An electronic health record is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings.
• Electronic health record, is the electronic
version of the client data found in the
traditional paper record.
• EHRs are defined as “a longitudinal electronic
record of patient health information generated
by one or more encounters in any care
4. Records system started in
EHRs developed between 1971 and 1992 were developed with
hierarchical or relational databases, around or added to hospital billing
and scheduling systems while others such as COSTAR, PROMIS, TMR,
and HELP were developed as clinical systems to help improve medical
care and for use in medical research
5. Who is created EHR first ?
In the 1960s, Larry Weed, an American
physician, researcher, educator, and
entrepreneur, developed the Problem Oriented
Medical Record. With this, Weed introduced
the idea of electronically recording and
maintaining patient data. Weed may be
identified as the person who invented
electronic health records themselves.
8. Time line for EHR history
The 1960s: Problem-Oriented Medical
(POMR). Developed by Dr. Lawrence Weed in
1968, POMR is still used by some medical and
behavioral health providers today.
The 1970s: The Dawn of the EHR System
In 1972, the world was introduced to the
very first iteration of what we now know as an
EHR. The Regenstrief Institute in Indianapolis
enlisted the help of Clement McDonald to
develop its EHR program.
The 1990s: The Internet’s Effects on EHR
By the early 1990s, the majority of U.S.
industries had already taken the plunge into
automating data and transactions. Health care,
on the other hand, was struggling to keep up.
In 1991, a book titled “The Computer-Based
Patient Record: An Essential Technology for
The 2000s: EHR Standardization and
The EHRs of the ’90s would likely be
unrecognizable to today’s user base. Before
the requirements of HIPAA, EHR capabilities
didn’t have to conform to any standards.
11. EHR Today
Over the course of five years, EHRs became
nearly ubiquitous in medicine as well
as behavioral health settings. In 2015, the
adoption rate for hospital clinics reached 92
percent. Independent clinics, usually due to
financial restrictions, were somewhat behind
with an adoption rate of nearly 80 percent.
14. The Future of EHR
The history of electronic health records is still
being written. EHRs have come a long way
since the development of problem-oriented
medical records, and there’s no sign of that
innovation stopping any time soon. For
behavioral health providers, two particular
trends stand out for the future evolution of
16. Some of the other ways EHRs are
continuing to evolve include:
Integrated tele health visits
17. Roles of EHR
• Represents patient’s health history
• Medium of Communication among health
• Legal document for health care
• Source for clinical outcomes and health
• Resource for practitioner education
• Alerts, reminders, quality improvement
22. CLINICAL DECISION SUPPORT
• A CDS system is a software that assists the
provider in making decisions with regard to
• CDSS provides physicians and nurses with
real-time diagnostic and treatment
24. What are 5 benefits of EHR?
With EHRs, information is available
whenever and wherever it is needed.
Improved Patient Care.
Increase Patient Participation.
Improved Care Coordination.
Improved Diagnostics & Patient Outcomes.
Practice Efficiencies and Cost Savings.
25. Patient Safety With EHR
Patient safety with EHR Researchers found
that computerized physician reminders
increased the use of influenza and
pneumococcal vaccinations from practically
0% to 35% and 50%, respectively, for
26. Prevention of complication
Prevention of complication with EHR Willson
et al, found a significant association between
computerized reminders and pressure ulcer
prevention in hospitalized patients. They found
a 5% decrease in the development of pressure
ulcers 6 months after the implementation of
computerized reminders that targeted hospital
28. Best uses of practice with EHR
• Rossi and Every, found that computerized
reminders as part of a CDSS have been linked
to an 11.3% increase in appropriate
hypertension treatment in a primary care
29. Decreased cost of care with EHR
•Tierney et al found a 14.3% decrease in the
number of diagnostic tests ordered per visit
and a 12.9% decrease in diagnostic test costs
per visit when using an EHR with CDS and
30. Computerized physician order
Computerized physician order entry(CPOE)
• CPOE is a software that allow physicians to
enter orders directly into the computer rather
than doing so on paper.
• laboratory tests,
• physical therapy
32. Benefits of CPOE
• Eliminates potentially dangerous medical errors
caused by poor penmanship of physicians.
• Eliminate errors caused by unclear telephone
• It also makes the ordering process more
efficient because nursing and pharmacy staffs
do not need to seek clarification or to solicit
missing information from illegible or
• Enhances patient safety
33. Evidence base practice
Evidence Studies suggest that serious
medication errors can be reduced by 55%
when a CPOE system is used alone, and by
83% when coupled with a CDS system that
creates alerts based on what the physician
• Using a CPOE system, especially when it is
linked to a CDS, can result in improved
efficiency and effectiveness of care.
•EHR adoption must be considered one of main
approaches that diversify our focus on quality
improvement and cost reduction.
•Over time, providers and researchers will be
eager to quantify the returns that are expected
from these investments.
• IOM. Crossing the quality chasm: a new health system for the
21st century. Washington, DC: Institute of Medicine; 2001.
• Dexter PR, Perkins S, Overhage JM, et al. A computerized
reminder system to increase the use of preventive care for
hospitalized patients. N Engl J Med. 2001;345(13):965–970.
• Willson D, Ashton C, Wingate N, et al. Computerized support
of pressure ulcer prevention and treatment protocols. Proc
Annu Symp Comput Appl Med Care. 1995:646–650. [PMC
• Rossi RA, Every NR. A computerized intervention to decrease
the use of calcium channel blockers in hypertension. J Gen
Intern Med. 1997;12(11):672–678. [PMC free article]
• Tierney WM, Miller ME, McDonald CJ. The effect on test
ordering of informing physicians of the charges for outpatient
diagnostic tests. N Engl J Med. 1990;322(21):1499–1504.
• Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized
physician order entry and a team intervention on prevention of
serious medication errors. JAMA. 1998;280(15):1311– 1316.
• Bates DW, Teich JM, Lee J, et al. The impact of computerized
physician order entry on medication error prevention. J Am Med
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• The National Alliance for Health Information Technology. Report to
the Office of the National Coordinator for Health Information
Technology on Defining Key Health Information Technology Terms.
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