Patient-Centric Systems
Introduction
The healthcare industry has undergone significant development changes in the recent times due to technological advancements. Technological advancements have influenced changes in the healthcare sectors leading to the emergence of new perspectives on the different healthcare delivery models. In the past, healthcare delivery was based on the healthcare facilities, meaning that the majority of care was offered in hospitals. However, this has changed in the last few years as the society now emphasizes on providing care outside a hospital setting via venues such as ambulatory/clinic services, outpatient, and home care (Agha, 2014). The society is drastically shifting from hospital-centered model of care to a more patient-centered continuum of attention view. This research paper seeks to address patient-centric systems, as discussed by Judy Murphy in her article “Patient as Center of the Health Care Universe: A Closer Look at Patient-Centered Care.”
Discussion
In the provided article, Murphy is convinced that adopting a patient-centered model, where a patient actively participates in his/her care would improve the quality of care achieved and at the right cost. Murphy (2011) is also convinced that such a model would help the healthcare sector to eliminate some barriers that undermine the industry’s efforts aimed towards promoting higher quality care by implementing health information technology (HIT). As a matter of fact, she feels that it was a time the healthcare sector considered a health care system that was centered around patients; and not on health care facilities. She argues that considering a patient-centric view when implementing and optimizing Health information technology would provide unexplored perspectives on the meaning of “integrated” health care. This is more so bearing in mind that healthcare systems are continuously becoming complex and fragmented each day. Clinicians are also being pressured by the society to more productive, making care appear to be more centered around the system, which is often at the patient’s expense (Murphy, 2011). Murphy argues that a patient-centric model would be essential for quality health care delivery since the patient would play an integral part in the care. She says that under the model, patients would be motivated to take responsibility in decision making on issues that would contribute to their wellness and illness care. Under such a model the patients would also take up important aspects of their preventive self-care routines, as well as disease monitoring and management practices. She argues that health information technology can help improve patient outcomes by supporting patient-centric care through ehealth, primary care, and hospital attention and health information exchange.
According to Chute & Kohane (2013), patient-centric models to and any other implemented systems need sound clinical decision support systems (CDSS). A clinical decision support system (CDSS) is a Health information and technology system. This system is designed to provide healthcare providers, clinicians, patients, hospital staff and other entities with intelligently filtered personal-specific information that is presented at appropriate times for enhancing health and health care of a patient (Chen et al., 2014). This system usually entails a wide variety of decision-making enhancement tools in the clinical workflow. According to Agha (2014), instruments in a CDSS system includes automated alerts and reminders to patient and care providers; clinical guidelines; focused patient summaries and data reports; condition-specific order tests tools and documentation templates. They also encompass other contextually relevant reference information tools as well as diagnostic support tools among others. The tools found in a CDSS system would be of significant value to the Patient-centric view proposed in the presented article. According to Lee, McCullogh & Town (2013), CDSS tools have many benefits including enhanced health outcomes and increased quality of care. They also help in avoiding medical errors and other adverse events. The author states that they also lead to cost benefits and improved efficiency, as well as provider and patient satisfaction.
However, a Clinical Decision Support System would also present some challenges especially when it came to the utilization of the Computerized Physician Order Entry (CPOE) tools in achieving the patient-centered goals outlined in the article. This is because a CDSS is usually a sophisticated health IT component that demands computable biomedical knowledge, an inference mechanism, person-specific data as well as a sound reasoning (Murphy, 2011). These skills are necessary for combining the obtained knowledge and generating data, and also for presenting crucial information to both the clinicians and patients as care are being delivered (Chen et al., 2014). Although most clinicians are well conversant with how such a system works, in a patient-centered model, a patient may not be in a position to interpret or even understand data obtained from such a system. This means that the idea of a patient-centered model where the patient is also supposed to contribute directly to the adopted model of treatment may not be as useful. Furthermore, the information obtained from such a system need to be properly filtered, organized and presented in a manner that supports current workflow to allow a clinician to make an informed decision quickly before taking any action (Agha, 2014).
Electronic health records (HER) allow clinicians to access and record patient information electronically. Research has shown that many pros come with linking electronic medical records to clinical information systems. For starters, it leads to improved data accessibility (Chute & Kohane, 2013). Second, connecting electronic health records to clinical information systems provides consolidated medical records. Furthermore, systems such as the Computerized Physician Order Entry (CPOE) allow care providers to request imaging and lab orders, prescription As well as other medical notices electronically. This system leads to reduced errors; previously witnessed in hand-written orders, and also allowing other physicians and patients access to the order (Lee, McCullough & Town, 2013). Linking these systems also allows healthcare organizations to track a patient’s use of hospital resources. Other advantages include the easement of signoffs for nursing practitioners and physician assistants. They also help in promoting preventive health screenings. A doctor can conveniently access preventive medical records in one place. EHR systems even allow doctors to e-message across practices, and can even schedule an appointment quickly without having to lay telephone tags (Agha, 2014).
There are also cons that are associated with linking EHRs with clinical information systems. For instance, privacy is a major health concern and the fact that cyber-terrorism has become a significant threat in the last two decade means that personal information may be accessed by unwarranted third-parties (Lee, McCullough & Town (2013). According to Chen et al (2014), there is also a concern that physicians productivity has gone down since the implementation of the fist EHRs in clinical systems. The author states that there is delayed documentation since there is more information to be recorded during and after a customer’s visit as compared to written notes. Use of e-messaging between providers can also be a disadvantage because of lack of face-to-face conversations. Physicians need to trust the information they acquire from fellow doctors, and they can only do that if there is face to face communication where one can read emotions and express fears or concerns. Additionally, there is a need for continuous updates in these systems which bring forth the lack of accountability among care providers (Chen et al., 2014). This issue can only be addressed if there was a clear and precise communication system between physicians and nurses so that updates are made on time and by the right person.
The main reason why health information systems such as EHR, CPOE, and CDSS are classified as patient-centered management systems is that they improve accessibility to patient data (Agha, 2014). As a matter of fact, in the recent times, physicians can access any patient’s data straight from their cell phones, bringing them up to speed on the clients’ medical history within no time. Based on this information, a physician can be able to make a well-informed decision quicker before taking any course of action even in emergency situations.
Conclusion
In conclusion, patient-centric systems are significantly important for improved quality and increased efficiency in healthcare delivery. Easier accessibility to patient information can mean life or death in an instance especially in emergency situations. As above mentioned, health information systems also give physicians access to preventive healthcare records at the convenience of their mobile phones and other electronic gadgets. With such access, a doctor can quickly mine the entire system on patients with a disease such as diabetes and haven’t received their cholesterol or hemoglobin AIC checks in the previous year. With this list, the physician can ask the management to contact these patients, and have them summoned to the facility for checkups. The fact that all CDSS and HER tools are meant to improve efficiency and enhance the quality of care accorded patients in health centers is also evident enough that these systems are patient-centered.
References
Agha, L. (2014). The effects of health information technology on the costs and quality of medical care. Journal of health economics, 34, 19-30.
Chen, D., Chen, L., Fan, X., He, L., Pan, S., & Hu, R. (2014). Securing patient-centric personal health records sharing system in cloud computing.China Communications, 11(13), 121-127.
Chute, C. G., & Kohane, I. S. (2013). Genomic medicine, health information technology, and patient care. JAMA, 309(14), 1467-1468.
Lee, J., McCullough, J. S., & Town, R. J. (2013). The impact of health information technology on hospital productivity. The RAND Journal of Economics, 44(3), 545-568.
Murphy, J. (2011). Patient as center of the health care universe: a closer look at patient-centered care. Nursing Economics, 29(1), 35.
