Information Technology Reference
In-Depth Information
any regional preferences for one system
over another.
classify diseases. The staff could also be resistant
to computer technology, in part because they're not
computer literate. They could also be concerned
that information will not be available when they
request it. And everyone - healthcare profession-
als, individuals and the general community - is
likely to be concerned about individual privacy.
It is essential to involve the healthcare personnel
and facility administrators with your project as
early as possible.
In remote areas, the system for storing and
retrieving EHRs should be as simple as possible.
Even so, developing such a system is likely to be
expensive, considering the cost and complexity
of acquiring computers and computer systems, as
well as the need to maintain and upgrade them.
Computer installations also have an environmen-
tal impact (Scott, 2009) and involve practical
implementation issues such as the quality of the
space needed to house the computers, the supply
of electricity and the electrical wiring. (Note that
the electricity supply relates directly to the Reli-
able Electricity Challenge.)
Once you've recognized the potential prob-
lems, you can move on to:
•
Calculate the cost and resources needed to
provide accurate individual identification
and the tradeoffs among different options.
•
Identify the importance of various disease
treatments in your areas, and the need to
accurately identify individuals needing
such treatment. Errors in some cases could
be fatal; at the least, they represent a waste
of time and resources.
3.3. Longer-Term Challenge
EHRs allow for the longitudinal collection of
health information generated by any number of
visits of an individual to a health facility. They
provide the knowledge needed to enhance the qual-
ity, safety and efficiency of health care (Maryland
Health care Commission, 2007). These records,
which can include demographics, problems,
diagnoses, medications, vital signs, past medi-
cal history, immunizations, laboratory data and
radiology reports, are legal records that must be
accessed securely by authorized parties.
However, implementing an electronic health
record system is a long-term project, and can take
many years, even in countries without the infra-
structure challenges facing developing countries.
You should design an intelligent data model for
multiple sites, and you must also consider what
functions will be needed in the future. Otherwise,
it will be difficult to scale up a flat-file data model
to a larger relational-model clinical system or one
that can be deployed to other sites.
Again, accurate individual (and provider)
identification is the backbone of an effective EHR
system, whether manual or electronic. Problems
abound, though, and may include such issues as
the lack of standard terminology in the country,
including how clinical data is to be entered (WHO,
2006). Another concern is a staff lacking appro-
priate training. This could affect the quality of
data entries and the information in general. For
example, staff members may not know how to
•
Identify the key benefits of migrating to
an EHR system with respect to local and
global disease control and management,
and the long- and short-term healthcare
benefits.
•
Identify best practices, along with the
problems (such as data migration from leg-
acy systems (Scott, 2007)), for implement-
ing data storage and retrieval of EHRs in
remote locations. (Note: this relates to the
IEEE Data Connectivity Challenge.)
•
Identify regional variations in your coun-
try's approach to EHRs, including cultural,
regulatory and political constraints.
•
Identify potential misuses and gaps in han-
dling EHRs.
•
Identify examples of systems for storing
and retrieving data that could be applied in
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