Incorporating Evidence into Your Essay What is the basic structure of a paragraph

8-9 pages Double space MLA 8 The most important thing is to follow the format and requirements.Before start writing, please read everything I send carefully.Please use the worksheet for topic.Read the sample essay, you essay should be similar to sample essay.And I also send a graded essay, you can read it and make sure you do not make same mistakes.Before you turn it your essay, check the grading sheet, make sure you did everything good.
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Format for the Argument Paper
[This is a general guide to follow]
Issue: “How is technology affecting and changing communication for people?”
Introduction: General introduction of the problem and the narrow topic. It should begin with a sentence that draws
the reader into the paper and points toward the thesis statement. Avoid the generic, avoid stating the obvious—
something that the reader/audience already knows. Introduction should engage reader about the issue and situate it
into the larger social, cultural, psychological or economic context. Why is this issue important? All sentences should
logically flow to the last sentence, which is the thesis statement. Provides background information by answering:
who, what, when, why, where and why. If you include facts, statistics, etc, you must cite them. Do not include a list of
reasons to support the thesis. Paragraph length: 5-8 sentences. Follow the guidelines for an effective thesis
statement: review the seven thesis pitfalls. No visuals (graphics or charts in the introduction).
Charts and Tables: Only one visual for the argument paper.
A General Guide: Keep your sources to no more than two per paragraph. Keep charts and tables to one and follow
the guidelines for placement and when to use them. Use direct quote, summary, or paraphrase, and always use a
signal phrase followed with the parenthetical reference and follow each source/evidence with an explanation that
clearly links the evidence to the reason and thus to the thesis statement.
Background Paragraph: (6-8 sentences). Current history of the problem as it relates to your position. State the
importance of your argument: why is this issue so important now? What motivated this issue? What will this essay
hope to prove to the reader? Keep your audience in mind: Do not assume the reader understands terms. You may
need to define words. One Source is needed. You may include a chart or table in this paragraph only if it
supports and provides background for your argument. This counts as one source and it does not appear on
the works cited page. MLA information follows underneath the chart/table.
Body Paragraphs: (8-10 sentences). Begin with an appropriate transition and state your reason that supports the
thesis, clearly and concretely. Do not include any source material in the topic sentence. Next follow the topic sentence
with context that leads up to your evidence. Do not jump from your topic sentence directly to the evidence: provide 1-2
sentences as needed to help the reader understand the purpose for adding the reason. Body paragraphs should
provide the support for your thesis statement. For this paper you should have four to- five solid and distinct reasons to
support your thesis. Sources must come from reliable, relevant, and scholarly sources. They must include print, and
some Web sites. End body paragraph with a linking sentence that transitions to the next reason/body
paragraph. Two block quotes: 5-7 sentences are allowed for this longer argument paper.
Method of Organization: Organize the reasons to support your thesis from least important to most important. All
topic sources should specifically focus on a separate part of the argument and clearly state one reason. Sources
needed for each paragraph.
Opposing Point of View: 2 paragraphs (7-10 sentences). Recognize the opposing positions. You want to
acknowledge that you are aware of the refutation of your position and stress that although there is opposition to your
thesis it is not relevant in the light of the research that you have presented to support your thesis. Sources needed.
Keep to one opposing point of view per paragraph. Keep this paragraph balanced between the opposing view and
your refutation. Refer to the handout “Format for the Body Paragraphs,” this handout has a framework for the
opposing view. No chart or table in the opposing view.
Conclusion: Begin with an appropriate transition and then restate the thesis as the topic sentence in order to bring
the essay to a close, summarize the main reasons that support your argument, and the final remark should reemphasize the importance of the issue, and your position. Do not introduce new material. Keep the conclusion to
five to eight sentences. No visual in the conclusion.
Works Cited/Annotated Bibliography: This follows the last page of your essay and it should follow the 2009 MLA
format. Refer to Hacker and Sommers, A Writer’s Reference and other handouts available on eCompanion in the MLA
folder. Every source on the works cited page will have a two-to-three sentence summary: annotated bibliography.
Follow the guidelines for formatting the annotated summary: indent 1 inch from the last line of the entry and doublespaced. The sources must be varied: print, scholarly journals, some Websites (no Wikipedia or Ask.com).
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Charlie Roberts
Professor Kauffman
English 1
13 December 2017
The Future of Health Information Management
What is an electronic health record (EHR)? According to Nathan Sayles, “The Health
Information Technology for Economic and Clinical Health (HITECH) component of the
American Recovery and Reinvestment Act(ARRA) of 2009 states that a qualified EHR: includes
patient demographic and clinical health information, such as medical history and problems lists;
and has the capacity to provide clinical decision support, support physician order entry, capture
and query information relevant to healthcare quality, and exchange electronic health information
with and integrate such information from other sources” (950). This description Sayles gives
reflects a growing interest of the broader purpose of the EHR than the past uses of paper-based
health records. Thus electronic health records is an ongoing controversy which presents the
issue: should electronic health records be adopted by physicians? This is not easily agreed upon
and there are pros and cons on this issue. With this goal in mind, the electronic health record is a
health record available electronically, allowing communication across providers and permitting
real-time decision making. Thus, electronic health record should replace paper-based health
record in all healthcare facilities.
To start with, medical records have played an important role in the care of patients. The
medical record or health record is the principle storage place for data and information about the
healthcare services provided to a patient; it documents who, what, when, where, why and how of
patient care. In the mid-1960’s when trying to address clinical information systems for analysis
and research, it was realized that paper-based records contained data that were textual and
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contextual which made it difficult to develop systems to collect and process the data effectively
and efficiently. Now the goal is for the health record to not only be a place where health
information is documented and stored but to be a tool that provides support for changing how
medicine is practiced. Furthermore, according to the National Health Statistics Reports, the
growth of the number of physicians using electronic medical records or electronic health records
is on the rise. See Figure 1.
Office Based Physicians with electronic health record system:
Source: Hsiao, Chun-Ju & Esther Hing. “Use and Characteristics of Electronic Health Record
systems Among Office-based Physicians Practices: United States, 2001-2013, Jan. 2014, no.
143, http://www.cdc.gov/nchs/data/databriefs/db143.pdf
As the table shows the trend for adopting electronic health records is on the rise. According to
the report more and more electronic medical records are being used by physicians. Eventually
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every healthcare facility will adopt a paperless health record system. The argument is well
grounded and establishes the importance of electronic health records to the medical field.
First of all, the electronic health record offers interoperability. This means that this is the
ability to communicate with and be available to multiple end users, in different locations,
simultaneously and something the paper-based record could never do. According to Zandieh et
al., “Electronic health records (EHRs) permit electronic documentation of current and historical
health, tests, referrals and medical treatments as well as enabling practitioners to order tests and
medications electronically. EHR systems have the potential to improve communication between
physicians and patients by making data more readily available” (755). Availability of data, as
Zandieh points out has the power to improve the flow of information to and from the provider’s
office for quicker results, decision making and recommendations for the patients. Furthermore,
Cheryl Safarty explains, “The value gained from carefully researching and employing electronic
health records system is worth the investment, especially for oncologists, who are managing a
gravely sick patient population. The U.S. Oncology Network is one of many oncology-based
organizations that advocate the use of healthcare information technology, encouraging
physicians to embrace the array of benefits that lead to few errors, better targeted care and
improved outcomes, and interoperability” (“The Truth About Electronic Health Records”). Thus
Safarty reinforces and supports that idea that EHRs will benefit physicians and thus improve
interoperability. Having this real-time access not only improves communication but it can also is
an inevitable result of technology improvements.
Second, technology is changing the way physicians and hospitals are keeping records and
thus EHRs are an inevitable part of this process. The need for updated information is important
and timely as a result of rapid changes with technology and needed and timely medical
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information. According to the handout on the Department of Health & Human Services Web
site, “ The nation is entering a new era of health care where providers can use electronic health
records to improve patients health and the way health care is delivered in this country. Electronic
health records make it possible for health care providers to better manage your care through
secure use and sharing of health information. Most health care providers still use paper charts
for their patients’ medical records and government programs are helping health care providers
across the country to make the switch to electronic health records” (“Electronic Health
Records”). As this handout emphasizes, technology is playing an important role in changing how
physicians and patients receive medical information and this is important. Besides the
importance of time there is cost savings associated with EHRs.
Third, there are many different avenues of cost savings associated with the
implementation of an EHR system. Some cost savings may come quickly in the form of
incentives form the government to implement an EHR system; others will come over time due to
the use of the EHR system like reduce storage of paper records and reduction in staff (clerical,
billers, transcriptionists, etc…). Kazley et al. provide positive cost savings:
Cost savings associated with EHRs are expected to come through better
coordination of care, reduction of medical errors and adverse drug events (ADEs)
and increased efficiency and reduction of duplicate testing; previous studies have
demonstrated the potential. Silow-Carroll and colleagues found that 9 hospitals
with comprehensive EHR use resulted in ‘faster, more accurate communication
and streamlined processes have lead to improve patient flow, fewer duplicative
tests, faster responses to patient inquiries, redeployment of transcription and
claims staff, more complete capture of charges, and federal incentive payments,’
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which lead to cost savings. . . . In a single hospital EHRs with computerized
provide order entry (CPOE) use was associated with a decrease in laboratory
tests, radiology examinations, monthly transcription costs, medication errors and
paper costs. . . . the automated nature of advanced EHRs may reduce errors
through overall coordination of care, less duplication of tests, and increased
efficiency. (e183-184)
As Kazley et al., emphasize, hospitals that have implemented and use EHRs have a lower cost
per patient admission than comparable hospitals with a similar case load. The cost benefits are
realized both at the hospital and with patients. In addition, Nathan Sayles affirms, “Value is the
combination of quality and cost” (951). As Sayles states, the value of the EHR is what is being
considered. With value in mind the EHR not only saves money by reducing costs but it
improves the quality of patient care.
Fourth and most importantly, EHRs help improve the quality of patient care.
Improvement of care is reached through support for clinical decision making, alerts to avoid
errors, reminders about preventive services needed and improved coordination of care.
According to D. Scott Jones:
Many schools of thought equate an EHR with improved quality of care. Easily
accessible health records and patient information may speed care and reduce the
potential for medical errors. Automated systems such as computerized drug
reconciliation programs or medication adverse event warnings can provide
physicians with immediate access to drug contraindications. Easily missed data
such as drug allergies can be readily accessed or searched for in electronic files
with appropriate database management. Patient identification with a specific
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record or data can be verified more easily using unique identifiers, reducing the
possibility of misdiagnosis. (“Quality, Defensibility, and the Electronic Medical
Record”)
As Jones shows, the reduction in medical errors and immediate alerts from medication programs
and lab results can greatly improve patient care ensuring that patients are receiving the proper
care when needed. The information from Jones is validated by the report by the Department of
Health & Human Services: “Health care providers use electronic health records to increase the
quality and efficiency of health care” (“Electronic Health Records”). Hence, this handout
validates the reason for EHRS to improving quality of patients’ care. Unfortunately, even with
all of the benefits of and incentives for implementing an EHR system there is still some who are
resistant to switch to electronic health records.
However, there are still physicians who believe that EHRs are not the best solution for
record keeping. Many take the opposite view that EHRs, like any computer based information
system comes up with errors. For example, Alexi Mostrous reports: “However, the Senate
Finance Committee has amassed a thick file of testimony alleging serious computer flaws from
doctors, patients and engineers unhappy with current systems. . . . but many current systems are
clunky, counterintuitive, and in some cases dangerous” (“Electronic Medical Records”).
Mostrous underscores in this report the many consequences of the new electronic health records.
However, in refutation of this report by Mostrous, there are some problems that may occurred in
2009 when Mostrous wrote this report but today these have been corrected. For example, Goetz
et al. emphasizes, “The major benefits of EHRS are that they have increased the accuracy of
patient documentation and this information is not longer obscured and difficult to find” (e50).
Thus from 2009 to 2012, the technology of EHRs have made medical reporting a better choice.
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The concerns do not go away as easier as some would like and there is another opposing view to
consider.
On the other hand, there is another opposing view to consider. There have been some
unintended consequences of EHR implementation. That is an unanticipated or undesired effect
of implementing and using an EHR. David Sittig, John Ash, and Deb Singh maintain, “EHR
users have experienced safety concerns from EHR design and usability features that are not
optimally adapted for the complex work flow of real-world practice. Few strategies exist to
address these unintended consequences from implementation of the EHRs” (418). Sittig, Ash,
and Singh, point out that some of these issues may be a result of poor use of the system and
could lead to more errors. If health care organizations take the time and tailor the process of
implanting EHR systems they can make the transition safer and more efficient and the
enhancements they offer will likely be realized more rapidly.
Therefore, the many benefits offered by implementing an EHR system far outweigh the
paper-based system. First of all the electronic health record is available, stored on a server with
the ability to be accessed by multiple users at the same time whether it is a physician, nurse,
pharmacy or laboratory all of the information needed to properly assist the patient is accessible.
Second of all EHRs is an inevitable change as a result of how technology is changing the face of
record keeping for medical reports. The benefits will outweigh the negative of this way of
keeping track of patients’ information. Thirdly, the cost savings with the EHR is great because it
saves money in many areas from record storage, to staff reductions, to reduction of duplicate
tests, to proper charge capture for billing and incentives for implementation. Lastly, the EHR
improves the quality of care for the patient by giving physicians immediate access to
information, reducing the amount of tests, alerting physicians to possible interactions and
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providing clinical decision making tools. All in all the electronic health record should be
implemented in all healthcare facilities nationwide to improve the value of healthcare in
America.
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Works Cited
Department of Health & Human Services, USA. “Electronic Health Records: Advancing
America’s Health Care, 2016, http://www.healthit.gov.
This is a brief overview of the benefits of electronic health records. This report
provides benefits not only to physicians but to families and those who need
medical information when traveling.
Goetz, Debora, et al. “EHRs in Primary Care Practices: Benefits, Challenges, and Successful
Strategies, Feb. 2012, pp. e48-54, http://www.ajmc.com
In this article the authors present both benefits and challenges to adopting
EHRs. They interviewed physicians and other staff employees who currently use
EHRs in record keeping. Basically they found that using HER functions will
require training and patience.
Jones, Scott, D. “Quality, Defensibility and the Electronic Medical Record.” Journal of Health
Care Compliance, vol.10, no. 6, 2008: pp.41-46, 71-72, http://eds.b.ebscohost.com
In this article published in the Journal of Health Care Compliance the author
speaks to how several elements of an EHR system may contribute to defensibility
and should be considered. He speaks about the development of the EHR, the
quality of care and EHR, the EHR and defensibility and to implementing
defensible EHR.
Kazley, Abby, et al. “Association of Electronic Health Records with Cost Savings in a National
Sample.” American Journal of Managed Care, 2014, vol. 20, no. 6, pp.183-190.
www.ebscohost.com
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In this article published in the American Journal of Managed Care the doctors
were trying to determine whether advanced electronic health record (EHR) use in
hospitals is associated with lower cost of providing inpatient care. Using 2009
data and a cross-sectional design with a gamma distributed generalized linear
model, a patient-level analysis is conducted with propensity scores to control for
selection bias.
Mostrous, Alexi. “Electronic Medical Records Increase Medical Error. Medical Technology,
25 Oct. 2009, http://link.galegroup.com/apps/doc
This presents opposing views of electronic health records. According to this
report there are many problems and errors and …
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