Overview of Electronic Medical Records Dr Sanjoy Sanyal MBBS, MS, MSc, ADPHA, ADHRD Staff seminar in Seychelles medical college in February 2008

Table of contents EMR – General considerations EMR – Screenshots from companies EMR – Specialty-specific examples EPM / PMS – Automated clinical workflow integration Conclusion – Relevance to us References

EMR – General considerations

EMR – Screenshots from companies

EMR – Specialty-specific examples

EPM / PMS – Automated clinical workflow integration

Conclusion – Relevance to us

References

General considerations

Definition ISO TC 215 defines an EHR as “a healthcare record in computer processable format.”

ISO TC 215 defines an EHR as “a healthcare record in computer processable format.”

Electronic medical record Should document history, examination, diagnoses intuitively , rapidly , efficiently Should automate tests, medication, submission of diagnostic / procedure codes Should include error checking rules to avert allergies / cross reactions

Should document history, examination, diagnoses intuitively , rapidly , efficiently

Should automate tests, medication, submission of diagnostic / procedure codes

Should include error checking rules to avert allergies / cross reactions

Electronic medical record Evaluation and Management (E & M) electronic guidelines should be built into the code system Should be compliant with HIPAA policies [ HIPAA : Health Insurance Portability and Accountability Act ]

Evaluation and Management (E & M) electronic guidelines should be built into the code system

Should be compliant with HIPAA policies

[ HIPAA : Health Insurance Portability and Accountability Act ]

EMR Inter-relationships

Framework of EMR solutions

Stages of EMR complexity 1 2 3 0 eMAR CDR is the central pivot

Company screenshots

EMR – Nuesoft Xpress

ChiroChart EMR – MediPro

EMR frontscreen – MediNotes

EMR – Veterans Affairs VA – DoD

EMR – MS Office OneNote

EMR – FileMed

EMR – Data Center

EMR – NextGen

EMR face sheet – AMBAS

EMR progress notes – AMBAS

EMR configuration – AMBAS

MedicsRIS – ADS

MedicsDocAsst EMR – ADS

MedicsDocAsst EMR – ADS

EMR – Medinformatix

RTS EMR – Customized page

RTS EMR – Tabbed menus

RTS EMR – Access rights

RTS EMR – Time savers

RTS EMR – Governance

RTS EMR – Electronic sign

Specialty-specific

Automated patient q’aire – ADS

MDA allergy EMR – ADS

MDA Int Medicine EMR – ADS

MDA pain Mx EMR – ADS

MDA pain Mx EMR – ADS

MDA pain Mx EMR – ADS

Cardiology EMR – MDS

Cardiology EMR – MDS

Chiropractic EMR – MDS

Dermatology EMR – MDS

Dermatology EMR – MDS

Pediatric EMR – MDS Medical

Pediatric EMR – MDS Medical

Pediatric EMR – MDS Medical

Oncology EMR – Synergy

Oncology EMR (Patient chart)

Oncology EMR (Complaints)

Oncology EMR (Diagnosis)

Oncology EMR (Staging)

3-D EMR Mapping Engine

Automated workflow integration

‘ Bugle’ patient database – ARG

PMS – Nuesoft Xpress

PMS patient info – AMBAS

PMS scheduler – AMBAS

PMS online charge slip – AMBAS

PMS + EMR – MedInformatix

EPM appointment scheduling

Automated docu distribution

Accounts – Medinformatix

Collections – Medinformatix

Automated remittance module

Real time claim status

PMS – Scheduling screen

ADS MedicsElite – Patient Demog

ADS MedicsElite – Finance

ADS MedicsElite – Scheduler

ADS MedicsElite – PDA access

EMR data entry in PDA

Summary EMR is ultimately geared towards reducing errors, improving safety and care and cutting costs of healthcare EMR is not about just installing a few computers and storing patient data EMR has to be integrated with PMS / EPM EMR is all about automating WORKFLOW process

EMR is ultimately geared towards reducing errors, improving safety and care and cutting costs of healthcare

EMR is not about just installing a few computers and storing patient data

EMR has to be integrated with PMS / EPM

EMR is all about automating WORKFLOW process

Automated clinical workflow

Automated clinical workflow

Automated clinical workflow

Governmental mandate April 2004 Bush issued an executive order to computerize USA medical health records by 2014. “ By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care ”; President George W. Bush; 2004 State of the Union address. Our ability to meet the 2014 deadline is highly doubtful

April 2004 Bush issued an executive order to computerize USA medical health records by 2014.

“ By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care ”;

President George W. Bush; 2004 State of the Union address.

Our ability to meet the 2014 deadline is highly doubtful

Conclusion A parallel can be envisaged in every organizational setup Every organization (hospitals, educational institutions etc) should aim for automated workflow integration It requires an attitudinal shift We are still quite a way off

A parallel can be envisaged in every organizational setup

Every organization (hospitals, educational institutions etc) should aim for automated workflow integration

It requires an attitudinal shift

We are still quite a way off

References HemiData: www.hemidata.com/emr.html The Aesculapius Research Group : http://www.aesculapiustech.com/articles/ElectronicMedicalRecords.htm HIMSS Analytics: http://www.himssanalytics.org/PDFFiles/ Nuesoft Xpress: http://www.nuesoftxpress.com/products/ MediPro: http://www.medipro.com

HemiData: www.hemidata.com/emr.html

The Aesculapius Research Group : http://www.aesculapiustech.com/articles/ElectronicMedicalRecords.htm

HIMSS Analytics: http://www.himssanalytics.org/PDFFiles/

Nuesoft Xpress: http://www.nuesoftxpress.com/products/

MediPro: http://www.medipro.com

References Veterans Affairs (VA) : http:// www.va.gov Advanced Medical Billing and Accounting Solutions (AMBAS) : http://ambas.net Advanced Data Systems (ADS) : http://www.adsc.com/ris.asp Medinformatix : http:// www.medinformatix.com /Products/

Veterans Affairs (VA) : http:// www.va.gov

Advanced Medical Billing and Accounting Solutions (AMBAS) : http://ambas.net

Advanced Data Systems (ADS) : http://www.adsc.com/ris.asp

Medinformatix : http:// www.medinformatix.com /Products/

References Residential Treatment Solutions (RTS): therts.com/EMR4RTC.php MDS Medical Software : www.mdsmedicalsoftware.com / Synergy EMR : www.synergyemr.com/product_overview.htm Charette RN : Visualizing Electronic Health Records With "Google-Earth for the Body" http://spectrum.ieee.org/jan08/5854

Residential Treatment Solutions (RTS): therts.com/EMR4RTC.php

MDS Medical Software : www.mdsmedicalsoftware.com /

Synergy EMR : www.synergyemr.com/product_overview.htm

Charette RN : Visualizing Electronic Health Records With "Google-Earth for the Body" http://spectrum.ieee.org/jan08/5854