Background

Scholars argue that if one is to discuss something, they first need to define it. An electronic medical record can be defined as a software program part or complete medical record of a patient kept in a computer (Angst & Agarwal, 2009). It is the electronic version of the traditional paper record, that stores information such as, patient demographics, past and current medication, medical history, surgery, progress notes, laboratory test results etc. Change to the electronic health record involves significant financial investment in various fields such as equipment, maintenance and replacement costs. Even though the cost is high, the benefits are huge which set a promising course for the future. The use of electronic records offers a platform in the medical field which makes various functions possible (Hillestad et al., 2005).

The EMR have been in existence for many years (Reid, 2010; Stead, 2009) from as early as the year 1958 but it has not been fully explored (Grams, 2009; Stead, 2009). Institute of Medicine endorsed the execution of the EMR usage according to the U.S Department of Health which had strategized on improving the services in the healthcare sector via the use of IT which is based on healthcare only (Layman, 2008; Simon et al., 2009).  According to Simon et al. (2009), IOM comprises of medical experts and service providers who assess medical practice for a better future while still providing the best of services to the patients of the United States. The incorporation of equipment that is technologically advanced improves any health-providing institutions’ capability to cater for their patients with excellent treatment adequately and as well as maximize on efficiency (Venkatraman et al., 2008).

EMR is a system containing computerized information which is either single or multiple useful at the different stages during a patient-doctor visit. The EMR systems offer a number of benefits in a medical facility such as assisting in lab analysis, expediting samples from patients so that they can be analysed and the results discussed with the patients during visits (Hsiao et al., 2009).  The ability of the system to test, analyze, record and store information can eliminate the unnecessary visits to the hospitals and also detect diseases earlier. This capability has proven to be beneficial to improving patient services (Anderson & Bowers, 2008).

However, just like any other information system, for the EMR system to work more efficiently, the users need to involve in every step of implementation where possible. Discussions will help the users understand its core basics and design for efficient implementation. In developing countries, the EMR has greatly helped in providing accurate results and cost saving (Blaya et al., 2010). Besides, the success of the system lies in its proper implementation. For the implementation of the system to beneficial, organizations need to have adequate resources for example infrastructure, computer literate staff, computers and tactical strategies (Mohammed-Rajput et al., 2011).

Despite the advantages, it is important to note that EMRs have some cons which include heavy investment in the system and its maintenance, security issues among others (Weitzman et al., 2012). It was discovered that some of the practitioners prefer noting down on a piece paper in the place of entering data since it is perceived as slow and tedious and at times it derails communication with the patient (Mazzolini, 2013). However, a study that was conducted showed that spending time on data entry on the EMR can give time to the patients to ask more questions regarding their health. This is viewed as a positive effect of the system (McGrath et al., 2007). In the execution of the system, there are some challenges encountered since the medical care facilities are complex (Scholl et al., 2011). If the methods are not fully and carefully bin corporates, then the implementation will be difficult. Minimum research has been conducted on the proper design strategies for the EMR system.

General poor and inadequate resources lead to an increase in expenditure which creates a resistance towards the EMR technology (Khalifa, 2013). Today, there is a new field in information science, health informatics which is mainly based on the management of data in the healthcare sector by utilizing technologies (Hoyt et al., 2012). Inadequate technical experts and financial difficulties were some of the challenges that were identified by WHO regarding the incorporation of the system (Boonstra & Broekhuis, 2010). The involvement of patients in the EMR system through the access of personal individual healthcare record not only does it offer better healthcare services but also reduce the costs of visiting the doctor on a regular basis both at a private practice level as well as the national level (Tang et al., 2006). The benefited accrued in the adaption of a computerized system which provides all the information needed are manifold especially in developing countries (Williams and Boren, 2008). The enactment of the EMR system has shown a vast improvement specifically in tracking the medical history of those patients and those of patients who avoid medical treatment.

Analysis of previous studies

As a result of a reduction in medical errors, operations in the EMR system have been related with enhanced care, diminished expenses, guaranteeing of social insurance staff approach – an institutionalized arrangement of data and expanded productivity as to staff workload assignments (Lau et al., 2012). Studies led in the U.S demonstrated that the social insurance framework is as of now confronting an assortment of difficulties, including the need to convey amazing patient care while limiting expenses (Dixon (2007).

Ayatollahi et al., (2009) believes that the United States is rather behindhand compared to other different nations when it comes to receiving wellbeing EMR system. To survey the level of safety on EMR execution in the United States, Poon and his colleagues contemplated on utilization of IT among eight partners (2006). The gatherings of the eight partners involved incorporated conveyance marketplaces; network remains solitary doctor’s facilities, gifted nursing offices/recovery clinics, doctor hones, home wellbeing organizations, drug stores, reference research centers, and outsider payers. Their examination focused on the utilizations of EMR and the effects on wellbeing, social insurance quality, and hierarchical effectiveness.

In light of start to finish gatherings with accomplices and a leading group of authorities, Poon and his partners contemplated that, irrespective of the rising excitement for the wellbeing of the IT systems in refining security, reception in these areas was especially low as a result of worries with respect to cost and profitability (2006). Jha et al., in audit review on EMR adaptation through 2005, realized that a quarter of the specialist utilized EMR structures in portable mobile phones (2009). Besides, Hillestad et al. uncovered that around 47% of service providers around the United States, together with specialists and other non-specialists, had previously executed HIS, broadly not precisely in various nations (2005).

Data from the country wide Ambulatory hospital treatment Survey (NAMCS) revealed that experts completion price on EMR and HER frameworks have continuously extended with  25.2% and 43.nine% respectively (Hing and Burt, 2009; Hing and Hsiao, 2010); anyhow, there has been no simple alternate beginning now and into the foreseeable future. Schoen et al. (2009) drove an expansive diagram of approximately 10,000 simple care experts within the United States of America and 10 particular nations, such as Australia, Germany among others, addressing a mix of human administrations systems. The revelations exhibited America waiting substantially at the back of numerous international locations to the quantity of HIS utilization. Schoen et al. (2009) found that selective 46% of U.S. experts used critical EMR limits, differentiated and about the comprehensive use that is more than 90% in Australia, Netherlands, Sweden, Italy, New Zealand, Norway, and the UK.

The American Recovery and Reinvestment Act of 2009 (ARRA) provided the answer for the U.S’ slack in actualizing EMR frameworks since it included $19 billion in jolt stipends to help in the advancement of HIS program. The prerequisites of the PPAHCA and the jolt stipends offered in ARRA made a wellspring of finances for the execution of the EMR frameworks in 2014. Regardless of the above support, Angst and his partner directed an investigation of doctors and healing center h