SOC 331-001
SOCIOLOGY OF HEALTH CARE
HEALTH IT WRITE-UP
According to Stefan Timmermans and Marc Berg’s The Gold Standard, the history of the medical record has come a long way since the 1900s. The medical record started as more of a personal notetaking tool to help the physician keep track of all the different patient’s he was taking care of and to take handwritten notes during day-to-day care. As we progressed technologically and there was more than one physician taking care of a patient, the medical record continued to develop. The first change was from the handwritten notebook to a standardized patient-centered folder that coincided with the needs of the interdisciplinary changes that were happening in the medical field. In other words, now that there is more than just a physician working with a client the patient’s records became standardized so they could be understood by all the different medical professionals providing care. Timmerman and Berg also described that one of the more important changes to the medical record was that the hospital was responsible for keeping all the medical records instead of the individual. They also mentioned that standardization of medical records gradually becomes more political and change with the motive of different parties.
Electronic Health Records (EHRs) are digital patient-centered records that are available to all patients and allow them to securely access all their medical information such as; medications, immunizations, medical history, and contact information. They are managed by the health care provider and designed to be shared by different health organizations to make it easier to treat a patient. Personal Health Records (PHRs) contain the same information as EHRs, but are designed and managed by the patient. They allow for the patient to be more engaged in their medical treatment and also offer a more secure way to keep their medical records safe.
According to the Centers of Medicare and Medicaid Services, an example of how the federal government is incentivizing providers to adopt health IT is by offering incentive payments to individual providers, hospitals, and organizations that are certified in using any of those technologies (2017).
An example of a population that is disadvantaged by the social determinants of health in terms of their health and health care outcomes are racial/ethnic minorities. Due to a history of racism and questionable experiments (e.g. Tuskegee Experiment) that were conducted on this population, there is a lack of trust held by patients toward medical professionals as well as the internet. This lack of trust can lower their health and health care outcomes because they do not trust that the medical professional has their best interests in mind and they also do not receive the benefits that health IT was designed to provide (e.g. higher patient engagement & access to medication lists). According to a study completed by Douglas et al. that evaluated data collection from the Hitech act in order to make policy changes to address disparities in populations like racial/ethnic minorities; EHRs do not fully identify health disparities that are experienced by patients therefore, doctors cannot provide the most effective/comprehensive treatment, which means that EHRs intensify disparities rather than solving them (2015).
In a study conducted by Ancker et al. that looked at the odds of patients activating PHR accounts after they receive their portal codes they found that racial/ethnic minorities were least likely to activate their accounts. This was due to their lack of trust in their provider and their concerns that their information would be shared with third party (2011). This leads to racial/ethnic minorities rejecting PHR’s overall and lowering their health and health care outcomes.
In the medical field it is important to be efficient and work in a timely matter when providing care to patients. Another characteristic of health professionals that differentiate them from other occupations is that they work for the common good of society. In a study that was completed by 25 physicians in a medical facility, the researchers found that all 25 physicians rejected EHRs due to lack of professionalism (Reich 2012). The main reason why the physicians rejected EHRs is because the main course of treatment that the EHR provides for any particular disease is assumed to be the best course of treatment. This uncertainty leads to deviating from what is recommended in the HER which leads to the patient not trusting their provider (2012).
In an article called The Personal Health Record Paradox: Health Care Professionals’ Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings, author Kim Nazi discusses profession of nurses and how they found that nurses embraced the implementation of PHRs in their study. According to the results of this study nurses revealed that PHR use improved their relationships with patients they provide care for because it increased patient engagement, which increased the trust the patients had in the nurses providing care (Nazi 2013). It also increased their ability to provide care efficiently and effectively because they could access PHRs before they saw their patient which eliminated the time it took during a visit to talk about the patients’ medical condition (2013).