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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY

Electronic Health Records are Impacting the Health Care Industry

Julie Khmelchenko

HCIN-540-02B-FA19 - Intro Health Care Info Mgmt

Suzi Mattox, MS, BSN, RN

9/29/19
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
In mid 1960s the fast data processing appeared on healthcare market in a form of

electronic medical records. Around the same time, Larry Weed developed the Problem-Oriented

Medical Records, which gave rise to implementing the electronic methods of recording patient

information. In less than a decade, the Regenstrief Institue created the original electronic medical

record (EMR) system. The visionary institutions and government hospitals were the first to adopt

the system while the rest of medical organizations and physicians could not afford it due to high

cost. In the 1990s, personal computers became affordable partially because of embedding the

microprocessing chips. Lately the global internet surfaced, making the EMR appealing to health

organizations allowing them conveniently access the desired files. In 1991, the Institute of

Medicine presented the goal of viable implementation computers by health organizations for the

next ten years, with a focus of enhancement on patient care. HIPAA policies got introduced in

1999 and perfected by 2003 with the required implementation.

The technological advancements in early 2000s revolutionized the medical field by introducing

electronic implementation to store and retrieve medical files. The technology made it possible for

physicians to afford using the EMR systems. The acceptance of new technology gave rise to

healthcare IT projects, enabling the hospitals to create cyber security analyst positions to support

the workflow utilizing the medical records. Adler-Milstein, Everson, and Lee (2014) state the

following:

In 2009, the federal government passed the Health Information Technology for

Economic and Clinical Health (HITECH) Act to spur widespread adoption of health

information technology. The centerpiece of HITECH is a financial incentive for

doctors and hospitals to implement electronic health records (EHRs) and use them
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
in ways expected to improve the safety, effectiveness, and efficiency of care—known

as the meaningful use criteria.

The government expects the doctors and hospitals to follow specific criteria to demonstrate the

meaningful use before qualifying for financial incentives. 

With given circumstances, the EHR system is performing by implementing meaningful

use. Unfortunately, the full potential of global use has not yet been reached. Currently, the

system has several limitations, such as ensuring patient confidentiality, HIPAA compliance

across health organizations, and EHR system standardization for research purposes. It is

important to understand what factors cause the drawbacks in order to be fixed. Understanding the

obstacles helps to develop the strategies to execute the plan. According to

The EHR system underwent many changes throughout the years, and it continues to face

challenges due to its infancy stage. Evans (2016), the author of “Health Records: Then, Now,

and in the Future” explains what drove the demand of EHR systems on a greater scale.

Sicuranza, Esposito, and Ciampi (2014) the authors of the article “A Patient Privacy Centric

Access Control Model for EHR Systems” unveil the vulnerability of patients and medical

personal using the EHR system, and what actions ensure the general confidentiality and patients’

privacy. 

Ferran (2015) the author of “Don’t Confuse EHR HIPAA Compliance with Total HIPAA

Compliance” discusses HIPAA security policies designed to protect Personal Health

Information. 

Herman, Flite, and Bond (2012) the authors of “Electronic Health Records: Privacy,

Confidentiality, and Security” answers the question of what actions are being taken by health

organizations to keep employees in check with HIPPA rules. Bowman (2018), the author of
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
“Coordination of SNOMED-CT and ICD-10: Getting the Most out of Electronic Health Record

Systems? Discusses a solution to what can facilitate evidence-based medicine. Kho et, al’s

(2013) the authors of “Practical Challenges in Integrating Genomic Data into the Electronic

Health Records” explain why EHRs systems are not fully capable of retrieving data for research.

Ross, Wei, and Ohno-Machado (2014), the authors of “Big Data” And the Electronic Health

Record,” come up with a solution of improving the EHR system and suggest who must start to

raise awareness to promote the change. 

Many physicians have adopted certified EHR systems, which resulted in an improvement

of the workflow with every entry of patient information. After the successful performance of the

program, it gradually was introduced to patients as a Personal Health Records (PHRs) capable to

retrieve medical records from the electronic portal. Many patients started to access the portal to

view lab results, discharge summaries, recent doctor visits, request prescription refills, securely

messaging physicians and other medical-related events. The convenience of being able to access

personal health data prompted more patients to use the PHRs. Now EHRs permit better

interaction and communication between health organizations and patients. Evans’s (2016)

explains the following: 

Many patients are taking a more active role in managing their medical data which is

essential for patient-centered care. Patient-centered-care allows patients to add

personal stories of key life events both medical and non-medical that enable

clinicians to better understand what matters and is important to patients, and what

are their personal health goals and care preferences.

 Patients use PHRs and disclose more information than ever before. In return, individuals want to

be reassured that their records are kept safe without any possible breaches. Medical entities must
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
reassure individuals by preventing violations of confidentiality and following the policies

implemented by cybersecurity.

The demand for the EHR system encouraged other physicians to join the electronic

system of their choice. However, the potential confidentiality concerns that came with adapting

the EHR system are present. The numerous safeguard actions are taken before reassuring

patients, doctors, and international users of sharing data safety. Sicuranza, Esposito, and

Ciampi (2014) explain the following:

So for EHR systems, it is necessary to ensure the confidentiality of data and

patient’s privacy, and to guarantee the quality of the data and the integrity that

leads the user (doctor) to have confidence in the data and in the information

contained. To meet these needs (integrity, confidentiality, and quality), a widely

used mechanism is access control (AC), which is a fundamental security barrier for

securing data in a healthcare information system. The AC is a mechanism that

limits the access to the documents in an EHR system, to who can operate them and

how.

The patients need to be in control to provide a consent to specific parties and to view their

medical records. They should have the ability to change the access to those who can see medical

files at any time.

Moreover, medical practices must have a system to manage security policies to a certain

degree of freedom, which protects patient data from unauthorized access. Ferran (2015) states:

The newly revised HIPAA Security Rule requires providers to assess the security of

their databases, applications, and systems that contain patient data against a list of
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
75 specific security controls. These controls include specific safeguards to be in place

for the purpose of protecting PHI. 

When working with electronic records, EHR HIPAA compliance should not be taken lightly.

Medical authorities must delegate time to review regulations weekly or monthly to stay

compliant with policies and regulations while ensuring privacy for electronic PHI. Keeping

patients records safe from prying eyes is difficult. Therefore, hospitals and clinics must observe

audit trails of the EHR system. According to Harman, Flite, and Bond (2012):

Alerts are often set to flag suspicious or unusual activity, such as reviewing

information on a patient one is not treating or attempting to access information one

is not authorized to view, and administrators have the ability to pull reports on

specific users or user groups to review and chronicle their activity.

Careful scrutiny of employee’s electronic actions relating to patient data allows organizations to

obey HIPPA guidelines aiding to avoid financial penalties.

Additionally, health organizations must always request patients consent to share their

files with other health institutions to conduct studies. It is crucial for medical entities to follow

disclosure policies of how personal data is intended to be used and what purpose it might

achieve. Patients should have a right to withdraw their consent at any given time. With patient

safeguards in place, utilizing the EHR system for sharing personal data between health

organizations should be reliable and safe.

With every decade, the medical field is witnessing breakthroughs in solving medical

mysteries. According to Bowman (2018), “Incorporation of clinical terminologies into EHR

systems is an important step in the creation of information systems capable of monitoring

quality and driving the practice of evidence-based medicine.” At this moment, the society
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
faces a global challenge in utilizing the collected data. The challenge involve limitations of

processing ability, accuracy, and completeness of records, lack of standardization, security and

privacy concerns, and inability to extract the required data. Kho et al., (2013) found “up to 80%

of the value in data may be locked up in free text, requiring so-called natural language

processing (NLP) to derive structured data elements from clinician notes.” Although, there

is potential for secondary use of data, however, it is out of reach for researches until the EHR

system can be perfected. 

Sadly, a system cannot be improved overnight. It will take time and influence to highlight

the concerns in developing a system capable of utilizing big data. Ross, Wei, and Ohno-

Machado (2014) believe it is critical to:

Encourage the scientific community to raise awareness about this issue and call for

researchers to define completeness by four criteria: documentation, breadth,

density, and predictive ability. Steps toward improved information extraction and

analysis in the USA include the formation of alliances between companies and

healthcare institutions.

 It is be a big milestone to celebrate once the EHR system is standardized. The standardized

system will allow to combine the information with knowledge and experience to implement the

specialized treatment plans. The tailored research is meant to benefit both doctors and patients.

References
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
Adler-Milstein, J., Everson, J., & D, S.-Y. (2014, May 22). Sequencing of EHR adoption among

US hospitals and the impact of meaningful use. Retrieved from

https://academic.oup.com/jamia/article/21/6/984/789355.

Bowman, S. (2018). Coordination of SNOMED-CT and ICD-10: Getting the Most out of Electronic

Health Record Systems. Retrieved from

http://library.ahima.org/doc?oid=106578#.XY1xx-dKgUs.

Evans, R. S. (2016, May 20). Electronic Health Records: Then, Now, and in the Future. Retrieved

from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171496/.

Ferran, T. (2015, March 11). Don't confuse EHR HIPAA compliance with total HIPAA compliance.

Retrieved from https://www.healthcareitnews.com/blog/don’t-confuse-ehr-hipaa-

compliance-total-hipaa-compliance.

Harman, L. B., Flite, C. A., & Bond, K. (2012, September 1). Electronic Health Records: Privacy,

Confidentiality, and Security. Retrieved from https://journalofethics.ama-

assn.org/article/electronic-health-records-privacy-confidentiality-and-security/2012-09.

Kho, A. N., Rasmussen, L. V., Connolly, J. J., Peissig, P. L., Starren, J., Hakonarson, H., &
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Running Head: EHR IS IMPACTING THE HEALTH CARE INDUSTRY
Hayes, M. G. (2013, September 26). Practical challenges in integrating genomic data into

the electronic health record. Retrieved from https://www.nature.com/articles/gim2013131

McGonigle, D. G., & Mastrian, K. G. (2018). Nursing informatics and the foundation of 
knowledge (Fourth). Burlington, MA: Jones & Bartlett Learning (p.161)

Ross, M. K., Wei, W., & Ohno-Machado, L. (2014, August 15). "Big data" and the electronic

health record. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287068/.

Sicuranza, M., Esposito, A., & Ciampi, M. (2014, November 2). A patient privacy centric access

control model for EHR systems . Retrieved from

https://www.researchgate.net/profile/Mario_Ciampi/publication/265380094_A_patient_p

rivacy_centric_access_control_model_for_EHR_systems/links/55097c8d0cf27e990e0ea4

63.pdf.