With 886 licensed beds, 2,100 physicians, 2,800 nurses, and tens of thousands of other healthcare professionals, Cedars-Sinai Medical Center is one of the leading non-profit academic medical hospitals in the United States. Cedars-Sinai is a non-profit healthcare organization serving the diverse community of Los Angeles and beyond (About Us). Diagnosis and treatment options range from minor ailments to the most complex and life-threatening situations requiring specialized skills. Cedars-Sinai Medical Group and Cedars-Sinai Health Associates are part of the Cedars-Sinai network. The paper will detail the responses from an interview with the Head of Informatics at Cedars Medical Facility. Cedar Sinai, where I currently work as a Nurse Resident in the Cardiology Emergency Department.
Cedars-Sinai signed a three-year agreement with Noteworth, a medical data software service company, to integrate patient data into clinical decision making. To maintain existing clinical workflows, Noteworth integrated into Cedars-Sinai’s Epic EMR within one month. Collaboration and implementation of EMR were needed to help increase patient satisfaction and improve health outcomes (Scott et al., 2018). Cedars Sinai’s EPIC system was adopted by training early super-lead users such as IT professionals, top doctors and IT managers, who then trained the rest of the hospital staff on EHR.
Before the adoption of EMR systems, paper medical records were physically stored, which could be a restrictive and costly expansion. According to Witkowski et al., backup and security are not enough because physically erased files are irretrievably lost and cannot be recovered. Paper medical records require a time-consuming and error-prone handwriting technique. As far as I can tell, there is no version history or audit trails. Paper records make it impossible to track changes over time (Scott et al., 2018). The patient must sign any changes or additions to the records made by the physician. It is impossible to pinpoint the exact location or person responsible for any changes. After introducing the EMR system, a significant part of the work related to documentation disappeared. EMR is easily expandable and can store an unlimited amount of information. Besides, data can now be backed up to cloud storage and quickly restored as needed. A significant fact is that after the introduction of EMR, healthcare professionals can now use pre-programmed templates, saving time.
EMR systems come with their own set of challenges, including but not limited to the risk that criminal computer hackers gain access to the systems and steal data or make changes that could affect the credibility of a healthcare facility. Xiao et al. (2018) show that the transition from paper to electronic requires extensive and costly staff training. Patients with poor manual dexterity may experience delays and inconvenience in using the EHR due to consultations.
EMR has a cyber security strategy and policy that’s not only understood but followed and enforced. An effective strategy involves:
- Enhancing administrative controls• Monitoring physical and system access
- Creating workstation usage policies
- Auditing and monitoring system users
- Employing device and media controls
- Applying data encryption
Cedars-Sinai Los Angeles Medical Center’s electronic health record system now includes Choose Wisely principles, reducing the amount of treatment that is not needed. In a hospital and multidisciplinary academic medical research center, clinicians can see EHR alerts on their computers during patient visits through EMR. They indicate if specialized care is required due to each patient’s unique medical conditions and medications.
Health care providers electronically report electronic clinical quality scores, which use data from electronic health records and other health IT systems to assess the quality of patient care. Company Cedars Sinai Healthcare follows the Quality Assurance Program procedures of the Center for Medicare and Medicaid Services to ensure effective eCQM reporting. Changes to evidence-based medicine coding sets and measurement logic are considered when CMS annually updates the eCQMs approved for CMS programs.
The amount of money spent treating patients in a medical facility has been reduced by hundreds of dollars. Jindal & Raziuddin (2018) argue that the EHR reduces the cost of care associated with physician-patient interactions if physicians correctly follow all EHR notices. After completing the first full year, a $6 million reduction in institution health care costs was realized through implementing systems (About Us). The cost savings occurred after implementing Choosing Wisely in EPIC Healthcare Systems.
An electronic health record (EHR) prompts the clinician to select which interactions in a patient’s record they are most interested in before granting access to that patient’s data. Diaz and Paulo (2018) argue that it is dangerous when EMR focuses more on documenting the degree of service than determining what is most beneficial from a therapeutic point of view. Practitioners should be consulted to understand what software templates need to be created or how they can be improved to provide more efficient patient care.
Through the informatics module this semester, I learned that there is a continuous development of processes that contribute to improving the medical services provided. Implemented in hospitals, EMR greatly facilitated the routine work of employees and increased patient satisfaction. At the same time, various systems only continue to develop, and new ones are also being created. The knowledge and skills I have gained with new technologies will help me improve my performance as a nurse practitioner. For example, using computer science, I can identify patients at risk of contracting life-threatening infections and take prompt action to protect them. Patient allergies and drug interactions can be detected automatically, reducing the chance of errors.
About Us. Cedars. (n.d.). Web.
Dias, D., & Paulo Silva Cunha, J. (2018). Wearable health devices — vital sign monitoring, systems and technologies. Sensors, 18(8), 2414. Web.
Jindal, S. K., & Raziuddin, F. (2018). Electronic medical record use and perceived medical error reduction. International Journal of Quality and Service Sciences, 10(1), 84–95. Web.
Scott, P. J., Dunscombe, R., Evans, D., Mukherjee, M., & Wyatt, J. C. (2018). Learning health systems need to bridge the ‘two cultures’ of clinical informatics and data science. BMJ Health & Care Informatics, 25(2), 126–131. Web.
Witkowski, C., Kimmel, L., Edwards, E., & Cosic, F. (2021). Comparison of the quality of documentation between electronic and paper medical records in orthopaedic trauma patients. Australian Health Review, 46(2), 204–209. Web.
Xiao, C., Choi, E., & Sun, J. (2018). Opportunities and challenges in developing deep learning models using electronic health records data: A systematic review. Journal of the American Medical Informatics Association, 25(10), 1419–1428. Web.