Clinical decisions reflect the electronic world we live in more than ever. The electronic health record (EHR) is quickly replacing the traditional paper chart. In the United States by the 2014, medical records will be converted to an EHR. Medical records were converted over a ten- year period in the United Kingdom from traditional charting to EHR. The electronic age is here and with it new terminology. Electronic Health (E-health) describes many topics from the EHR to several systems and new subspecialties. Telemedicine has grown to include many activities within the electronic realm. The Internet and external delivery sources are quickly gaining favor for follow up care and rural medicine visits. Patients’ no longer have to wait or drive far distances to see their physician they can simply go to an outpatient clinic and visit the physician via videoconference using SKPE like technology. Internet/Electronic Communication as an External Delivery Source The estimates state that about eight billion people can access some form of electronic communication network across the globe.
The estimation of this global access is the ability to investigate and research any health condition by symptom or chief complaint. The user simply inputs his or her perceived diagnosis and several choices are displayed in most search engines such as GOOGLE or BING. The programming used today does not even require that the spelling is correct because of the built in spell check feature. The electronic/computer age has brought with it many advantages that ten years ago were impossible. The ability to research as many topics/symptoms once performed at the library can be done at home. The Internet/e-communication has revolutionized both personal and professional fact-finding missions. E-health is quickly replacing both the research and word of mouth referrals. Going online and asking a question provide all the physicians in the area as well as what type of specialist to visit. Blogs have replaced word of mouth. The impact is clear e-health is here to stay.
Nomenclature depends on the type of patient care activities described. EHR is a universal and global term. Programs that support clinical decision-making can include: * Computerized provider (or physician) entry (CPOE) systems used by clinicians to enter, modify, review and, communicate orders, and return results for laboratory tests, x-ray images and referrals. * E-prescribing – clinical information systems used to enter, modify, review, and output, or communicate medication prescriptions. * Computerized decision support systems – (CDSS) used in the context of eHealth technologies, clinical information systems that integrate clinical and demographic patient information to provide support for decision making by clinicians. * Picture Archiving Computer System – (PACS) used radiology to store data and x-ray images.
“The widespread availability of medical information on the internet and its effects on health care has exponentially increased over the last decade” (Black, et. al, 2011, p. 9). The impact of e-health has changed the landscape of health care. The growth has ushered in a new way for providers to communicate and educate patients. Instead of handouts concerning particular disease processes the provider can give the technologically clever patient the information by directing him or her to the website. Safe and effective instructions are the responsibility of the provider so investigation and verification for accuracy is important.
Impact of Distance Delivery on Health Care
Distance to the clinic or hospital is a concern for patients in rural areas. The convenience of participating in an e-health visit is beneficial. “On-line, computer-assisted communication between patients and physicians promises to replace a substantial amount of care now delivered in person” (Kassirer, 1995, p. 52). The prediction of Dr. Kasssirer is true today telemedicine, is on the rise. Large scale acceptance of e-medicine is yet to be realized. The backbone of American healthcare the physician office visit is under construction with the advent of e-Health. The patient is more in control of their health care than any time in history “ideally, responsibility for decisions could be shared by the patient and the physician, with the patient playing a substantial part” (Kassirer, 1995, p. 52). Transformative power is evident in this fundamental shift in thinking throughout the health care community.
Communication Issues and Health care today
Medical and scientific data is available to both the physician and the patient through the use of the Internet. ”The Internet is clearly the modern vehicle with the potential to improve information dissemination and perhaps change the way health care is delivered” (Podichetty, et. al, p. 274). Smart phone and device technology is accessed and often used throughout the course of the day by both the physician and patient. Electronic interactions have replaced many of the traditional forms of communication. The move toward electronic exchanges between health care providers is becoming a common occurrence. Web-based medical resources are accessed by the patient and the physician equally. “Over 90% of physicians use the internet to research clinical issues” (Podichetty, et, al, p. 274). Researching can occur at the bedside with direct collaboration with the patient. The ability to understand and explain multiple disease processes is achieved through the interactive technology advances of today.
Impact of Communication Techniques in the Future
The future of healthcare communication and current trends are evolving as rapidly as technology will allow. Technological advances are occurring so rapidly that the health care environment will continue to evolve and invent new forms of communication techniques over the next five years. “Information and communications technology will play a key role in delivering health care in the future” (Dumiak, 2011, p. 328). Standards are changing within the cultural landscape of e-health. As the environment changes so too will the standards and regulations of telemedicine.
As the landscape continues to change “there is cultural and historical resistance to heavy centralization of record-keeping and privacy concerns about the potential intrusion of government or business into sensitive personal documents” (Dumiak, 2011, p. 328). Soon we will be able to provide our complete medical history and medications through the use of a master patient record that updates in real time. The cloud is already offering “a place to remotely store and access gigantic sets of experimental data” (Dumiak, 2011, p. 329). The logical transition to electronic documents is on the horizon.
In conclusion, the future of centralized electronic records is on the horizon. The landscape will continue to evolve and shape itself around the acceptance of new technologies and ways to communicate medical information. As the evolution continues the legal and ethical considerations will mirror that of technological advancement “work is still under way to establish standards and rules on how to send information to the central system” (Dumiak, 2011, p. 329). The future will determine a set of standards for e-Health technologies. The technology exists but can health care can keep up with the future needs of the patient.
Biscup, R.S., Booher, J., & Podichetty, V.K. (2006). Assessment of Internet Use and Effects among Health Care Professionals: A Cross Sectional Survey. Postgrad Medicine, 8(2), 274-279. Black, A.D., Car, J., & Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., McKinstry, B., Procter, R., Majeed, A., Sheikh, A., (2011, January). The Impact of E-Health on the Quality and Safety of Health Care: A Systematic Overview. Plos Medicine, 8(1), 1-16. Dumiak, M. (2012, September). E-Health’s Future Frontiers. Bull World Health Organization, 328-329. Kassirer, J.P. (1995, January). The Next Transformation in the Delivery of Health Care. The New England Journal of Medicine, 332(1), 52-54.