The Importance of Patient-Centered Health Care

Murphy's article on patient-centered care illustrates on the necessity of patient as the center of a healthcare system in addition to health information technology in improving patient healthcare (Murphy, 2011). The article explains more on the importance of patients as the center of health care which traditionally took place in hospitals as patient-centric health care model of illness. It further states that the initial disease model of hospital-centric view reduces hospital costs by transforming into a patient-centric care in the outpatient setting. Through the use of comprehensive medical approach, Health Information Technology (HIT) has advanced the Electronic Health Records (EHR).

According to Murphy (2011) through the use of new technology of ensuring effective medical care, EHR can be developed as per patients' health and medical complications. The patient-centered health care model involves views on the patients care based on an individual. Health care has become more compound, especially in incorporating Electronic Health records systems communication in national organization initiatives, health providers, health care facilities, local pharmacies, county and state health specialists. Implementing Health Information Technology in patient-centered health care will provide new scopes on the significance of a patient health and care services. (CDSS) refers to the process of enhancing decisions and actions that are health-related with relevant, organized patient information and clinical knowledge so as to improve patients’ health and healthcare service delivery. Clinical Decision Support Services (CDSS) value is important to; doctors, dietitians, medical personnel, or other health care providers as it provides them with specific patient details in an electronic form to improve patient health care. The decision support system has helped minimize medical errors and outcomes by increasing healthcare quality.

Clinical decision support has five rights that require interventions in order to address the system benefits. Clinical decision support interventions provides the right to information for the right people who are the entire health care team who are; the patient who have the right to information channels such as mobile device, patient portal and electronic health records in the right format such as having order sets, flow sheets and patients list formats and at the right time for decision-making and action (Murphy, 2011).

Clinical decision support system is important in providing timely information to patients, clinicians, and other healthcare teams so as to provide decisions about the health care. Some of the tools used in the CDSS are; order sets which are formats for specific types of patients or conditions. Databases are also DCSS tools used to provide reminders for preventive care and warn of the dangerous situations. CDSS also improves efficiency, lower cost and reduce patients’ inconvenience. Clinical decision support system can be used on a variety of devices such as computers, electronic medical record networks, written materials, and the internet (Dean et al, 2008). Despite the fact that clinical decision support system has several benefits to health care, there are challenges that the system encounters.

One of the major challenges of the CDSS is to summarize up the patients’ electrically available data especially a patient with complicated data. It also has the challenge of accounting for competing factors and values that influence the clinical decision making and thus, affecting the support system. There is also the challenge of priority order ranking and reducing the number of computer generated policies and recommendations that both patients and clinicians have to deal with to achieve value model.

Creating new CDSS interventions is also a challenge where the problem arises on which content development and implementation should come first. Mining large clinical data becomes challenging in creating new CDSS intervention. (Dean et al, 2008) asserts that disseminating existing CDSS knowledge and intervention is a challenge especially disseminating best practices in CDSS designs, implementation, and development. Computerized provider order entry (CPOE) is a method that allows the entry of medical orders electronically in inpatient and ambulatory settings through the use of computers directly by the health care providers, thus changing the initial order entry methods such as verbal communication, written papers, telephone calls and fax. CPOE systems can allow entry of medication orders such as admittance, laboratory, cancer operation, transfer, and procedure orders.

CPOE is greatly concerned with safety and this is achieved by making sure clear and readable orders are put in place, however, the safety value is facilitated by CPOE combination with clinical decision support system (CDSS). This key component, therefore, provides the practitioners with real-time support on a range of information on identifying and labeling of a health problem and offering treatment. CPOE is also used as a tool for improving patient care and reducing medical costs as well as errors. Moxey, (2010), further elaborates that the clinical decision support may come up with more information on medical complications, food allergies, drug-drug interactions, and renal problems. CPOE systems in combination to clinical decision support systems reduce healthcare cost; improve value and safety of health care and also ensures compliance with rules and the hospital workflow productivity. During EHR implementation, elimination of excessive information is done.

However, if EHR system becomes defective, development and implementation of technology result in more complications and thus the results might turn up to be good or bad. Therefore, the healthcare providers ought to be aware and understand the advantages and disadvantages of EHR. EHR system has made it easier for clinicians to access data so fast compared to the physical storage of data where data may even go missing. The EHR system has also helped in the reduction of space as initially data was kept in files according to each patient.

EHR system has greatly reduced the error handling orders written down. The computerized physician order is achieved with CPOE as it allows physicians to be able to organize and place all prescriptions and lab order electronically. (Hsiao et al, 2008). EHR system has made it possible and convenient for physicians to access preventative health records at one point and allows for preventative screening. The system also allows for data mining in the entire system which can’t be done through paper records.

The ERH system has eased the messaging process among providers in different departments. DesRoches et al (2008), states that with this system, it is easier for physicians to make referrals and appoint schedules. The goal of EHR is to ensure an increase in productivity and indicates a significant drop in productivity occurs during initial phases of development and implementation. This is clearly shown in a research done by the University of California where there was a drop in productivity in the implementation of electronic health records. Setting up of the EHR system and its maintenance require some finance from the provider and organization as well. There is also some cost incurred such as training and updating IT support system. The cost associated with EHRs is often limiting. The EHR has, in turn, lead to increase in workload as compared to handwritten where the documentation is always brief and straight to the point.

E-messaging limits face to face conversation and a give and take conversation. There is no expression of emotions, thus, interpretation of such messages becomes problematic reducing the interaction among health care providers. Continuous updating of records is tedious and time-consuming since updates need to be done continuously whether a procedure, diagnosis or prescription is done whether small or large needs to be updated and someone has to be responsible for updates (DesRoches et al, 2008).

The health information technology components (EHR, CPOEs, and CDSS) are classified as patient-centric health care management system due to the transformation of health care from a hospital as center care to patient-centered care. Murphy further indicates that the HER, CPOEs, and CDSS are important aspects of health care, especially during development, implementation, and application of health information technology (HIT). Although much have been done concerning the quality of health care services on patient-centric care, not much has been done on support and use patient as center care by health care providers.

According to Murphy if patient-centric care is done well and positively in a satisfactory way by making it available and accessible to both patients and health care providers, patients health care will improve.

References

DesRoches, C. M., Campbell, E. G., Rao, S. R., Donelan, K., Ferris, T. G., Jha, A. & Blumenthal, D. (2008). Electronic health records in ambulatory care—a national survey of physicians. New England Journal of Medicine, 359(1), 50-60.

Dean, F. S, Adam.W, Jerome, A.O., Blackford, M. Jonathan, M. Teich Joan S.A., Campbell, E., David, W. (2008). Grand challenges in clinical decisions. Journal of Biomed inform, 41(2) 387-392.

Hsiao C, Burt C, Rechtsteiner E, et al. Preliminary estimates of electronic medical record use by office-based physicians: United States. Health E-Stat, 2008. Retrieved from http://www.cdc.gov/nchs/products/hestats.html.

Moxey A, Robertson J, Newby D. (2010). Computerized clinical decision support for prescribing: provision does not guarantee uptake. Journal of American Medicine Inform Association, 17(1): 25-33.

Murphy, J. (2011). Information systems and technology. Patients as center of the health care Universe: A close look at patient-centered care. Nursing Economics, 29(1), 35-37.