EHRs and information availability: are you at risk? The EHR initiative is changing the face of disaster and the nature of prevention planning

Health Management Technology, May, 2006 by Jim Grogan

Stakeholders

In the evolving world of electronic health records and electronic medical records, it is best to prepare for automation failures by considering the various stakeholders depending on the timely, accurate availability of patient information. These include:

* The patient;

* Primary care physicians and staff;

* Attending physicians and nursing staff within a hospital or institution;

* Specialist care providers--both within and outside the facility where the patient is being treated;

* Ancillary department medical staff;

* Insurance providers;

* Pharmacy staff;

* Outpatient healthcare facilities;

* Home healthcare and hospice professionals.

With each stakeholder, it is important for individuals within organizations to discuss information that might be missing during an automation outage and to develop appropriate protocols for delivering treatment. Staff involved on these protocols need to be trained, and the training must be updated on a periodic basis.

Increased Dependence on Automation

Healthcare delivery is becoming dependent on information technology, as evidenced by the increased use of automation in all aspects of patient care--from computer aided diagnosis, drug interaction, image-guided surgery and physician order entry. The EHR, coupled with the widespread deployment of a national health information network in the future, will increase this dependence on patient information being available in real-time to clinical practitioners. Many traditional components come into play to help those utilizing EHRs keep connected to the data and systems they require. These include provisions for effective electronic security and privacy controls, high availability data protection architectures, and cost-effective recovery of operations from any disruption.

Downtime procedures and carefully planned medical treatment protocols to be followed during automation failures are essential. When intraoperative computerized tomography is used in the surgical suite, there must be contingency plans if the failure occurs before or after surgery begins. Similar considerations are needed for interventional radiology and other areas of modern healthcare delivery.

As the nation prepares for EHRs and a national health information network, private and public sector groups will continue working together to adopt standards that meet the goals of improved patient care. Each stakeholder needs to be considered under the magnifying glass of information availability--the real-time access to information by healthcare providers around the clock.

Each stakeholder, too, has an obligation to consider how inevitable outages can be mitigated through carefully designed downtime procedures and supported by established medical protocols. The future is evolving at a fast pace for the healthcare use of automation, and there are no signs of this slowing down. Each vendor and practitioner needs to build in the protection that will be a key to the success of this immense project.

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