UNIVERSITY OF CAPE COAST

COLLEGE OF HEALTH AND ALLIED SCIENCES

SCHOOL OF ALLIED SCIENCES
DEPARTMENT OF HEALTH AND INFORMATION MANAGEMENT

ASSIGNMENT ONE (1)

COURSE CODE: 303

COURSE NAME: HEALTHCARE SYSTEMS: IMPLEMENTATION AND

INTEGRATION

INDEX NUMBER: AH/HIM/18/0028

 QUESTIONS:
1. Explain how electronic health records will affect existing jobs in allied
health as well as creates new jobs.
Because of the change from a paper environment to a digital environment,
jobs needed for processing paper medical records and documentation will
become obsolete in the future. For example, the need to employ file clerks
for medical records will decrease; a manual process will not be needed to
collect, index, store, and retrieve medical records. Those workers need to
be retrained to take on other roles in the electronic environment. In
another example, the job market for medical transcriptionists will mirror
the average growth rate of the entire workforce, which is slower than that
of jobs in the health care industry. The ease of data entry, use of templates,
and adoption of voice recognition technologies have lessened the need to
transcribe doctors’ dictations into medical documentation.
New job roles will emerge as EHR systems are implemented in health care
organizations. These new job roles will either support the continual
integration of EHRs with clinical workflows or will leverage the captured
clinical and other data to improve health care outcomes .
Health care quality improvement specialists will be able to leverage
the data available in the EHR system to deliver quality improvement
projects for service and clinical activities. One touted benefit of EHR
systems is the potential for positive impacts on patient safety and quality.
Indeed, many health care organizations are using the data available in EHR
systems for quality improvement.
 Clinical informaticians will emerge to utilize their clinical expertise
and knowledge of patient care, operational processes, and information
systems to participate in the design, specification, implementation, and
evaluation of an EHR system. They act as knowledge resources regarding
the EHR system, and they ensure effective problem resolution at initial
technical levels.
Information management redesign specialists are workers who will
assist in reorganizing the work of providers to optimize the features of HIT
that are designed to improve health care. Individuals in this role may have
backgrounds in healthcare.
2. Why are some healthcare professions resisting the use of Electronic
Health Records?
Some physicians or healthcare professionals are resisting the adoption of
EHRs due to several reasons. These reasons are discussed below;
(a) Monetary issues
Some healthcare professionals or physicians are resisting EHRs because of
the monetary issues involved in implementing EHRs. The monetary aspect
was an important factor for many physicians. Their major concern is
whether the costs of implementing and running an EHR system are
affordable and whether they can gain financial benefit from it. In
implementing the EHR system physicians and some healthcare
professionals took the costs into consideration which include the start-up
costs and the ongoing costs.
The start-up cost include all the expenditure needed to get an HER
system working in the physician practice, such as purchase of hardware and
software, selecting and contracting costs and installation expenses. In
addition, to the start-p costs, implementing an HER system requires
extensive commitment to system administration, control, maintenance and
support in order to keep the it working effectively and efficiently.
(b) Technical reasons
 Electronic Health Records are hi-tech systems and as such, include complex
hardware and software. There are some technical problems with EHRs,
which lead to complaints from physicians, and they need to be improved.
Some physicians or healthcare professionals have insufficient technical
knowledge and skills to deal with EHRs, and that this results in resistance.
Further, good typing skills re needed to enter patient medical information,
notes and prescriptions into the EHRs, and some physicians lack them.

(c) Time consuming

A fluent workflow is very important to the work of physicians. The
introduction of EMRs will slow a physician’s workflow, as it will always lead
to additional time being required to select, implement and learn how to use
EHRs, and then to enter data into the system. As a result, their productivity
will be reduced and their workload will be increased. This can cause
financial problems, such as a loss of revenue. Physicians think they don’t
have to spend much time in system selection and procurement but rather
spend time and effort on patients.
(d) Psychological reasons
Physicians have concerns regarding the use of EMRs that are based on their
personal issues. Knowledge, and perceptions. Their perceptions of the
questionable quality improvement associated with EMRs and worries about
loss of professional autonomy. According to Kemper et al, more than half
(58.1%) of the physicians without an EMR doubt that EMRs can improve
patient care or clinical outcomes.

3. Discuss some of the economic pressures forcing changes in the healthcare

system in respect to EHR.
(i) Skyrocketing Prescription Drug Costs:
A 2013 report from CVS Health estimated that specialty drug costs
would quadruple from $87 billion to $420 billion by the year 2020.
These skyrocketing costs would extremely have a domino effect. If
consumers can't afford the drugs, they won't buy them, which means
 facilities won't carry them. At the end of the chain, you have
pharmaceutical companies limiting how much they can spend on
research and development of new drugs.

(ii) Access and Digital Transformation

People growing up in the digital age expect convenience. You can hail
an Uber, order food for delivery, and book a hotel room all from your
smartphone. But the patient experience hasn't caught up with these
consumer expectations. In major U.S. cities, for example, the average
wait time for an appointment is 18.5 days.

(iii) Healthcare Complexity

43 million Americans have unpaid medical debt on their credit

reports, and over half of debt collections are related to medical
expenses, according to the Consumer Financial Protection Bureau.
Between medical facilities, doctors, insurers, and pharmaceutical
companies, healthcare billing quickly gets overly complicated. In
many cases, consumers simply don't understand who they owe and
for what.

(iv) Increased Cost Sharing:

Over just the past five years, out-of-pocket medical expenses have
doubled for employees. In turn, a 2015 study by PwC found that the
number of consumers declining medical care has risen to 40%. And
when skeptical consumers turn down medical services, their
employers and healthcare companies both take a hit.

4. Describe the role of the government in bringing about changes in the

healthcare system in general.
Government, through ministries of health and other related ministries and
agencies, play an important role in health development, through
strengthening health systems and generation of human, financial and other
resources. Some important roles of government in bringing about changes
in healthcare are:
(i) Health care financing
Government play a major role in health care financing by mobilizing
the necessary resources through public budgets and other
contributive mechanism, pooling resources allocated to health
development, guiding the process of resource allocation and
purchasing health services from various providers. Ministries of
Health are entrusted to protect equity in access by improving
financial risk protection, by reducing financial barriers to access
particularly to the poor and to vulnerable population, and by
ensuring that health care financing by all income groups is fair.
(ii) Human resource development
As human resources contribute the main inputs and assets in health
systems, government are responsible for designing appropriate
policies for human resource development aimed at meeting the real
needs of populations, securing appropriate policies skill mix,
improving equity in distribution of human resources, managing them
properly, and monitoring and evaluation of the national health
workforce.
(iii) Health service delivery
The role of government is often to steer the overall health
development by designing health policies and programmes, securing
essential public health functions and regulating the delivery of health
 services. Government provide health care services, including public
goods such as promotive and preventive services and hospital care.
Government helps in provision of clinical services at the primary,
secondary and tertiary levels of health systems. These services are
provided in communities, work settings and public institutions.
Government are responsible for the provision of medicines and
vaccines and supporting laboratory networks.

5. Discuss what happens when a patient data is leaked/hacked to

unauthorized user’s of the EHR.
(i) 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.
(ii) 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 organizations 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
organization’s ability to attract new customers, future investment
and new employees to the company.

(iii) 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 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.
(iv) 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 plaintiff’s 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. Adler-Milstein J, DesRoches CM, Karlovec P, et al. Electronic
health record adoption in US hospitals: progress continues, but
challenges persist. Health Aff (Millwood). 2015;34(12):2174-2180
2. Mennemeyer ST, Menachemi N, Rahurkar S, et al. Impact of the
HITECH Act on physicians’ adoption of electronic health records.
[published online ahead of print July 30, 2015] J Am Med Inform
Assoc. doi: http://dx.doi.org/10.1093/jamia/ocv103.
3. “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_Implicati
ons, n.d.)
4. Damaging Consequences Of A Data Breach | MetaCompliance
(https://www.metacompliance.com/blog/5-damaging-
consequences-of-a-data-breach/, n.d.)