National Electronic Health Record (EHR) Mandate

This is a practice or strategy where the information and data relating to health is collected (on a national level) through an electronic system and stored in the electronic system. Several technologies intersect with the use of a reformed system that is technology-based, and in which EHR is also encompassed. The practice exists in the hope of improving the care quality. Data from these systems, drawn from “paper and electronic medical records”, finds use when it is applied, for example, through an analysis (Gunter and Nicholas, 2005). There are models included in these systems, namely “distributed, personal, non-institutional models”. National EHR is developed for many reasons. Its interest in development has been growing with the conception that errors made in health care could be reduced through the application of Information Technology.

Thus the stakeholders have admired the whole issue of development. There has been an advancement towards a reform based on technology (Institute of Medicine, 2001; cited in Gunter and Nicholas, 2005) and there have been calls to commit to the development of information infrastructure, with the intention of improving “quality measurement”, and “consumer health” (Gunter and Nicholas, 2005). The interlacement of technology in the technology-based reforms has helped in the recovery of errors made in the practice, enhancing the use of “clinical decision support systems” as well as enhanced research in the areas involved. In the U.S a pure model of EHR on a national level has “focused primarily on the technical aspects of EHR.

The goal of the EHR is to “eliminate most handwritten clinical data by the end of this decade”, among many others. With electronic records, there would be reduced paperwork, leading to error reduction (Hippisley et al., 2003; cited in Gunter and Nicholas, 2005), as well as easier storage of the records. It would be expected that there will be easier and increased sharing of the information as far as electronic health records are concerned.

There will be expectations of safety and privacy for the information stored in the electronic records. There is a need for limited rights of access to private information (this has already been implemented in many hospitals and healthcare facilities). In addition, for data to be used for such purposes as research, it would be necessary for the users to have consent from the patients and other owners before. It is expected that issues of privacy would need more careful attention and inspection with the use of the internet-based methods because data is exposed to more possibilities of unauthorized access (such as hacking) and transfer, as well as usage.

This will be a challenge with the application of the internet. Confidentiality by the providers regarding the data given to them by the patients will ensure that they continue trusting these institutions to seek health care from them. Confidentiality is also captured in a legal framework and provides an obligation for providers to observe and achieve it. This also means that the patients and other people have the right to confidentiality.

There are so many challenges that accrue from the emerging models of HER that are coming up, including those experienced during implementation. One of the challenges that have been experienced regarding National EHR systems is the cost of them. The initiatives and allocation of the systems may comprise costs that cannot be properly projected or that are uncertain. Technologies may lead to rising costs as the nation seeks to adjust to better systems.

In addition, it is possible that costs will impact the usage of these systems if it will be too costly to update to more modern systems or that healthcare will continue taking more of the national expenditure. There have been attempts to reduce the costs for healthcare through the application of “Administrative Simplification”. Another challenge is the confidentiality and privacy of the National Health Electronic Records especially with the application of the internet. In regard to this, it is important that the providers implement regulations that do not contradict “principles of privacy and confidentiality” (Mandl, Szolovits, Kohane, 2001; cited in Gunter and Nicholas, 2005).


Gunter, T., and Nicholas, T (2005). The emergence of National Electronic Health Record architectures in the United States and Australia: Models, Costs and Questions. Web.

Hippisley-cox, J., Pringle, M., Cater, R., Wynn, A., Hammersley, V., and Coupland, C., et al. (2003). The electronic patient record in primary care – regression or progression? A cross sectional study. BMJ, 326 (7404):1439-1443.

Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press. Web.

Mandl, D., Szolovits, P., Kohane, S. (2001). Public standards and patients’ control: how to keep electronic medical records accessible but private. BMJ, 322 (7281):283-287.

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