Electronic Health Record_Issues and Challenges in Primary Health Care
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Outline of some issues and challenges that need to be faced in implementing electronic health records in primary health care facilities.
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- 1. Jillian Nadette G. De Leon, RN MSHI-HI 201
- 2. WHAT IS AN ELECTRONIC HEALTH RECORD (EHR) ? • Contains all personal health information belonging to an individual • Is entered and accessed electronically by healthcare providers over the person’s lifetime • Extends beyond acute inpatient situations including all ambulatory care settings at which the patient receives care.
- 3. WHAT IS PRIMARY HEALTH CARE? • An essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford to maintain at every stage of their development (WHO) • Characterized by partnership and empowerment of the people that shall permeate as the core strategy in the effective provision of essential health services that is community based, accessible, acceptable and sustainable at a cost which the community and the government can afford (DOH-PH)
- 4. ISSUES AND CHALLENGES IN IMPLEMENTING EHR IN PRIMARY CARE? 1. HUMAN HEALTH RESOURCE ISSUES • Computer-literate health workers • Old-aged health workers • Health workers and administrators resistant to change. • Lack of health professionals who are experts in the field. (especially needed when a technical glitch occurs.) • Formulation of training programs for the use of an EHR. • Retention of health workers who are trained/ experts in health IT.
- 5. 2. TECHNOLOGICAL ISSUES • System has to be user-friendly for it to be easily used by health workers. • Formulation of a back-up system in case of glitches in the system and/or calamities. • Interoperable and standard software to be used in the different areas of the primary care facility. • Standard terminologies and codes to be used. • Availability of space and feasibility of the primary care facility for the adoption of electronic systems (space, cable, wiring, internet); especially in the Geographically Isolated and Depressed Areas.
- 6. 3. PRIVACY AND SECURITY ISSUES • Use of unique patient identifier is needed. • Presence of laws ensuring the privacy of each individual. What, when and who can access the data? Under what circumstances will they be printed out?
- 7. 4. DATA QUALITY ISSUES • Who can encode the data? • How is the data gathered? • What are the needed data to be gathered in Primary Health Care facilities? • Are the health workers competent enough in using the Electronic Health Record? • How often do we monitor and evaluate the data? What’s the criteria in ensuring that data gathered is high quality data?
- 8. 5. EFFICIENCY ISSUES (ESPECIALLY IN THE TRANSITION PHASE) • How do we transfer paper-based records to electronic health records? • Work flow and health care delivery may be slower than usual since health workers are still adapting to the electronic system. • Benefits of having an EHR may take some time to be acknowledged and seen in the healthcare setting.
- 9. 6. OTHER ISSUES • Influence of political/ government officials in communities especially in the rural areas.
- 10. SOURCES: • http://www.who.int/topics/primary_health_care/en/ • http://www.slideshare.net/DocLorie/primary-health-care- presentation • http://www.wpro.who.int/publications/docs/EHRmanual.pdf