Today's healthcare manager is faced with similar pressures as managers from other industries, including the need to improve service, cut costs, increase efficiency and productivity, and increase profits. One of the areas that is the most labor intensive and inefficient for the hospital and nursing staff in the healthcare industry is the manual charting and reporting of patient records. The advent of bedside technology has enabled healthcare management to apply economies of scale across vast service areas when it comes to electronically charting patient records.
New technologies enable hospital information systems to be automated in a manner that increases accuracy, reduces barriers to access, cuts costs, reduces manual labor, and according to many studies it is responsible for elevating the level of patient care. The following analysis will discuss the following: impact of computerized charting on the healthcare manager and industry, including types of electronic information systems; the manager's role in implementing such a system; the impact on hospitals and nursing staff; and, the benefits and drawbacks of such systems.
TYPES OF SYSTEMS
There are many electronic patient charting systems available on the market. One that has been implemented at Santa Teresita Hospital in Duarte, California, is known as ChartMaxx Electronic Patient Recording System by MedPlus, Inc. One of the biggest obstacles with information systems that are manual is the absence of a centralized source of data which necessitates a cumbersome paper trail that increases labor and economic inputs while increasing the chance for error. This system is designed to eliminate these flaws of conventional patient charting while providing a information system flexibility and options never before available to healthcare management:
The system employs computer output to laser disk technology, discrete data capture and imaging to form an enterprisewide data repository that stores all clinical, financial and administrative information for each patient chart. Once a patient is discharged, the medical records department immediately scans the chart into ChartMaxx so it is accessible to all authorized users at the hospital. Benefits include decreased costs and increased productivity.
The conventional method of patient charting continued to be an area of inefficiency and high costs because it required employees to spend enormous amounts of time writing and copying patient records, storing them in files, compiling charts, and making them available to doctors and others who requested them in ways that also were time consuming and costly (fax, mail, courier). The computerized information systems available today are designed to eliminate these processes and replace them with a technology-based options which also expand access, increase speed of exchange, eliminate costs, and increase efficiency. At Barnes Hospital in St. Louis, Missouri, healthcare management selected the EMTEK System 2000 Point of Care (POC) Electronic Medical Record System which is unique because of its distributed architecture. Some healthcare providers cannot afford a system that is elaborate and as complex as the enterprisewide ChartMaxx. The EMTEK offers an alternative because it can be expanded and allows an incremental implementation across various departments:
The system configuration consists of EMTEK Health Care System's comprehensive object-oriented database software running on intelligent workstations interconnected via a local area network. Starting with a small pilot project in its surgical ICU in 1990, Barnes has expanded the POC to 110 bedsides throughout 9 ICUs. In the automated environment, patient records are more complete, up-to-date, accurate, and accessible to designated caregivers at all times.
(Weiss and Hailstone 1)
ROLE OF MANAGEMENT
The role of management in...