Sample Health Care Research Proposal Paper on Performance measures of Electronic Health Records

Performance measures of Electronic Health Records

Summary

            The development of electronic health records has facilitated better services in the health institution. This study seeks to find performance standards in terms of quality and effectiveness of the EHR. The objectives of this study are to find out performance measures in different systems of the EHR. Health complications in America are increasing over recent times. Time and cost is high. EHR is perceived to be a better approach in controlling this problem by analyzing the patients’ information. With an updated system, health care professionals will be in a position to assist a patient from different institutions by the click of the name and basic information. Five case studies are to be applied in finding out this research. Specific areas of study to be applied include compilation of the blood pressure, management of diabetes, automatic alert in the interaction between antibiotics and anticoagulant warfarin, language processing device for the counseling of the tobacco application, and approaches in which problem records and the provider-list notes can be merged in the diagnosis of the high impact chronic diseases.

Introduction

            The development of electronic health record (EHR) has resulted to necessity and feasibility of quality and safety indicators (Car 108). This study seeks to find performance measures of the electronic health records (EHR). Performance measures are adaptable in varied EHR systems. To carry out this task, the study will involve case studies which will also incorporate typology for the labeling the electronic indicators. There are translational, Health Information Technology facilitated, Health Information Technology enabled, Health Information Technology system-management, cerner and care electronic indicators. Health institutions are therefore called to increase the cost of care as one of the approaches in managing this problem (Fowles 16). In Improving on quality care, EHR is a welcoming machinery to overcome the predicament. The lifestyle of the public is a major contribution to this predicament as time and cost is high in the end. One of the approaches in managing the care and the cost is through EHR, which has been perceived to be a better approach in managing this problem by first analyzing the records of the patients. With an updated system, health care professionals will be in a position to assist a patient from different institutions by the click of the name and basic information. Therefore, more problems are detectable earlier and complications managed.

Qualitative methodology will be applied in the research. More than 5000 patients will be chosen randomly from the nation with an equal number in gender. Participants in the diabetes research should be 46-85 year old with at least one-year use of the drugs. The patient ought to have at least been treated as an outpatient at one of the Hospitals at Riyadh. Additionally, the patient should have a stable blood pressure with controlled readings of around 140/90. Researchers are to identify a health institution to assist in identification of the patients, collection, and analysis. The hospital must conform to the standards of the HEDIS. For the diabetes and the hypertension study, EHR in collaboration with the manual system are to be used to compare the results. Patient’s information is to be entered into both systems and results compared for accuracy and reliability. The concrete measurement is assumed the percentage of hypertensive patients (Miller 210).

Researchers have to seek for permission from the government, health institutions and from patients. Permission from the government needs to be made through the ministry of health. Oral and written permission of the patients to bring into play their details are to be acquired. The information to be applied is strictly limited as basic information such as names and background will however not be used. What is to be included are age and gender. From the study, it is expected to realize that application of the EHR is simpler to use in finding data of diabetics. It is expected that institutions will apply this system in documentation, which will assist in finding more patients with hypertension complications. Eventually, more patients with health complications shall have received enhanced treatment. This system is expected to minimize time and cost applied in manually pulling out the results.

Objectives

  • To evaluate the performance measures of EHR systems
  • To highlight the benefits of EHR
  • To evaluate the challenges related in applying EHR
  • To highlight ways of improving adaptability of EHR

Research questions

  1. How can the output of the EHR be measured in relation to its differences?
  2. What are the benefits of using EHR in health sector?
  3. What are the prevailing challenges in employing EHR system in the health sector?
  4. How can the adaptability of EHR be improved?

PURPOSE OF THE STUDY

The study aims are evaluating performance measures in varied EHR systems. The objectives of this study are to find out performance measures in different systems of the EHR. The study additionally seeks to explore benefits of EHR, its challenges and ways of improving its adaptability.

Hypothesis

  1. Ho – The performance in terms of efficiency and quality of EHR system varies in relation to its application

H1 – The performance in terms of efficiency and quality of EHR systems is constant all through

  1. Ho – Diverse benefits can be realized in the application of the EHR systems

H1 – Limited benefits can be realized in the application of the EHR systems

  1. Ho – Application of EHR has several challenges

H1 – No challenges has been experienced when applying EHR system

  1. Ho – open opportunities are present for improvement of the EHR system

H1 – There are presently no open opportunities for improvement of the EHR system

METHODOLOGY

            To carry out the study, qualitative methodology will be applied. 1000 patients are to be randomly chosen within Saudi Arabia with an equal number in gender. Participants in the diabetes research should be 46-85 year old with at least one-year use of the drugs. The patient should have at least been treated as an outpatient in one hospital in Riyath City. Additionally, the patient should have a stable blood pressure with controlled readings of around 140/90. In addition to the records, patients are expected to have electronic reminders, have hemoglobin A1c<7, cholesterol <100 and should not be using tobacco.

STUDY INSTRUMENT(S)

Five case studies will be applied in collecting information of the study.

  • the application of the electronic records in the completion of the measurement of blood pressure
  •  management of the diabetics
  •  automatic alert in cases on interaction of the antibiotics and anticoagulant warfarin
  • application of the natural language processing tool in the counseling cases of tobacco use
  •  Cases where problem records are to be merged with the provider-visiting notes on the diagnosis of high-impact chronic diseases.

A system for grouping the standards of quality and safety has been incorporated. These e-indicators are applied in relation to the ambulatory care.

  • Translational electric indicators which have been deciphered from the traditional dimension sets for health information technology
  • Health Information Technology facilitated electronic indicators are applied in the Health Information Technology derived data sources in the presence of only Health Information Technology platforms.
  • Health Information Technology enabled electronic indicators are applicable only in the presence of Health Information Technology context.
  • Health Information Technology system management electronic indicators are essential for the enhancement of the Health Information Technology systems.

DATA ANALYSIS

            For the diabetes and the hypertension study, EHR in collaboration with the manual system are to be used to compare the results. Patient’s information is to be entered into both systems and results compared for accuracy and reliability. The concrete measurement is assumed the percentage of hypertensive patients (Miller 210). In this study, elements to be analyzed were the accuracy of the data derived outside and within the system. Reliability of the information has to be consistent across the entire population and on particular records. The study had to ensure that information was easy to be translated in different system; workflow efficiency analysis ensured that the data collected is structured as part of the study for efficiency of the patients’ visits (Welch 324). Additionally staff support was examined to ensure that the researchers were encouraged to uphold quality in the study. 

PILOT STUDY

            This is expected to be carried out at least one month before the main research. Researchers should identify correct system and be acquitted with the process especially for the EHR system. The researchers must identify the institutions to collaborate with to acquire details of the patients, permission to use the data and patients to choose. During this period, it is essential to understand the process, requirements and apply for the permission such as acquire consent from the government and from parents of the minors in carrying out the study. The patients in addition are to offer their written and oral permission before commencement.

FEASIBILITY OF THE STUDY

Updated EHR systems are to be applied in the case study of the diabetics (Fowles 4). Among the challenges expected, include lack of familiarity with the system, which can result to difficulty in collecting data. To overcome this challenge, researchers need to become acquainted with the systems during the pilot study. Organization and teamwork are essential in the success of this study. As the study on the anti-coagulation is to be carried out, independence of the patients is expected to reduce as alerts are to be automatically sent to the anticoagulation clinics. This has been proven previously to cause minimal challenges in the course of research (Succi-Lopez 12).

ETHICAL CONSIDERATIONS

            Researchers have to seek for permission from the government, health institutions the patients to use the records. Permission from the government needs to be made through the ministry of health. As the researchers will identify institutions to incorporate in the study, written permission has to be granted by the administrators of the health facilities. After accessing information of the patients, the researchers have to seek for oral and written permission of the patients to use their details. The information to be applied is strictly limited as basic information such as names and background will however not be used. What can be included can be the age, gender and ethnic background only.

EXPECTED APPLICATION OF THE RESULTS

            Application of the EHR is simpler to use in finding data of diabetics by professionals and auditors, which can result to higher compliance rate. It is expected that institutions will apply this system in documentation, which will assist in finding more patients with hypertension complications. This is feasible by analysis of the documented blood pressure and controlled (Welch 320). Eventually, more patients with health complications shall have received enhanced treatment. This system is expected to minimize time and cost applied in manually pulling out the results. Complications such as BMI and immunization background can be examined in the process.

TIME LINE OF THE PROPOSED RESEARCH

This study is expected to cover at least two years.

ActivityDuration
Pilot study3 months
Collection of data2 years
Data analysis2 months
Releasing the results of the researchOne month
PublicationOne Month

Works Cited

Car, Jeremy et al. 2008. “The Impact of e-Health on the Quality & Safety of

Healthcare: A Systemic Overview & Synthesis of the Literature. Birmingham.” NHS Connecting for Health Evaluation Programme.

http://www.haps.bham.ac.uk/publichealth/cfhep/documents/NHS_CFHEP_001_Final_Report. pdf

Fowles, B. Jinnet, et al. “Performance Measures Using Electronic Health Records: Five Case Studies.” Commonwealth Fund. 2008. Publication 1132.

Keyhani Hebert, et al. “Electronic Health Record Components and the Quality of Care.” Med Care. 2008; 46: 1267–1272.

 Miller West. “The Value Of Electronic Health Records In Community Health Centers: Policy Implications.” Health Aff . 2007; 26(1): 206–214. DOI:10.1377/hlthaff.26.1.206.

Succi-Lopez Walter. “Physician acceptance of information technologies: Role of perceived threat to professional autonomy.” Decis Support System. 2008.

Welch Bazarko, et al. “Electronic Health Records in Four Community Physician Practices: Impact on Quality and Cost of Care.” J Am Med Inform Assoc. 2007; 14: 320 –328. DOI 10.1197/jamia.M2125.