Medical Record Keeping and Management

Paper Info
Page count 3
Word count 659
Read time 3 min
Topic Health
Type Essay
Language 🇺🇸 US

Medical Record Keeping and Management

  • Definition of health record and management
  • Explaining the importance of good health records
  • Health records management effect on service delivery
  • The different types of medical records

The records offer detailed data pertaining to a patient’s condition, disease management, and treatment (Tharpe, 2020). The information is essential in monitoring the patient and providing the required nursing care.

Health Information Systems and Technology

  • What is a health information technology
  • The use of electronic health records (EHR)
  • The use of electronic medical records (EMR)
  • The use of personal health records (PHR)

Patient information can be loaded into computer systems from which it can be accessed by different parties. The electronic health record (ERC) contains information that can be accessed by many people concurrently. Electronic medical records (EMR) are owned and managed by the doctors and the medical facility and can be accessed by patients only (Tharpe, 2020). The PHR details information as regards a patient’s diagnosis.

Ethical Issues in Health Information Technology and Record-Keeping

  • Define ethics in health information technology
  • Privacy and confidentiality issues in HIT
  • Data accessibility and reliability in HIT
  • How to ensure the security of HIT

The information in the electronic medical record needs to be managed appropriately without raising ethical concerns (Tharpe, 2020). The major ethical issues that arise in handling the information include; privacy and confidentiality, data accessibility and reliability, and security of the information.

Health Information and Communication Systems

  • Define health information and communication systems
  • The function of health information and communication systems
  • Clinical information systems (CIS) and administrative information systems (AIS)

All parties in health including the patients, clinicians, nurses, the health administrators, and government need to have access to health records. According to Beaver (2019), the information is integrated and delivered through health information and communication systems.

Clinical information systems (CIS)

  • An overview of the clinical information systems
  • Types of clinical information systems
  • Factors influencing the implementation of CISs

Clinical information systems are a database of data that clinicians use to plan, apply and assess patient care. The systems can be developed for different purposes. Some types of CISs include Emergency Department Information systems, Laboratory Information Systems, and Outpatient or Ambulatory Clinical Information Systems (Tharpe, 2020). The implementation of CISs can be influenced by the ease of use, and patient, system, and management outcomes.

Administrative information systems (AIS)

  • An overview of the administrative information systems
  • Types of administrative information systems
  • Factors influencing the implementation of AISs

The administrative information system is a database for managing non-clinical information in a health facility (Tharpe, 2020). The information entails the patient’s demographics, financial data as well as the facility’s quality assurance systems, employees, and human resources.

Systems being used at the Organization

  • Need for health systems in the organization
  • The application of mHealth
  • The application of eHealth

To enhance quick and efficient service delivery, the organization has affected the use of eHealth and mHealth systems. eHealth is applied by using the applications developed for both computers and smartphones. mHealth system has been developed principally for the use of mobile phones.

Rating of information systems in the organization

  • Excellent in meeting the organizational needs
  • Good in terms of cost management
  • Excellent in flexibility/innovation to meet future needs

The information technology used by the organization has eased operations within the organization and has helped to reduce expenses. The system is flexible and therefore can be used in the future long-term (Bowie, 2018). The system also provides a basis for further innovation.

Strength and Weaknesses of the Current Information Technology

  • Impact of the current information technology
  • Strengths of the current information technology
  • Weaknesses of the current information technology

The use of information technology has a great impact on enhancing the competitiveness of the organization through the effective application of the technologies. Ismail (2017) states that technology enhances instant communication and ensures service availability around the clock. However, the systems are subject to abuse through malicious attacks and require a colossal amount of funds to install.

References

Beaver, K. (2019). Healthcare Information Systems. 2nd ed. Auerbach Publications

Bowie, M.J. (2018). Essentials of Health Information Management: Principles and Practices. 4th ed. Cengage Learning

Ismail, N. (2017). Modern technology: advantages and disadvantages. Web.

Tharpe, C. (2020). Types of EHR Systems. Web.

Cite this paper

Reference

EssaysInCollege. (2022, July 28). Medical Record Keeping and Management. Retrieved from https://essaysincollege.com/medical-record-keeping-and-management/

Reference

EssaysInCollege. (2022, July 28). Medical Record Keeping and Management. https://essaysincollege.com/medical-record-keeping-and-management/

Work Cited

"Medical Record Keeping and Management." EssaysInCollege, 28 July 2022, essaysincollege.com/medical-record-keeping-and-management/.

References

EssaysInCollege. (2022) 'Medical Record Keeping and Management'. 28 July.

References

EssaysInCollege. 2022. "Medical Record Keeping and Management." July 28, 2022. https://essaysincollege.com/medical-record-keeping-and-management/.

1. EssaysInCollege. "Medical Record Keeping and Management." July 28, 2022. https://essaysincollege.com/medical-record-keeping-and-management/.


Bibliography


EssaysInCollege. "Medical Record Keeping and Management." July 28, 2022. https://essaysincollege.com/medical-record-keeping-and-management/.