1. UNIT-IV
COMPONENTS OF EHR
Dr.Anjalatchi Muthukumaran Vice principal
,ECON

2. ELECTRONICHEALTHRECOR
D(EHR)
• 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
delivery setting.

3. EHR sample record

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.

6. Trends in EHR

7. Charateristic

8. Time line for EHR history
 The 1960s: Problem-Oriented Medical
Records
 (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.

9. Continued
 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
Health Care”

10. Continued
 The 2000s: EHR Standardization and
Adaptation
 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.

12. EHR evolution 2021

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
EHR.

16. Some of the other ways EHRs are
continuing to evolve include:
 Improved accessibility:
 Optimized workflows
 Integrated tele health visits
 Ongoing automation

17. Roles of EHR
 • Represents patient’s health history
 • Medium of Communication among health
care practitioners
 • Legal document for health care
 • Source for clinical outcomes and health
services research
 • Resource for practitioner education
 • Alerts, reminders, quality improvement

18. Components of EHR

19. Data Components of EHR

20. Continued

21. Clinical Decision support
System

22. CLINICAL DECISION SUPPORT
SYSTEM (CDSS)
 • A CDS system is a software that assists the
provider in making decisions with regard to
patient care.
 • CDSS provides physicians and nurses with
real-time diagnostic and treatment
recommendations.

23. Function of CDSS

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
hospitalized patients.


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
nurses.

27. Continued

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
setting.

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
CPOE components.

30. Computerized physician order
entry(CPOE)
 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.
 Example
 • drugs,
 • laboratory tests,
 • radiology,
 • physical therapy

32. Benefits of CPOE
• Eliminates potentially dangerous medical errors
caused by poor penmanship of physicians.
• Eliminate errors caused by unclear telephone
orders
• 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
incomplete orders.
• 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
orders.
 • Using a CPOE system, especially when it is
linked to a CDS, can result in improved
efficiency and effectiveness of care.

34. Health Information Exchange
(HIE)

35. Health information exchange
(HIE)

37. HIE Benefit

38. Technologies involved In EHR

39. PICS

40. Meaning of PICS

41. Bar Coding System

42. Continued

43. RFI-Radio frequency
Identification

44. Meaning of RFI

45. ADM-Automated Dispencing
Medicines

46. Automated dispensing medicine

47. Benefits ADM

48. Electronic Medication
Administration records (EMAR)

49. Meaning EMAR

50. Benefits of EHR

51. Benefits of block chain EHR

52. Benefit Outcomes

53. Draw backs
including
• adoption and implementation
costs,
• ongoing maintenance costs,
and
• loss of revenue associated
with temporary loss of
productivity.

54. Barrier adoption Research
abstract

55. continued

56. Continued

57. Advantages and Disadvantage of
EHR

60. Current problems with EHR

61. Issue with EHR

62. Summary

63. Conclusion
•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.

64. Summary

65. References
• IOM. Crossing the quality chasm: a new health system for the
21st century. Washington, DC: Institute of Medicine; 2001.
[PubMed]
• 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.
[PubMed]
• 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
free article][PubMed]
• 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]
[PubMed]
• 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.

66. Continued
 • 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.
[PubMed]
 • Bates DW, Teich JM, Lee J, et al. The impact of computerized
physician order entry on medication error prevention. J Am Med
Inform Assoc. 1999;6(4):313–321. [PMC free article] [PubMed]
 • 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.
[Accessed April 18,
2011].http://healthit.hhs.gov/portal/server.pt/community/healthit_
hhs_gov__reports/1239.
 • Walker J, Pan E, Johnston D, et al. The value of health care
information exchange and interoperability. Health Aff (Millwood)
2005;Suppl:W5-10–15-18. [PubMed]