This research paper is going to address the Electronic Health Records (EHR) as well as the argument whether the PCEHR (Personally Controlled Electronic Health Record) is being instituted, should be an opted out system. In other words, this paper is going to critically assess the intervention on using the Health Information Management (HIM) on the basis of the Electronic Health Records (EHR) that we are to count all the major aspects regarding this matter. The research is going to be based on “the Electronic Health Records (EHR) importance for the improvements in the health sector by means of addressing the Health Information Management (HIM)” with the help of STELA MODEL and / or SMART evaluation approaches (US Department of Labor, 2011).
In all, this paper is a combination of the research aimed at developing the area of health climate that is made easy for the reason that Electronic Health Records are to expand and with this they are constantly edited based on the culture of the health application. The definition of the HER based on the Health Information Management Systems Society that claims the following: “The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting”. This means that we are to analyse the current trends of the Electronic Health Records in order to address the main question of the paper and this would be possible if we can count both the advantages and disadvantages of such a health data managing approach for the patient’s information. Electronic Health Records (EHR) are also known as the electronic records of a patient’s medical histories related to the person’s overall health profile, include record of past treatment and contact with various health care providers. The government has instituted the setting up of EHRs through Personally Controlled Electronic Health Records System (PCEHR) systems (Public Health Observatories, 2013).
The overall understanding of the STELa Model is hidden in its approach to examine the scope of the intervention or any kind of project. The next phase of the model addresses it capability to test the same project and / or intervention on the matter of its effectiveness and efficiency. The third step of the model adheres to the ability to enable the overall system to work in order to best assess the intervention and / or project in the contemporary environment. The forth level of the STELa Model emphasizes the importance to learn from the outcomes of the analysis by means of focusing on both positive and negative factors that have an impact on the intervention and / or project as well as the possible derivatives of the projects or the interventions of any kind. Finally, the STELa Model concludes its analysis by means of the final stage of the evaluation process and shows the exact areas of work where one has to act in order to improve or correct the situation as well as create any potential improvements for the whole system (STELa, 2013).
Thus, the STELa Model could be acknowledged as one of the major tools that the marketers use today in order to analytically evaluate the particular sphere of interest in terms of the size and shape of the project and / or intervention and hence enhance the approach of evaluation. For example, the STELa Model approach to experience the scope, testing ability, enactment, learning power / acting process could be practiced with the help of the mobile phone application as a draft. The reason for it is that it could be used as a record and / or update tool for the personal efficient social marketing strategies (STELa, 2013).
STELa Model is a strong and bendable instrument that could be used by the social marketers all over the world in order to “determine the ways of spreading over the greatest practical solutions grounded on the base of the all-encompassing social marketing model, including the advantage of the practical implications” (Social Marketing Centre, 2013).
The STELa Model is a “social marketing organization tool serves as guidance for the people for the reason that it helps to create a pure social marketing strategy”, which could significantly upsurge the likelihood of the social marketing project or the platform, which could be used in order to meet the objectives of the companies all over the world (Scottish Health Education Board, 2013).
STELa Model offers markers methodical development frameworks that could be used as a means of the management and / or communication tools for any project or intervention. Thus, it makes it possible for the marketers to make sure that everyone, whoever uses this kind of tool will be elaborated with the unblemished objectives about the project as well as the delivery of the expected results (STELa, 2013).
The process of the application of the STELa Model is grounded on the principles of a serious evaluation procedure of the areas of social marketing along with the overall process of planning by means of using the instruments of the STELa Model. Its tools could be used as the guidelines for the best practical solutions in the broad planning of the project implementation. Thus, the STELa Model adheres to a great number of definite practical instruments combined with the experience of analysts and marketers all over the world.
STELa Model stands alone as the only fully developed interactive social marketing planning too that is currently available. STELa Model requires no formal training due to its intuitive interface; the tool also has the advantage of allowing both the importation of previous planning materials and the automatic production of project plans.
The SMART Approach is another way of evaluating the information about any particular intervention and / or the project based on the specific criteria of analysis. The major characteristics of evaluation address the aspects such as (Meyer, 2003):
– Specific, meaning the project and / or intervention should have a particular outcome, or alternatively an accurate objective to be proficient. The outcome could be given in any methodical outcome aspects, including the figures, reach, percentages, pounds, numbers, frequency, etc. At the same time, the objectives should be noticeably addressed through the analysis.
– Measurable, meaning the objectives should be measured by means of the source based on which the analysis could be performed. In case it is difficult to measure the objectives, there should be other undertakings that will define the target questions that would help to measure the discussed project and / or intervention. It should also consider the comparative scope of the investment, in case it is given in numbers or figures. In fact, all kinds of actions should be measurable.
– Achievable, meaning it should be understood that the objectives of the intervention and / or project should meet the expectations of the analysis and therefore should be able to meet the realistic concerns of the relevant marketing conditions, time frame, allocated resources, etc.
– Relevant, meaning it should be to the topic and be based on the results of the project and / or intervention. The idea is to manage the outcomes of the points that are important to meet the requirement of the evaluation and overall analysis.
– Time bound, meaning all the information that is addressed through the analysis should be up to date and state the clear objective to be reached in the course of analysis.
The EHR has the power to produce a comprehensive documentation of a clinical patient meeting, as well as maintaining other care-related accomplishments directly or indirectly over the interface – comprising the evidence-based decision to support, quality management, and results commentary” (British Medical Association, 2011).
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What is included in such a health record is that it has the information on the patient “demographics, progress notes, problems and issues, prescriptions, vital signs, past medical history, vaccinations, all the possible data from the laboratory, and radiology reports” (Aceijas, 2011).
The local health information scheme could be worked out with the help of the longitudinal records all over the country. Therefore, “The Electronic Health Records that are custom-designed or reside in other health care delivery venues are to function differently and thus support people in everything they need and review the scope of answering the question about both the advantages and disadvantages” (COAG Business Case, 2008).
The possible benefits of using the Electronic Health Records are that they take significantly less physical storage space than “hard copy” records and at the same time, they are easily transferable. When patients visit different specialists, “it’s much easier to send electronic records from one office to another” (Catalano, 2006).
Therefore, the likelihood of errors is reduced with the help of using the electronic health records. Thus, “all the obscured records are rejected with the usage of automated records”. Such health records make the information freely obtainable (Health records, 2012).
There was a research according to which, 1 in 7 patients have been hospitalized without a need and this happens when health records are not obtainable”. Patients can simply gain access to their own health records in the automated outline. “Electronic records may assist in the defence of doctors in the event of a malpractice claim”. In case people have the comprehensible record then the information about the situation delivers strong evidence (Department of Health, 2013).
The possible drawbacks of using the Electronic Health Records are that there are concerns about the privacy of a patient’s information. Consistent with the latest research, “about 150 different people have the admission to view some part of the patient’s health while hospitalization”. The expenses are a huge issue for experts and clinics (Tones and Tilford, 2001).
The specialists, who have refused to use the Electronic Health Records, had only one strong reason, which is the budget. Furthermore, “adding to the expenses on the Electronic Health Records application, more money are taken for the supporting of the system as well as teaching employees on how to use it” (Health Information Service, 2013).
Electronic systems can develop problems that lead to “crashes” and viruses. These problems can occur in the software, hardware and/or the network. People make mistakes. Doctors, nurses, billing specialists and other folks who are inputting information in an Electronic Health Records are prone to mistakes too. Electronic Health Records are not standardized, nor are they centralized. Ideally, “all healthcare providers (doctors, hospitals, labs, pharmacists, etc.) would be able to enter information from their electronic system on a patient’s central Electronic Health Records” (Health Information Management Association, 2011).
Currently, this just is not the case. All the systems are not compatible with one another and there is not an arrangement of a centralized Electronic Health Records. All of the above is “opening the new horizons on the way to advancements that are to be made in the near future” with this in mind to concentrate on the alternatives to such a system in terms of the “Opt- In or Opt-Out approach” (Jamal, McKenzie and Clark, 2012).
According to the Personally Controlled Electronic Health Record (PCEHR), the systems can be both opt-in and opt-out. The difference is that the PCEHR opt-out system addresses the approach where the patient along with the health providers can dynamically update as well as keep the existing Electronic Health Records with all of its medical history.
This results in the advantage for the rapid health care receivable based on the procedures of handling the medical experts. In parallel, the opt-in system works in a bit different way as the patients have to opt – in “by means to get the advantages of the Personally Controlled Electronic Health Record System” (International Labor Organization, 2011).
According to the details on the Medical Association (MA), “the opt-in systems have a very low participation levels that equals to a minimum of 10% according to the statistical data given by the customers”. Such information is grounded on different resources and owing to a pad participation factor that is shown by the clients, the medical consultants will have lower application to the Personally Controlled Electronic Health Record System directed by the patient. Thus, such an “Electronic Health Record model will not have a positive effect in case of using the opt-in system” (Joseph Rowntree Foundation, 2013).
This could happen for several reasons. The very first one is that the Medical Association claims that, “the Personally Controlled Electronic Health Record System machinists are setting the default access controls for patients for the data of the Electronic Health Records in a way that would be implemented in the opt-in system” (Jones and Douglas, 2012).
The second reason is about the fact that such kind of approach will result in “information disproportionateness” and this point is a foremost aspect in the medical society. This goes completely opposite from the position of the opting-out system that surely has an advantage for the elderly people (Kings Fund, 2013).
In other words, “the elderly people who have chronic health issues will obtain strong healing bonuses for the reason that they will use the opt-out system”. In this way, it will help to implement the process of improvement that is aimed at sharing the information correctly. In succession, “it will lead to a better health care that is provided to such elderly people as a different target group” (Killoran and Kelly, 2010).
This speaks about the disadvantage of the opt-in system to be used in the healthcare sector. By using the opt-in system the doctors and all kinds of medical specialists that are using the Electronic Health Record will address the “process of finding new clients for the Personally Controlled Electronic Health Record System” that is dedicated for new patients (London Health, 2013).
In case of difficulty situations, in the position where the patient is not conscious and the doctor who is in charge of this medical treatment “will not be able to access the Personally Controlled Electronic Health Record System”, which will result in the fact that this will lead to a terrible concerns for the Australian Medical Association (McDowall, Bonell and Devies, 2006).
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Another aspect to be discussed is the protection that is required for the opt-out system. In a situation, “when patients use the opt-in system it addresses the Shared Health Summary that arise other difficult problems to contemplate” (Neighbourhood renewal, 2013).
By taking advantage of the Shared Health Summary, “the patients will have the possibility to suggest the healthcare provider with an IHI-I in order to restrain the health care records”. This is all about the thoughtful proficiency about the problems that affect the number of healthcare specialists in the IHI-I group of people that are in fact not qualified enough as a completely ready medical specialists (Naidoo and Wills, 2010).
This will lead to a fact that, “such people will not have the medical assurance” compared to other people who have been trained enough and could be called as professional medical practitioners; they will have all the chances to consider and evaluate the information in the Electronic Health Records (NEHTA, 2011).
One more advantage of the opt-out system is that, “it can fully deal with the Aboriginal and Torres Straits Islanders”. With this in mind, the Personally Controlled Electronic Health Record System will address the opt-out system on the basis of a huge support to assess the requirements for the community in the country while being the Aboriginal and Torres Strait Islander people (National Institute of Health and Clinical Excellence, 2013).
This will result in the fact that, “the trained medical specialists will have all the capability to operate in accordance with the public brief medical conclusion in order to raise the position of this traditionally agreed and honoured community of the country people” (The Evidence for Policy and Practice Information and Co-ordination Centre (EPPI-Centre), 2013).
The outcomes of the research paper address the following. For the research, there was chosen an approach of a SMART system as well as the STELa Model. The paper covered and critically evaluated the intervention of using the Personalised Electronic Health Record System. It also adhered to the comparison of using the versions of opt-in versus the opt-out systems by means to improve the health sector as well as make a contribution to the overall health industry through the proper health information management procedure.
Therefore, the SMART Approach addresses the target by means of the specific criteria of using the Electronic Health Records in order to improve the overall Health Records management procedure. It was measurable in terms of the approach of both methods that could help improve the system of helping doctors and medical personnel to operate with the health records of the patients.
The research was achievable for the reason that the paper reached the objectives by choosing to use the proper opt-in system as well as take the advantage of the opt-out system in order to manage the information health records. Since the paper addressed the aspects of managing the health information, the usage of the Electronic Health Records was relevant to the research. The analysis was also time bound in terms of the application of the Electronic Health Records system as well as the usage of the Health Information Management in the medical environment.
To summarize, it is of vital importance to accept the very competent system that can help with the aspects of implementing the Personally Controlled Electronic Health Record System to be the opt-out system. This is the outcome of the Medical Associations that has a “statistical evidence of the fact of a 10% involvement rate for those who use the opt-in system” (World Health Organization, 2011).
The people, who support the PCEHR opt-in system, keep saying that, “this is due to the absence of the patient confidentiality addresses by using the opt-in system”. Nevertheless there are thoughtful medical advantages that are addressed with the help of using the opt-out system, which also balance the opportunity cost of the patient privacy (Waegemann and Claudia, 2002).
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