Recent scientific progress and current technologies are frequently used in many fields. Advanced information management plays a crucial role in the development of healthcare services, and it cannot be ignored due to a number of benefits. The improvement of patient outcomes, care delivery, and information exchange may be achieved by different methods, and the implementation of Epic is one of them. If a new health information system is a step toward successful decision-making, it must be taken in accordance with specific governmental regulations and standards.
Epic services are available to people from different parts of the world in community hospitals, retail clinics, and medical/rehab centers (Epic, n.d.). In this paper, the analysis of an Epic health information system, its organizational benefits, risks, and potential stakeholders will be developed to introduce a plan for evaluating its implementation success.
Health Information System Analysis
Advantages and Disadvantages
Nowadays, many modern healthcare facilities focus on promoting effective information management. Using the definition by the World Health Organization, Moucheraud et al. (2017) explained health information systems (HISs) as the collection, storage, and management of data within a particular health sector. The content of this system may vary from disease surveillance and laboratory analysis to routine demographic information. Like any system, HISs are characterized by certain benefits and shortages that are evaluated through the prism of four factors, namely usability, interoperability, scalability, and compatibility.
To be successful, healthcare providers must have enough resources, knowledge, and experience to use the offered system in their setting. In any nursing or medical process, the usability of a system is defined as a possibility of a user to identify the appropriateness of the system, learn its applicability, and recognize its operability (Oliveira & Peres, 2015). Epic is a friendly-user technology with necessary training and explanations being given by the Epic team. Its advantage is the possibility to personalize information in accordance with offered templates. Along with a number of technical advances and benefits, EPIC is characterized by hidden high costs and expensive vendor support as its main disadvantage (Johnson III, 2016). Therefore, it is necessary for potential users to predict possible expenses on the implementation.
Interoperability is another important quality that shows if the chosen system is able to work with other systems within the established limitations and requirements. As soon as it is proved, effective delivery of health care is promoted, and patients, as well as the medical staff, gain the necessary benefits. The advantage of Epic interoperability is the movement of information from one place to another (Arndt, 2018). Still, the disadvantage that includes its unpredictability and incompleteness should be considered by users to understand that new changes may challenge its Interoperability qualities.
Being an important element of a health information system, scalability determines its ability to grow and develop in accordance with the increased demand. A scalable system has an advantage of applicability to changing needs and new conditions. As a scalable system, Epic remains competitive and stable in a constantly growing world of technology by means of improving its needs, choosing effective trends, and offering flexible foundations (Coquerel, 2016). The disadvantage is the necessity to change costs as soon as larger networks and options are required and a threat of losing clients because of new policies and implementation conditions.
Finally, the compatibility of Epic determines the way of its implementation and the decision of a clinic/hospital to choose this platform. Compatibility is a technological characteristic that refers to the degree of use while integrating with other facilities and practices (Salleh, Zakaria, & Abdullah, 2016). Epic’s advantage is its ability to work with different types of hardware and constantly improve its data resources. However, its disadvantage of compatibility is the impossibility of predicting problems within other hospitals and the work of their IT departments with conflicting software environments (Cybernet, 2017). Epic representatives and modern hospitals must strive to choose similar systems, software, and resources to cooperate and exchange information properly and quickly.
Patient Care and Documentation
Nowadays, many hospitals, clinics, and other healthcare settings aim at choosing electronic sources to gather and store patient information. The electronic health record (EHR) is one of the common documentation tools to enhance patient safety, care quality, and medical workers’ needs (Lavin, Harper, & Barr, 2015). Epic improves caregivers’ ability to diagnose disease and control (reduce and prevent) medical errors. For example, in 94% of cases, patient records are available at the point of care, and 88% of cases are characterized by positive clinical outcomes (“Improved diagnostic & patient outcomes,” 2019).
In addition, about 75% of healthcare providers admit that Epic and similar EHRs create enough conditions to improve the level of care they offered to their patients worldwide (“Improved diagnostic & patient outcomes,” 2019). The use of such systems is a good chance to reduce the number of errors associated with medications and health peculiarities of patients. For example, Epic automatically checks potential problems of new medications in regard to past history and treatment plans at the moment a medical worker enters data (Johnson III, 2016). The identification of risk factors is another benefit of the HIS under analysis.
The main feature of clinical documentation is the improvement of health care and interprofessional communication. There are many documentation templates in the system with the help of which nurses and other workers reduce the time that is required for administration and registration. Unfortunately, Johnson III (2016) discovered that Epic lacks the management of e-documentation, but new steps to integrate standardized forms are taken. Such improvements will allow a fast exchange of information within a healthcare team and prevent losing important facts about patients.
Quality and Delivery of Nursing Care and Patient Outcomes
Epic helps improve the quality of nursing care, enhance its delivery, and achieve positive patient outcomes. The number of satisfied clients is one of the major signs that the quality of care has been improved. Approximately 92% of patients were happy that their nurses and doctors used the HIS and saved their time, and 76% enjoyed the improvements in obtaining their medications (“Improved diagnostic & patient outcomes,” 2019).
Extended academic research systems and the possibility to discover the latest technological advances have a number of positive effects on the delivery of care (Johnson III, 2016). The best interventions are quickly defined and offered to medical workers as a part of a treatment plan. Finally, the possibility to avoid serious consequences and using past experiences stored by Epic contributes to better patient outcomes. The system identifies specific conditions of patients and available preventive measures alone with necessary medications. For example, 14% of asthmatic patients get access to improved spirometry and care plans (“Improved diagnostic & patient outcomes,” 2019). These achievements prove the effectiveness of Epic as a part of the care offered to populations.
Organizational Benefits
Quality Improvement Methods
Measurement is an integral element of a quality improvement (QI) process. Several domains to evaluate the outcomes of quality improvements could be offered to hospitals. Prevention of complications and the accuracy of diagnosis are the measures that depend on data collected from Epic. The power of the HIS is to provide discrete and easily reportable data throughout the healthcare team (Andonian, 2016).
In general, the improvement of healthcare services is possible because patient data is organized in specified criteria and relevant metrics. In its turn, the health care of specific populations, e.g., diabetic people, is improved due to access to specific metrics like last LDL results, blood pressure indicators, or last foot examination (Andonian, 2016). This information contributes to a fast recognition of diagnosis and discussion of complications that may challenge a patient.
HITECH and HIPAA Security Standards
The Health Information Technology for Economic and Clinical Health Act (HITECH) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) aim to control the flow of health information through the adoption of EHRs. It is expected from any system to have credible safeguards to promote effective data transactions and protect patients’ privacy. Epic respects the rights and freedoms of its users and develops specific privacy policies to be defined as a HIPAA and HITECH compliant HIS.
The Epic team underlines that the security of patient information is critical for the company, and the protection of confidentiality and storage integrity are supported by Transport Layer Security (TLS)/Security Sockets Layer (SSL) certificate technology and encryption (“Privacy policies,” 2018). There are also data recovery labs available to clients in case they lose information or are technically challenged. Confidentiality, technological training, security, and certification are the integrated features of Epic in its intention to follow HITECH and HIPAA standards and regulations.
Patient Privacy
Any HIS is created to gather and store personal information and offer access to users when it is necessary. Epic takes care of its clients and introduces a variety of policies and rules to protect patient privacy. For example, security staff is hired to check and control the flow of patient information in the system. Although it is impossible to understand what facts are revealed, the staff has an obligation to detect and report any unusual features. There is an access log (Google Analytics) within the frames of which enough information about recent users and their location (cookies) is given (“Privacy policies,” 2018). All potential users accept or decline cookies policies as soon as they enter the site. It is the main contribution to support protected health information (PHI) and follow confidentiality rules.
Organizational Efficiency and Productivity
The chosen HIS has a number of benefits in terms of its productivity and impact on health care. Epic is the system with an ability to connect information and select standardized data that can be necessary for comparative analysis (as cited in Johnson III, 2016). Standardized documentation facilitates the processes of ordering medications, choosing therapies, and following procedures. The reduction of waste is another proof of the organizational efficiency of the system.
This practice requires the analysis of the environment and control of materials and other unnecessary resources. Preventative interventions and sophisticated coordination are helpful in reducing waste and health care costs. Finally, the implementation of Epic in a setting results in increasing productivity and improving human and capital resources. Healthcare providers have reliable access to patient health information when care must be offered. Less time is spent to diagnose a patient, and more supportive information is given to predict complications. Instead of involving many people, there is a chance to use the same human and capital resources on the improvement of human health but not on gathering information.
Stakeholder Roles
To be sure of choosing a correct HIS, it is necessary to have a team of professionals who are aware of their roles and responsibilities. In case of Epic implementation, a “dream team” should include four essential stakeholders, a team leader, a nurse, a technician, and a financial manager. The work of an interdisciplinary team is a complex process where people with different experiences and knowledge backgrounds cooperate and share their skills. A team leader should perform the role of a supervisor and a researcher in order to combine personal information with evidence-based practices. The expertise of this person is to support cooperation in a team, communicate with people at different levels, and evaluate the achievements of other members to make solid conclusions and contributions.
The role of a nurse is to use patient histories and notes and establish the criteria for the system. His or her expertise of a registered nurse contributes to a better understanding of the factors that differentiate patients and their medical facts. A technician is responsible for the implementation of the system within the setting. The expertise of this person is to explain all the details and train the staff. Finally, a financial manager follows the major expenses and costs of different services offered within the system. His or her expertise is to control the decisions of a leader from a financial point of view to make sure profits prevail over losses.
Success Evaluation Plan
Evaluation of the implementation of a HIS is an important step to be taken. It will allow understanding of what should be improved, what goals have been achieved, and what needs must be underlined. Finally, a properly developed evaluation plan helps identify the benefits of Epic for a setting. There are six main components of a health information system. Regarding the two standards, HIS resources and data management, the analysis of the implementation process must be developed. Data management, including collection, storage, and processing, is controlled by the stakeholders. The expected benefit is the reduction of waste and time for gathering patient information. Patient satisfaction with the speed of care delivery is a critical factor. HIS resources include legislative and regulatory frameworks to ensure the quality of information, care, and privacy.
Conclusion
In general, the implementation of a HIS in a new healthcare setting is a complex process that is characterized by a number of steps, starting from identifying its benefits and ending with evaluating its success. In this paper, attention was paid to Epic as one of the most frequently used HISs globally. Despite the existing shortages and concerns about the necessity to make improvements and continue its technological advances, high levels of usability, scalability, interoperability, and compatibility promote its recognition. Improved quality of care, delivery of care, and positive patient outcomes are the factors that prove Epic’s efficiency and productivity.
References
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