By Indrajit Bhattacharya, Professor, International Institute of Health Management Research
The Institute of Medicine, also referred to as the IOM, is an independent organisation dedicated to improving healthcare at the national level by delivering unbiased and evidence-based healthcare advice
|The introduction of EHR systems has a huge potential for cost savings and removal of workplace inefficiencies. Its expected that these cost reductions, combined with a reduction in patient care errors, should eventually result in lower malpractice premiums and litigation fees|
According to a report completed by IOM in 2001, the United States ranked 37th worldwide for quality of healthcare. That same year, the Institute of Medicine compiled a report listing 13 recommendations designed to revamp the nations healthcare system. In the last two years alone, EHR adoption rates in the US have doubled.
A recent survey conducted in August 2011, showed that 51 percent of physicians offices, with three to five providers, and 31 percent of the solo-provider practices, are currently using EHRs. Many of the EHR initiatives have been taken in the past few months, thanks in part to HITECH Act of 2009. Through the HITECH Act, the US federal government has committed billions of dollars to promote both adoption and meaningful use of EHRs.
The IOM listed six aims in improving healthcare quality:
To make healthcare environments safer for patients
To provide more effective healthcare
To make healthcare more patientcentred, which can be done by ensuring that the patient is more involved in the decision-making process and has a better understanding of the healthcare choices available
To improve the timeliness of healthcare service
To make the process of providing healthcare more efficient
To work toward the elimination of healthcare disparities among diverse populations ensuring that all patients have equal access to healthcare
Electronic Health Record
According to the Computerised Patient Record, published in 1991 by the Institute of Medicine, an electronic health
record system is defined as The set of components that form the mechanism by which patient records are created,
used, stored, and retrieved. A patient record system is usually located within the healthcare provider setting. It
includes people, data, rules and procedures, processing and storage devices (e.g., paper and pen, hardware and software),and communication and support facilities.
The Institute of Medicine (IOM) lists the key capabilities any EHR system as the following:
A longitudinal collection of electronic health information for and about persons
Immediate electronic access to person and population-level information by authorised and only authorised, users;
Provision of knowledge and decision- support that enhance the quality, safety, and efficiency of patient care;
Support of efficient processes for healthcare delivery
Potential Advantages of EHR Systems
With an EHR system, the physician can enter the data directly into the system interface, thereby dramatically reducing
handwriting errors. With EHRs, massive amounts of data can be stored digitally in a substantially lesser space. This
eliminates storage problems and virtually eliminates record search time. With an EHR system, healthcare staff can
have critical patient information at their fingertips.
These realised efficiencies, combined with value-added software designed to minimise procedural and prescription errors, should, over time, improve overall patient safety in the healthcare environment. The increased ease of updating records often leads to more time becoming available for conducting those important physician-patient level interactions.
The introduction of EHR systems has a huge potential for cost savings and removal of workplace inefficiencies. Its
expected that these cost reductions, combined with a reduction in patient care errors, should eventually result in
lower malpractice premiums and litigation fees.
Fig 1 Illustrates that, prior to centralised EHR system management software, each organisation or department had to maintain its own system and software designed to capture the data required for each specialty area. This means that multiple databases and patient records existed and the healthcare provider was required to open a different client application for each department and compile the data using a manual process.
Fig 2. Illustrates that EHR systems are designed to receive data from each of these organisational silos and compile
them within a centralised database. EHR software is designed to compile the data in a more efficient manner, allowing
the healthcare provider to access and cross-reference data from all available sources from one convenient client interface.