HTVnetwork: History of Healthcare
The History of Healthcare uploaded by HTVnetwork briefly touches upon the advances in the field of surgery over time. It is explained that surgeons were the barbers through the middle ages. Barbers would perform primitive procedures with the absence of anesthesia in people such as tooth extractions and bloodletting. Bloodletting is a procedure that draws blood out of people in hopes of curing them of their illnesses or diseases.
In the mid 1800s, the introduction of anesthesia helped patients relieve pain and improve recovery rates, which allowed surgeons to perform more invasive procedures and caused the advancement in the field of surgery.
In contemporary society, surgeons manipulate the use of medical technological devices to help them complete invasive and complex surgery procedures such as the da Vinci surgical system. The da Vinci surgical system is a robotic device that guides surgeons to perform complex procedures such as dealing with tiny incisions. The device can also view the surgical site in a high resolution 3-D magnified view for maximal accuracy (Intuitive Surgical, Inc., 2013).
The field of surgery is one of the many areas in which healthcare has evolved in over time. Another evident example of improvement in healthcare is electronic health technologies.
In class, we discussed the differences between electronic medical records, electronic personal records, electronic health records, and personal health records.
An electronic medical record (EMR) is often used interchangeably with electronic personal record (EPR). EMRs and EPRs are less comprehensive and complete in comparison to electronic health records. They are "partial health record under the custodianship of a health care provider(s) that holds a portion of the relevant health information about a person over their life time" (Booth & Donelle, 2012, p.537).
An electronic health record (EHR) is a complete and comprehensive health record of an individual's. It is only accessible under proper authorization of the custodianship of the health care provider. Properly defined by Canada Health Infoway, electronic health record is "a complete health record under the custodianship of a health care provider(s) that holds all relevant health information about a person over their lifetime. This is often described as a personcentric health record, which can be used by many approved health care providers or health care organizations" (Booth & Donelle, 2012, p.536).
The advantages of EHR include reducing medication errors and promoting collaboration between health care providers and the patients. Medication errors can be reduced via computer provider order entry (CPOE) system. CPOE enables health care providers to electronically input medication and treatment orders into the system (Booth & Donelle, 2012). The use of EHR also eliminates the limitation of health information stored by only one health care provider since information can now be shared among the people who are involved in the patients' care.
However, there are disadvantages of EHR such as sharing health information between health care providers and patients. Studies have shown that the use of EHR can lead to poor communication and understanding between health care providers and their patients because of how they were trained to use EHR (Lynott, Kooienga & Stewart, 2012). The study was demonstrated to examine how the use of computer to input data affects a patient-provider relationship. It was concluded that the participants (providers) in the study who had a longer training period made their patients more comfortable. For example, the participants noticed that the positioning of their laptops or computer monitors played a major role in communication between themselves and their patients. Thus, the providers were able to communicate with their patients in ways that both parties could understand and see what is documented (Lynott, Kooienga & Stewart, 2012). In conclusion, the study found that the positioning of the computer and the level of communication skills and openness between the provider and patient can greatly impact the patient's comfort level and health.
In reflection, I do agree that poor communication between a health care provider and his/her patient is a huge factor that can inhibit a patient's care. Last summer when I visited my doctor, the first thing that I had noticed when I walked into her office was the office setting. Here is a basic idea of what her office was like:
During the interaction with my family doctor, I noticed that she was too engaged with documenting on her computer that she had neglected my presence. She hardly made any eye contact with me and that made me feel uncomfortable and not cared for. For example, she would read off her computer screen and type while I was talking.
To conclude, I would most certainly rate my doctor visit as non-therapeutic.
Pesonal health record (PHR) is defined by Kim & Nahm (2012) as "an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual" (Definition of PHR section, para. 1). The purpose of PHR is to ensure that the patients are involved in their care since they have control over their PHRs. PHRs allow patients to share selected health information to selected people.
The greatest advantage of PHR is that the patient has complete control over his/her care because he/she is the one who is managing the PHR. This way, the health providers are forced to work at the patients' pace and accordingly to what information is revealed to them. In InfoButton, the Patient Clinical Information System (PatCIS) is incorporated in the patients' PHR (Kim & Nahm, 2012). The PatCIS allows patients to understand medical terminology and medical data such as test results.
In contrary, there are many disadvantages to PHR. For one, since PHR is handled by the patient, the health care providers may not be able to understand what the patient is describing in his/her PHR since he/she would not be using correct medical terminology. In addition, the patient may also leave out important and/or relevant health information, which can inhibit the patient's care.
Telehealth is another example of health technology. Its purpose is to remotely serve patients based on these four ways (Booth & Donelle, 2012):
1. teleconsultation
2. health education and training
3. health information transfer to/from health care providers
4. healthcare information for clients
Telehealth can improve patients' health and well-being by ensuring continuing care, reducing geographical and financial barriers (such as transportation fees), allowing for health education, collaboration, and participation with other health care providers in the patients' care (Booth & Donelle, 2012).
There is no doubt that the shift in healthcare has brought along tremendous discoveries in technologies and studies through research and experiments to help cure diseases and save lives. However, it is unfortunate that there are some underlying factors that can prevent patients or other individuals from receiving maximal care. A few prominent issues that affects one from utilizing electronic health technologies include not having the literacy to do so and the financial stability to maintain Internet access at home, let alone purchasing a computer. Users can be affected by health literacy and an adequate literacy level to read and type the language that the PHR is provided in.
Electronic health technologies have their advantages and disadvantages. The factors vary for every user because not everyone suffer from the same health conditions or physical and social barriers in life. For example, in class we discussed various factors that can affect the older generation and the new generation from obtaining optimal health via electronic health technologies. The older generations stress that computer literacy is their biggest underlying factor as they may not want to learn how to operate a computer. However, there are many programs that encourage elders to learn how to operate a computer. In addition, the younger generations do not see any obvious barriers that can inhibit their care since they believe that they manage well with computers.
Booth, R., & Donelle, L. (2012). Nursing Informatics and Technology, Chapter 25. In B. Kozier, G. Erb, A. Berman, S. Synder, M. Buck, L. Yiu, & L. Stamler (eds.). Fundamentals of Canadian nursing: Concepts, process, and practice, 3rd Edition (p.536-539). Toronto: Pearson.
HTVNetwork. (2010). History of healthcare [Web]. Retrieved from http://www.youtube.com/watch?v=i2mpgwGRJyw&feature=youtu.be
Intuitive Surgical, Inc. (2013). The da Vinci surgical system. Retrieved from http://www.davincisurgery.com/da-vinci-surgery/da-vinci-surgical-system
Kim, K. & Nahm, E. (2012). Benefits of and barriers to the use of personal health records (PHR) for haelth management among adults. Online Journal of Nursing Informatics. 16(3).
Lynott, M.H., Kooienga, S.A., & Stewart V.T. (2012). Communication and the electronic health recording training: a Comparison of three healthcare systems. Informatics in Primary Care. 20:7-12.
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