Electronic Health Record System (EHRS)

Published: 2021-07-07 00:24:37
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Category: Health Care

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AbstractBackground: Electronic Health Record System (EHRS) is used largely in developed countries, though developing countries have also implemented the system in their health care industries. Electronic Health Record System (EHRS) is expected to improve the quality of patient care and its successful implementation depends upon the clinical perception of EHR systems. Many medical staff have resisted digitalization, observing the system as uncaring, confusing and dehumanizing. The literature showed physician’s perception and attitude towards the significance of the system to improve healthcare facilities but also identified the factors influencing the resistance in using the new system.Research Question: Do healthcare professionals perceive that the use of electronic health records improves the quality of healthcare services in healthcare organizations in Gulf Cooperation Council Countries?Objective: The systematic research was conducted to evaluate the physician’s perception and satisfaction with the newly implemented EHRS in healthcare organizations to improve the quality of healthcare services in Gulf Cooperation Council Countries.Method: A systematic literature review is used to examine the physician’s and medical staff’s attitude, knowledge, satisfaction, preferences and perception about the Electronic Health Record system. The study was focused on physicians, pharmacists, receptionist, medical staff, and nurses working in various hospitals in Gulf countries such as Saudi Arabia, Bahrain, Kuwait, U.A.E, and Oman. The literature review was concentrated on the government and private hospitals in different regions of Saudi Arabia i.e. Makkah, Jeddah, Taif, and Riyadh. In Oman, Bahrain, Kuwait, and U.A.E several clinical specialist, public hospitals, and primary healthcare centers were investigated.Result: The overall response of physician’s and other medical staff’s perception and satisfaction towards using EHR systems to improve healthcare services was positive. However the study identified negative perception of the system in Saudi Arabia, mainly because of the lack of sufficient technical training and personal preferences.Conclusion: Majority of the studies specified the positive perception and high satisfaction rates toward the newly implemented computerized record keeping system. Physician’s agreed on the useful impacts of using electronic health record system to reduce errors and maintaining a proper record of patients especially in diseases like HIV which requires constant medical treatment and assistance. The review also revealed the barriers and factors influencing the adoption of EHRs in hospitals and medical care facilities. Two major barrier identified to hinder the successful implementation and adoption were human barriers; related to knowledge gap, personal beliefs, and financial barriers; related to the high cost and insufficient funding to implement EHRs in developing countries.Literature ReviewIntroductionElectronic health record system is a digital form of a patient’s paper chart (McDonald, Tang, and Hripcsak, 2014). It is widely used in any healthcare organization to collect patient’s data such as medical history, prescribed medication use and demographic information. The developed countries such as Canada and the United Kingdom have a national EHR system. In 2012, 72% of office-based physicians used EMR/EHR systems in America (Hsiao, and Hing, 2012). Keeping health records digitally is undergoing a transition not only in developed countries but also in developing countries.The developing countries lack a well-organized healthcare infrastructure to effectively fight against Malaria, Human Immunodeficiency Virus (HIV) among other deadly disease that requires constant medical assistance and treatment. The basic paper-based record keeping is not enough and needs to be substituted by a new, innovative electronic health record system (Kalogriopoulos, et al., 2009).The study aim to investigate the physician’s perception about the impact of using electronic health record systems (EHRS/EMRS) to improve the quality of healthcare services in Gulf Cooperation Council countries. The literature review reflect the most current and pertinent research available on electronic health record systems in Gulf countries. In Saudi Arabia, the Saudi Ministry of Health (MOH) has taken initiatives to implement EMRS nation-wide. According to a research conducted by Shaker, Farooq, and Dhafar in 2015, 52.8% physicians appreciated EHRS positively in Saudi Arabia. However there is a deficiency of awareness about the use of EHR systems among a range of administrative staff and health professionals (Hasanain, Vallmuur, and Clark, 2015).EHR is an assisting technology that let physicians to apply quality improvement processes in the practice of medicine. The systems provides accuracy of information, speed of communication, date revision, and data retrieval, and improve adherence to clinical practice guidelines in health care facilities (Al Alawi, et al., 2014). The computerized clinical record system are useful to storage huge volume of regulatory information, administrative, and clinical information. These systems not only provide speed and accuracy but also decrease the rate of medical error, increase quality, and fulfil the regulatory audit. Physicians see the digital system as a mean to advance quality care, increase cost efficiency (Al Farsi, and West, 2006). It is a new way of communication and interaction among paramedical employees, nurses, and physicians. EHRs is reducing the medical cost by eliminating inappropriate care, inefficiency, and medical errors (Fleming, et al., 2014). The system is also capable of detecting unusual pattern such as high number of lab investigations ordered by physicians, oddly high degrees of hospitalization or patient readmission.The successful use of electronic health record system is crucially dependent upon the clinical perception of EHRs. The literature review of nine articles from different countries in Middle East is focused to determine the physician’s satisfaction and perception of the electronic health record system. The study conducted in United Arab Emirates (U.A.E) concluded that physicians are satisfied with the system and have an affirmative perception regarding the application (Al Alawi, et al., 2014). Similarly researches conducted in Saudi Arabia indicate the positive attitude of nurses towards EHRs (Alzobaidi, et al., 2016) and they agree on the benefits of using this system (Asiri, AlDosari, and Saddik, 2014). An article from Taibah University of Medical Sciences in 2014, stated the dissatisfaction of physicians with the digital system significantly associated with the performance of the system and the quality of the information (Youssef, et al., 2014). Another study showed an increase adoption of the EHRs in Saudi Arabia however it indicated the computer training and literacy rate directly proportional to the clinical efficiency and EHR satisfaction (Alasmary, Metwally, and Househ, 2014).Two researches conducted in Kuwait have showed a very positive perception of EHRs by the physicians and their confidence in the efficiency and accuracy of EHR systems (Al Azmi, et al., 2008). The majority of physicians participated in a study has reported the EHR system as easy to use (Al Azim, and Al Saleh, 2008). However, In Oman physicians indicated low satisfaction with the current EHR system because of its inadequate and inappropriate usage (Al-Mujaini, et al., 2011). Most of these studies showed positive attitude and a high satisfaction of physicians in electronic health record system however, there are several barriers and challenges involved in the adoption of a digital system.Adopting the new technology is always challenging. Nurses are the largest part of the healthcare personnel in the critical care facilities; therefore, nurse’s advocacy of the electronic health record system is a crucial factor prompting its implementation. The process of adopting EHR systems is growing rapidly within the healthcare industry. The Medical secretaries and the nurses interact with EHR systems as receptionists, transcriptionists, and nursing diagnoses, write nursing care plans, check physician orders, and record vital signs. This makes them the primary users of the system but the evaluation of EHRs by nurses has received less devotion (Mahalli, 2015).The major barriers identified by several researches that hinder the successful implementation and adoption of health information systems in Saudi Arabia are human barriers and financial barriers (Khalifa, 2014). Human barriers refer to the healthcare professional’s knowledge, personal beliefs, and attitude regarding the health record adoption (Mahalli, 2015). While financial barriers include insufficient money and funding to implement EMR system.The studies investigated the barriers and factors affecting the user satisfaction with Electronic Health Record System and concluded that the physicians agree on the usefulness of digital system to record medical history but adopting a new technology is challenging. Computer literacy and training can improve the satisfaction. Another important element to improve the physician adoption of system is the involvement of the primary users in developing the EHR system and ask for the recommendation of how to improve the interface. The implementation of a computerized system is not as challenging as providing the maintenance and the technical support to sustain the system. Low budget countries face difficulties in technically maintaining the system and thus indicate the need of improved technical trainings.

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