EHR & Healthcare
By Nainil Chheda
This Presentation Contains
• EHR Industry Trends
Percentage Of Office-Based Physicians
Using Electronic Medical Records, By
Probability Of Using Electronic Medical
Records (EMRs) By Practice Size And
Degree Of Electronic Health Record
(EHR) Implementation, By Practice
Perceived Benefits Of Electronic
Health Records (EHRs) To The
• What is HIPAA?
– Health Insurance Portability and Accountability Act of
1996 (HIPAA), also known as the
– Primary purpose was to improve health insurance
accessibility for people changing employers or leaving
– HIPAA also included “Administrative Simplification”
provisions to encourage and protect the electronic
transmission of health-related data
What are the HIPAA Administrative
• 1. National standards for electronic data
• 2. Unique health identifiers for providers,
employers, plans, and individuals
• 3. Security standards to protect electronically
maintained health information
• 4. Privacy and confidentiality provisions for
individually identifiable health care data
Who must comply with HIPAA?
1.Health care providers or any other
person or organization that furnishes, bills,
or is paid for health care in its normal
course of business
2.Health plans that provide or pay the cost
of medical care, including Medicare and
3.Health care clearinghouses that process
data elements or transactions
Continuity of Care Records (CCR)
• The CCR, or Continuity of Care Record, is
a standard specification being developed
– ASTM International,
– the Massachusetts Medical Society (MMS),
– the Health Information Management and
Systems Society (HIMSS),
– and the American Academy of Family
Goal of CCR
• To create a CCR that will enable the next
provider to easily access the information
outlined above at the beginning of a first
encounter and easily update the
information when the patient goes on to
another provider, in order to support the
safety, quality, and continuity of patient
Uses of CCR
• The CCR may be used as a vehicle to
exchange clinical information among
providers, institutions, or other entities.
• It may also be used by the patient as a
brief summary of recent care.
Conceptual Model of CCR
Conceptual Model of the CCR
1 Document Identifying Information
“From/To” info re Provider/Clinician
Reason for Referral/Transfer Extension
2 Patient Identifying Optional
3 Extension Eligibility, Co-payment, etc.
Insurance and Financial Info
4 Health Status of Patient Extension Med. Specialty-specific Info
Current Medications Extension Disease Management-specific Info
Immunizations Personal Health Record Info
Vital Signs Extension
Documented by the Patient
Extension Med. Specialty-specific Info
5 Care Documentation
Extension Disease Management-specific Info
Extension Institution-specific information
Extension Care Documentation for Payers
Extension Personal Health Record Info
Documented by the Patient
6 Care Plan Recommendation
Version 6– 10/31/03
Mandated Core Elements of the CCR
• The next healthcare provider will not have to search for or guess about a
patient’s allergies, medications, or current and recent past diagnoses and
other pertinent information.
• The next healthcare provider will be informed about the patient’s most
recent healthcare assessment and services.
• The next healthcare provider will be informed about recommendations of
the caregiver who last treated the patient.
• As patient demographics will be provided, time and effort will be saved by
not having to repeatedly ask a patient for demographic information in detail.
Rather, this information can be more quickly and easily verified.
• A patient’s insurance status will be more easily established. Over time, this
can be expanded within the system.
• Costs associated with the patient’s care will be reduced, for example
through avoiding repetitive tests and basic information gathering.
• The effort required to update the patient’s most essential and relevant
information will be minimized
What is CCHIT?
• CCHIT – Certificate Commission for
Health Information Technology
• CCHIT's mission:
To accelerate the adoption of health
information technology by creating an
efficient, credible and sustainable product
• Reduce the risk of HIT investment by
physicians and other providers
• Ensure interoperability (compatibility) of
• Assure the participants that the ROI will be
• Protect the privacy of patients' personal
Who would benefit from CCHIT
• Physicians & Hospitals
• Health Systems
• Healthcare consumers (accurate & secure
record of health)
• Standards development experts (CCR)
• Quality Improvement Organizations
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