Greenway Medical Technologies: The Pace-Setting David of Electronic Health Records

This article discusses Greenway Medical Technologies and their electronic health record system. It covers the background information, executive summary, key recommendations, strategic context, analysis of the investment, and more.

Running head: E-HEALTH RECORD SYSTEM
Greenway Medical Technologies: The Pace-Setting David of Electronic Health Records
Name of the Students
Name of the University
Author’s Note

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E-HEALTH RECORD SYSTEM
Table of Contents
1. Background information........................................................................................................3
2. Executive Summary...............................................................................................................4
3. Key recommendations............................................................................................................4
4. Strategic Context....................................................................................................................5
5. Analysis of the investment.....................................................................................................8
5.1 Multi criteria approach.....................................................................................................8
5.2 Financial benefits.............................................................................................................9
5.3 Non financial benefits....................................................................................................11
5.4 Project and social/ethical risks.......................................................................................13
5.5 Stakeholder analysis.......................................................................................................16
6. Benefits Realization.............................................................................................................17
6.1 Project Governance and oversight.................................................................................17
6.2 Risk Management...........................................................................................................19
6.3 Target measures.............................................................................................................20
6.4 Benefits register.............................................................................................................20
7. Ethical and social implications.............................................................................................21
7.1 Identify ethical and social principles..............................................................................21
7.2 Customer principles.......................................................................................................21
7.3 Describe and evaluate potential risks and threats to patients and staff..........................22
7.4 Customer journey map...................................................................................................22
7.5 Describe measures to ensure outcomes are acceptable..................................................22
7.6 Key performance indicators...........................................................................................22
8. Limitations...........................................................................................................................23
References................................................................................................................................24

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E-HEALTH RECORD SYSTEM
1. Background information
The paper mainly reflects on the Greenway medical technologies that is one of the
software companies that helps in delivering electronic health record solutions to the different
physicians. The utilization of electronic health records is considered to be quite important for
the present healthcare industry. It is found that in the absence of proper health record system,
the data as well as information including the personal information as well medical history of
the patients are generally collected within a document or manual system. It is found that the
utilization of manual data entry can cause misinterpretation and the entire procedure is very
much time-consuming. If data about a patient is needed, then the doctors needs to search for
the files and it is also impossible to keep the records of the patients properly. All the
problems that occur due to the utilization of manual system generally create a lot of
obstruction for the doctors. Moreover, in the absence of medical records of the patients, the
doctors face difficulties in providing proper medicines to the patients and they need to
undertake all the check-ups again that make the procedure very much time consuming which
generally can create negative impact on the health of the patients.
Electronic health record is defined as one of the digital version of the patient’s paper
chart that helps in electronically storing the health information of the patients. It is found that
the use of EHR as well as the ability of exchanging different types of information
electronically can be helpful in providing proper quality as well as proper care to the patients
while creating proper tangible enhancements for the entire organizations (Clegg et al., 2016).
Moreover, the utilization of electronic health record helps in providing accurate as well as up
to date information about the patients by properly enabling quick access to the records of the
patients. On the other hand, it is found that proper assessment of the vendors are generally
needed for properly collecting the information on the basis of several vendors that further

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E-HEALTH RECORD SYSTEM
helps in narrowing the vendor field before the proper selection of the entire EHR system
(Madden et al., 2016).
2. Executive Summary
The paper mainly reflects on the greenway medical technologies that helps in
providing HER system for improving the services of the healthcare industries. It is found that
presently there are many healthcare industries that faces manual system for data entry and for
keeping record of the patients. The utilization of manual data entry system is not efficient and
creates lot of challenges within the operations of the organization. Therefore, the utilization
of electronic health record within the various healthcare industries will be helpful. It is found
that proper analysis on the importance of the healthcare industry is mainly necessary for
reflecting the strengths, weaknesses, opportunities as well as threats. In addition to this, it is
found that proper analysis on the investment is generally done for analyzing the NPV, ROI,
IRR. Moreover, proper stakeholder analysis is generally done for reflecting the organizational
change impact. There are a number of benefits that are generally realized from the
development of the electronic health record system. The paper also focuses on the social as
well as ethical implications by evaluating the potential risks as well as threats. The paper also
illustrates the limitations of the system that generally can cause a number of issues and
challenges.
3. Key recommendations
Primary recommendations
The primary recommendations generally include:

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E-HEALTH RECORD SYSTEM
 The healthcare industry must focus on the alternative option with which they can be
able to manage the data as well as information of the patents accurately for resolving
the issues that the doctors are facing today.
 Secondly, it is quite important to keep the data of the patients securely so that the data
as well as information can be utilized whenever necessary without facing any type of
issues.
Secondary recommendations
The secondary recommendations generally include:
 It is recommended that the healthcare industry must focus on development of an
electronic health record system so that proper, accurate, up to date as well as complete
information related with the patients. This is generally recommended so that the
proper access to the records of the patients can generally be enabled.
 The data within the electronic health record system must be stored within the cloud so
that the information that is associated with the patients can generally be kept secure.
In addition to this, with the help of proper backup system, the information can be able
to retrieve data at any time.
4. Strategic Context
It is found that the organization “Greenway medical technologies” that is one of the
software companies helps in delivering electronic health record solutions to the different
physicians. It is found that within the different healthcare industries, the data as well as
information are presently utilizes manual systems for managing data that further creates a
number of problems as well as including inconsistency in data entry, misinterpretation, time
consumption that creates a lot of obstruction within the operation of the healthcare industry.

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E-HEALTH RECORD SYSTEM
It is very much necessary to resolve the gaps or bridges that the healthcare industry faces in
managing their services and in providing excellent services. In order to do so, it is necessary
to implement EHR system that not only improves the operation of the healthcare industry but
also helps in providing up to date information in context to the patients (Cheek et al., 2017).
The utilization of EHR helps in providing accurate information that further helps in providing
quick access for the records of the patients. It is found that utilization of EHR further helps in
properly communicating as well as interacting with the customers. Moreover, the use of EHR
helps in enhancing the privacy as well as security related with the data of the patient.
SWOT analysis
It is found that SWOT analysis on the EHR generally helps in analyzing the
strengths, weaknesses, threats as well as opportunities that the system provides. The SWOT
analysis is provided in the table below:
SWOT Analysis
Strengths
 Provides accurate, up to date as well as
complete information associated with
the patients (Bohari, Hin & Fuad, 2017).
 Secures the electronic information with
the patients as well as other clinicians
 High availability as well as proper full
time support
 Proper security of the entire system for
storing records securely.
Weaknesses
 Non-existent system documentation is
generally present
 The graphical interface of the EHR
system that is used
 The education as well as training that is
generally provided to the various health
professionals are insufficient.
Threats Opportunities

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E-HEALTH RECORD SYSTEM
 The main threat is the competition as
well as market pressure
 Different types of security vulnerability
including cybersecurity issues
 Readiness to generally get recovered
from the disaster.
 Ability of properly expanding as well as
sustaining different types of services
 The main opportunity that is associated
with the electronic health record system
is that its ability of integrating with
different types of applications
 Development of effective security
protocols (Bull et al., 2016).
Mission statement
The main mission statement of the organization is to provide proper facilities with the
help of EHR system so that the problems that current healthcare industries faces due to the
utilization of the manual system for managing the healthcare records. It is found that the
present system that is utilized in some of the healthcare industries creates inconsistencies in
data entry as well as creates other types of issues in managing the operations of the healthcare
organizations. Therefore, utilization of electronic health record system not only helps in
resolving issues but also helps in properly designing the application with very much high
applications including security, productivity, flexibility as well as reliability. In addition to
this, it is found that the developed healthcare system is also helpful in improving the clinical
decision support system that further assists in reducing the risks that are associated with the
provided medical facilities.

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E-HEALTH RECORD SYSTEM
Business process model
Business process modelling is defined as one of the business process management as
well as system engineering activity that generally helps in representing number of processes
of an enterprise so that the present procedure that is analyzed and can be improved as well as
automated (Rosemann & vom Brocke, 2015). It is found that presently many of the
healthcare organizations mainly utilizes manual system that creates a lot of issues and
therefore for improving the operation, new HER system is generally developed. The business
process model for the HER system is generally reflected with the help of the below diagram.
Figure 1: BPMN
(Source: Created by Author)
5. Analysis of the investment
5.1 Multi criteria approach
It is found that the multi criteria approach is considered as one of the complimentary
approach for the cost benefit analysis. This type of analysis based approach is generally

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E-HEALTH RECORD SYSTEM
accomplished with the help of two stage analysis approach of decision making. It is found
that the first stage generally helps in the identification of different set of commercial as well
as economical goals for determining the trade-offs with other types of policies. Moreover, the
assigned policy that is mainly associated with this particular approach is helpful in
undertaking the feasibility analysis quite effectively.
5.2 Financial benefits
The figure that are provided below generally showcases the calculation for NPV, ROI,
IRR as well as breakeven point.
Year Total benefit from the Ehealth record keeping system The rate fo discount @ 7%PV profit NPV for total profit Nr profit
Initial year -$ 1 -$ -$
1st year 6,000.00$ 0.93 5,580.00$ 5,580.00$
2 nd year 8,000.00$ 0.86 6,880.00$ 12,460.00$
3rd year 10,000.00$ 0.79 7,900.00$ 20,360.00$
4th year 13,000.00$ 0.72 9,360.00$ 29,720.00$
5th year 16,000.00$ 0.65 10,400.00$ 40,120.00$ 40,120.00$
One time investment cost
Total development Cost 22,000.00$
Year Recurring Costs Discount rate @ 5% PV of Recurring Costs NPV of all Benefits total benefits
Initial year -$ 1 -$ 22,000.00$
1st year -$ 0.93 -$ 22,000.00$
2 nd year -$ 0.86 -$ 22,000.00$
3rd year -$ 0.79 -$ 22,000.00$
4th year -$ 0.72 -$ 22,000.00$
5th year -$ 0.65 -$ 22,000.00$ 22,000.00$
NPV 18,120.00$
Total ROI 0.823636364
Return on Investment and Net Present Value
Figure 2: Return on investment and net present value
(Source: Created by Author)

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E-HEALTH RECORD SYSTEM
Development phase Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Year 13 Year 14 Year 15 Year 16 Year 17 Year 18 Year 19 Year 20
Total Investment 7,00,000
Revenue 750000 825000 907500 998250 1098075 1207882.5 1328670.75 1461537.825 1607691.608 1768460.768 1945306.845 2139837.53 2353821.283 2589203.411 2848123.752 3132936.127 3446229.74 3790852.714 4169937.985 4586931.784
Cumulative cashflow -700000 50000 875000 1782500 2780750 3878825 5086707.5 6415378.25 7876916.075 9484607.683 11253068.45 13198375.3 15338212.83 17692034.11 20281237.52 23129361.27 26262297.4 29708527.14 33499379.85 37669317.84 42256249.62
Payback period 12.89951931 Years
year Total Investment Revenue Cumulative cashflow Payback period
Development phase 7,00,000.00£ 7,00,000.00-£ 12.90
Year 1 7,50,000.00£ 50,000.00£ Years
Year 2 8,25,000.00£ 8,75,000.00£
Year 3 9,07,500.00£ 17,82,500.00£
Year 4 9,98,250.00£ 27,80,750.00£
Year 5 10,98,075.00£ 38,78,825.00£
Year 6 12,07,882.50£ 50,86,707.50£
Year 7 13,28,670.75£ 64,15,378.25£
Year 8 14,61,537.83£ 78,76,916.08£
Year 9 16,07,691.61£ 94,84,607.68£
Year 10 17,68,460.77£ 1,12,53,068.45£
Year 11 19,45,306.85£ 1,31,98,375.30£
Year 12 21,39,837.53£ 1,53,38,212.83£
Year 13 23,53,821.28£ 1,76,92,034.11£
Year 14 25,89,203.41£ 2,02,81,237.52£
Year 15 28,48,123.75£ 2,31,29,361.27£
Year 16 31,32,936.13£ 2,62,62,297.40£
Year 17 34,46,229.74£ 2,97,08,527.14£
Year 18 37,90,852.71£ 3,34,99,379.85£
Year 19 41,69,937.99£ 3,76,69,317.84£
Year 20 45,86,931.78£ 4,22,56,249.62£
-£50,00,000.00
£-
£50,00,000.00
£1,00,00,000.00
£1,50,00,000.00
£2,00,00,000.00
£2,50,00,000.00
£3,00,00,000.00
£3,50,00,000.00
£4,00,00,000.00
Payback Period
Revenue Cumulative cashflow
Figure 3: Payback period
(Source: Created by Author)
Year
One time
investment
cost (E-health
record
system)
Rec
urri
ng
cost
Tota
l
inve
stme
nt Return
The rate
of
Cumulati
ve cash
flow
The
total
cash
flow
The
discou
nted
Cash
Flow
Net
Discou
nted
Cash
Flow
Pay
bac
k
pha
se
At
the
Initiat
io
phase $1,500
$
26,0
00.0
0
$
(26,000.0
0)
$
(26,0
00.0
0)
$
(26,00
0.00)
$
(26,000
.00)
12.
708
141
32
Year
1
$
-
$
5,000.
00
$
(21,000.0
0)
$
(47,0
00.0
0)
$
(19,53
0.00)
$
(45,530
.00)
year
2
$
-
$
7,000.
00
$
(14,000.0
0)
$
(61,0
00.0
0)
$
(13,02
0.00)
$
(58,550
.00)
Year
3
$
-
$
9,000.
00
$
(5,000.00
)
$
(66,0
00.0
0)
$
(4,650.
00)
$
(63,200
.00)
Year $ $ $ $ $ $

10
E-HEALTH RECORD SYSTEM
4 -
12,000
.00 7,000.00
(59,0
00.0
0)
6,510.0
0
(56,690
.00)
Year
5
$
-
$
15,000
.00
$
22,000.0
0
$
(37,0
00.0
0)
$
20,460.
00
$
(36,230
.00)
At the
Initiatio
phase
Year 1 year 2 Year 3 Year 4 Year 5
$(30,000.00)
$(20,000.00)
$(10,000.00)
$-
$10,000.00
$20,000.00
$30,000.00
Period for Breakeven
Figure 4: Payback period
(Source: Created by Author)
5.3 Non financial benefits
Use of key performance indicators
The key performance indicators are generally defined as one of the procedure that is
generally utilized in order to obtain proper measurable results that further helps the owners of
the business in improving the sales, customer satisfaction as well as return on investment
(Akkermans & Van Oorschot, 2018). The benefits which are generally achieved due to the
utilization of the key performance indicators within the business operations are generally
listed below:

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E-HEALTH RECORD SYSTEM
 The key performance indicators mainly help in tracking as well as monitoring the
approaches
 It is found that the problem can be identified in its initial stage with the help of this
particular approach
 The utilization of key performance indicators also helps in improving the marketing
flexibilities
Balanced scorecard
Balanced scorecard is defined as one of the strategic procedure that is generally
utilized as one of the important managerial tool in order to aligning the activities of the
business with the mission, vision as well as with the strategic operations of the organization.
It vis found that for improving both the external as well as internal communication, this tool
is considered to be quite beneficial (Keyes, 2016). The balanced scorecard is utilized within
the healthcare record system that is generally reflected in the table below:
Aim Strategic
imperatives
Performance
measured
Initiatives
Survey of internal
procedure
Proper analysis of
various types of
deployment related
requirements
Proper tracking as
well as management
Undertaking survey
Readiness of the
medical records
Individual readiness The usage of the
electronic health
record system
Proper
implementation of th
doctor medical home
implementation
Tracking as well as

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E-HEALTH RECORD SYSTEM
identification of the
various limiting
conditions
5.4 Project and social/ethical risks
Risk register
Risk Id Risk
description
Impact Probability Rank Mitigation
1 Violation of
system
security as
well as
privacy
Catastrophic Possible High It is found
that
encryption
technology
must be
present
within the
health record
system that is
implemented
in order to
resolve both
the security
as well as
privacy
issues.
2 Security High High High It is found

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issues occurs
during data
migration
that the
developers
must use
proper
platform for
migrating
data
effectively
for resolving
the issues
that are
associated
with data
migration.
3 Improper
skill among
the team
members
Catastrophic Possible Medium The
organizations
must arrange
proper
training
facilities so
that the staffs
of the
healthcare
industries
can be able

14
E-HEALTH RECORD SYSTEM
to utilize the
HER system
quite
effectively
by gaining
proper IT
knowledge.
4 Risks related
with integrity
Catastrophic Possible Medium Before using
the health
care
industries it
is quite
necessary to
make sure
that the
electronic
health
records work
effectively.
5.5 Stakeholder analysis
Role Internal/external Power Interest Responsibilities
Project
manager
Internal High High The project
manager take
the
responsibility of

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E-HEALTH RECORD SYSTEM
finishing the
work of the
project work
properly within
the time that is
presumed.
IT manager Internal Low High The IT manager
helps in
managing helps
in planning,
organizing,
controlling as
well as
evaluating IT for
managing the
data of HER
system.
System
developers
Internal Low High The system
developers
undertake
testing as well
as make proper
modification
within the
system for

16
E-HEALTH RECORD SYSTEM
ensuring the
operation quite
effectively.
Team leaders Internal High High The team
leaders
generally guides
the workers so
that they can be
able to develop
the HER system
quite effectively.
6. Benefits Realization
6.1 Project Governance and oversight
Into the selected healthcare organization, the Electronic Health Record System is used
for keeping the data of the patients secured so that no third party person can able to access to
the data. The manager as well as system analyst is supported to use the proposed system as it
can able to support for taking all the managerial decisions as well as operational processes of
the Greenway Medical Technologies (Ratanawongsa et al., 2018). The governance structure
is able to maintain the data so that they can record the entire patient’s data to provide them
better services. Following is the governance structure of the Greenway Medical
Technologies.

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E-HEALTH RECORD SYSTEM
Figure 5: Organizational structure
(Source: Created by Author)
The implementation of the electronic healthcare system can provide financial
management and information management into the healthcare business organizations. In
order to determine and meet with the clinical needs of the healthcare organization, the system
helps to improve over the human errors. The members of the project steering group such as
project manager, project sponsor and others can ensure that the healthcare organization can
check with the periodic intervals. In order to improve over the manual healthcare system,
EHR system is implemented into the healthcare organization. The steering committee group
such as IT manager, quality manager, financial manager, functional operational manager and
project manager are responsible to implement the proposed system so that it can provide
better healthcare by making improvement into the patient care aspects, included safety, care
of the patients, communication, efficiency as well as equity among the patients. The proposed

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E-HEALTH RECORD SYSTEM
system is a real time system which is used by the governance so that it can make information
availability as well as secure to the authorized persons (Kruse et al., 2016). The system is not
included medical as well as treatment history of the patients so that the system can maintain
statistical clinical data. The steering committee can able to operate the project manager so
that they can provide support to the E-Health system. The system can able to manage the
operations of the outpatient’s programs along with doctor’s program so that they are satisfied
with their services and would attract more towards their services.
6.2 Risk Management
The project group members are able to meet with the organizational goals as well as
reach its objectives by means of the risk management. The main aim and goal of the
healthcare organization is safety of the patients by means of risk management strategies such
as:
Type of risk Description Impact Likelihood
Not filling the
expired
prescription
details
There is sending of proper notification
of the prescription will support
communication among the patients as
well as physicians.
High High
Tacking the
missed
appointments
There is implementation of system for
following up with the patients those
are missing the appointments but it
also fails to reschedule the
appointment.
High Medium
Communication
with the patients
The patients have limited
understanding of the information
High Low

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E-HEALTH RECORD SYSTEM
which is received from the physicians.
Immobility When there are minor changes into the
patient’s usefulness equipment’s, then
it increases the risk to failure into the
healthcare equipment’s.
High Medium
6.3 Target measures
There is measurement of the clinical performance of the Greenway Medical
Technologies so that it can estimate an extent to which there is healthcare providers those are
delivering the clinical services which are proper for the conditions of the patients. It provides
services to the patients securely and in proper timeframe. It is achieved throughout desired
outcomes based on aspects of the healthcare system.
6.4 Benefits register
Benefits Description Impact Potential
benefit on
the project
organization
Review the
patient’s data
The system can provide update and
healthcare status to the patient’s data over a
lifetime period. There is review of the
patient’s data in order to make sure that the
doctors are providing quality services to
them.
Positive
impact
86%
Better patient
care
The digital care record system helps the
doctor to track the health conditions of the
patients so that it can provide better care to
Positive 45%

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E-HEALTH RECORD SYSTEM
them.
Sharing of the
information
The doctors and physicians are sharing
clinical information to the doctor’s
throughout email and phone calls. It can
take proper decisions.
Positive 78%
Cost savings The system can increase into the healthcare
operational efficiency which can save the
cost.
Positive 34%
7. Ethical and social implications
7.1 Identify ethical and social principles
 There is privacy as well as confidentiality of the clinical data and make them not to
access from any third party.
 The sharing of information as a result of the clinical interactions is considered to be
confidential.
 The healthcare organizations are required access to the data when EHR is able to
function as it is designed.
 Controlling access to the healthcare data is required as it is not sufficient to protect
confidentiality.
7.2 Customer principles
 The healthcare service providers should meet with the customer’s needs and
expectations.
 Following up with the internal as well as external customers.
 Continuous improvement over the customer’s services.

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E-HEALTH RECORD SYSTEM
7.3 Describe and evaluate potential risks and threats to patients and staff
 The patients as well as staffs are worried about the data breaches caused by means of
ransom ware and cyber security risks.
 Without any proper training, it is critical to use medical practices to learn the
proposed system.
 Transcribing of the paper records in proposed system is a time consuming process.
7.4 Customer journey map
Research Questions Phase Sign off
How does EHR record keeping system will make
improvement over the clinical data?
Implementation
decisions
Operation
Manager
What is expected cost of EHR system? Proactive Operation
Manager
How does there is protection of the data from the
hacker to be stolen?
Display of the
EHR system
Project Manager
7.5 Describe measures to ensure outcomes are acceptable
 94% of the healthcare providers are reported that EHR can record at quality care of
the patients
 88% of the system procedures provide clinical benefits for the healthcare practices.
 Efficiency as well as feasibility of the healthcare data
 Usage of EHR system for recording data for means off quality reporting
7.6 Key performance indicators
 Average stay at the hospital: This measures and evaluates total amount of time the
patients are staying at the hospital.
 Cost of treatment: It calculates how the patients cost to the healthcare facility.

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E-HEALTH RECORD SYSTEM
 Waiting time: It can monitor times for increasing satisfaction level of the patients.
 Safety of patients: It can analyze the satisfaction level of patients in details.
 Emergency wait time: It can calculate the rush hours of the emergency room.
8. Limitations
The limitations of the health record system are generally illustrated below:
Missing data: While diagnosis, the health record of the patients is necessary.
However, if any of the single data related with the health or medical history of the patients
gets deleted or missed then it will be impossible to undertake the diagnosis.
Lack of security: Security is considered as one of the important perspective that is
considered to be very much important as well as essential for the electronic health record
system. It is found that if the system is not able to provide proper security to the servers then
number of issues can generally occur due to access of data by unauthorized users.
Late responses: It is found that beside the efficiency of the doctors, it is also
important to be efficient for the patients who also utilizes the system. It is found that if the
patients are unable to use the system properly then doctors will get late response which again
make the entire procedure time consuming.

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E-HEALTH RECORD SYSTEM
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