Health Information and Patient Satisfaction
System, Challenges, and Solutions
Sovandany Wang
HEA 476, Wednesday 7-9:45
Professor Kida
5 December 2018
Healthcare information technology has revolutionized patient care by implementing systems within hospitals that affects the practices and steps to provide transformation in their business internally. Several systems of healthcare information technology also known as HIT or health IT, shares common capabilities in software within hospitals. Health information technology (HIT) is a way to promote the quality and reducing medical errors by increasing the proficiency of the administration and clinical process. Within HIT, there have been various of research that provides challenges, systems, and solutions in regards of health information and patient satisfaction. The different systems of health information exchanges are correlated to patient satisfaction because it includes the innovative and effectiveness of the new age of information, and the knowledge to discern between lower and higher quality of health information through health information (Miller, 2017). The process of using Health IT is to make decisions based on the impact of the patient’s care delivery system in the organization.
Health Information Exchanges
Rudin et al. (2011) explains health information exchanges transfers information electronically through heath care organization, which also significantly decreased spending and improved the healthcare’s quality in patients. The functions have focused on the deliverance of laboratory records, but HIE’s is starting to support more advanced exchange such as directed exchange, query-based exchanged, and consumer mediated exchange
Directed exchange provides the ability to send secure information electronically such as laboratory results, referrals of patients, discharge information to other health care party involved to the patient’s care through encryption (HealthIT, 2018). HealthIT (2018) also describes query- based exchanged as the ability to request or find information on the patient from the other parties involved, such as the unexpected or emergency care. For example, if a patient is transferred to another emergency care, the health care provider can have access to receive any information necessary to the patient’s medical records and results. Rudin et al. research that most of the HIE were used in intensive care units in case of any missing information. The result of the query-based exchange can provide better quality of care and decrease medical errors for health care providers. Lastly, consumer mediated exchange offers patients the accessibility to their own health information via internet. The interoperability between transferring information between health care providers can improve the patient’s managing their own health information such as billing, medical, demographics, and results (HealthIT, 2018).
Health Information Systems in Patient Satisfaction
One healthcare information software that is frequently used for patient satisfaction are the electronic health records. Most of the hospitals in healthcare organizations utilize EHRs because of the decrease of administration and clinical work for physicians. In this study, Pozdnyakova et al. explained, “In the USA, 83% of the office-based physicians reported using electronic health records (EHRs) in 2014” (2018). EHR is a system that is used to prevent any medical errors, but also has shown results of the lack of patient and doctor relation. The development of clinical practice includes assistance of uploading documentation and thorough navigation in EHR systems (Pozdnyakova et al., 2018). EHR influence the patient-doctor relationship, which “80% strongly agreed that their doctor “explain things in a way that was easy to understand and “spent enough time with them.” (Pozdnyakova et al., 2018).
Secure electronic messaging is another heath information source that is applied for patient interaction to health care providers (HealthIT 2018). The secure e-messaging can be used to encrypted coordination for visitations, routine health issues, addressing the concerns about the patient, and also handle the “routine for nonclinical tasks such as medication refills and referrals” (HealthIT, 2018). The patient has been satisfied of contacting the doctors directly rather than via phone with another staff member. Many patients have felt more comfortable with health issues discussed in an encrypted secured messaging than in person (HealthIT, 2018). According to Walsh, the requirement of communicating effectively within health care providers, secure messaging can assist with transitioning and coordinating care that the patient needs privately. (2013). Provider-provider relationship that communicates through secure messaging can be the next development of supporting patient’s solution of increasing satisfaction and quality of care.
Personal Health Records allows them to be available for any patient without constantly seeing the doctor or keeping documents from their physicians (Agarwal et al., 2013). The patient can engage with managing their health information and retrieve their records via online if they needed. Argawal et al. determined environmental, individual, and communication influences whether patients accept the usage of patient health records. Within Individual factors, Argarwal et al. explains the satisfaction with provider and activating the patient to use the PHR are the two main causes of accepting the tool (2013). The environmental factors such as technology is the perception of the potential of empowerment and perception of how much they value the functionality of PHR. Lastly, the communication of organizations and their effectiveness of communicating to the patients about PHRs have a bigger implement of intending to you PHR (2013).
Challenges of Health Information and Patient Satisfaction
HIT delivers many challenges with any exchange of patient’s information due to security reasons, environmental factors, and other influences that may be decreasing its value. However, the challenges are always occurred in any form that involves technology, which is a risk factor health care provider are willing to take in order to increase the stability of the new technology era. Technology is very difficult to control and regulate if there are individuals who use it for their own well-being. Patients need to be aware of situations of their information being breached if anything does occur and health care providers does not prepare for any situation that may happen.
Mi Ok Kim research explained that the most challenging about electronic health records many health care providers face with satisfying patients is the cooperation of the system and difficulties of using the system (2017). Health care providers transitioning from hard copy documents to the usage of technology due to their training and not understanding how to navigate through a system easily. Another challenge the EHR system is that patients found doctors are not showing what is inputted in while seeing the patient. Many of the patients preferred seeing what doctors are actually doing affecting the patient’s satisfaction with healthcare (Mi Ok Kim, 2017). Another challenge Tustin’s research examined was many physicians using EHR systems spent more time on certain tasks, such as writing prescription, ordering labs, and etc. reduced the preventive care and managing chronic disease (2010). IT can also cause a potential challenge for patient satisfaction if providers by their clinical errors. Clinical errors can cause patients to intake wrong dosages of medication that were originally for another patient in the health care organization, which will lead to legal actions for patient.
Secure Messaging challenges in patient satisfaction can fail to not communicate the details needed to transition to another health care provider. According to Walsh et al., their findings indicated “false sense of security may reduce verbal communications when they are needed most – during emergencies or when caring for complex patients who are required details, nuance discussion” 2013). The patient’s transition from provider-provider will not feel comfortable sharing details that might be critical their well-being. The translation between provider-provider can be misinterpreted because of the different communication style. Another challenge secure messaging face provider to provider includes the decrease of knowledge shared and the interactions that are necessary to maintain a collaboration between to health care providers (Walsh, 2013). The common challenge among secure messaging in a health information exchange are the privacy and confidentiality of patients. Many HIT systems are vulnerable to breaches, and this concerns many patients due to their privacy rights of their own health information. Suspicious acts in health care providers are often challenging, and ultimately a slow process of improvement due to patients who are unaware to their privacy rights and providers miseducated on information that might be sensitive.
Patient Health record presents several challenges satisfying the patient’s needs. Woollen found that giving all access of health records to patients will be excessive, so they have rather identify the more important information that might be more suffice to them (2016). Other factors that shows challenges between patient health records and patient satisfaction making sure the patient’s language is implemented, patient’s understanding the health information, technology literacy, and being patient friendly (Woollen, 2016). The main concern are passwords can be forgotten often, and patients who are in critical condition would have trouble accessing their patient health record (Woollen, 2016). Unauthorized users can somehow have access to patient’s information and more easily access when not in a hospital setting.
Current Trends
Health IT still remains a significant problem for health care providers because the quality of care given to the patients are affected. However, the Hospital Consumer Assessment of Healthcare Providers and Systems analyzes the patient’s experience and satisfaction by surveying the health care organization (CMS, 2017). In order to participate in the HCAHPS, the patient has to be 18 years old when they are admitted, has stayed overnight as an inpatient in the hospital, diagnosed as non-psychiatric, and also be alive when discharge (HospitalHCAHPS, 2017). Centers for Medicare and Medicaid Services (CMS) states patients are usually surveyed “48 hours and six weeks after getting discharged”, because they are prohibited to survey them while admitted in the hospital. The goals CMS are trying to obtain, are allowing the patients to convey meaningful thoughts about their experience, and then CMS are able to compare hospitals “locally, regionally, and nationally” (HospitalHCAHPS, 2017). Hospitals also will receive incentives whether they improve the care of patients in the hospital. Lastly, the goal for HCAHPS is hospitals are held accountable for increasing the quality in care delivery and will CMS will give a “public investment” to hospitals (HospitalHCAHPS, 2017).
Health IT have many potential solutions for patient satisfaction, such as medical scribes for physicians in the health care organization. Pozdnyakova et al., explains by implementing a medical scribe, it improved and satisfy physicians “without compromising patient satisfaction” (2018). Pozdnyakova found that “One third agreed that their physician “listened better,” “provided more education,” or was “more attentive” when the scribe was present compared to prior visits without a scribe present” (2018). The patients never thought the scribes made them uncomfortable in any circumstances. There was a huge impact of physician’s satisfaction because they were able to connect more with patients rather than doing documentation for the appointments. Pozdnyakova et al., points out that scribes can be the potential solutions in decreasing the multitask in physicians, and reducing medical errors in health IT (2018).