KENYATTA UNIVERSITY
UNIT NAME: ELECTRONIC HEALTH RECORD MANAGEMENT
Author note
1. Using appropriate examples, explain the criteria used in the selection of medical archives. (10 mks)
With an efficient archiving system, capturing of information becomes easy and ensures that document flows can be directed and controlled throughout the entire lifecycle process. This ensures that storage and retrieval of documents is transparent. Below are some quick strategies for selecting archiving systems effectively;
• The kind of information to be stored. This can be either physical information, digital or both Health records typically entail personal and family medical history, allergies, insurance information and contacts, health conditions, demographic information and what has occurred during the visits with the provider.
• Duration that the document needs to be stored. This can be a complex area since different types of health records should be stored for different periods of time. For instance GP records should be stored 10 yrs after the patient has died, medical records for children and young adults can be stored until the patient is 25 years, maternity records should be kept for 25 years after the birth of the las child.
• Availability of the legal documents required for document storage and understands the legal implications of storing documents and ensuring documents are well stored for the minimum period required by law so that the business does not become vulnerable to lawsuits. HIPAA created standards for the storage and disposal of protected health information (PHI). Not only should healthcare providers comply with the law and protect patient information but also avoid lawsuits and fines.
• The kind of procedure to be followed to archive records. For instance most records follow the procedure of being sorted, listed, batched and packed.secondly retain minimum information about the patient, thirdly keep the registers in one file in each primary healhthcare facility. These procedures should be able to help in rulling out the kind of recording archives to be used.
• The format that the documents will be n if they are to be stored electronically. For certain files and records with required retention period in physical form (Liu, 2020), the most reliable way to keep them safe is through offsite storage services with climate-control, 24 hours surveillance and fast document retrieval options. This not only keeps documents safe but also saves on space.
• The scope of the archiving ;is it meant to store only business document or will the project document be stored as well. Wit all documents considered important,it is very crucial to choose a system that will be favourable for all documents.
2. Explain any five precautionary measures that should be taken to ensure capture and storage of authentic electronic medical records.
With the high value of health data, healthcare organizations have become prime targets for cybercriminals for they are exponentially more valuable than even personal credit card data. Hence, it is very essential for an organization to take proactive measures to ensure its data is not readily available for cybercriminals. Below are some of the measures that can prevent your data from falling into the wrong hands;
1. Perform Updates and Patch Your Systems
Updating the system is not only important in repairing security holes and fixing bugs but also benefits in adding new features and removing ones that are no longer needed/outdated.
Hackers prey on unpatched security holes with malicious intent which can lead to several issues in the organization.
2. Utilize Encryption
For protection of patient’s data, encryption in a healthcare organization is very crucial. Data breaches can occur despite proactive measures put in place since data can be exposed to risks when either in transit or at rest, hence it is very important for the organization to utilize encryption across the board- by encrypting the emails and laptops since it is the only safeguard keeping cybercriminal out of the sensitive data if they access the system again.
3. Check your audit logs
Any system that is being used to access or store patient data should be capable of producing a log report to provide details on who accessed the data, and the time of access. These logs ensure the employees are only looking at the required data required to perform their job function, therefore it is important that the system is capable to perform these reports and checked regularly. If not, they are rendered useless..
4. Perform vulnerability scans and penetration tests
This is sometimes referred to as network assessment. Vulnerability scans mostly focus on pointing out vulnerabilities in an organization that can be exploited and expose the organization to attacks. This scan looks for hole in the firewall (Muinga, 2020), unpatched system and many more. After performing a vulnerability scan it is important to perform a penetration test (pen test) which has anability to safely test the systems resistance to hacking. These thorough tests can come handy with large price tags so it is recommended to plan early and include it in the budget.
5. Perform risk assessment regularly
With the constant changing and evolving of healthcare organizations, they should be evaluated for the risks they pose. Apart from identifying security gaps in the organization’s administration technical and physical safeguards, risk assessments are also required for HIPAA compliance and in most cases MIPS requirements.
3. Kenya is not ready for electronic medical records. Discuss (10 mks)
The healthcare quality improvement being the recent point of focus, enhanced patient experience and containment of cost has led to increase in the need for adoption of Electronic Medical Record Systems (EMR). Basically, this will tackle the issue of clinical workload and medical errors which also save the major expenses of an institution. Despite kenya being considered a leader globally for its Information Communication Telecommunication (ICT), it still has a long way to go in the adoption of EMR system. Below are some of the potential challenges that interfere with Electronic Medical Records(EMR) adoption in a public hospital and suggestions on possible interventions to the challenges;
Resistance by staff; Sadly, not every medical staff would be in for the idea of technological implementation in the establishment. Most or quite a number will doubt the effectiveness and efficiency of the the Electronic Medical Record most probably because they don’t know its benefits, which will lead to reluctance in adjusting to the new system and leaving the documentation process (Muinga N. M., 2018). Whereas, adoption of EMR system requires extensive commitment to system administration, control, maintenance and support in order for it to work more effective and efficiently.
Cost of implementation is high; The cost of purchase and installation of the Electronic Medical Record (EMR) is a very expensive affair. This makes it a challenge for the Medical institutions in Kenya especially for the smaller establishment because finding financial resources for this installation is a great hurdle.
Data migration; It is a workload for staff to transfer all the data up to date, from paper-based documents to the digital records. Transfering the medical records of hundreds of patients will be time consuming and very tedious for the staff. This makes it a challenge for establishments in Kenya to adopt the EMR system because it will cost a lot of time and expenses to transfer data.
Inadequate usability; Physicians will find it hard to adapt to EMR if it does not fit to the existing workflow. With the flaws in the design and absence of training, the use of the software will be difficult, because the workflow of a physician wont be the same with that of a dentist.
Training is time consuming; before the actual implementation of the system, thorough training of the staff on the new workflow is highly recommended. Therefore, the physician and the medical team have to dedicate their extra time and put in more effort to understand th e new system. During this training phase, small and mid-sized organizations might lose business which will affect them financially hence most establishment might not be in support of the system.
References
Muinga, N., Magare, S., Monda, J., Kamau, O., Houston, S., Fraser, H., … & Paton, C. (2018). Implementing an open source electronic health record system in Kenyan health care facilities: case study. JMIR medical informatics, 6(2), e22.
Muinga, N., Magare, S., Monda, J., English, M., Fraser, H., Powell, J., & Paton, C. (2020). Digital health Systems in Kenyan Public Hospitals: a mixed-methods survey. BMC medical informatics and decision making, 20(1), 1-14.
Liu, B. J., & Huang, H. K. (2020). Picture archiving and communication systems and electronic medical records for the healthcare enterprise. In Biomedical Information Technology (pp. 105-164). Academic Press.
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