Exploring the Electronic Health Record, Interoperability and Patient Engagement: The App Solution

Exploring the Electronic Health Record, Interoperability and Patient Engagement: The App Solution

Stephanie Morish | 2016

Abstract

The healthcare industry in the United States is considered broken based upon published reports which rank the United States healthcare system last compared to other industrialized nations (Commonwealth Fund, 2014). The ranking of 8^th(The Commonwealth Fund) has government agencies (The Department of Health and Human Services, through the Centers for Medicare and Medicaid Services-CMS) and healthcare organizations scrambling to address cost, decrease waste and utilization while remaining viable entities in their communities. The facts state 31% of primary care physician’s (PCP’s) in the U.S are able to receive routine notifications electronically of a patient encounter in the hospital setting, although the use of electronic health records has increased from 10% in 2012 to 69% in 2015 (Health IT Dashboard).

The issues around the lack of effective communication are rooted in understanding the internal and external culture and subcultures that inhibits organizational goals in healthcare institutions nationally. The American Hospital Association reports approximately, “100,000 people die annually in hospitals from medical errors—and 1 out of every 370 people admitted to a hospital dies due to medical errors”. These numbers also state that hospitals are becoming very dangerous environments, where there is vulnerability and the absence of detail (Houle and Fleece, 2012).

A major contributing factor associated with the aforementioned statistics is receiving medical histories and relevant facts with the details that are buried in electronic folders within the electronic health records (EHR). Most EHR’s inhibit the ability to make effective care decisions timely, and in the case of the transient patient—the correct past medical history is absent and therefore inhibits proper care management. The U.S. is respected internationally for initiating the best trauma services, but weak providing concurrent care (continued care post trauma care) contributing to low quality scores. Within the healthcare arena, emergent care is supported in most cases by an assigned hospitalist physician whose potential practice patterns are absent of co-management by the PCP (who has the best knowledge of the hospitalized patient). Another factor is increasing hospital length of stay (LOS) with physicians waiting on pertinent health details that could impact the treatment plan and prevent hospital-borne (nosocomial) infections and sentinel (adverse) events that contribute to readmissions.