Over the last 20 years dramatic changes have occurred in the health care industry. “Health care technology has exploded over the last 20 years, not just in the arena of medical diagnosis and treatment, but also in the area of health information and documentation” (The art of patient care, 2008, p. 1).
Two Major Events
Twenty years ago, Riverview Hospital was limited with technology. The use of paper files for patient records is a thing of the past. Today Riverview Hospital uses electronic medical records (EMR).
“An EMR is able to electronically collect and store patient data, supply that information to providers on request, permit clinicians to enter orders directly into a computerized provider entry system, and advise health care practitioners by providing decision-support tools such as reminders, alerts, and access to the latest research findings, or appropriate evidence-based guidelines” (Wagner, Lee, & Glaser, 2009, p. 1). “Paper-based records have been in existence for centuries and their gradual replacement by computer-based records has been slowly underway for over twenty years in western healthcare systems” (Open Clinical, n.
d., p. 1).
Riverview Hospital has also seen an increase in using personal digital assistants (PDAs). Twenty years ago, PDAs did not exist. Doctor’s and other health care providers had to look up information in books and other publications. “The use of personal digital assistants (PDAs) in medicine and the health sciences has rapidly increased. Health care professionals are using PDAs for patient tracking, medical reference, and drug dosage, as well as personal use” (Journal of the Medical Library Association, 2004, p. 1). “Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase.
Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need” (PubMed, 2008, p. 1). “According to a May 2002 article in BNET, PDA software enables health care professionals to store patient information, order prescriptions directly to pharmacies, check on lab results and access medical information remotely. PDA programs even allow health care professionals to document billing and claims encounters to be submitted to health plans” (eHow, 2010, p. 1). The EMR system can connect doctors in a single practice and then share patient data with clinics, hospitals, and pharmacies if their systems are linked and compatible.
EMR and PDA
With the implementation of the EMR and the PDA, Riverview Hospital has seen an increase in the number of patients. Although patient stays have decreased, the number of patients which pass though the hospital has increased. The average stay today is half of what it was 20 years ago. “With the introduction of technology, health care providers have the ability to look up almost any aspect of medical information needed at the touch of a button” (The art of patient care, n.d., p. 1).
The EMR implementation at Riverview Hospital has improved quality, outcomes, and safety. The EMR has improved efficiency, productivity, and cost reduction. The EMR has also improved service and satisfaction. “With PDAs, health care professionals can provide quality medical services to patients that are efficient and effective. PDAs offer instant access to critical information, so patients do not have to wait long to hear back from their doctors about lab test results or their prescription needs” (eHow, 2010, p. 1).
One has to take into consideration with the EMR and the PDA that HIPPA is not violated. Although with the introduction of the EMR, it is less likely to see HIPPA violations as compared to paper charts. “Health care professionals who use PDAs must be careful to properly secure their electronic devices in a way that complies with the Health Insurance Portability and Accountability Act” (eHow, 2010, p. 1).
President Obama has pledged that every American will have an electronic medical record by 2014. Twenty years ago, this was not even a consideration. President Obama sees health care information technology and electronic medical records as key to improving the quality of care while reducing costs. This implementation will not only improve care coordination that will lead to better health care (reduced cost, enhanced quality), it will create jobs.
The EMR and the PDA can also cause barriers within the health care system. Some of the barriers are resistance. This resistance was seen among health care practitioners at Riverview Hospital, although the implementation happened. There may be technical matters that occur, financial matters, resource issues, training and re-training issues, certification, security, ethical matters, and confidentiality issues. There may also be incompatibility between systems and doubts on clinical usefulness.
Remarkable advances in medical technology, especially at Riverview Hospital, continue to transform health care delivery. With this transformation comes many issues that arise. The EMR and the PDA can enhance how health care is delivered and can pose both positives and negatives. Within the 20 years at Riverview Hospital much has changed with technology and information systems, although one thing remains the same, the mission to treat patients as well as to improve and preserve the health and well-being of those they serve. Their vision is to redefine the healthcare experience, becoming the best place to work, practice medicine, and receive care.
eHow. (2010). Use of personal digital assistants in health care. Retrieved from http://www.ehow.com/facts_7436608_use-personal-digital-assistants- healthcare.html
Journal of the Medical Library Association. (2004). The use of personal digital assistants in the health sciences: results of a survey. Retrieved from
Kreidler, M.K. (2008). Health Care and Information Technology. Research Starters – Business, (1).
Open Clinical. (n.d.). Electronic medical records. Retrieved from http://www.openclinical.org/emr.html
PubMed. (2008). The use of the Personal Digital Assistant (PDA) among personnel and students in health care. Retrieved from
Scientific American. (2009). Will Electronic Medical Records Improve Health Care. Retrieved from http://www.scientificamerican.com/article.cfm?id=electronic-health-records The art of patient care. (n.d.). Health Care Technology and Patient Care. Retrieved from http://www.art-of-patient-care.com/health-care-technology.html Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health care information systems: A
practical approach for health care management (2nd ed.). San Francisco, CA: