Health Information Technology and Family Physicians
Professor: Dr. Timothy Delicath
Table of Contents
Review of Literature. 11
Research methodology and design……………………………………………………………….38
Data Collection Process …………………………………………………………………………42
Synthesis of Information………………………………………..……………………………… 45
Data Analysis ………………………………….….……………………………………………..46
Appendix A………………………………………………………..……………………………. 58
With health information technology making such a huge impact on health care, and with the family physician being on the forefront of health care, the purpose of this project was to examine and analyze the effectiveness, advantages, and disadvantages of combining the two fields in the past, present and future. The methodology used was to research scholarly articles on health information technology and how this technology pertains to family medicine and the impact it has on physicians and patients. The researched material and data was then gleaned and synthesized to be presented to the reader in a clear and concise manner. The results found from the research were that there were indeed many advantages and disadvantages as well as challenges in combining health information technology and family medicine. In conclusion it was found that health information technology, although still relatively new, can be used as an advantage to the family physician and their patients. However, it was also concluded that there was much work to do in utilizing health information technology by family physicians in such a way that it could be used to its full potential in family medicine.
Health Information Technology and Family Physicians
As we examine the field of health information technology, and more specifically how it applies to the field of family medicine, we will hopefully be able to identify the challenges, and the benefits that this technology can offer. Furthermore, if we can identify the challenges that family physician’s and medicine has when it comes to health information technology, perhaps this will also help us to find or propose solutions to help the effectiveness and efficiency of family medicine and thereby increase the quality of patient care.
Health information technology has had a dramatic effect on the field of family medicine for quite some time now. It has impacted the way that physicians practice medicine, and how they interact with their patients. It has also influenced how patients receive their care. Health information technology has helped the patient to become more of an active user in terms of being more proactive and knowledgeable about their health care management.
In the past, family medicine and health information has been mainly on hard copy. This meaning that the patient records were kept in their file, with handwritten notes by the physician and the health care workers. Prescriptions were also hand written by the physician. The prescription would then be handed over to the patient, where the patient would take the piece of paper with the hand written prescription to the pharmacy and the prescription would finally be filled.
With the progress that has been made with health information technology, many family medicine offices are paperless. Everything is kept in a database. This database is easily accessible wherever there is an internet connection. Prescriptions can be sent from the physician directly to the patient’s pharmacy of choice. Patients can also look up their health records from home to see lab results. The patient can also be made aware of the other information that may be of interest or benefit to them.
With all of this new technology however, there have also been many challenges. Some of these challenges include patient confidentiality, as so called hackers can break into health information systems and steal patient information. This is also amplified by health care workers accidentally leaving their computer screens open to reveal private patient information. There is also a potentially huge cost to have or participate in a safe and secure health information system that is an operating cost for a lot of family practices today.
An enticing carrot to adapting to all of this technology is that there is a monetary bonus to family practices that use health information technology from the government, especially if the practice deals with Medicare or Medicaid patients. However, is this bonus enough to offset the costs that come with implementing health information technology, in terms of paying for the software, staff training, and upgrades? Another important question to ask is that if the perceived efficiency really going to make a difference in net gains?
As we discuss and examine these points and many others in this paper, we will hopefully be able to synthesize the best solution to family physicians and the health information technology that will be of most benefit to them, their practice, their staff, and most importantly the highest quality of patient care that they can deliver. The ultimate goal of this paper is to figure out the best way that health information technology can help the family physician to be more effective and efficient in all aspects of their practice to improve the overall delivery of healthcare.
At the forefront of health care in the United States is the family physician. This is arguably the most demanding and stressful portion of employment for health care professionals. This is because of the rising cause of health care, the struggle to get reimbursements from insurance companies, and the desire for more cost effective and higher quality of health care from the patient. The family physician is pulled in all of these directions, on top of trying to pay their staff and the other overhead costs that come with running a medical practice.
Health information technology, in many ways, can help to lessen the challenges of the practicing family physician. As the challenges that face family physicians mounts on an ever changing daily basis, health information technology has come at the right time. With the implementation of new technology however, come the challenges that come from implementing it. One cannot help but question if the benefits indeed outweigh the costs.
One of the goals of this endeavor is to conclude whether or not health information technology is a benefit that outweighs the costs and challenges to implement it. If this is successfully accomplished then perhaps this paper may be of benefit to the future of family physicians to help them to more effectively and efficiently manage their patients and practice, while a concomitant effect will be that of a more healthy and satisfied patient.
For the main objectives of this study, it is important to keep in mind that technology in the health care industry is ever changing. This especially applies to the rapidly growing and evolving segment of health information technology. When we narrow this study down and focus on how this applies to family medicine, we can see how an important objective would be to try to figure out how health information technology can best help the family physician and all that encompasses, and ultimately to be able to anticipate how or in what direction this technology is going to head towards in the future.
In order to accomplish this objective, we must have the objectives of gathering the pertinent information, gleaning it, and then synthesizing it in such a way that intelligent conclusions can be made in regards to our ultimate objective. If this can be accomplished, it is the hope of the author that another objective will be that of helping family physicians, and or those that manage family physician practices, to be able to find and successfully implement a health information technology system that will best meet their needs.
The problem this study will address are the growing pains, perceived advantages, and the disadvantages of health information technology as utilized by family physicians in the realm of family medicine, and how this impacts a family practice and the quality of health care for its patients. The various problems that will be encountered and discussed in this paper will primarily apply to the challenges that family physicians have, or can potentially have when they strive to improve upon their business, the practice as a whole, while at the same time striving to improve the highest possible quality of patient care. Specifically, with the advent of the relatively new technology of health information being electronically based, it can be difficult to discern between competitors which health information system would be the most fitting for their specific practice.
This would have to be examined on a more tailored level, as family medicine can have a wide scope as to what their ultimate goals are, and what exactly are the services they provide. To further amplify this challenge, one would have to also consider the demographic of the patient care, which could be divided into gender, age, and socioeconomic status, just to name a basic few variables (LaTour, 2013).
Because the health care industry is so competitive, and because of the high cost of health care, it is very important for family physicians to address these problems as it could affect their bottom line, their quality of patient care, and their overall business. There are also many other problems or challenges that are a subset of the aforementioned challenges, such as HIPPA laws, that will also be addressed in this paper (LaTour, 2013).
The family physician is the front line of a patient’s health care, and therefore addressing these problems on this level is probably very important. At the very least, these problems should be explored and discussed. This is important to note, as they do apply, and are an integral part to family medicine in the United States today. Furthermore, health information technology will continue to play a vital role in health care and will be even more so integrated and common in the future of family medicine.
Purpose of the Study
The purpose of this study is to identify health information technology strategies that will be a benefit to the family physician, and or to identify areas in which health information technology needs to be improved upon in order to maximize the quality of patient health care. This will help to make aware to the family physician, or the family practice manager, of the various aspects of health information technology and its use in family medicine. This can apply to the family physician or the family practice manager in any stage of their career, be it aspiring, starting out, in their prime, or on their way out and perhaps thinking of selling their practice.
This project will also shed some light on the reader about how integrated health information technology is in health care today. This is because the information that is gathered for a particular patient, in a particular segment of practice, can potentially be readily available and shared with other portions or practitioners of health care in other specialized fields. Ultimately, this could equate to less medical errors, and lead to a better quality of patient health care in the United States.
The way in which the research questions were developed was by keeping in mind the dramatic impact that health information technology has on the family physician. This lined to the problem and the purpose of this project seamlessly as the main research questions that this project focused on was: How is health information technology utilized by family physicians today and in the future. Sub-research questions that stem from the main research question were: what are the advantages and disadvantages of health information technology in family medicine? How can health information technology be improved upon in family medicine? And finally, how does health information technology utilized in medicine help to increase the quality of health care for the patient.
When conducting the research on health information technology as it applies to family physicians in medicine, it was fundamental to ask if health information technology was in fact necessary. If health information technology, as it is widely used today in medicine, why was it necessary? Or, if it was not necessary, was it beneficial to those that had implemented health information technology into their practice.
It was also important to ask why health information technology was deemed beneficial by those that used health information technology. What were they measuring, and what were their results? What were some of the challenges of health information technology? Was it the training of staff and the integration of it? Was it difficult to figure out which system would be best suited for their needs and wants? What are the problems and challenges that they encounter today? Is the pace at which the technology evolves to fast? Is it the government mandates that add to the difficulty? The most important question for all of this research was however that if health information technology was in fact helping to increase the quality of patient care.
Significance of the Study
The significance in studying health information technology as it applies to family physicians is important because this is basically a new frontier. With this new frontier comes the challenges of how can we make this beneficial for the patient. Also, the frontier is vast and ever changing in the form of legislation, novelty, and refinement of what is health information. The family physician is at the forefront of health care. If the family physician can utilize health information technology and harness the best parts of it, the quality of patient care could potentially be better than it was, and will continue with the ultimate goal to improve over time (LaTour, 2013).
Introduction to Literature Review
The literature review for this worked first focuses on what health information technology is as it is applied to the practice of medicine and health care in general, and more specifically as it applies to the family physician and their role in health care in the United States. Next the advantages and disadvantages of health information technology are examined. A closer look is made for certain aspects such as the patient portal as this is an integral part of health information technology in the setting of family medicine. Also there is a review of which parts of health information technology can be refined or improved upon in order to maximize its effectiveness for family physician. There is also a good portion dedicated to how and if health information technology in family medicine is utilized effectively to the point that it is in fact raises the level of the quality of patient care.
Health Information Technology and its importance to Family Medicine
Health information technology is an ever growing, and almost all encompassing part of health care today. Health information technology refers to the electronic health record, and more information than that. Perhaps one has experienced the new technologies first hand when as a patient; one notices a change in the procedure of seeing their physician. For instance many patients and family physicians can now communicate via email if there is the health information technology infrastructure on the family physicians end and a personal computer and an internet connection on the patient’s end.
This type of technology was not available at all fifty years ago, and email was not available to the general public until about twenty years ago. Health information technology is relatively new to the practice of medicine from about five to ten years ago. This is not only an example of a new technology that can help in family medicine, but it also shows how fast health information technology has really come into the field of medicine. One of the interesting new concepts in health information technology, if we carefully examine it, is the fact that the patient is a lot more pro-active in their health care as they can access many records from the internet and also learn more about their illnesses and the medications that they are taking. In other words, the patient today is much more educated about their health care than the patient was fifty years ago.
Patients can also, if they prefer, can make an appoint to see their family physician online if the family physician has the proper health information system. This is another relatively new concept in the world of family medicine as many patients are only accustomed to or grew up having to make an appointment by calling up the medical secretary at the family physician’s office that they wished to go to. However, as with the email, a patient can now make an appointment if the physician has the health information technology set up and the patient has internet access.
When it comes to health information technology and family medicine, another change that is taking place that may seem novel is the way that a patient’s history is taken. Even though this may seem somewhat redundant as the physician once again reconfirms the patient’s testimony of their health, there is another way that patient histories are taken. A patient receiving health care today in the United States may also notice that it is not necessarily the physician that is taking the initial history of their illness or the reason for their visit, but they may find that they are entering their health complaints or concerns on an ipad questionnaire that the physician and the health care team prefer the patient to fill out first.
Obviously this type of technology would not be beneficial if the patient were illiterate, blind, or another disability that would hinder their use of a computer, but this type to health information technology can be of great benefit to a small family medical office as it may cut down on the time needed to see the patient. It definitely does cut down on the time that is needed to properly check the patient in as the patient has already done a lot of the work on the electronic questionnaire.
Health information technology systems are used so much in health care today because in it one can find the patient record. The patient record contains a lot of important information on the patient that would pertain to their health care. For example the patient record would include the proper identification of the patient. It would also contain the vital records of the patient like their blood pressure, weight, and height. The patient record would also contain how their breath sounds and heart sounds are on that day and the previous days or appointments that the patient came into the office. The patient record is also important as it contains a medical history of the patient as given from the patient.
Usually, or in the past, the patient record was kept on a hard copy, or in other words written on paper and kept in a file that was unique to the patient. With a health information system however all of this patient information and data can be stored on a database and the medical office could be paperless. Other important information that may be contained in the patient record is the lab results or test results of the patient, the notes the physician has made during the appointment with the patient and the orders from the physician.
Along with the ever important patient record, health information technology encompasses a way to order prescriptions for the patient in a paperless manner. This can be a great help to the physician as many medications have interactions with each other and or are contraindicated to each other. The health information technology can have a system implemented where certain medications are flagged or alerts the physician for any adverse effects or contraindications that may occur if the particular medication was prescribed to the patient.
The health information technology usually also has a way in which a medical office can coordinate with a medical laboratory to order labs for the patient. The health information technology may also help to analyze labs. One of the most important features or advantages of health information technology is that it could afford a way for one physician to communicate with other physicians or health care teams within their system. Health information technology also makes it possible for family physicians or their medical team communicates with insurance companies, and as was stated earlier, to communicate with their patients (LaTour, 2013).
Health Information Technology and the Pro-Active Patient
Health information systems are not only for the health care team or professionals either. An exciting and revolutionary element in health information technology is that it enables the patient to become much more pro-active in their health care by a number of ways. One of the ways that a patient can become more pro-active in their health care is that patients can often access their own records and health care information. This means that when a patient for example has a lab drawn, and the physician receives the results of that lab, the patient can look up their patient record online and find out the results of their lab work, thereby becoming more proactive in their health care. To carry this example a step further, after the patient as looked at their labs, the patient could then learn what the labs are all about, or what the results may mean by doing research online on their own to help them better understand why the labs were ordered in the first place, and why the family physician prescribed the certain or appropriate therapy (Mullner, 2006).
Challenges and Barriers of Health Information Technology
There has also been a downside or challenges that come from the relatively new health information technology. For example, privacy issues and security are a constant ethical question and patient privacy has to be guarded from white collar criminals and the like. Patient information security could possibly be the biggest obstacle that health information technology is coming up against as the privacy of the patient is very important to keep confidential in medical health care, especially as it pertains to family medicine. This is because the patient may not want anyone to know the health problems that they have, as it could be embarrassing, or hurt their reputation socially or professionally. If there is a breach in patient and physician confidentiality, this could be a huge liability to the health care organization, or even the physician. It is for this reason that special attention is made to strive to make sure that the highest security standards are met for health information technology (Mullner, 2006).
The access to patient records could be a huge liability for the family physician, or for any health care professional team for that matter. This is an enormous issue for all of health care technology because a breach in patient confidentiality and security could be a huge liability for not only the family physician, but also all of the auxiliary health care teams that are involved. If a relative, who was terminally ill for instance, came in to see the physician, this could be a very delicate matter. The patient could be heading towards the end of life.
The family of the patient could be very stressed out at the thought of losing a loved one and all of the issues and drama that come with such a tragic end of life scenario. It would be horrifying to find out that after all of the rigorous testing, and therapy, and emotional distress, that somehow the information that was used for the health care of a loved one was exploited in some way for monetary gain, research, or any other reason. This would be especially disheartening if the patient gave strict orders that this information was not to be shared or leaked to researchers or anyone for whatever reason. This is the loved ones last and final wish.
The difficulty with this wish is that if a criminal or a careless health care worker made a mistake, the security and the privacy of the patient could in fact be compromised. Furthermore, what if there was legislation that granted immunity or an exemption to the private records of the patient because of a particular illness that they had, and therefore could be readily accessible to all researchers in the United States of America, or perhaps even worldwide. This is an ongoing debate that needs to be addressed and the security of the patient needs to be ensured if there is going to be any confidence in the patient, and in the family physician, if there is to be a successful integration and use of a health information system.
Other problems that are arising from health information technology are the fact that there is not a simple standard because the technology is relatively new. This also means that certain health information systems are not linked together or are very limited in the information that can be shared or exchanged through cross platforms and between physicians or hospitals.
When communication is not hindered however, the health information systems are a great tool in improving the quality of patient care. This is one of the reasons that health information technology has grown so much in such a short period of time, because it can increase the quality of patient care. There needs to be a way for the health information systems to be able to exchange information if there is to be any success in a huge health information system that is shared and used by family physicians and other health care workers.
There is a professional organization that was founded to help set up some type of standard for health information technology. The organization is called the American Health Information Management Association, otherwise known as AHIMA. AHIMA represents over 63,000 professionals in health information technology management professionals in the United States of America. Since their inception AHIMA has been trying to set a standard and guidelines to help there to be some kind of consistency in health information technology.
This is done in hopes that this will not only make the standard of health care better, but it will also help various health organizations to be able to communicate one with another, or that their systems will be able to communicate with each other (AHIMA 2012).
AHIMA has even gone so far as to lobby for legislation in Washington because this has been such a challenge. AHIMA feels that if health information technology was held to some sort of standard that there would be better communication between the physicians, health care teams, the insurance companies, the patients, and all other parts of the health care system in the United States (Two, 2011).
AHIMA also feels that there should be some kind of code of ethics and standards set up for the assurance that the patient’s privacy will be held secure from hackers and other white collar criminals as a lot of very sensitive and person information, as well as financial information is commonly stored in health information technology systems (AHIMA 2012). For this reason, this approach may be of benefit as it may help to ensure that at least a minimal standard is held and perhaps preventing certain fly by night companies from ripping off consumers.
For an alternative perspective however, it may be of a hindrance as the author feels that it may be best if government legislation not intervene in this aspect of medicine and let the free market work itself out instead of government mandates that are often ignored or circumvented or become antiquated as soon as they are approved because of the fact that health care information technology is growing and evolving at such a fast pace (Rockefeller, 2012).
In a recent article from the Journal of Medical System, it was proposed that the organizational challenges so rampant in medicine in the United States, that the care is in fact very rarely organized. Because of this there have been studies conducts as to how a better health information system could be designed and utilized. This has been found to be a very complicated process however as health care can be very complicated. Because health care takes the coordination of so many different teams, including the cooperation of the patient, it can be very difficult as time constraints make it difficult to make sure everything is in place when someone’s life is on the line and time is of the essence (Dobalian, 2012).
It can be argued however, that the investment in time and money to organize and execute a properly organized health information system could be of great benefit and worthwhile. This is because the information, if the different health information systems could communicate with each other, would be available to researchers, physicians, and other members of the health care team.
Precision Medicine, Continuing Education, and Interoperability
There is a movement that is called precision medicine that is gaining steam, and would use in very large par an integrated health information technology system. The family physician would have to very much be on board with such a system to make strides in its success due to their interaction with patients.
In order to ensure that the health information technology is properly utilized in the United States, it is argued that proper training of physicians and their staff is a very important piece of the puzzle in order to ensure its success. This is because health information technology has faced some resistance from physicians and their staff when they are not on board to the new way of practicing medicine.
In order to circumvent or augment this challenge, an article in Health Affairs has stated that it may be a great idea to implement training in health information technology as soon as possible, perhaps in the early years of physician training and education. This would be a way to help shape the future of health care in the United States and to help them know of the importance of evidence based medicine and how health information technology can be utilized for this purpose (Graham-Jones, Friedman, Marcotte, & Blumenthal 2012).
Another interesting way to implement health information technology in a successful way to those that may be well into their medical profession, is to require some knowledge of it on their board certifications or recertification. This will help to ensure that at least in continuing education that physicians and staff are getting some training and acquiring some knowledge about health information systems (Graham-Jones, et al., 2012).
Graham-Jones suggests that to ensure that physicians are properly trained to use health information technology; this can be acquired in at least two different ways. This can either occur during the physician’s private time, or it can also be a part of the training of the facility in which they are employed. Making health information technology a priority in training is very important to ensure the success of this new endeavor (Graham-Jones, et al., 2012).
Senator Alexander out of Tennessee has really made a huge push in wanting to mandate some standards for health information technology. The senator used the name of Dr. Francis Collins, who is the director of the National Institutes of Health, as his main source of information in regards to the importance of a unified health information system. The system Senator Alexander argues has to at the very minimum allow for other systems to communicate with each other in the realm of health information systems.
The systems need to do this so that there can be some kind of interoperability between hospitals, offices and smaller physician offices such as can be found in much of family medicine. If this were to happen then what the Senator refers to as precision medicine could more fully come into fruition. If the physicians were made accessible to a lot of the genetic information and the information was made available to researchers all across the country then great medical strides would be made in precision medicine. In other words, for precision medicine to be successful, there needs to be an effective system of communication between health information technology, and the technology has to be accessible and used by as many health professionals as possible, and especially to family physicians (Alexander, 2015).
It is also much more feasible for health information technology to be used especially as it pertains to mapping genomes is concerned. It was found that just fifteen years ago the cost was actually four-hundred million dollars to map the first genome, and today the cost is approximately one thousand dollars. This means that more genomes can be mapped and the data entered and shared in a health information system for researchers to use.
For example, this information could be used to target and find a cure, or to reduce the onset of a disease such as Alzheimer’s. Alzheimer’s is the leading cause of dementia in the United States. If this were to occur, than the funds that were used for Alzheimer’s and all of the problems that come with it could be used in other ways to help prevent or cure other pathologies. Dr. Collins has stated that a well mapped out genome can also help physicians to prescribe the medication that will be of most benefit to their patients (Alexander, 2015).
Family Physicians utilizing Health Information Technology
Family medicine is often considered the first line of the health care system. It is the family medicine physician who is like the quarterback, referring patients to their necessary specialists after they are properly diagnosed by them. Family medicine physicians also handle a lot of the chronic illnesses and diseases such as hypertension and diabetes. Family physicians also handle the common clue, influenzae, and other acute problems that may arise. The family physician may also specialize in weight loss, bariatrics, and even some basic dermatology. The family physician may also work in the emergency room or even be the town obstetrician and gynecologist.
The realm of family medicine is far and wide, depending largely on the scope of practice that the physician chooses, and the population that they serve. Because of this, health information technology and its use in family medicine by the family physician is also a very wide window, with many different variables to consider. This is important to note because this just goes to show how different systems of health information technology may be more important or suited for certain family medical practices (Rogoski, 2006).
It is for this reason that perhaps just one common standard of health information technology will not work for the family physician. A more viable solution may be to have a more customizable alternative to better personalize and meet the needs of the family physician and their area of practice (Rogoski, 2006).
When health information technology and family medicine are used in the most utopian manner, the family physician can find that his or her practice is also running optimally. This is because communication is seamless between the disciplines. Communication is great with the insurance companies (Payer, 2012).
Prescriptions are ordered and ready for the patient at the click of a mouse. Labs are ordered and analyzed seamlessly. The staff is therefore more effective and time efficient as the health information system runs seamlessly, and is user friendly. It would also be great if the health information technology is also easy to learn, and to train the staff to use (Zandieh, 2008).
Another benefit for the family physician is that the time with the patient is also more effective because the patient is more proactive in their health care. The patient is able to look up their vital information and in some cases meet with health care professionals online. The patient is therefore a more educated patient and when the patient meets with the physician the patient is able to ask the most important questions, and relay the most important information to the physician. All of this will ultimately make patient care quality the highest (Electronic 2011).
As far as a business argument is concerned, it seems that the general consensus is that if the implementation is successful, then the health information technology can increase the net value of a family practice. The important point to be underlined and not underestimated is that it is very important and vital to the success of the health information technology is if it is implemented successfully, and a huge part of a successful implementation is if the physician and the staff are on board and have a good attitude for integrating a new system into their way of practicing medicine (Kumar & Bauer, 2011).
Some of the more specific ways that health information technology makes sense in a business sense is the savings that can be attributed to more effective time management. For example, a lot of tasks can be streamlined and be less labor intensive, such as writing and delivering prescriptions. This can be very labor intensive if one is dealing with a class II medication that is highly addictive.
Without the health information technology, one would have to do a lot of phone calls, to law enforcement agencies, other physician, checking various records, just to make sure that the medication is okay for the patient to ensure that the ethical beneficence is being practiced. However, with health information technology all of the pertinent information as it applies to the patient and the medication can be found with a few simple clicks on the computer screen (Kumar & Bauer, 2011).
The savings from an effective health information system can also be attributed to a more effective and less bloated staff, as theoretically you will have less staffing requirements. This is because less staff will be needed to do the same job with health information technology (Kumar & Bauer, 2011). A prime example of this is the aforementioned prescription writing and delivery for a patient that needs highly addictive medication for therapy.
Another way that health information technology can be used effectively to increase the bottom line for the family physician is that when implemented correctly can drastically reduce the costs of charting. It has been found that paper charts, and the pulling and refiling of them can cost a practice upwards of eight dollars a year per chart to maintain. A healthy medical practice has approximately two thousand patients per physician. This would mean that at least sixteen thousand dollars per year can go towards patient charts alone (Kumar & Bauer, 2011).
With health information technology it has been found that because charts do not have to be pulled physically, and with the pertinent patient information found in the records that fewer phone calls have to be made to answer health related questions. The reduction in cost for maintaining electronic patient charts using health information technology can reduce the costs of patient chart maintenance by fifty to one hundred percent (Kumar & Bauer, 2011).
Medical errors have also been found to be reduced with the use of health information technology. According to a recent study there was a huge reduction of medial deaths and injuries due to medical errors because of health information systems. There was a reduction of 45,000 to 98,000 deaths and an astounding 777,000 injuries to adverse drug interactions. One excellent feature of health information systems is that there can be a flag or a warning when there may be a medical error or an adverse drug interaction (Kumar & Bauer, 2011).
Medical health errors for the most part can be prevented if proper attention to detail is applied. With the proper knowledge applied to the health care of a patient by the medical health team. Medical health errors are an important area to look at reducing as it can increase the quality of health care and reduce the cost of health care (Kumar & Bauer, 2011).
In an article published in the Wall Street Journal, it gave great insight as to how health information technology has helped the patient to be much more pro-active in their patient care and how this has helped to reduce medical errors. The article claims that because patients have been more knowledgeable about their health care with the internet and health information technology, that they are able to make subtle corrections to their health care and this in turn helps the physician to be happier in the care and the responsibility that the patients are showing for their own heatlth care (Landro, 1999).
It was suggested that physicians would not adapt or that they would resist using health information technology in their patient care, and they have to a point. However, it seems that physicians have been more apt to use health information technology because in a way this helps them to stay on the cutting edge of medicine and also to keep up with whatever information that their patients may have, and to be able to guide their patient as to the validity of the studies or the information that they are reading. In a way the family physician has used health information technology as a tool of self-defense in some instances. What is really great however is that the patient and the physician have combined there knowledge and their relationship of respect has strengthened which means that the patient quality of care has ultimately increased and medical errors have decreased (Landro, 1999).
Since the advent of the microprocessor, and its availability to the public, combined with the use of the internet, the medical world and the knowledge and literature available to the patient and the physician is growing ever so rapidly. It has been said that even if a physician is fresh out of medical school for only a few years that the physician may be behind in the latest and greatest technology and care if the physician does not keep up with continuing education credits. Health information technology has been very instrumental in this revolution and arming the patient with more knowledge about their health care (Landro, 1999).
The Importance of an Effective Patient Portal
The use of health information technology by the patient is commonly referred to as the patient portal. Because the patient will be more proactive in their health care, or could potentially be, this also opens up the possibilities of more of a breach in security. This breach in security would come because the patient would be able to access their records through the patient portal from a computer outside of the health medical office.
For example, the patient could with the proper health information technology, access from the comfort of their own home, the lab results that were just drawn earlier that week. There are however, even within the realm of the patient portal, so many different levels of functionality between different electronic health record systems (Electronic, 2011).
It must be understood that in order to make an effective patient portal, it is also important to personalize the health information system in such a way that it does indeed meet the needs of the population or demographic that it is serving. A great example of how personalizing the health information system for specific population was found in a study in the Journal of Community Health, in which a look at Native Americans and Eskimos were found to have a very unique set of needs to their health care (Geana, et al., 2012).
For example it was found that when Native Americans were encountered with health information technology in their patient care, that they were able to receive tailored care and an increased quality of health care for their needs. However this was not possible unless their health information system was also personalized to meet their needs as acquiring information from this demographic was different than acquiring information from say New York City residents (Geana, et al., 2012).
Another challenge to consider in the patient portal is the computer literacy of the patient. Some patients may be more willing to deal with their computer, whereas others prefer to deal with a human being. The family physician may have to ask the important questions, and use professional judgement, as to whether the patient would even benefit the utilization of the patient portal, or would it raise more questions and cause more anxiety to the patient because they have to use a computer.
For this reason it is important to realize that health information technology may not be a solution to those that are computer illiterate or that may have some other underlying conditions that would make it difficult for them to access a computer, or even have the desire to use one. In some cases health information technology may not be a variable that could increase the quality of patient care, especially as it pertains to the patient portal (Electronic, 2011).
Because of the many challenges that can be presented just in the patient portal alone, it is interesting to note that there are some companies that focus solely on that portion of the health information technology department. This is because it has been found that patients are much more satisfied with their experience using the health information technology if the experience is user friendly, seamless, and meets their needs.
In a recent editorial by to family physicians from the Virginia Commonwealth University, some very interesting conclusions were made in regards to health information technology. These family physicians realize the importance and how great health information technology can be especially as it pertained to how the technology could help patients to be more active in their own health care (Information, 2011).
What these physicians found and recommended was that personal health records and the technology that was used for them needed to have one variable at the forefront, and that was to make sure that the technology would keep the patient in mind when designing the software and front end usage. This is because collecting information from the patients is a great way, and one of the most important ways of helping a family physician to properly diagnose and to treat the patient (Information, 2011).
Keys for Health Information Technology and Family Medicine
The family physicians from Virginia Commonwealth University stated that there were five key functions that were necessary for an effective and efficient health information technology system. Much of it had to do with the way information was gathered, analyzed, and utilized. These family physicians stated that the five main functions should be to collect and store information from patients. The second would be to collect and store the information from the patient’s physician (Information, 2011).
Another key function would be to be able to translate the clinical information into a lay language so that the patient could understand how to improve their health based on this information. Finally the information had to be actionable for the patients. By making the information actionable by the patients it is meant that the patients would be able to take the information and make decisions and tailor their health care through education, priorities, and also to be able to integrate and use the information in other areas or specialties of their health care (Information, 2011).
These family physicians felt that although health information technology was great, that the technology was not used to its full potential. They make some really great points as there is not any health information technology out there that is utilized by the patients in such a way that the technology actually translates the information into language that they will understand, or involves to a deeper level of patient integration where they are making more of the decisions (Information, 2011).
Concerns and Frustrations with Health Information Technology
This is understandable as new technology can be frustrating to begin with, so the more seamless the integration of a new user, the more satisfied that user will be. This is a very important aspect for the family physician to consider when purchasing or trying to decide which system of health information technology is best suited for their practice. If the patient is comfortable and satisfied using the patient portal this will be one more area that the patient will be satisfied in their overall health care provided by their family physician (Electronic, 2011).
Another one of the big concerns with health care today is the fact that the delivery of it is often times fragmented. What is meant by this is for example is that a patient that has testicular cancer may first see a surgeon to remove the cancer. Then the patient may have to periodically see the oncologist to make sure that the cancer does not return. In addition to this the patient may be seeing their family physician for other chronic diseases such as diabetes or hypertension (Pawlson, 2007).
The health care delivery fragmentation is exacerbated by the lack of communication between the various specialties of physicians that the patient is seeing. This can lead to medical errors as one physician may prescribe a medication that could be contraindicated by a physician that is prescribing another medication for a different disease (Pawlson, 2007).
Health information technology, if designed correctly, can help lessen by a great degree the fragmentation of the delivery of health care to a patient. This would in turn help greatly to reduce medical errors and thus increase the quality of patient care, as well as maximizing resources to more productive endeavors. This is amplified by an increase in digital communication, in the collection of data, and in the delivery of important data pertaining to the patients’ health. Another advantage that is coming because of health information technology is more effective follow ups from the patient and the data that can be recorded (Pawlson, 2007).
When there is better communication between physicians, the fragmentation of the patient care is lessened. This is said to help the physician to increase their learning about the patient. It is also said that health information technology increases the learning in treating diseases that could be epidemic, and predict how to contain them in such a way that they don’t become pandemic. Health information technology has really made an impact when it has come to containing certain strains of influenzae. Health information technology has also helped researchers to predict which strains of influenzae are going to be the most dominant in the flu season (Pawlson, 2007).
As good as the aforementioned utopian health information technology system scenario sounds, it is very rare. This is because health information technology is so new, and there are so many competitors. Furthermore the standards and ethical questions in regards to health information technology are being defined and figured out as the technology and the needs and wants of the patient, physician, and auxiliary health care is determined. Not to mention the government mandates and legislation that has made other rules that health information systems must adhere too. This would not be so difficult if the legislation and mandates did not change so often.
Importance of Cybersecurity in Health Information Technology
Because the health information technology is so new, and still growing and being improved upon, and because of the other aforementioned variables, the family physician is finding them in a situation in which they have to constantly adapt to all of the change. The other option is to not be as effective with their health information technology, and still another option is to not use it at all. Some physicians choose not to not use health information technology at all when it comes to patient care because it helps to avoid a lot of problems. Some of these problems are the privacy of information that their patients desire are not threatened when the information is not stored in the cloud, or a database (Shwayri, 2014).
One of the challenges that really became an issue of health information technology is that of security of the information that is found therein. There has been a focus that has been highlighted by the Health Information Technology for Economic and Clinical Health Act (HITECH). This act was developed to help ensure that health information technologies that were being produced and used in the United States were meeting at least a certain amount of security measures to help ensure the privacy of the patient, the health care organization, and academia (Greiman, Zlateva, & Chitkushev, (2012).
Cybersecurity is a very important issue as an integrated health information technology will not, and cannot be in full effect until this issue is solved. These privacy issues will continue to be an issue not only in the United States, but also if there was a worldwide communication network it would seem that this could be even a bigger problem.
The bigger problem is because a lot of personal information may be utilized and shared without the permission of the patient or whoever has the stewardship over the information. There is going to be an increased need to use electronic storage databases that are protected and kept safe, and that can be upgraded as cyber systems are continually being compromised (Greiman, et al., 2012).
All of the cybersecurity issues need to be addressed along with maintaining the HIPPA regulations and federal laws that have been put into place to protect the rights of the patients and the citizens of the United States of America. The HIPPA regulations are even today under scrutiny however as there is currently new legislation that is searching for exemptions for research (Greiman, et al., 2012).
Paper Charts, or the Old Fashioned Way
Sometimes good old fashioned paper charts are the most dependable as they will not be erased or compromised by a breach in electronic security. The physicians that do not use health information technology also do not have to worry about training their staff and the cost in time and money that takes to learn a new system (Zandieh 2008). Another problem that they would avoid is not having to continually upgrade their software, their system, or their training in order to learn new methods (Spratt, 2008).
For some family physicians avoiding these pitfalls is worth it and they feel that the old fashioned way is indeed more effective and efficient. This is especially true in areas where Medicaid and Medicare patients are not being seen, and no government funds are being utilized for patient care. This is because the physician is not held to government standards and mandates in order to get reimbursed for their services, whereas family physicians that do accept Medicare and Medicaid are obligated to be a part of health information technology if they want to get reimbursed, and in fact are given a bonus as of last year if they are properly integrated into the health information system (LaTour, 2013).
Because a lot of patients are on Medicare or Medicaid, a lot of family physicians are finding it necessary to be on the grid so to speak so that they can get properly reimbursed. Physicians are also seeing that there can be potentially a lot of benefit of having a smooth running health information technology system (Wakefield, 2008).
Proper reimbursement is definitely important in the realm of family practice, because this can increase their revenue by being a more efficient office and team, and also the patient care can be more increased which leads to more satisfied patients and then in turn a good opinion and word of mouth that could also increase the potential patients that a family physician has in the future.
Medical Registries and Family Medicine
Because health information technology is still relatively new, there are a lot of questions as to how in depth the health care teams in the United States, and especially physicians, are willing to delve. To address this, there was a study conducted in Massachusetts that cost over fifty million dollars. In this study it was found that physicians that actually used the health information system more effectively were also more apt to participate in medical registries.
Medical registries are important as they help the Center of Disease Control and other organizations including academic organizations to use the data for case series studies or other studies to figure out biostatistics of diseases and other pathologies. For example the prevalence of diabetes in a population can be tracked, as well as the methods that are effective for treating it. The yearly incidence rate of chlamydia can be calculated by the information found in the health registries, as well as sensitivities and specificities of diagnostic tests. For these reasons and others, the strength of the health care registries is very important and vital in health care. Not to mention, a very drastic reason why health information technology can be utilized to increase the quality of patient care. This is especially true as it pertains to the family physician.
According to the study by Fleurant, it was found that the ability for primary care or family physicians to contribute to the registry could accomplish a great deal to strengthen the sample size thereby increasing the confidence of the data. As we can see in exhibit 1, the primary care physicians played a vital role in the generation of registries that could be used for health information systems (Fleurant, 2011).
(Please See Exhibit 1 in Appendix A).
To further demonstrate how health care registries are important in the organization of the health information system we can look at a study by Hinman that showed the increase in immunization tracking when this type of system was implemented. This is not to say that there was necessarily and increase in the immunizations, but it does show that with time and more use of the health care registry that more immunizations were reported.
Immunizations and vaccines are a very important part of the prevention of very dangerous diseases in the United States, and the family physician is the health care professional that is responsible for the delivery of common vaccines. If this information is properly tracked, than outbreaks and epidemics can be predicted, prevented and anticipated, and hopefully a better quality of life and more lives can be saved.
This is especially true in areas of the United States where there may be a popular trend in not vaccinating children. When these trends are tracked, the epidemiologist can predict where an outbreak may be for the certain disease. This is important as epidemics can than possibly be contained and not turned into a pandemic. The results of the participation of immunization system registry survey can be seen in exhibit 2 where a registry has been able to track immunizations in the United States, which is very important information for the epidemiologist and the Center for Disease Control (Hinman, 2010).
(Please see Exhibit 2 in Appendix B).
Importance of Interoperability in Health Information Technology
In a recent article from Medical Economics, it is predicted that there will in fact be what is called interoperability in the United States between the different health information systems by the year 2024. What this means is that the health information systems will be able to seamlessly share health data that would allow for the increased quality of patient care (Ritchie, 2014).
This increased interoperability between health information systems will have a drastic impact on the family physician. According to Ritchie, this will mean that the business model that family physicians have now will of course continue to evolve. Ritchie predicts that this will be good for the family physician. It is predicted that the family physician will be even more valuable to the health care system as they will be more integrated and have a deeper collaboration with the hospitals and the communities in which they serve (Ritchie, 2014).
Improved Lifestyle with Health Information Technology
One of the benefits of the predicted business model and role that the family physician will have in the future is that they will not have to deal with many of the administrative headaches that they have to deal with today. This would mean that there would be less time and resources spent of fighting with insurance companies for reimbursement, and other time consuming tasks that take the family physician away from practicing medicine and seeing patients (Ritchie, 2014).
Perhaps one of the most important reasons that a family physician would want to look into utilizing health information technology is because the technology can help the family physician to have a better and more enjoyable lifestyle. In a recent article by Montague, it was stated that a lot of physicians are suffering from being overworked and burnt out. The article also states that many physicians are not satisfied with their work and they feel that they are not making a difference. Among the physicians that are in the survey, those ranking with the highest amount of dissatisfaction were the physicians that specialized in internal medicine and primary care, both of which contribute to family medicine (Montague, 2014).
The way that Montague reports that health information technology could help the family physician is by solving a lot of the problems that are presented with the shortages of workforce. The way that health information technology can help to alleviate some of the problems with the shortage of workforce is by allowing the family physician to accomplish more work with less complexity. This in turn would also allow the family physician to see more patients that may have more difficult problems or diagnoses (Montague, 2014).
Montague claims that in order for health information technology to accomplish the goal of helping the physician and the patient to work together in such a way that health care will improve, that it is vitally important for the health information system to be designed in such a way that the technology is human centered. The design is imperative to be user friendly for both the family physician and the patient because if it is not, this could lead to frustration and then an ultimate failure of the utilization of health information technology in the realm of family medicine (Montague, 2014).
The reason that it is so important for the family physician to utilize health information technology in this day and age is because it has been found that when there is a good front line of health care, which the front line is the family physician, that this can help to increase the quality of health care. Serious illnesses can be dealt with at earlier stages. Emergency rooms with the expenses that come with using them, will be lessened as patients go to their family physicians first, thus health care dollars are not wasted and can be used more efficiently and effectively. Chronic diseases can be treated in such a way if they are maintained properly in the setting of family medicine, that more drastic treatments and therapies can often be avoided, which ultimately leads to a higher quality of patient care (Montague, 2014).
Research Methodology and Design
Due to the vast amount of information that was available in the area of health information technology, it was vitally important to focus on the scope of the project and to try to stick to the outline, goals, and objectives that the author felt was most important. Therefore, it was a great asset to have at the forefront, research from scholarly articles that were made available from the Davenport online library databases. This work would have been much more difficult without the access to the scholarly database that was available for student use with internet access.
When searching for information in the databases, it was important to focus the searches as specifically as possible. A specific search was important because of the incredible amount of articles that would be found with the search of a broad term. In fact, even with a narrowed search, the amount of articles that was found and made available were really quite numerous and had to be discerning for the benefit of this work. Then, from the results that would appear, the author would have to peruse the articles to find literature that was most pertinent and that the author felt would be for the benefit of the paper in order to get the most comprehensive information. Once this was accomplished the author would then try to glean the information and subsequently synthesize the work of the authors to come to some type of conclusion. Before this was done however, depending on the research, it was also important to compile the literature and research in such a way that it would make sense for the reader of this work to easily understand.
The author felt that in researching literature for this project that it was especially important to consider the source of the information that was used. For this reason, only scholarly work of the highest level was considered as a source. The author felt that if the research adhered to the highest standards of quality, that this would then be reflected in the content and validity of the project. The author maintained this method of research and ensured the highest standards were used steadfastly throughout the entire process of this work. It is the hopes of the author that the reader will confidently find that the work contained to be credible as the sources from which this work was synthesized were indeed credible.
The procedures that were used for collecting information and hard data for the project were rather straightforward. Most of the research was found searching the Proquest Database that is a service of the Davenport University online library source. The Proquest Database is an invaluable and indispensable resource to use for this project as the Proquest Database has a huge library of scholarly data acquired from various sources scholarly sources and journals from around the world. Most importantly, there was a huge amount of data on health information technology and family medicine that the author had the pleasure of perusing. As the author would search through the various articles it was important to find literature that would help the author to demonstrate how health information technology would be beneficial to family physicians, and also look at some of the challenges that this relatively new technology has, and will inevitably continue to have for many more years to come. This is because for one there are many ethical questions and issues that need to be addressed.
Some of these ethical questions are for example if the researcher would be exempt from many of the patient privacy information in order to create a better registry to track the data of certain diseases. Or would the researcher be able to use data for bio statistical reasons for example to figure out the incidence and prevalence of a new strain of influenzae, and if so, how much personal information are they going to be privileged to acquire.
To go even further in depth, ethical questions can also be spread to a worldwide health information system because health information technology if used on a global scale could really be invaluable to the medical community and for health care in general if it were used correctly. However the privacy and ethical questions need to be raised and resolved first and foremost.
A great amount of data and literature are submitted and considered scholarly sources which are appropriate for a project of this nature. This is vitally important when screening sources for scholarly work because if the source has no credibility than the information contained therein is essentially useless, which would in turn would weaken the credibility of this work. It was for this reason that only the best and highest level of scholarly sources were used when citing work in this project.
A vital part in the procedure of finding the best literature was to search the appropriate key words. For example, one could not simply search for “information technology” as this would yield far too many results to comb through in the short amount of time that we have for this project. Therefore the author would have to carefully submit searches that narrowed the results significantly. Some examples of the searches used were “health information technology family physicians,” and “challenges in health information technology.”
Even when the search was narrowed the results were many which led us to our next challenge. The author even found it necessary to focus the search of literature to results that were applicable to the United States of America, as the main focus of this project was how health information technology would or could be applied to the family physician in this country.
The biggest challenge when implementing this procedure was using sound judgement as to which sources would be of most value to the work. This is because there was such a huge array of information of health information technology that it was important to be selective. Even from the information that was selective it was difficult to glean and choose the information that was the most beneficial to the project, while also trying to be fair and unbiased.
This was undoubtedly a difficult task, as the author definitely has opinions on health information technology and family medicine. However the author is proud to report that there were points of view and information that help the authors, and hopefully the readers understanding of health information technology as it applies to family medicine really became more in depth and grew to a broader base.
The instruments that we used were the personal computer to enter and record data. The word processors to compile, write, and edit work. This was also beneficial in using the graphs and charts creator to illustrate important points in the work. Also, as mentioned earlier, the author used electronic databases, primarily the Proquest Database, which was an invaluable source of information that was used for this project. These databases, when searched properly, delivered some of the most respected and scholarly work available on the subjects of health information technology and its various applications to family medicine.
Without the aforementioned instruments, this project would have been much more difficult to come into completion. It was extremely important that these tools and instruments were in top working order to conduct the research and to put all of the information together and to present the information in a cohesive and in a concise manner. This was important to the author because one of the main personal objectives of the author was to make a piece of work that would be enjoyable for the reader. With the combination of the instruments used for this project, it was miraculously possible to accomplish this work to the highest standards as outlined by the professor Dr. Tim Delicath, and Davenport University.
Data Collection Process
Collecting the data was an arduous process, not due to the lack of data, but because of the abundance of it. In order to collect the appropriate data, one must find it first. With a wealth of information in the digital age literally available at your fingertips, one must be able to discern the data that is worthwhile or not. The first step is to look in the proper general area, and this would be a database that contains a library of scholarly articles. Next would be to effectively search for these items in a focused and concise manner.
As we searched for health information technology and family physicians together, we found most of the best information. In order to find data for specific areas such as HIPPA regulations and health information technology, the search terms would have to be changed accordingly. After an effective search was executed, one would have to then peruse through the various scholarly works and articles to find the ones that were most useful and pertinent for the scope of information that would be applicable to the project. This process was repeated until all of the objectives were covered for the focus of the project.
As far as limitations were concerned, there were two obvious ones. One was the fact that the author was working solo, and already had ideas concerning the project, and personal opinions. This could very much limit the study as there could have been an unintentional bias when gathering and interpreting information. In order to ensure or strive to not let this observer bias occur, the author strived to be as open minded in the gathering of information, data, and opinions from a wide range of sources.
This was done with the spirit that a good piece of work could be accomplished from this process due to the aforementioned limitation. One possible way to resolve this limitation would be to do a group project or if this paper were able to be peer reviewed. However, due to the logistics and to the time allotted it was found to be a welcomed challenge to the author to strive to make and report a project in which learning was had not only by the author as an open mind and point of view was kept, but to also pass this new knowledge on to the reader of this work.
Another obvious limitation was the fact that because of the rapidly changing field of health information technology, and the constant change in legislation, that it is very possible that the information is outdated as soon as it is published. For the purposes of this paper however, it is assumed that the highest quality and latest information was used for this project and that the author strived to not be misleading or biased in the gathering and presentation of information.
The author felt that if the latest and most credible sources were used in the gathering of information that this would in fact give more legitimization to the project and greater confidence to the reader that the information presented herein was in fact as accurate as could possibly be, and thus is a means of hopefully minimizing this limitation. It was for this reason that a considerable amount of time and careful consideration and professional judgement was used to discern which sources of literature would be the best for the scope of this project.
Other limitations were the time constraints that were due to the seven week class time. It would be very easy to work on this project for another seven weeks to get more in depth first person interviews and other types of research. The time constraints did however keep the author on task. Even though a deadline could be perceived as a limitation, it could also be a good way to make sure that the project was completed in a timely manner. With the time allotted, the author had to be sure to be diligent in the work and strive to maintain a consistent work ethic in order to not have the time constraints to be a hindrance.
It is also important to note that there are limitations to the research of health information systems due to the difficulty of figuring out the actual costs and benefits of implementing health information systems. Furthermore it is important to note that due to the limitations of this study, that not all of the variables were factored into analyzing every single cost and benefit that a family physician and their practice has. This is because the variables could be immeasurable intangibles such as bedside manner and being able to personalize health care to individual patient’s personality (Kumar & Bauer, 2008).
Synthesizing Data from the Literature Review
After the data was collected from credible scholarly sources, it was important for the author to take the time to analytically read and comprehended the material first and foremost. It was also vitally important to put all of the information together in such a manner that it would be presented to the reader in a way in which they could properly understand the points that the author of this project thought was important and trying to get across to and relay to the reader.
To accomplish this task, was only made possible after the author was able to glean and synthesize the data in a cohesive manner. The synthesizing of data was also very important as it helped the author to come to specific conclusions as to the effectiveness of health information technology in the field of family medicine. This is especially true, as it pertained to the family physician, because the family physician is in a unique area of patient health care because of the innumerable amount of variables in the realm of family practice. One may say that no two family practices are the same, so finding the common threads or areas that may pertain to a great number of family physicians was definitely a lofty but worthy goal of the author.
The author was also able to conclude from synthesized data more specific information such as which health information technology software was popular and what were the reported problems and challenges that family physicians faced in the wake of health information technology. The proper synthesis of data from literature review was only possible after reading and comprehending the data from the scholarly articles that were researched.
Some of the hard data from graphs and charts that were from other authors were gleaned and used in this work to better illustrate points of health information technology and family medicine, in a more visual and aesthetically pleasing manner. For example, it was found that many patients appreciated the use of health information technology when they were receiving care from their family physician as they were able to access information about their health care in the privacy of their own home.
The data analysis was primarily from the secondary research that was found in scholarly articles. From reading what the authors of the literature concluded about their data analysis, the author of this work tried to understand and comprehend it in such a way that the author was able to then relay the more meaningful points of the data to the readers of this project. In order to accomplish this goal, the author would also utilize graphs and calculations properly cited from scholarly articles if it would add to the understanding of the data analysis.
The author of this work would then try to amplify and expound on the work of other authors by backing up similar findings by other authors in order to strengthen the data analysis. The author felt that it was important to analyze the data in this way because it would help strengthen the conclusion of the author if other scholarly works were found to have the same conclusion. This in turn would give the reader a higher confidence level that the work concluded in this work was in fact legitimate.
It was found that there were many positive benefits to health information technology that would be applicable to family physicians. There was also many challenges to overcome and to work out before health information technology and family medicine could be combined and work in the best possible manner. Before the challenges and ethical questions can be worked out however, there needs to be a time for growth and a time to see in the real world how these challenges can be overcome. This will no doubt take many years to finally come up with a near perfect system.
Although paper charts can still have a place in medicine, it seems that the more beneficial way to practice medicine and to increase the quality of health care would be to integrate health information technology into the family practice, while at the same time being able to customize the system as no one system will be able to fit every family physician and their practice. This is vitally important as there are many different ages, demographics, and cultures in the United States that the family physician serves.
Being able to be trusted and being able to communicate with the patient is one of the most important variables in successfully diagnosing and treating a patient. The family physician is usually the first medical care provider that the patient comes across, and it is for this reason that if a family physician is to use health information technology it has to be in a way that the patient can trust the physician in such a way that they will be confident that the physician will be ethical in confidentiality, privacy, beneficence and in informed consent to the patient. In other words, it would be a very great thing for the patient to feel that the physician has their best interests at heart and will do the patient not harm in any way, shape or form.
It is important to note that in order to have an integrated and successful health information system that the physicians and their staff need to be enthusiastic and onboard. It would definitely be beneficial for proper training of health information technology to occur as soon as possible. This could occur even during the early years of medical training. To ensure that additional training is happening requirements in board certification may in the future also be able to require the family physician to have a working knowledge of health information technology (Graham-Jones, et al., 2012).
We need to also remember the importance of personalizing the health information system in such a way that it will be most beneficial to the patient population that is being served. A great example of how personalizing the health information system for specific population was found in a study in the Journal of Community Health, in which a look at Native Americans and Eskimos were found to have a very unique set of needs to their health care. For example it was found that when Native Americans were encountered with health information technology in their patient care, that they were able to receive tailored care and an increased quality of health care for their needs. In other words, creating a health information system can be a very complex and arduous process as there are so many different cultures and demographics with variables to consider. However this was not possible unless their health information system was also personalized to meet their needs as acquiring information from this demographic was different than acquiring information from say New York City residents (Geana, et al., 2012).
Cybersecurity is an area of health information technology that also needs to be addressed if there is going to be a successful and fully integrated system that will be used by all family physicians. This is very important because it is imperative that the rights of the patients are protected first and foremost. This standard however may not be made for some time as the debate as to what is ethical and what should be available for researchers as far as patient data is concerned, has not been legislated as of yet (Greiman, et al., 2012).
It would also be important to remember that there has to be some kind of way to customize health information technology to fit the needs of different family physicians, as well as the culture or demographics that they serve. If this were to happen, the implementations and integration of a health information system would be able to successfully acquire the pertinent information to add to medical registries and also be available to researchers. If this were to somehow happen, then great strides in healthcare could really take place (Geana, et al., 2012).
It is very important to note that family physicians and those that are managing a family practice need to be made aware of the great tool that health information technology can be to a family practice in modern medicine today. If they were to implement health information technology into their family practice they would see an overall increase in production by the physician and their office staff, and more importantly in the quality of health care delivered to their patients. With this increase in productivity would also mean that the family practice would make more money and have and increase in net revenue.
It is also important for these parties to understand that there will be many costs and expenses associated with implementing such a complex system. One major cost will be that of training the staff, as well as the physician. This is difficult to gauge how much this will cost as some people have a higher aptitude for computers and some people are faster learners. Another major cost will be that of the actual software program. Depending on what is needed and wanted in a health information system, and how many work stations it will be connected to, they system could cost as little as a thousand dollars to upwards of tens of thousands of dollars.
The family physician also has to realize as well and be braced for the future upgrades that will inevitably be required to stay current in the future. As far as health information technology is concerned, especially in the growing stage that it is in now, upgrades are a very common occurrence in this field. For this reason it is very important to have planned in the budget a portion for upgrades in order to ensure that this would not be an unforeseen expense in the future.
These upgrades can range from increased cyber security to ensure patient and organizational safety, and to minimize liability, to new and improved software features. Other reasons to upgrade could be a change in government mandates and legislation requirements to the health information system that needs to be upgraded or else there may be a fine or a penalty applied which could in the worst case scenario mean that the family physician would not be able to effectively care for their patients (Kumar & Bauer, 2008).
It is strongly recommended by the author that family physicians in the United States get on board with health information technology. The sooner the integration of a health information technology system into their practice, the sooner the customizations and growth can begin in order to better suit their needs, and the needs of their patients and staff. It would be much more feasible to grow with the technology than to be left behind and not reap the benefits that health information technology can offer family physicians today.
It is also recommended by the author that the training of family physicians or any physicians for that matter would include training in health information technology as this is surely a way to move the practice of medicine forward in a more rapid and positive direction. This will help to ensure that the new physician will then better be able to integrate health information technology into their practice more seamlessly.
Another recommendation would be to make sure first and foremost that patient privacy will be protected, because without this the health information technology will never be all that it could be. If the patients do not trust their privacy will be protected, they will feel vulnerable and look for alternatives. If this were the case, then medicine would not move forward as swiftly as it could with the help of health information technology.
This would be because the old paper-chart system, although very secure, would not be readily accessible to those that may research, or to pharmacists, or to the wealth of knowledge that is available to help the physician and the patient to use evidence based medicine to properly treat the patient.
A paper chart system may be recommended for very specific and private health care such as a family physician run weight loss clinic. This may be of benefit to use a paper chart, as the weight loss medication is rarely covered by insurance in the first place. This would mean that reimbursements using the health information technology would be non-existent making this type of family medicine cash only. Also, due to the high confidentiality requirements of patients seeking weight loss, a paper chart is really secure.
However, some other portions of health information technology could be used in this realm of family medicine such as emails and appointment settings. This would in large part depend on the physician and the patients in regards to how private the practice would want to be, because it could be argued that an appointment book being hacked could just as well be considered compromised privacy.
Perhaps the most important and final recommendation would be is to have an open mind and a positive attitude toward health information technology. If the family physicians and their staff can buy into the bigger picture of health information technology, and how it can improve the many facets of their medical practice, they may be more apt to integrate, change and to learn new things. The same recommendation also goes to the patients of these family physicians.
Though it may be difficult to actually realize how perhaps being generous with a little information may be, that the patient population as a whole could greatly help to progress the practice of evidence based medicine. It is important to see that this benefit could in fact have a huge impact on their posterity and also help to solve some of the problems that have been plaguing health care today and that have been a hindrance to the practice of evidence based medicine for a long time.
In order for health information technology to become an amazing system of health care benefit, it is important for and recommended that globally there be some kind of communication between health information systems and data. Although this is a very lofty goal that will undoubtedly take years to achieve, it is definitely a worthwhile goal to work towards for the greater good of human kind. It all starts today with using the health information technology that we now have and improve try to improve upon it. It also starts at the front lines of medicine, and that is with the family physician.
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