsuits against hospitals, and physicians’ practices; but they can also be a result of workforce training, EHR/EMR systems development, etc.

1. Human Costs/Implications ofEHR/EMR systems disparities and lack of Interoperability

There sure are human costs to failures of EHR/EMR systems even if we cannot see it immediately.

1. Who are the Stakeholders ofEHR/EMR systems disparities and lack of Interoperability?

Just like in any other human activity, there are stakeholders of EHR/EMR systems utilization that are directly involved or affected by the systems’ failure or near misses. Such actors are policy makers, systems developers, and staff.

1. Public Awareness ofEHR/EMR systems disparities and lack of Interoperability?

I do not think that the general public is aware of EHR/EMR systems disparities and lack of Interoperability at this stage because the whole topic is fairly new, and an average person is not concerned with the implementation and use or EHR/EMR systems.

1. Trajectory of the Current State of EHR/EMR systems disparities and lack of Interoperability?
2. Although EHR/EMR systems disparities and lack of Interoperability are recognized as issues within the healthcare industry, they are not getting worse. In fact, different actors and stakeholders in the field are coming together to resolve those issues and improve on what already exists.
3. There is no doubt that if EHR/EMR systems disparities and lack of Interoperability are not addressed in a concerted manner by all actors, this could develop into more serious and complicated problems affecting many people.

• Proposed Solutions

All human endeavor come with their own issues or challenges but, when faced with these challenges, common sense calls for the search and implementation of solutions. Solutions to EHR/EMR systems disparities and lack of interoperability can come in different shapes and forms and from different stakeholders/partners of the industry.

1. Non-technical Solutions to EHR/EMR systems disparities and lack of Interoperability
2. Changes and/or solutions at the policy level by the government or public health authorities
3. Changes and/or solutions at the management level or healthcare organizations.
4. Changes and/or solutions by other skateholders not directly involved
5. Changes and/or solutions involving the public such as health habits, preventative care, buy-in campaigns, etc.
6. Technical Solutions to EHR/EMR systems disparities and lack of Interoperability
7. Systems design based on industry standards and regulations and known best practices
8. Other technical requirements

1. Other Considerations aboutEHR/EMR systems disparities and lack of Interoperability
2. Sources of funding for EHR/EMR systems improvement
3. How to design and implement EHR/EMR systems with a risk management approach
4. Should ethical considerations come into play as well?

1. Outcomes of Proposed Solutions toEHR/EMR systems disparities and lack of Interoperability
2. Well thought out, planned and designed EHR/EMR systems would be more effective and efficient in the delivery and practice of healthcare. Although the current situation is not alarming and probably cannot raise to the level or threshold that would make it a public health issue, there should be policies, measures, standards, directives, technical solutions as well as non-technical solutions in order to assure safer use of EHR/EMR systems.
3. Remediation of faulty EHR/EMR systems do not need timelines to be completed. It should be an unending quest. Once encountered such failure or default should be fixed as soon as possible.
4. To measure EHR/EMR systems performance, rigorous metrics should be put in place, and scientific evidence-based approaches should be used.
5. Summary and Conclusions
6. Briefly review/re-state the issue that is subject to this paper.
7. Recall the different aspects of the subject (root causes, financial/human implications, possible solutions, future perspectives, etc.) developed in this paper.
8. Summarize why is it important to us
9. Offer an opinion of the issue