Implementing an Electronic Medical Record to Reduce Medical and Medication Errors Karena Russell, DHA Candidate*

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1 Implementing an EMR/Russell 1 ISSN (Online) Implementing an Electronic Medical Record to Reduce Medical and Medication Errors Karena Russell, DHA Candidate* Abstract The government is pushing healthcare organizations to implement an electronic medical record (EMR) for the prevention of medical and medication errors. Implementing an EMR has important health and safety benefits; $81 billion can be saved annually if organizations implemented and networked EMR. Implementing an EMR will improve health care efficiency and safety and enable prevention and management of chronic diseases. Keywords: executive information systems; electronic medical record; EMR, HIT, EHR *Doctor of Health Administration Candidate. University of Phoenix School of Advanced Studies Correspondence: Karena Russell [email protected]

2 Implementing an EMR/Russell 2 Implementing an Electronic Medical Record to Reduce Medical and Medication Errors Healthcare organizations have a goal to ensure quality care for patients and to ensure a reduction in medical errors. Health care leaders are continually seeking ways to reduce medical errors and ensure quality at the least financial cost, notwithstanding the continual skyrocketing of healthcare cost. Inadequate quality of care and medical errors are major contributors to the healthcare expenses. In 2008 bed sores, post-operative infections, and implant or device complications cost the U.S. economy $19.5 billion (Hobson, 2010). The $19.5 billion includes the medical cost associated with the increased mortality rate and lost productivity, which equates to conservative $1.5 million in measurable errors (Hobson). According to the Society of Actuaries (SOA) (2010), of the $80 billion in cost associated with medical injuries, 25% were the result of avoidable medical errors (2010). SOA estimated that lost productivity in healthcare resulted in expenses estimated at $1.1 billion, and $1.4 billion from increased deaths due to medical errors. Medication errors are just as prominent as medical errors adding to the overwhelming increase in healthcare cost. Medication errors add to the $ 2 billion a year per hospital nationwide healthcare cost (The LeapFrog Group, n.d.). Medication errors include incorrect dosage, drug overdose, and overlooked drug-drug interactions and allergies (The LeapFrog Group). Other causes of medication errors include nurse interruptions, illegible writing from physicians and decimal point errors (The LeapFrog Group). In this proposal example, I seek to persuade the board of directors to fund a capital project for electronic medical records software. In the proposal I attempt to address the advantages of the project, identify the national goals and assess, the timeline for meeting the goals, the problems that may arise, the project approval process for capital budgeting, and project priorities in relation to other software applications. Furthermore, in this proposal I include any access to outside funding for the project. Statement of the Problem Healthcare costs are on the rise. Healthcare cost absorbs more than $1.7 trillion annually (Hillestad et al., 2005). Medical and medication errors account for the majority of the increased cost in the healthcare sector. Kane-Gill, Kowiatek, & Weber (2010), reported that 3,252 medication errors reported occurred daily; mostly in ICUs and general care units. Medication errors related to illegible handwriting by physicians, wrong medication dosages given to patients can be eliminated by implementation of an electronic medical record. Tragic consequences are often caused by medication errors (The LeapFrog Group, n.d.). In 1999, the Institute of Medicine reported that nearly 98,000 Americans still died each year because of medical errors despite the industries focus on providing quality healthcare (Weise, 2005). In 2005, The IOM reported significant improvements since the release of the report in 1999 (Weise). Since the 1999 report, reductions in medical errors are as much as 93% in regards to particular kind of error-related illnesses and death (Weise). Government is pushing for healthcare sectors to implement an electronic medical record system (EMRs) as a tool for preventing medical and medication errors. Hillestad, et al. (2005) reported that implementing an EMR, modeled important health and safety benefits, and resulted in $81 billion savings annually. Further, implementing an EMR will improve health care efficiency and safety; enable prevention and management of chronic disease (Hillestad et al.).

3 Implementing an EMR/Russell 3 Advantages of an EMR Implementing an electronic medical records system can potentially save healthcare organizations million of dollars in medical and medication errors. According to Juchem (2008), implementing an EMR results in (a) enhanced quality of care because healthcare professionals have a vast amount of information at hand from every available source and viable medical source; (b) faster and more efficient diagnosis and treatments; (c) a more convenient data trail; and (d) always available system workflow facilitating faster and smoother medical audits. National Goals The push for healthcare organizations to implement electronic medical record systems began with the Bush Administration (Health Care IT Staff [Staff], 2004). President George W. Bush called for a widespread adoption of electronic health records in 10 years doubling funding to $10 million for demonstration projects on Healthcare IT (Staff). President Barak Obama administration, eager to promote electronic medical records designated $19 billion of stimulus money to create incentives for adoption of EMR (Son, 2009, para. 1). Although the adoption process started in 2004 for implementing the electronic medical records systems, in 2010, there is still much work to accomplish, as only 14% of physicians have minimally functional EMR systems (Hansen, 2008). EMR timeline Table 1 below depicts the EMR timeline. Table 1 EMR Project Timeline Choose EMR Software January 1, 2010-March 31, 2010 Install EMR Software April 1, 2010 EMR Staff Training April 5, 2010-May 5, 2010 Enter patient information into EMR system May 6, 2010-June 6, 2010 Inform of changes June 7, 2010 Time and financial constraints can interfere with implementation of an electronic medical record. Other barriers to implementation include uncertainty about the levels of return, technical issues, and lack of interoperability between different organizations (Doubert & Formoso, 2008). To ensure project approval, the organization can create a comprehensive project plan, build a team with the right people, use the right procurement processes, be mindful of significant time constraints, and verify compliance (Tarver, 2010). The priorities of implementing electronic medical records with other systems is the federal government s push for hospitals and doctors to implement EMR systems in the next several years (Kolbasuk-McGee, 2010). An EMR system is important for the quality of care. To ensure quality, and EMR system must have the ability to operate within other systems and other organizations. Systems working together ensures that healthcare professional are in a position to not only diagnose patients quicker but to ensure that all patient information is in one system and is easier to treat patients. Decision and Outside Funding The decision to purchase and EMR in this proposal was based on the need to reduce medical and medication errors that are increasing in the healthcare industry. Electronic medical records systems give healthcare professional the tools needed to ensure better patient care and increase the quality of patient care. Cost associated with funding an electronic medical system is shown in Table 2 below.

4 Implementing an EMR/Russell 4 Table 2 Basic Costs of Implementing an Electronic Medical Record System System Costs Base Case Range Software (annual license) $1,600 $ Implementation $3,400 - Support and Maintenance $1,500 $ Hardware $6,600 $ Induced Costs Temp. Productivity Loss $11,200 $ ,500 Note. Values calculated from example in S. J. Wang, B. Middleton, L.A. Prosser, C. G. Bardon, C. D. Spurr, P.J. Carchidi, A. F. Kittler, R. C. Goldszer, D. G. Fairchild, A. J. Sussman, G. J. Kuperman, D. W. Bates. (2003). A Cost-Benefit Analysis of Electronic Medical Records in Primary Care. American Journal of Medicine, 114(5), Funding to implement EMRs is part of a government incentive and the organization will request funds to begin the implementation process. Healthcare organizations adopting the EMR system understands that a cumulative cost can reach 90 percent adoption are $ 17.2 billion (Hilestad et al., 2005). Conclusion Healthcare professional and government are seeking ways to ensure quality patient care, reduce medical and medication errors, and implement a system where healthcare organizations can work together. Implementing an EMR system can aid in the reduction process of medical and medication errors, thus decreasing the healthcare deficit. Although the process is not an easy one, there are many resources and software companies that can assist with ensuring that an organization receives the best EMR system for the organization. The government is stepping in to ensure that healthcare organizations implement electronic medical record systems or after a particular time, organizations will be penalized for not having a system in place.

5 Implementing an EMR/Russell 5 References Hansen, D. (2008). EMR deadline does not compute: Falling short of 2014 goals. Retrieved from Healthcare IT Staff (2004, April 26). President Bush continues EHR push, sets national goals. Healthcare IT News. Retrieved from Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Retrieved from Hobson, K. (2010, August 9). Study puts cost of medical errors at $19.5 billion. The Wall Street Journal. Retrieved from billion/ Juchem, B. (2008). EMR advantages and disadvantages. Retrieved from Kane-Gill, S. L., Kowiatek, J. G., & Weber, R. J. (2010). Error management: A comparison of voluntarily reported medication errors in intensive care and general care units. The International Journal of Healthcare Improvement, 19(55-59). doi: doi: /qshc Kolbasuk-McGee, M. (2010). EMRs top priority for 58% of hospitals CIOs. Retrieved from Society of Actuaries. (2010). Study finds medical errors annually cost at least $19.5 billion nationwide. Retrieved, from Son, C. T. (2009). Electronic medical records take center stage. Retrieved from Tarver, T. (2010). Five steps to ensure federal reimbursement for EMR installation. Retrieved from The LeapFrog Group. (n.d.). Computerized physician order entry. Retrieved, from Computer_Physician_Order_Entry_Fact_Sheet.pdf Weise, E. (2005, May 18). Medical errors still claiming many lives. USA Today. Retrieved from