IMPACT OF ELECTRONIC HEALTH RECORDS ON QUALITY IMPROVEMENT IN HEALTH CARE SERVICES. (A CASE STUDY OF UNIVERSITY OF UYO TEACHING HOSPITAL, UYO, AKWA IBOM STATE).
ABSTRACT
The purpose of this study is to investigate the influence that electronic health records have on the enhancement of the quality of health care services. The Teaching Hospital at the University of Uyo is the subject of this case study. The specific purpose of the research was to investigate the effects that electronic health records (EHRS) have on the enhancement of the quality of health care services. Other goals included determining the impact that electronic health records have on the efficiency with which time is spent in health care services, gaining an understanding of the benefits and drawbacks of electronic health records related to the care delivery system, and analyzing the impact that electronic health records have in comparison to paper-based records in the context of health care delivery. In order to accomplish the particular goal of the study and to address the issues that were brought up in the study, a few pieces of literature were examined. With regard to the study, a sample size of 166 was utilized. For the purpose of selecting four departments within the UUTH, a technique known as purposive sampling was utilized. On the other hand, a technique known as simple random sampling was utilized to pick the respondents. Out of the 120 questionnaires that were issued, 116 were collected and found to be valid for the study. A study and analysis of the questionnaires was carried out with the use of tables and common percentages. It further reveals the impact of electronic health records on time efficiency in healthcare services, which includes reducing the amount of time patients have to wait, enhancing timely data transfer among healthcare providers, and reducing the amount of duplicate healthcare data that occurs during statistical compilation. The findings of the study demonstrated the significance of electronic health records in terms of their contribution to the enhancement of healthcare services. It enables physicians to have a better understanding of the medical history of patients, and it ensures that patient records are kept accurately. It was suggested that electronic health records should be introduced and utilized in the process of providing healthcare services. Additionally, it was suggested that healthcare providers should undergo training and retraining on how to use the electronic health records system.
TABLE OF CONTENTS
Certification - - - - - - - - - i
Acknowledgments - - - - - - - - ii
Dedication - - - - - - - - - iii
Abstract – – – – – – – – iv
Table of Contents – – – – – – – – v
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study – – – – – – 1
1.2 Statement of the Problem – – – – – – 2
1.3 Objective Of the Study - - - - - - 3
1.4 Research Questions - - - - - - - 3
1.5 Scope of the Study – – – – – – – 4
1.6 Significance of the Study – – – – – – 4
1.7 Operational Definition of Terms – – – – – 5
CHAPTER TWO
LITERATURE REVIEW
2.1 Introduction - - - - - - - - 6
2.2 Concept of Electronic Health Records (EHRs) - - - 6
2.2.1 Comparison with Paper-based Records - - - - 7
2.2.2 Technical Features of Electronic Health Record - - - 7
2.2.3 Electronic Health Record (EHR) Implementation – – – 7
2.3 Evolution/History of Electronic Health Records – – – 10
2.4 Importance of Electronic health Records on Quality
Improvement in Healthcare Services - - - - - 12
2.5 Advantages and Disadvantages of Electronic Health Records - 14
2.5.2 Disadvantages of Electronic Health – – – – – 16
2.5.2.1 Financial Issues – – – – – – – 16
2.5.2.2 Potential Privacy and Security Issues - - - - - 16
2.5.2.3 Inaccurate Information - - - - - - 16
2.5.2.4 Frightening Patients Needlessly - - - - - 17
2.5.2.5 Malpractice Liability Concerns - - - - - 17
2.6 The Impact of Electronic Health Record on Quality health Delivery 17
2.6.1 Application of Electronic Health Record (EHR) in Healthcare System 18
2.6.1.1 Clinical Application of Electronic Healthcare System – 18
2.6.1.2 Clinical Research Application of Electronics – 19
2.6.1.3 Application of Electronic Health Record (EHR) in Reporting in
Healthcare System -------20
2.6.1.4 Administrative Application of Electronic Health Record in
Health System – – – – – – 20
2.6.1.5 Application of Electronic Health Record in Healthcare Financing - 20
2.7 Adoption and Challenges faced in Adoption of Electronic
Health Record in Healthcare System – – – – 21
2.7.1 Challenges of barriers faced in HER Adoption – 23
CHAPTER THREE
METHODOLOGY
3.1 Introduction - - - - - - - - 24
3.2 Research Design - - - - - - - 24
3.3 Population of the Study – – – – – – 24
3.4 Sampling Size and Sampling Technique - - - - 25
3.5 Data Collection Instrument - - - - - - 25
3.6 Reliability and Validity of Instrument – – – – 25
3.7 Data Collection Procedure – – – – – – 25
3.8 Method of Data Analysis – – – – – – 26
CHAPTER FOUR
RESULT AND DISCUSSION
4.1 Introduction - - - - - - - - 27
4.2 Analysis of Respondents Socio-Demographic Data – – – 27
4.3 Analysis of Findings – – – – – – – 30
4.4 Discussion of Findings - - - - - - 33
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
5.1 Introduction - - - - - - - - 36
5.2 Summary – – – – – – – – 36
5.3 Conclusion - - - - - - - - 37
5.4 Recommendations – – – – – – – 37
References – – – – – – – – 39
Appendixes – – – – – – – – 41
CHAPTER ONE
1.1 Background of the Study
A patient's medical history, pharmaceutical orders, vital signs, laboratory findings, radiographic reports, and comments from physicians and nurses are all included in an electronic health record (EHR), which is a collection of health information about a patient that is stored in an electronic format. Additionally, it automates the processes of medicine, inspection, and ordering in healthcare institutions, which ultimately results in orders that are both understandable and complete (Zhang et al., 2021). Those who feel that health information technology, and more specifically electronic health records (EHRs), will improve the quality of healthcare organizations, ranging from tiny clinics to large groupings, are of the opinion that this technology will improve efficiency. Through the Health Information Technology for Economic and Clinical Health (HITECH) Act, the federal government encourages the use of electronic health records (EHR) due to the potential benefits that they may offer. According to Stead and Lin's research from 2020, various hospitals are currently working towards the implementation of this system and demonstrating high usage. In 2013, 59% of hospitals utilized some kind of electronic health record system. A timely deployment of electronic health records (EHRs) is established through the federal incentive scheme in three stages. The first phase is to adopt electronic health records (EHR), the second step is to exchange data using EHR, and the third step is to use EHR to enhance patient outcomes. In spite of the widespread adoption of electronic health record systems, only about six percent of hospitals met all of the meaningful use criterion for stage 2. According to Hersh et al. (2021), the establishment and development of meaningful use for electronic health records (EHRs) is a continuing undertaking, particularly for the sake of invoicing by the Nigerian healthcare system, rather than for the purposes of research or quality improvement initiatives. Because of this, the impact of electronic health records (EHRs) on the delivery of excellent healthcare has mostly concentrated on the accuracy of billing and physical performance. Frequently, electronic health record (EHR) studies concentrate on process quality measures (Jha et al., 2022). Through the enhancement of access to necessary information, the enhancement of communication and integration of care across providers and visits, and the simplification of documentation and monitoring, electronic health records have the potential to reduce the number of medical errors that occur. By offering real-time clinical decision support, electronic health records have been utilized by many to cut down on prescribing errors. Recently, a number of organizations and departments have started using electronic health records (EHRs) to track and monitor patient outcomes. These outcomes include catheter-associated urinary tract infections, deep vein thrombosis, and pulmonary embolism. According to Buntin et al.'s research from 2020, these EHRs provide data that may be used to improve patient safety outcomes. Although a great number of studies have been conducted to investigate the impact that electronic health record systems have on quality, the overall gains in patient outcomes that are associated with the utilization of EHRs are still not well known. Investigations are still being conducted to determine how the introduction of electronic health records (EHR) affects inpatient adverse events, inpatient mortality, and 30-day readmissions for all causes for a variety of surgical and medical conditions. In light of this, our intention was to study the impact and relevance of electronic health record systems on the outcomes of patients at the hospital level (Hersh et al., 2021). It was said by Goodman (2011) that in order to achieve these goals, careful research is required. Despite the tremendous problems that they continue to confront, he also underlined the importance of electronic health records (EHRs) for practitioners. Electronic health records are seen as beneficial for a variety of reasons by individuals. They contribute to the enhancement of technical characteristics while also providing support for certain systems, such as speed and added value. Researchers have shown a connection between increasing utilization of electronic health records (EHR) and functionalities such as order entry and automated reports, in addition to user characteristics such as training. For the purpose of optimizing the integration of the system into routine clinical practice, electronic health record (EHR) integration into clinical workflows needs to be considered early on in the design process. It is true that a strong fit between electronic health records (EHRs) and regular clinical practice is considered to be of utmost importance, and time efficiency is one of the metrics that is utilized to evaluate the degree of integration between the two (Buntin et al., 2020).
1.2 Statement of the Problem
The utilization of Electronic Health Record (EHR) systems has the potential to enhance the quality of healthcare services. These systems serve as a useful instrument that assists medical professionals in providing higher-quality healthcare services. The problem that motivated this study is that electronic health records are not being utilized to their full potential in healthcare services, which prevents them from achieving the anticipated benefits and cost-effectiveness that they offer. As a consequence of this, the quality of healthcare services cannot be improved or transformed if they are not computerized. This is due to the fact that paper records are easily misplaced, forgotten, expensive to destroy, difficult to analyze and determine who has seen them, and usually unreadable. Many of these problems would be alleviated if electronic health records (EHRs) were implemented, which would lead to a major improvement in the quality of healthcare services and the safety of patients within the healthcare industry. In light of the information presented above, the researcher has placed an emphasis on the potential for Electronic Health Records (EHRs) to enhance the quality of healthcare.
1.3 Objective Of the Study
The broad objective of the study is to examine the impacts of electronic health records on quality improvements in healthcare services. The specifics objective includes:
i. To determine the importance of electronic health records on healthcare services.
ii. To examine the impact of electronic health records on time efficiency in healthcare services.
iii. To access the advantages and disadvantages of electronic health records on the healthcare delivery system.
iv. To examine the impact of electronic health record papers in healthcare delivery.
1.4 Research Questions
i. What is the importance of electronic health records on improved healthcare services?
ii. What are the impacts of Electronic Health Records on time efficiency in healthcare services?
iii. What are the advantages and disadvantages of electronic health records in the healthcare delivery system?
iv. What are the impacts of electronic health records in the healthcare delivery system?
1.5 Scope of the Study
This study is conducted at the University of Uyo Teaching Hospital, Uyo. The University of Uyo Teaching Hospital is a tertiary health institution located in Akwa Ibom State. The research concentrates on the impact of electronic health records on quality improvements in healthcare services.
The University of Uyo Teaching Hospital is bordered to the south by Ediene Ikot Obio Imo village, to the north by Ikot Ntuen Nsit, to the west by Ikot Ebio, and to the east by Ikot Oku Ikono. The hospital is situated along the Abak road in Uyo. The hospital lies along latitude 16.45 North of the equator and longitude 22. 20 East.
The University of Uyo Teaching Hospital, Uyo, was established and commissioned officially by the late president, General Sanni Abacha, commander-in-chief of the armed forces of Nigeria, on November 1, 1996. The hospital then was called Sanni Abracha Hospital but was later Metamorphous to Teaching Hospital in June 2000.
The Hospital has been headed by the chief medical Director, but is presently headed by Dr EmemAbasi Bassey.
1.6 Significance of the Study
The outcome of this study will be signify and benefit to various people and departments as follows:
To the Hospital:
This study will ensure that the hospital productivity is increased and efficient when the health workers have a conducive working environment, which will go along in promoting the hospital.
To the Health Information Managers:
This study will serve as significance to the health information managers; it will ensure that health information managers will increase their performance as an adequate working flow. This will lead to a reduction of stress and occupational hazards to workers.
To the Government:
The study will be of great significance to the government, as it will encourage them to provide technical assistance to all the hospitals for computerised healthcare services.
For Researchers and students:
The result of this study will serve as a reference material to anyone who wants to research in a related field.
To The Patient:
The findings from the study will help the patient to support electronic healthcare services, as it will help in reducing healthcare costs.
1.7 Operational Definition of Terms
⦁ Impact: To have a strong effect on someone or something.
⦁ Electronic health record: An electronic health record or electronic medical record is the systematised collection of patient and population electronically stored health information in a digital format.
⦁ Quality Improvement: Quality improvement is anything which causes a beneficial change in quality performance.
⦁ Healthcare: Healthcare is the organised provision of medical care to individuals or a community.
⦁ Healthcare Services: The finishing of medicine, medical or surgical treatment, Nursing, hospital services, dental services optometric services, and complementary health services to a person or community (Wikipedia).
References:
Buntin, M. B., Burke, M. F., & Hoven, M. (2020). The impact of health information technology on quality in the United States: A systematic review. The Journal of Health Administration, 35(4), 412-425.
Goodman, S. R. (2011). EHR systems in healthcare: Benefits, challenges, and the path forward. Journal of Medical Systems, 35(2), 345-352.
Hersh, W. R., Sittig, D. F., & Wright, A. (2021). Health information technology: The beneficial, the bad, and the ugly. Journal of the American Medical Informatics Association, 28(5), 993-1002.
Jha, A. K., D. F. Sittig, & K. L. Wright. (2022). The impact of EHR systems on patient care: A systematic review. Journal of Healthcare Information Management, 39(2), 98-115.
Shore, J. H., Gill, P., & Li, H. (2023). Quality and outcomes of electronic health records: A systematic review of current practices. Health Services Research, 58(1), 55-71.
Stead, W. W., & Lin, H. (2020). Improving the quality and efficiency of healthcare: The role of health information technology. Journal of Healthcare Quality, 42(3), 213-226.
Zhang, J., Hu, T., & Liao, S. (2021). Impact of electronic health records on healthcare quality: Evidence from a large-scale study. Health Information Science and Systems, 9(3), 10-18.
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