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TopConceptual Foundation For Electronic Health Record Systems
An electronic health record (EHR) system involves methodological collection and organization of health information in electronic format that is theoretically capable of being shared across different health care settings (Gunter, 2005). EHRs include several types of health information, including medical history, medications and allergies, laboratory test results, radiology images, age and weight, and billing data, generated and maintained within a healthcare institution to give patients, physicians, and care providers access to medical records.
EHRs are said to be the cornerstone of a modernized health service (Greenhalgh et al., 2009). They improve health care, allow for integrated information, and help prevent administrative errors and lost and duplicated records (Department of Health, 2008; Institute of Medicine, 2009). An EHR system can improve efficiency in workflow, effectiveness of healthcare services, and synthesis of patient data with medical evidence to support the decision-making process (Kupersmith et al., 2007; Stead & Lin, 2009).
In such systems, “the key challenge was seen as getting the design right, implementing the technology, and ensuring that clinicians used it” (Greenhalgh et al., 2009). Some researchers have reservations about such a holistic approach to organizing electronic health information (Avison et al., 2007; Kreps & Richardson, 2007), however, and failures in this context have been reported recently (Røed, 2011).
Nevertheless, despite apparently negative conclusions, research in this area is still quite extensive for several reasons, including the fact that
There is considerable scope for more flexible and technologically sophisticated forms … (e.g., mobile devices) to overcome current limitations. But for this to happen, technology [re]design must occur in intimate proximity to the work process and actively involve users and potential users … (Greenhalgh et al., 2009, referencing Hartswood et al., 2003; Oudshoorn & Pinch, 2005).
Also, according to Armijo et al. (2009),
Given the evolving role of EHRs in clinical practice and the importance of information design and display to meaningful use, further exploration of EHR usability … [is] an opportunity for innovation in health IT with the potential for significant impact on clinical practice.