Health Information System: EMR, HIPAA, HITECH Act, Workflow Analysis

This report provides a comprehensive overview of Health Information Systems (HIS). It begins by examining the barriers to Electronic Medical Record (EMR) implementation, including lack of computer skills, security concerns, and cost issues. The report then explores the impact of the Health Insurance Portability and Accountability Act (HIPAA) on patient medical records, highlighting its role in protecting patient data. Furthermore, it analyzes the advantages and disadvantages of the Health Information Technology for Economic and Clinical Health (HITECH) Act for healthcare professionals, including both positive organizational outcomes and challenges in health information exchange. The report also reviews typical workflow processes in healthcare organizations, emphasizing the need to replace paper-based medical records with electronic systems to improve efficiency and patient safety. Finally, it discusses the role of federal initiatives in improving healthcare information standards and outlines the advantages of applying IT systems within healthcare organizations, along with predictions of future IT developments such as mobile health technologies and advanced medical devices. The report concludes by emphasizing the importance of integrating EHRs into clinical workflow and addressing usability concerns to enhance the overall effectiveness of HIS.

Running head: HEALTH INFORMATION SYSTEM
Health information system
Name of the student:
Name of the University:
Author’s note

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Reasons for not implementing EMR
Electronic medical record (EMR) is necessary in the health care system for high quality
and safer care by exchanging health care information electronically. It enables getting quick
access to accurate and up-to-date information of patients and promotes effective diagnosis of
patients and minimizes chances of medical errors (King et al., 2014). Despite numerous
advantages of EMR in improving quality and efficiency in care, many health care organization
are reluctant to implement EMR. The main reasons for this are as follows:
1. The first barrier for this is the lack of computer skills in health care staffs. To effectively
use EMR, staffs must have appropriate knowledge and skills to use the application user
interface and then adequate typing skills so that all information can be recorded.
However, lack of computer skills often leads to resistance and EMR is not implemented
in such organization (Ajami & Bagheri-Tadi, 2013).
2. Another important reason for health care organization reluctance to implement EMR is
that they have the perception that EMR has more security and confidentiality related risk
compared to paper records (Ajami & Bagheri-Tadi, 2013). Hence, to avoid ethical and
legal consequence, they avoid implementing EMR. Fernández-Alemán et al., (2013) has
also proved about the security related concern in EMR by stating that EMRs can be
seriously threatened by hackers thus violating privacy and confidentiality requirements in
care.
3. The third reason for not implementing EMR includes time and cost issue involved in
implementation. High financial cost is a factor that makes much health care organization
to go against the use of EMR in health care setting (Ajami & Bagheri-Tadi, 2013).

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Impact of HIPAA on patient’s medical records
The Health Insurance Portability and Accountability Act (HIPAA) was mainly
implemented to protect health insurance coverage for people who have lost or change their jobs.
It also directs establishing national standards for processing and securing health care data. By
this means, it plays a role in protecting and securing patient’s medical records. After the
enactment of the Act, the federal law took the responsibility to maintain confidentiality of
medical records and enforce high standards to protect confidential patient’s information. By
considering the appropriate disclosure process for sharing or not sharing private medical
information, it has played a role in improving health care service in all areas (Klein et al., 2016).
Hence, with the Privacy rule in the HIPAA, patients got certain important rights with respect to
disclosure and confidentiality of their health information
Advantage and disadvantages of adapting HITECH act for health care professionals
The Health Information Technology for Economic and Clinical Health Act (HITECH)
was implemented in 2009 to promote adoption of electronic health record (EHR) and supporting
technology in United States. It mainly aimed to incentivize health care providers to adapt HR and
use them in a meaningful way to reduce medical errors and additional cost in delivery of care.
The advantages of HITECH Act for health care professional are as follows:
 With organizational support for using EHR, it has helped health care professionals to gain
many positive organizational and clinical outcomes. Clinicians who have adopted EHR
has improved operational performance and productivity of the health care organization as
well as promoted satisfaction of patients with care. Health care professional’s efficiency

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and effectiveness in health care delivery has increased with the establishment of better
system for using EHR (Menachemi & Collum, 2011).
 Use of EHR has also been associated with lower mortality cost and fewer complications
in health care environment. This has finally reduces the burden experienced by health
care professionals due to readmission and medical errors.
The disadvantage of adopting HIPPA for health care professional is that sudden
implementation of HIPAA has affected health care professional’s work flow in the initial stage
of implementation. The responsibility to handle and protect diverse patient related information
through EHR has posed many challenges for health care professionals in the area of health
information exchange. Many ethical and legal dilemmas have been experienced by the health
care professionals due to inappropriate methods of adopting health information exchange (Vest
& Gamm, 2010). Hence, this means that just technological progress cannot improve the quality
of health information exchange (HIE), strategies are also needed to implement the barrier in
adapting the technology.
One strategy to mitigate the disadvantage of HITECH
The health information exchange (HIE) issue experienced by health care professionals in
adopting the technology can be solved by leaving the organizational efforts and combining it
with individual consumer based model. This will help them to achieve the objective of HITECH
as well as promote complete provider participation in using EHR (Vest & Gamm, 2010).

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Review of typical work flow process in health care organization
The typical workflow process in health care organization consist of clinical
documentation process to record new patient’s information and direct them to appropriate
clinician and health care department, diagnosis process, assessment of patient and the appropriate
care and treatment process following final diagnosis of disease. The clinical documentation
process mainly relies on a combination of paper and electrical format. Hybrid system of
duplicative paper and electronic records exist in health care organization. A survey showed very
few organization captured patient information electronically (Smith & Haque, 2006). Hence,
paper is a major form for organizing patient’s information in health care and without the lack of
standardization of the information system, the clinical documentation process is risky and full of
errors. Other disadvantage of depending on paper based format for managing critical patient’s
information is that it is a very time consuming process as well as inefficient process. Hence, the
process of clinical documentation and information exchange by means of paper based medical
records needs to be replaced completely as it is seriously affecting the pace of work and other
process involved in typical workflow process.
The lack of standards for a fully electronic documentation process and dependence on
paper based medical record has been the reason for more chaos and inefficiency in the workflow
process. In addition, paper records are takes up lot of space. A review of paper based medical
records has shown that such data have lot of inconsistencies both on quality as well as its scope.
This ultimately has an impact on the health care delivery process. The challenges and issues
becomes high in case of patients with chronic illness because their treatment relies on historical
data about life trajectory, changes in condition with time and types of treatment implemented for
the patient. The hybrid paper/electrical medical record system also makes data coordination

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process very challenging (Smith & Haque, 2006). Hence, it can be said that there are very few
benefits with paper based medical record system and large chances of issues in the clinical work
flow process particularly for critically ill patients. In addition, after the enactment of the HIPAA
and HITECH Act, adopting EHRs is a major responsibility for health care organization.
However, paper documentation process acts as the main factor for the slow adoptions of EHRs
(Heisey-Grove et al., 2014).
The above issue in the health care workflow process indicates that although electronic
record system has been integrated in the health care system, however the usability of the system
is affected by the presence of a hybrid paper and electronic system. There is a need to take
adequate steps to eliminate the paper based medical record completely to enhance the data
coordination process, improve timeliness and efficiency in delivery of care and promote patient
safety. Ajami & Bagheri-Tadi, (2013) has pointed out that there are several barriers to adapting
the EHRs system in health care organization. This comprise extra time and cost involved in using
the system, poor computer skills, disruption in workflow process, security and privacy issues,
communication among users and interaction problem with doctors and patients. To promote
usability of the EHR, there is a need to effectively integrate EHRs into clinical workflow so that
it can readily used during routine clinical documentation process. Another recommendation is to
take account of all types of usability concerns before standardization of the EHRs system within
the health care organization. Development of a common user interface style guide can also
promote usability of the system (Middleton et al., 2013).

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Role of few federal initiatives in improving the standards of health care information
The enactment of the HIPAA and HITECH are example of some federal initiatives to
improve the standard of health care information. The federal initiative focused on optimizing the
use of EHR in health care environment, however they also realized the issues risk of authorized
used and challenges in disclosure of confidential patient information. Considering the high
challenges in maintaining confidentiality and balancing the need for privacy while using EHR,
the federal made it an obligation to protect the confidentiality of patient health information
according to HIPAA and HITECT Act. This ensures that organizational practices related to
confidentiality, security and disclosure of patient information is consistent with regulations. It
also promoted education of health care professionals to understand confidentiality and data
security requirements (Ethical Policy Statement: Health Information Confidentiality, 2017). . In
this way, federal initiatives have ensured proper integrity and safe management and exchange of
health care information during the health care delivery process.
Advantages of applying IT system within health care organization and prediction of new IT
developments in the health care industry
There are numerous advantages of applying IT system within health care organization.
Firstly, it is cost effective as it has cut out lot of manual work and health care personnel gets easy
access to patient data and health care information. Documentation and keeping records of
patients was a major challenges, however implementation of electronic medical records has
enhanced the retreivability of the data and improved data security. Another advantage is that the
use of automated software and advanced technology according to health care organizations need
has improved the efficiency in the delivery of care. The IT systems are automated and this

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ensures that large amount of task can be done without human intervention. With these changes,
the scope of error has been reduced dramatically (Wager, Lee & Glaser, 2017). .
Some of the new IT development that can take placed in the health care environment in
the coming two decades includes greater development of mobile health technologies such a
wearable device to tracks patient’s health status and preventing wide range of disease. Although
this type of technology is already available, however within 20 years they may more
sophisticated and cost friendly too so that people with low socioeconomic status can also use it.
New medical robotic device and implantable health IT system may also be interfaced to EHRs
system to establish exceptional standards of care. This is likely to occur because current EHRs
have not reached a stage where it can be used by all group of people irrespective of education
and socio-cultural background.

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