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Issues and Challenges in 
EMR in a private clinic of 
an Orthopedic Surgeon 
Lyndon Bathan, MD 
Orthopedic Sports Surgeon ...
Data Problems 
 Clinical data entry issues and lack of standard 
terminology 
 In a private setting, where most will ent...
Data Problems 
 Concern by providers as to whether information will be 
available on request 
 In the current state of p...
Data Problems 
 Concerns raised by healthcare professional, patients and 
the general community about privacy, confidenti...
Data Problems 
 Quality of electronic healthcare information and 
accuracy of data entries 
 In a a private setting ther...
End User/Support Issues 
 Resistance to computer technology and lack of 
computer literacy 
 Strong resistance to change...
End User/Support Issues 
For all the above problems: In a clinic or private 
practice where they do not see the benefit of...
End User/Support Issues 
If there are still employees with computer 
literacy problems they should be taught in 
seminars ...
Other Issues 
 High cost of computers and computer systems and 
funding limitations 
 Environmental issues – electrical ...
Other Issues 
Not all physicians stay in one clinic except the old 
established ones, most have multiple clinics in 
diffe...
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EHR Issues and Challenges MSHI201

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Assignment for MSHI 210

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EHR Issues and Challenges MSHI201

  1. 1. Issues and Challenges in EMR in a private clinic of an Orthopedic Surgeon Lyndon Bathan, MD Orthopedic Sports Surgeon HI201 Thursday, 9-12
  2. 2. Data Problems  Clinical data entry issues and lack of standard terminology  In a private setting, where most will enter a standard text entry, coding it will prove to be difficult if no standard form or classification system will be followed  The act of entering paragraphs in a computer might take more time and in some centers you might still make a physical chart.  In orthopedics where we give priority to functional outcomes, these standard functional scores that can just be ticked can be used by physician during interview and/or patient while waiting to save time and also to standardize what is to be entered in the system.
  3. 3. Data Problems  Concern by providers as to whether information will be available on request  In the current state of practice and technology where everybody is a sms away i.e. any patient from any of your clinic can ask you a question, the more accurate question is: Is the information information available anytime,anywhere and any device?  The solution is cloud data and mobile access of information/data in across all operating systems. This is to facilitate the physicians ability to retrieve data 24/7.
  4. 4. Data Problems  Concerns raised by healthcare professional, patients and the general community about privacy, confidentiality and the quality and accuracy of electronically generated information  In a a private setting who owns the data? The practioner or the patient?  We should be guided by the data privacy act to avoid legal problems and it will not hurt to also get some kind of consent if we are planning to use the data in research.
  5. 5. Data Problems  Quality of electronic healthcare information and accuracy of data entries  In a a private setting there will be issues of correct data entries as different end users are entering data from patient to nurses to doctors?  At the start or while the system is still being created the end users must be in the design stage to cater to what they believe should be in their data or any electronically generated data from just demographics to functional scores.
  6. 6. End User/Support Issues  Resistance to computer technology and lack of computer literacy  Strong resistance to change by many healthcare providers  Lack of staff with adequate knowledge of disease classification systems  Manpower issues – lack of staff with adequate skills  Involvement of clinicians and hospital administrators
  7. 7. End User/Support Issues For all the above problems: In a clinic or private practice where they do not see the benefit of going electronic, as patients in our country still pay on out of pocket basis, and there is no need of coding to bill or to create a study, writing on paper/form and earning is much easier to learn than to use a computer, hopefully this is changing with younger physicians.
  8. 8. End User/Support Issues If there are still employees with computer literacy problems they should be taught in seminars or buddy system. While the providers should be enlightened with the future. Health Maintenace Organizations are on the rise. Philippine Health Insurance are now asking for correct codes to get the accurate payment. Sad to say earning still holds a big factor to persuade the uninitiated. For the encoders i.e. nurses/staff, it is an added skill needed for future employment/promotion.
  9. 9. Other Issues  High cost of computers and computer systems and funding limitations  Environmental issues – electrical wiring and supply of electricity, amount and quality of space needed for computers, etc.
  10. 10. Other Issues Not all physicians stay in one clinic except the old established ones, most have multiple clinics in different settings, academic, private, rural, etc, how can the physician maintain his records?  EMR on handheld devices as most of professionals or workforce have it have it and cloud technology. Going mobile EMR is the next step in EMR and it is just around the corner.

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