ELECTRONIC HEALTH RECORDS

REOLIQUIO, NERILYN

MAPILE, JR. NEIL JOHN F.

UNION CHRISTIAN COLLEGE

INTRODUCTION

The necessity for the quick adoption of technology that can handle the ongoing and

changing needs of the health industry is growing. Yet, a mutual alignment between technology

and local context is required for technologies to work in local health contexts. Despite the fact

that there is literature on the adoption of health technology, few studies have looked at how

human and non-human actors adopt technology. We investigate how healthcare practitioners

dealt with the many and competing motions of human and non-human entities throughout the

adoption of health technology using the mobilities lens. We base our conclusions on the primary

care providers from the Philippines' experiences adopting electronic medical records (EMR) in

rural health facilities. We contend that divergent rates of mobility highlight the workarounds

used by healthcare professionals. The necessity for the quick adoption of technology that can

handle the ongoing and changing needs of the health industry is growing. Yet, a mutual

alignment between technology and local context is required for technologies to work in local

health contexts. Despite the fact that there is literature on the adoption of health technology, few

studies have looked at how human and non-human actors adopt technology. We investigate how

healthcare practitioners dealt with the many and competing motions of human and non-human

entities throughout the adoption of health technology using the mobility’s lens. We base our

conclusions on the primary care providers from the Philippines' experiences adopting electronic

medical records (EMR) in rural health facilities. We contend that divergent rates of mobility

highlight the workarounds used by healthcare professionals. These solutions give users of

technology places to carry out their regular activities and places for technology to do its job.

Furthermore, we demonstrate how a focus on accelerated, rapid intervention implementation

may devalue technology in the use of their intended beneficiaries. Mobility and speed are
important factors in this regard. We address how a mobility-centric approach can further muddle

the adoption of health technologies as we wrap off this essay. This study updates two earlier

evaluations of the literature on the advantages and disadvantages of electronic medical records

(EMRs), which were based on papers from 1966 to January 2004 and from 2004 to 2010. This

review investigates the development of empirical study evidence using the same methodology.

Regarding the evidence supporting eHealth in general, the World Health Organization (WHO)

has a clear stance. The WHO said that "the potential influence that developments in information

and communication technology might have on health-care delivery" was already observed in

2005.

The latter is highlighted in the present European digital strategy for data by developing a

unified European health data space that assures interoperability of health data and in which every

person has secure access to their EHR. Thus, several governments embraced these goals and put

into practice national plans for eHealth in general and the EHR in particular (see for an overview

of Europe or for country profiles from the Global Observatory for eHealth). The Health

Information Technology for Economic and Clinical Health (HITECH) Act mandated the use of

EHRs for all citizens up to 2014, which promoted the meaningful use of health care information

technology (IT). A basic EHR was adopted by hospitals at a higher rate thanks to HITECH,

which saw an increase from 9.4% in 2008 to 15.6% in 2010, to 97% in 2014. The Patient Data

Protection Act in Germany requires public sickness funds to provide its clients with an electronic

patient record (EPR) by January 1, 2021, at the latest. Moreover, on the basis of the law and

patient informed permission, medical practices and hospitals are urged to support and make use

of the EPR. Similar to the situation in Austria, half of the German hospitals in 2017 mentioned

the availability of institutional electronic records. Only Swiss hospitals reported a greater
percentage (78%), which is statistically different from Germany. EHRs will provide fundamental

benefits by giving "the correct information at the right time in the right location." By enhancing

the patient record's conventional role as a repository for information pertinent to the patient's

treatment, this goal is accomplished. EHRs should, however, also assist clinical decision-making

and serve as a guide for clinical issue resolution. Four strategies were provided by the Institute of

Medicine (IOM) in 1991 for improving healthcare quality: (1) enhancing clinical data quality

and accessibility; (2) integrating data across time and environments; (3) disseminating

knowledge; and (4) offering decision assistance. Regarding expenses, the IOM anticipated

benefits in three areas: (1) a decrease in unneeded tests and treatments, (2) a decrease in

administrative expenditures, and (3) an increase in the efficiency of medical staff.

Since that an EMR is almost entirely implemented, some would claim that additional

explanation of its stated usefulness is superfluous. No one will vote in favor of a paper backup.

The users' view may not be favorable despite the implementation, nevertheless. In a recent poll

of 208 doctors from three hospitals in Norway, it was found that 53% of the doctors said that the

EHR is difficult to use and increases their burden, while 72% of the doctors said that the EHR

hangs or crashes at least once a week. In addition to the undisputed benefits mentioned in the

Norwegian study, these data provide a reasonable area for development. Even if modern

healthcare is unimaginable without an EMR, a continual assessment of its benefits and

drawbacks is a must for thoughtfully considering its continuing evolution and correction. To

deliver a high quality of treatment at acceptable prices in terms of efficacy and efficiency, we

placed the ultimate aims of health care in the midst of our series of literature studies. By

maintaining the selection and evaluation criteria for the included studies, the series of reviews

also enables the tracking of the EMR's value over time. There were two separate study questions.
What impact do electronic medical records have on the standard of inpatient care? What impact

do electronic medical records have on hospital care costs?

PURPOSE AND SIGNIFICANCE

Hospitals going digital is an important component in the success of the Universal Health

Care (UHC) Law implementation since it provides quality care for more patients, a health care

expert said. In Mandaluyong City, St. Luke’s Medical Center President Arturo de la Peña told

the Philippine News Agency (PNA) that the use of electronic medical records (EMR) would

allow hospitals, both private and public, to provide faster and quality health care services,

especially now that every Filipino is entitled to them under the UHC law. The EMR, a relatively

new system being used in some hospitals in the Philippines, integrates existing hospital systems

and provides immediate access to patient records.

Modern technology allows almost all industries to work more conveniently and

effectively. The healthcare industry, particularly in the Philippines, should absolutely catch up.

In addition to being expensive, electronic medical record (EMR) systems are frequently complex

and challenging to understand. Technically, the Philippine Health Information Exchange serves

the following purposes:

a. Ease the unification and integration of health data and processes across different health

facilities employing disparate electronic medical record systems;

b. Promote interoperability by providing means for communication and coordination of

electronic health data among the various health domains (i.e., disparate clinic information

systems, and applications) without loss of semantics;

c. Increase accountability for the proper management of health information;

d. Harmonize and optimize eHealth processes and workflows;

e. Serve as reference in the development of integrated information systems

f. Promote the implementation and use of interoperability standards.

From the viewpoint of business process owners, healthcare services aim to achieve and

deliver that is also seamlessly responsive, efficient, cost-effective, and real-time. Specifically, the

system will aid in:

a. Enabling secured data sharing between authorized healthcare providers and consequently,

supporting protected access to client’s health data record across providers in many geographic

areas of the country;

b. Providing a single unified view of clients’ health data record across health facilities whether a

hospital or clinic through an interface that is accessible anywhere and anytime; thereby,

enhancing client care collaboration;

c. Facilitating aggregation of health data into a longitudinal electronic medical record; and

d. Generating accurate and real-time health statistical reports for monitoring and evaluation, with

subsequent development of appropriate interventions, policies, and protocols.

It is appropriate to think of EMRs in the same way that paper records are thought of: as a

technology necessary to routine work in RHUs. This is because electronic recording is intended

to replace paper recording (DOH & DOST, 2014; Ongkeko et al., 2016). Everyone should be

responsible for implementing the EMR, according to our interviews. On second thinking, Janice

(midwife, EMR1) expressed that such a notion was incorrect and that "no one is excused from

utilizing the EMR if it is supposed to replace the paper records."

 We investigate how healthcare practitioners dealt with the many and competing motions of

human and non-human entities throughout the adoption of health technology using the mobilities

lens. We base our conclusions on the primary care providers from the Philippines' experiences

adopting electronic medical records (EMR) in rural health facilities. We contend that divergent

rates of mobility highlight the workarounds used by healthcare professionals. These solutions

give users of technology places to carry out their regular activities and places for technology to

do its job. Furthermore, we demonstrate how a focus on accelerated, rapid intervention

implementation may devalue technology in the use of their intended beneficiaries. Mobility and

speed are important factors in this regard.

PICO/T QUESTIONS

1. In a population of patients being served by the nurses of a single at home nursing agency

(P), how does a single-session retraining on inputting appropriate documentation into

each patient’s EHR for their attending nurses (I) as compared to their perception of care

quality prior to the training (C) affect the each patient’s perception of care quality after

the training (O) measured one month prior and one month after the educational session

using a custom-designed Likert-like survey or a previously developed survey for patient

satisfaction in an at home care population (T).

REFERENCES

Macabasag, R. L. A., Mallari, E. U., Pascual, P. J. C., & Fernandez-Marcelo, P. G. H. (2022).

Catching up with rapid technology implementation: mobilities, electronic medical records,

and primary care work in the Philippines. Applied Mobilities, 1-16.

Ongkeko Jr, A. M., Fernandez, R. G., Sylim, P. G., Amoranto, A. J. P., Ronquillo-Sy, M. I.,

Santos, A. D. F., ... & Fernandez-Marcelo, P. H. (2016). Community Health Information and

Tracking System (CHITS): Lessons from eight years implementation of a pioneer electronic

medical record system in the Philippines. Acta Medica Philippina, 50(4).

Macabasag, R. L. A., Mallari, E. U., Pascual, P. J. C., & Fernandez-Marcelo, P. G. H. (2022).

Normalisation of electronic medical records in routine healthcare work amidst ongoing

digitalisation of the Philippine health system. Social Science & Medicine, 307, 115182.

Premji, S., Casebeer, A., & Scott, R. E. (2012). Implementing electronic health information

systems in local community settings: examining individual and organisational change

experiences in the Philippines. Electronic Journal of Information Systems Evaluation, 15(2),

pp187-198.