This document discusses a study evaluating the adoption of electronic health records (EHR) in Egypt. It surveyed public, private, and educational hospitals. The study found that the adoption rate of EHR in Egypt is very low, around 6.7%. Major barriers to adoption included high costs and lack of technical support. Hospitals that had adopted EHR reported benefits like increased quality and improved performance. However, more work is still needed to increase EHR adoption across Egyptian hospitals and develop systems that meet international standards.
IRJET - Classification and Prediction for Hospital Admissions through Emergen...IRJET Journal
This document discusses using machine learning techniques to predict hospital admissions from emergency departments in order to improve patient flow and reduce overcrowding. It compares the performance of logistic regression and random forest algorithms on a dataset. Logistic regression identified several factors related to admissions including age, arrival mode, previous admissions. Random forests had the lowest accuracy. Predictive models could allow advance planning of resources to prevent bottlenecks. Future work involves exploring additional machine learning methods.
Medical Informatics: Computational Analytics in HealthcareNUS-ISS
Presented by Dr Liu Nan, Senior Research Scientist and Principal Investigator, Singapore General Hospital at ISS Seminar: How Analytics is Transforming Healthcare on 31 Oct 2014.
iHT² Health IT Summit Beverly Hills – Case Study "The EHR & Quality: The Current Evidence" Abha Agrawal, MD, FACP, COO & VP of Medical Affairs, Norwegian American Hospital
Case Study "The EHR & Quality: The Current Evidence"
∙ Understand where EHRs have demonstrated evidence based quality improvement
∙ Learn what areas for improvement exist to improve quality and physician productivity
∙ Discuss how results can be driven across diverse care settings and systems
∙ Identify unintended consequences of HIT
The document describes a report submitted by a group of students from Bharati Vidyapeeth College of Engineering on an "Integrated Health Information Platform". The report provides an introduction to the need for integrated health information systems and discusses key aspects of an integrated platform such as electronic medical records, electronic health records, how the platform would work, advantages, and implementation. It aims to present information on applying information technology to healthcare to create a nationalized healthcare database.
Proposed Framework For Electronic Clinical Record Information Systemijcsa
This research paper is drawn from an ongoing, large-scale project of implementing Electronic Clinical Record (ECR). The overall aim in this study is to develop a deeper understanding of the socio-technical aspects of the complexities and challenges emerging from the implementation of the ECR, and in particular to study how to manage a gradual transition to digital record. We have proposed ECR conceptual mode. The end result of our research was a collection of ideas / surveys, and field work that clinical institutions and medical informatics must consider to ensure that patients and clinics do not lose long-term access to ECR and technology continually progress. Results of our study identified the need for more research in this particular area as no definitive solution to long-term access to electronic clinical records was revealed. Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records.
Adopting Information Systems in a Hospital - A Case Study & Lessons LearnedNawanan Theera-Ampornpunt
This document summarizes the journey of adopting health information technology (IT) at Ramathibodi Hospital in Thailand over four generations from 1987 to the present. It describes the hospital's transition from a file-based system built in-house to a more standardized, project-based approach integrating commercial and custom-built systems. Key lessons learned include the strategic advantage of early IT adoption, balancing customization with standardization, and making careful build vs. buy decisions that consider long-term sustainability. The goal of health IT should be improving care quality, efficiency and supporting clinical and organizational strategies.
This research poster summarizes technologies that improve efficiency in hospitals. It finds that radio frequency identification (RFID) technology, iPad use in radiology, vascular pattern identification, ultrasonic sensors for tracking, and live endoscopic video all help to enhance efficiency. RFID technology improves processes, reduces costs and errors. iPads streamline radiologist work flows. Vascular patterns and ultrasonic sensors aid patient identification and tracking. Live endoscopic video benefits education, diagnostics and documentation. Overall, the technologies highlighted save time, lower expenses and improve workflows to increase both provider and patient satisfaction.
IRJET - Classification and Prediction for Hospital Admissions through Emergen...IRJET Journal
This document discusses using machine learning techniques to predict hospital admissions from emergency departments in order to improve patient flow and reduce overcrowding. It compares the performance of logistic regression and random forest algorithms on a dataset. Logistic regression identified several factors related to admissions including age, arrival mode, previous admissions. Random forests had the lowest accuracy. Predictive models could allow advance planning of resources to prevent bottlenecks. Future work involves exploring additional machine learning methods.
Medical Informatics: Computational Analytics in HealthcareNUS-ISS
Presented by Dr Liu Nan, Senior Research Scientist and Principal Investigator, Singapore General Hospital at ISS Seminar: How Analytics is Transforming Healthcare on 31 Oct 2014.
iHT² Health IT Summit Beverly Hills – Case Study "The EHR & Quality: The Current Evidence" Abha Agrawal, MD, FACP, COO & VP of Medical Affairs, Norwegian American Hospital
Case Study "The EHR & Quality: The Current Evidence"
∙ Understand where EHRs have demonstrated evidence based quality improvement
∙ Learn what areas for improvement exist to improve quality and physician productivity
∙ Discuss how results can be driven across diverse care settings and systems
∙ Identify unintended consequences of HIT
The document describes a report submitted by a group of students from Bharati Vidyapeeth College of Engineering on an "Integrated Health Information Platform". The report provides an introduction to the need for integrated health information systems and discusses key aspects of an integrated platform such as electronic medical records, electronic health records, how the platform would work, advantages, and implementation. It aims to present information on applying information technology to healthcare to create a nationalized healthcare database.
Proposed Framework For Electronic Clinical Record Information Systemijcsa
This research paper is drawn from an ongoing, large-scale project of implementing Electronic Clinical Record (ECR). The overall aim in this study is to develop a deeper understanding of the socio-technical aspects of the complexities and challenges emerging from the implementation of the ECR, and in particular to study how to manage a gradual transition to digital record. We have proposed ECR conceptual mode. The end result of our research was a collection of ideas / surveys, and field work that clinical institutions and medical informatics must consider to ensure that patients and clinics do not lose long-term access to ECR and technology continually progress. Results of our study identified the need for more research in this particular area as no definitive solution to long-term access to electronic clinical records was revealed. Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records.
Adopting Information Systems in a Hospital - A Case Study & Lessons LearnedNawanan Theera-Ampornpunt
This document summarizes the journey of adopting health information technology (IT) at Ramathibodi Hospital in Thailand over four generations from 1987 to the present. It describes the hospital's transition from a file-based system built in-house to a more standardized, project-based approach integrating commercial and custom-built systems. Key lessons learned include the strategic advantage of early IT adoption, balancing customization with standardization, and making careful build vs. buy decisions that consider long-term sustainability. The goal of health IT should be improving care quality, efficiency and supporting clinical and organizational strategies.
This research poster summarizes technologies that improve efficiency in hospitals. It finds that radio frequency identification (RFID) technology, iPad use in radiology, vascular pattern identification, ultrasonic sensors for tracking, and live endoscopic video all help to enhance efficiency. RFID technology improves processes, reduces costs and errors. iPads streamline radiologist work flows. Vascular patterns and ultrasonic sensors aid patient identification and tracking. Live endoscopic video benefits education, diagnostics and documentation. Overall, the technologies highlighted save time, lower expenses and improve workflows to increase both provider and patient satisfaction.
This document summarizes a research paper on using Markov Decision Processes (MDPs) to improve inpatient hospital care. It discusses challenges in the current healthcare system and how machine learning and artificial intelligence could help address issues like overtreatment, inconsistent care quality, and high costs. The paper proposes using MDPs and other algorithms to analyze patient electronic health record data, detect abnormal care patterns, and make real-time predictions to optimize treatment and resource allocation. A web application with modules for patients, doctors and administrators is designed to facilitate this approach. Simulation results suggest it could increase care efficiency by better connecting patients and doctors. Future work may expand this to personalized treatment planning, diagnostic testing optimization and knowledge discovery from medical literature.
This study developed a survey instrument to segment physicians into groups based on their preferences and opinions regarding information technology. The survey was developed using qualitative research including interviews and focus groups. It presented physicians with statements about IT to rank order.
The findings identified six distinct preference profiles among physicians: 1) "Full-Range Adopters" who saw many benefits of IT, 2) "Skills-Concerned Adopters" who saw benefits but had skills concerns, 3) "Technology-Critical Adopters" who saw benefits but had strong concerns about privacy, monitoring and skills, 4) "Independently-Minded and Concerned" who emphasized independent research uses of IT but also had strong privacy and skills concerns
The document provides an overview of clinical information systems and electronic health records. It begins with an introduction to the presenter, Dr. Nawanan Theera-Ampornpunt, which includes their educational background and research interests related to health IT. It then covers key topics such as the differences between healthcare and other industries, forms of health IT including electronic health records and clinical decision support systems, and components and uses of electronic medical records. The document aims to explain the role and value of health IT in clinical settings.
These slides review problems with current electronic medical record (EMR) systems and makes suggestions for future improvements in design and usability. This work was sponsored by the Szollosi Healthcare Innovation Program (www.TheSHIPHome.org).
Mobile application for_monitoring_of_addMerianPadlan2
This document describes a mobile application developed to help nurses monitor intravenous fluid drips and drug administration to patients. The application was created using Android and aims to facilitate fluid therapy management and reduce medication errors. Currently, drip monitoring is done manually which is time-consuming and prone to errors. The application was developed using the Rapid Application Development method and User requirements were gathered through observations, interviews, and questionnaires with nurses. It uses the Unified Modeling Language to design the system and specifications. The goal is to support nurses and improve patient safety during intravenous fluid and drug administration.
Web based tutorial on electronic patient records system trainingElba Curt
Holy Cross Hospital recently acquired an Electronic Medical Records System (EMRS) but has not trained its medical staff how to use it. A gap exists between the staff's current lack of EMRS skills and what is needed. The document proposes a web-based training for hospital personnel on proper EMRS use. The training will have performance-based objectives and assess trainees throughout to ensure goals are met. Trainees will practice with simulated patient records to learn EMRS functions like accessing, entering, and reviewing patient information.
This document discusses Community Health Connections' implementation of an electronic health record system. It provides an overview of the organization and outlines their plan to implement OpenVista EHR software across three clinics by February 2011. It describes the anticipated benefits of EHR including reduced errors, improved workflows and access to patient information. The implementation plan includes teams for project management, hardware, software and stakeholders. It also covers training, data migration, technical infrastructure including servers and network upgrades, meeting meaningful use requirements and realizing financial benefits and savings.
This is a presentation from 2011 highlighting the possibilities of IT in private cardiology practice. It is of historical value but touches on early fundamental concepts of digitalization of a private practice in the field of cardiology.
Ihe cpoe the_twine_shall_meet_for_healthcarePankaj Gupta
This document discusses how computerized physician order entry (CPOE) systems can help reduce medical errors by catching them at the point of order entry. However, CPOE systems require integrated data across different hospital systems like EMR, pharmacy, and labs. Integrated Healthcare Enterprise (IHE) provides a framework to integrate these disparate systems and enable the full benefits of CPOE by allowing clinical decisions to be made using consolidated patient data. For CPOE to be effective, healthcare systems need to move beyond standalone systems to fully integrated models that comply with standards like IHE.
The document discusses IT and decision support systems in hospital supply chains. It provides an overview of clinical decision making and clinical decision support systems (CDS), including definitions, types of CDS like alerts and reminders, expert systems, and references. It also discusses the roles of information technology in clinical decision making processes and how CDS can help reduce human errors.
Design and implementation_of_a_microcontMerianPadlan2
This document describes the design and implementation of a microcontroller-based infusion pump system for automatic drug delivery. The system uses a stepper motor to precisely deliver drugs to patients on a scheduled basis. It also includes Bluetooth connectivity to allow nurses to remotely monitor the system status without frequent bedside visits. Testing at a hospital showed the remote monitoring was particularly useful for nurses. The programmable microcontroller-based design allows for flexible control and monitoring of drug infusion.
Machine learning is the field that focuses on how computers learn from data. Today, machine learning is playing an integral role in the medical industry. This is due to its ability to process huge datasets beyond the scope of human capability, and then convert the data analyzed into clinical insights that aid physicians in providing care. Machine learning is a powerful, relatively easy to implement tool with numerous possibilities to enhance medical practice. The applications of machine learning in medicine are advancing medicine into a new realm. Therefore, educating the next generation of medical professionals with machine learning is essential. This paper provides a brief introduction to applying machine learning in medicine. Matthew N. O Sadiku | Sarhan M. Musa | Adedamola Omotoso "Machine Learning in Medicine: A Primer" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20255.pdf
Paper URL: https://www.ijtsrd.com/computer-science/other/20255/machine-learning-in-medicine-a-primer/matthew-n-o-sadiku
The document discusses key points healthcare providers should know about implementing electronic medical records (EMRs) by the 2014 mandate. It notes that current EMR vendors do not fully meet federal requirements and standards are still being developed. EMRs will be very expensive to implement and maintain, though government loans and grants are available to help fund them. Proper implementation requires addressing barriers like costs, unclear returns on investment, training needs, and resistance to change. Non-adoption will result in lower Medicare reimbursements starting in 2015.
A study on real time plant disease diagonsis systemIJARIIT
The document discusses developing a real-time plant disease diagnosis mobile application. It aims to allow farmers to easily capture images of plant leaves using a mobile camera, send the images to a central system for analysis, and receive diagnoses and treatment recommendations. The proposed system would use image processing and data mining techniques to analyze leaf images for abnormalities, identify the plant species, recognize any diseases present, and recommend appropriate pesticides and estimate treatment costs. This would provide a low-cost, convenient solution for farmers to quickly diagnose and respond to plant diseases.
Health IT Summit in Chicago 2014 – “The EHR & Quality: The Current Evidence” with Abha Agrawal, MD, FACP, COO & VP of Medical Affairs, Norwegian American Hospital
Abha Agrawal, MD, FACP
COO & VP of Medical Affairs
Norwegian American Hospital
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
This document presents a methodology for mapping multidimensional transforms onto reconfigurable architectures like FPGAs. The methodology uses tensor product decompositions and permutation matrices to express transforms recursively in terms of lower-order blocks. This allows large transforms to be computed by combining many parallel, smaller transform blocks. Specific examples are given for mapping one-dimensional linear convolution and discrete cosine transforms. The overall goal is to provide a unified framework and design process for implementing multidimensional transforms in a modular, parallel architecture.
This document describes the simulation of a dynamic voltage restorer (DVR) using PI control with fuzzy logic to mitigate voltage sags. A DVR is connected between a distribution system and critical load to inject compensating voltages during faults. The control system uses PI controllers for the dq components of load voltage with additional fuzzy logic control. Simulation results under different fault conditions show the DVR maintains the load voltage, demonstrating its effectiveness in compensating voltage sags. Total harmonic distortion is also improved by increasing the DC link voltage of the DVR. The PI with fuzzy logic control provides faster response compared to conventional controllers.
This document summarizes a research paper on using Markov Decision Processes (MDPs) to improve inpatient hospital care. It discusses challenges in the current healthcare system and how machine learning and artificial intelligence could help address issues like overtreatment, inconsistent care quality, and high costs. The paper proposes using MDPs and other algorithms to analyze patient electronic health record data, detect abnormal care patterns, and make real-time predictions to optimize treatment and resource allocation. A web application with modules for patients, doctors and administrators is designed to facilitate this approach. Simulation results suggest it could increase care efficiency by better connecting patients and doctors. Future work may expand this to personalized treatment planning, diagnostic testing optimization and knowledge discovery from medical literature.
This study developed a survey instrument to segment physicians into groups based on their preferences and opinions regarding information technology. The survey was developed using qualitative research including interviews and focus groups. It presented physicians with statements about IT to rank order.
The findings identified six distinct preference profiles among physicians: 1) "Full-Range Adopters" who saw many benefits of IT, 2) "Skills-Concerned Adopters" who saw benefits but had skills concerns, 3) "Technology-Critical Adopters" who saw benefits but had strong concerns about privacy, monitoring and skills, 4) "Independently-Minded and Concerned" who emphasized independent research uses of IT but also had strong privacy and skills concerns
The document provides an overview of clinical information systems and electronic health records. It begins with an introduction to the presenter, Dr. Nawanan Theera-Ampornpunt, which includes their educational background and research interests related to health IT. It then covers key topics such as the differences between healthcare and other industries, forms of health IT including electronic health records and clinical decision support systems, and components and uses of electronic medical records. The document aims to explain the role and value of health IT in clinical settings.
These slides review problems with current electronic medical record (EMR) systems and makes suggestions for future improvements in design and usability. This work was sponsored by the Szollosi Healthcare Innovation Program (www.TheSHIPHome.org).
Mobile application for_monitoring_of_addMerianPadlan2
This document describes a mobile application developed to help nurses monitor intravenous fluid drips and drug administration to patients. The application was created using Android and aims to facilitate fluid therapy management and reduce medication errors. Currently, drip monitoring is done manually which is time-consuming and prone to errors. The application was developed using the Rapid Application Development method and User requirements were gathered through observations, interviews, and questionnaires with nurses. It uses the Unified Modeling Language to design the system and specifications. The goal is to support nurses and improve patient safety during intravenous fluid and drug administration.
Web based tutorial on electronic patient records system trainingElba Curt
Holy Cross Hospital recently acquired an Electronic Medical Records System (EMRS) but has not trained its medical staff how to use it. A gap exists between the staff's current lack of EMRS skills and what is needed. The document proposes a web-based training for hospital personnel on proper EMRS use. The training will have performance-based objectives and assess trainees throughout to ensure goals are met. Trainees will practice with simulated patient records to learn EMRS functions like accessing, entering, and reviewing patient information.
This document discusses Community Health Connections' implementation of an electronic health record system. It provides an overview of the organization and outlines their plan to implement OpenVista EHR software across three clinics by February 2011. It describes the anticipated benefits of EHR including reduced errors, improved workflows and access to patient information. The implementation plan includes teams for project management, hardware, software and stakeholders. It also covers training, data migration, technical infrastructure including servers and network upgrades, meeting meaningful use requirements and realizing financial benefits and savings.
This is a presentation from 2011 highlighting the possibilities of IT in private cardiology practice. It is of historical value but touches on early fundamental concepts of digitalization of a private practice in the field of cardiology.
Ihe cpoe the_twine_shall_meet_for_healthcarePankaj Gupta
This document discusses how computerized physician order entry (CPOE) systems can help reduce medical errors by catching them at the point of order entry. However, CPOE systems require integrated data across different hospital systems like EMR, pharmacy, and labs. Integrated Healthcare Enterprise (IHE) provides a framework to integrate these disparate systems and enable the full benefits of CPOE by allowing clinical decisions to be made using consolidated patient data. For CPOE to be effective, healthcare systems need to move beyond standalone systems to fully integrated models that comply with standards like IHE.
The document discusses IT and decision support systems in hospital supply chains. It provides an overview of clinical decision making and clinical decision support systems (CDS), including definitions, types of CDS like alerts and reminders, expert systems, and references. It also discusses the roles of information technology in clinical decision making processes and how CDS can help reduce human errors.
Design and implementation_of_a_microcontMerianPadlan2
This document describes the design and implementation of a microcontroller-based infusion pump system for automatic drug delivery. The system uses a stepper motor to precisely deliver drugs to patients on a scheduled basis. It also includes Bluetooth connectivity to allow nurses to remotely monitor the system status without frequent bedside visits. Testing at a hospital showed the remote monitoring was particularly useful for nurses. The programmable microcontroller-based design allows for flexible control and monitoring of drug infusion.
Machine learning is the field that focuses on how computers learn from data. Today, machine learning is playing an integral role in the medical industry. This is due to its ability to process huge datasets beyond the scope of human capability, and then convert the data analyzed into clinical insights that aid physicians in providing care. Machine learning is a powerful, relatively easy to implement tool with numerous possibilities to enhance medical practice. The applications of machine learning in medicine are advancing medicine into a new realm. Therefore, educating the next generation of medical professionals with machine learning is essential. This paper provides a brief introduction to applying machine learning in medicine. Matthew N. O Sadiku | Sarhan M. Musa | Adedamola Omotoso "Machine Learning in Medicine: A Primer" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20255.pdf
Paper URL: https://www.ijtsrd.com/computer-science/other/20255/machine-learning-in-medicine-a-primer/matthew-n-o-sadiku
The document discusses key points healthcare providers should know about implementing electronic medical records (EMRs) by the 2014 mandate. It notes that current EMR vendors do not fully meet federal requirements and standards are still being developed. EMRs will be very expensive to implement and maintain, though government loans and grants are available to help fund them. Proper implementation requires addressing barriers like costs, unclear returns on investment, training needs, and resistance to change. Non-adoption will result in lower Medicare reimbursements starting in 2015.
A study on real time plant disease diagonsis systemIJARIIT
The document discusses developing a real-time plant disease diagnosis mobile application. It aims to allow farmers to easily capture images of plant leaves using a mobile camera, send the images to a central system for analysis, and receive diagnoses and treatment recommendations. The proposed system would use image processing and data mining techniques to analyze leaf images for abnormalities, identify the plant species, recognize any diseases present, and recommend appropriate pesticides and estimate treatment costs. This would provide a low-cost, convenient solution for farmers to quickly diagnose and respond to plant diseases.
Health IT Summit in Chicago 2014 – “The EHR & Quality: The Current Evidence” with Abha Agrawal, MD, FACP, COO & VP of Medical Affairs, Norwegian American Hospital
Abha Agrawal, MD, FACP
COO & VP of Medical Affairs
Norwegian American Hospital
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
This document presents a methodology for mapping multidimensional transforms onto reconfigurable architectures like FPGAs. The methodology uses tensor product decompositions and permutation matrices to express transforms recursively in terms of lower-order blocks. This allows large transforms to be computed by combining many parallel, smaller transform blocks. Specific examples are given for mapping one-dimensional linear convolution and discrete cosine transforms. The overall goal is to provide a unified framework and design process for implementing multidimensional transforms in a modular, parallel architecture.
This document describes the simulation of a dynamic voltage restorer (DVR) using PI control with fuzzy logic to mitigate voltage sags. A DVR is connected between a distribution system and critical load to inject compensating voltages during faults. The control system uses PI controllers for the dq components of load voltage with additional fuzzy logic control. Simulation results under different fault conditions show the DVR maintains the load voltage, demonstrating its effectiveness in compensating voltage sags. Total harmonic distortion is also improved by increasing the DC link voltage of the DVR. The PI with fuzzy logic control provides faster response compared to conventional controllers.
IJERA (International journal of Engineering Research and Applications) is International online, ... peer reviewed journal. For more detail or submit your article, please visit www.ijera.com
IJERA (International journal of Engineering Research and Applications) is International online, ... peer reviewed journal. For more detail or submit your article, please visit www.ijera.com
This document describes a telemedicine monitoring system developed using LabVIEW. The system acquires vital sign data like ECG, temperature, and oxygen saturation from patients. It then transmits this physiological data over the internet in real-time to remote monitors. The remote monitors can access the patient data and history using LabVIEW web services. The system blocks include data acquisition, signal processing in LabVIEW, transmission over the internet, and signal analysis in LabVIEW. The patient data can be displayed and remotely monitored in a web browser. This telemedicine system allows continuous remote patient monitoring with mobility and usability advantages over traditional monitors.
This document summarizes a research paper that proposes an Energy Efficient Reserved Path Routing Topology (RPRT) routing scheme for mobile ad hoc networks. The RPRT aims to improve energy efficiency and reduce end-to-end delay compared to the existing M-Trace routing scheme. It allows nodes to use estimated energy levels to make better channel admission control decisions for providing quality of service guarantees. The paper presents the RPRT scheme and its energy level estimation, routing discovery, route maintenance, and path selection mechanisms. Simulation results demonstrate that the RPRT achieves a 16% increase in energy efficiency and 37% reduction in end-to-end delay compared to M-Trace.
The document discusses a simulation model of a new single-phase to single-phase cycloconverter based on a single-phase matrix converter topology with sinusoidal pulse width modulation. A cycloconverter directly converts alternating voltage at the supply frequency to an output voltage at the load frequency without an intermediate DC stage. Simulation of the cycloconverter is done using MATLAB/Simulink incorporating Sim Power Systems blocks. Sinusoidal pulse width modulation is used to control the output voltage by varying the pulse widths. The document provides background on cycloconverters, their types and applications in power systems.
O documento resume as principais alterações introduzidas pelo Acordo Ortográfico da Língua Portuguesa de 1990, assinado por países da CPLP. Privilegia-se agora o critério fonético em vez do etimológico e introduzem-se três novas letras no alfabeto. Reduzem-se as regras de emprego do hífen e definem-se duplas grafias entre Portugal e Brasil.
Este documento resume el Plan Hidrológico de la Demarcación del Guadalquivir. Los objetivos son conseguir el buen estado de las masas de agua y satisfacer las demandas de agua de forma sostenible. Actualmente existe contaminación por vertidos urbanos e industriales, así como por nitratos y fitosanitarios agrícolas. También hay problemas de erosión y afecciones hidromorfológicas. El documento propone medidas como mejorar el tratamiento de aguas residuales, aplicar buenas prácticas agrarias y restaurar ecos
Este documento describe 4 actividades para el Proyecto 50. La Actividad 1 propone una estrategia para publicar experiencias educativas en la comunidad virtual de docentes de EAFIT. La Actividad 2 presenta una propuesta para incorporar Facebook en un evento académico internacional. La Actividad 3 da recomendaciones a docentes sobre cómo usar blogs para apoyar asignaturas. Y la Actividad 4 presenta una propuesta para usar Twitter para difundir y dialogar sobre el Proyecto 50.
O documento discute castanhas, castanheiros e como as castanhas são usadas. Detalha que castanhas amadurecem dentro de ouriços em árvores de castanheiro, que podem viver mais de mil anos. As castanhas são uma fonte de energia popular consumida cruas, cozidas ou assadas, especialmente no S. Martinho. Uma receita de bolo de castanha é fornecida.
El documento presenta el Plan Hidrológico de la Cuenca del Ebro, cuyo objetivo es gestionar el agua de forma sostenible y alcanzar un buen estado ecológico para 2015. Se elaboró siguiendo la Directiva Marco del Agua de la UE para garantizar la participación pública, el equilibrio entre usos y la conservación de los ecosistemas acuáticos. El plan incluye un diagnóstico inicial, objetivos y medidas para reducir la contaminación y mejorar la gestión del agua a través de controles periódicos
Este documento trata sobre la jornada de debate sobre los caudales ecológicos en la Demarcación Hidrográfica del Tajo. Explica la importancia de las centrales hidroeléctricas para garantizar el suministro eléctrico y los servicios de ajuste del sistema eléctrico nacional. También analiza cómo los nuevos caudales ecológicos podrían afectar negativamente a la generación hidráulica y la seguridad del suministro eléctrico.
Los expertos exigen priorizar el abastecimiento a las poblaciones de la cuenca del Tajo frente a Madrid, las hidroeléctricas y el Segura. Los científicos confirman que los trasvases no tienen sentido hoy en día y que existen otras alternativas sostenibles. Se debe mejorar la planificación del Tajo para satisfacer primero las necesidades de la cuenca antes de considerar trasvases.
Este documento describe los servicios de desarrollo organizacional de una consultora. Explica que construir una marca interna es esencial para aprovechar el conocimiento y el entusiasmo de los empleados y generar ventajas competitivas. También destaca que adaptar a cada persona a su puesto de trabajo es clave para la competitividad. Luego, detalla algunos programas de formación en habilidades directivas, orientación al cliente, motivación, coaching y tiempo libre que ofrece la consultora para ayudar a las empresas a gestionar mejor el cambio y ser más
Este documento presenta una guía para estudiantes de primaria sobre cómo tratarse bien los unos a los otros y evitar el maltrato. Explica qué comportamientos constituyen maltrato como pelearse, insultar o excluir a otros, y destaca la importancia de respetar los derechos y responsabilidades de cada persona. Además, ofrece consejos sobre qué hacer si se es víctima o testigo de maltrato y la necesidad de resolver los conflictos de forma pacífica.
This document discusses management and z-leadership. It is authored by Franck Bourdeau and published by DIA Editions. The title of the document is "Stupeur" which discusses innovative approaches to leadership.
Este documento describe los posibles riesgos laborales para los higienistas dentales y medidas para prevenirlos. Algunos riesgos incluyen permanecer en la misma postura por largos períodos, realizar movimientos repetitivos y contacto con productos. Esto puede causar fatiga, dolor de espalda, síndrome del túnel carpiano u otros problemas musculares. El documento recomienda tomar descansos, alternar tareas y posturas, y asegurar un espacio de trabajo ergonómico y bien iluminado para prevenir estos riesgos
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
Cis evaluation final_presentation, nur 3563 sol1SBU
An overview of a Computer Information System (CIS) and considerations that need to be taken with implementing an Electronic Health Record (EHR) in a healthcare setting.
This document explores barriers to implementing electronic medical records (EMRs) in primary care practices. It identifies the main barriers as financial cost, issues with technology, the time investment required, concerns over patient privacy, and potential negative impacts on patient-physician interactions. The document provides details on each of these barriers and recommends ways to address them, such as through government funding, improved technical support, protecting privacy under HIPAA, and optimizing EMR use during patient visits.
Evaluation of a clinical information system (cis)nikita024
This power point presentation provides an overview of a clinical information system (CIS). It discusses what a CIS is, how CIS have evolved, and the key players involved in designing CIS. It also examines the electronic health record component of a CIS and discusses the eight basic components that make up an EHR. Additional topics covered include clinical decision making systems, safety, costs, and education regarding CIS. The presentation was created by four students with each student covering specific slides and aspects of the topic.
IRJET- A System for Complete Healthcare Management: Ask-Us-Health A Secon...IRJET Journal
This document proposes a system called ASK-US-HEALTH that uses machine learning algorithms and data mining to provide healthcare management. It aims to help patients access a second medical opinion by entering symptoms and receiving the probable diagnosis. It would also provide doctor recommendations and store patient medical histories and prescriptions. The system intends to improve healthcare access and help manage patient care and data for research through connecting patients, doctors, and nearby pharmacies via a web application.
The document discusses engaging laboratory staff in electronic health record (EHR) implementation to reduce safety risks. It summarizes recommendations from the Clinical Laboratory Improvement Advisory Committee to include laboratory experts in EHR policy and establish systems for reporting EHR safety issues. The LabHIT Team aims to advance safe use of laboratory data in EHRs. Their report identifies three areas for action: engagement of laboratory professionals, ensuring data integrity and usability, and stimulating innovation. The document also reviews EHR safety studies and guidelines like the SAFER Guides to help reduce laboratory-related EHR risks.
Chapter 9 Patient Safety, Quality and ValueHarry Burke MD P.docxmccormicknadine86
Chapter 9: Patient Safety, Quality and Value
Harry Burke MD PhD
Learning Objectives
After reviewing the presentation, viewers should be able to:
Define safety, quality, near miss, and unsafe action
List the safety and quality factors that justified the clinical implementation of electronic health record systems
Discuss three reasons why the electronic health record is central to safety, quality, and value
List three issues that clinicians have with the current electronic health record systems and discuss how these problems affect safety and quality
Describe a specific electronic patient safety measurement system and a specific electronic safety reporting system
Describe two integrated clinical decision support systems and discuss how they may improve safety and quality
Patient Safety-Related Definitions
Safety: minimization of the risk and occurrence of patient harm events
Harm: inappropriate or avoidable psychological or physical injury to patient and/or family
Adverse Events: “an injury resulting from a medical intervention”
Preventable Adverse Events: “errors that result in an adverse event that are preventable”
Overuse: “the delivery of care of little or no value” e.g. widespread use of antibiotics for viral infections
Underuse: “the failure to deliver appropriate care” e.g. vaccines or cancer screening
Misuse: “the use of certain services in situations where they are not clinically indicated” e.g. MRI for routine low back pain
Introduction
Medical errors are unfortunately common in healthcare, in spite of sophisticated hospitals and well trained clinicians
Often it is breakdowns in protocol and communication, and not individual errors
Technology has potential to reduce medical errors (particularly medication errors) by:
Improving communication between physicians and patients
Improving clinical decision support
Decreasing diagnostic errors
Unfortunately, technology also has the potential to create unique new errors that cause harm
Medical Errors
Errors can be related to diagnosis, treatment and preventive care. Furthermore, medical errors can be errors of commission or omission and fortunately not all errors result in an injury and not all medical errors are preventable
Most common outpatient errors:
Prescribing medications
Getting the correct laboratory test for the correct patient at the correct time
Filing system errors
Dispensing medications and responding to abnormal test results
5
While many would argue that treatment errors are the most common category of medical errors, diagnostic errors accounted for the largest percentage of malpractice claims, surpassing treatment errors in one study
Diagnostic errors can result from missed, wrong or delayed diagnoses and are more likely in the outpatient setting. This is somewhat surprising given the fact that US physicians tend to practice “defensive medicine”
Over-diagnosis may also cause medical errors but this has been less ...
Chapter 9 Patient Safety, Quality and ValueHarry Burke MD P.docxtiffanyd4
Chapter 9: Patient Safety, Quality and Value
Harry Burke MD PhD
Learning Objectives
After reviewing the presentation, viewers should be able to:
Define safety, quality, near miss, and unsafe action
List the safety and quality factors that justified the clinical implementation of electronic health record systems
Discuss three reasons why the electronic health record is central to safety, quality, and value
List three issues that clinicians have with the current electronic health record systems and discuss how these problems affect safety and quality
Describe a specific electronic patient safety measurement system and a specific electronic safety reporting system
Describe two integrated clinical decision support systems and discuss how they may improve safety and quality
Patient Safety-Related Definitions
Safety: minimization of the risk and occurrence of patient harm events
Harm: inappropriate or avoidable psychological or physical injury to patient and/or family
Adverse Events: “an injury resulting from a medical intervention”
Preventable Adverse Events: “errors that result in an adverse event that are preventable”
Overuse: “the delivery of care of little or no value” e.g. widespread use of antibiotics for viral infections
Underuse: “the failure to deliver appropriate care” e.g. vaccines or cancer screening
Misuse: “the use of certain services in situations where they are not clinically indicated” e.g. MRI for routine low back pain
Introduction
Medical errors are unfortunately common in healthcare, in spite of sophisticated hospitals and well trained clinicians
Often it is breakdowns in protocol and communication, and not individual errors
Technology has potential to reduce medical errors (particularly medication errors) by:
Improving communication between physicians and patients
Improving clinical decision support
Decreasing diagnostic errors
Unfortunately, technology also has the potential to create unique new errors that cause harm
Medical Errors
Errors can be related to diagnosis, treatment and preventive care. Furthermore, medical errors can be errors of commission or omission and fortunately not all errors result in an injury and not all medical errors are preventable
Most common outpatient errors:
Prescribing medications
Getting the correct laboratory test for the correct patient at the correct time
Filing system errors
Dispensing medications and responding to abnormal test results
5
While many would argue that treatment errors are the most common category of medical errors, diagnostic errors accounted for the largest percentage of malpractice claims, surpassing treatment errors in one study
Diagnostic errors can result from missed, wrong or delayed diagnoses and are more likely in the outpatient setting. This is somewhat surprising given the fact that US physicians tend to practice “defensive medicine”
Over-diagnosis may also cause medical errors but this has been less.
Computerized physician order entry (CPOE)Norah Alfayez
This document provides an overview of computerized physician order entry (CPOE) systems. It defines CPOE and describes its key features and functions, including ordering, decision support, safety checks, and improved documentation. The document discusses common CPOE hardware and software and examines legal/ethical issues. It outlines both the advantages of CPOE in reducing errors and costs and the disadvantages such as high implementation costs. The document also reviews studies on CPOE's impact on patient safety and productivity issues during implementation.
Medical Simulation 2.0: Improving value-based healthcare deliveryYue Dong
This document provides an overview of medical simulation and its applications in healthcare delivery. It discusses how simulation can be used as a tool to systematically analyze complex healthcare systems and processes, identify bottlenecks, and test interventions to optimize quality and safety. Specific applications mentioned include using simulation to study workflows like sepsis care, test user interfaces on clinical tasks and performance, and evaluate new system designs before implementation. The goal is to move from traditional education-focused "Simulation 1.0" to a more integrated "Simulation 2.0" approach that leverages simulation throughout healthcare systems and daily practices.
This document discusses clinical information systems and their role in healthcare. It begins with background on healthcare and how information technology has helped address issues with declining resources and rapid knowledge growth. It then defines and discusses hospital information systems, clinical information systems, clinical decision support systems, and electronic medical records. It explains how these systems help with tasks like data management, decision making, and improving quality of care. The document also covers healthcare strategy making and how clinical information systems are developed and integrated.
Group project health_care_informatics[2guest1e610e
1) The document discusses components of a Clinical Information System (CIS) including an overview presented by four speakers and components of the Electronic Health Record such as health information, results management, and decision support.
2) It also discusses education and training needed for a CIS, safety and costs associated with electronic health records, and clinical decision making systems within a CIS.
3) References are provided at the end to support information discussed throughout the document.
Running Head EVALUATION PLAN FOCUSEVALUATION PLAN FOCUS 1.docxcowinhelen
Running Head: EVALUATION PLAN FOCUS
EVALUATION PLAN FOCUS 1
Evaluation Plan Focus
Student Name
University Affiliations
Date
Professor
Scenario 1:
Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also
Introduction
Evaluation plan involves an integral part regarding a grant suggestion providing information aimed at improving a project during the development and implementation. I will participate in the assessment of the scenario system in throughout the project. The scenario includes the hospital that is implementing the new unified as well as the Ambulatory EHR (Electronic Health Record) system that enhances the documentation of patient care. The purpose of the paper is explaining the selected scenario one, explanation of the reasons for selecting it, and summarizing of the research findings on the similar HIT implementations. More so, there is a description of the evaluation viewpoint, and goal guiding the assessment plan and same rationale.
HIT System Selected
The new system to be implemented has various modules that contain interdisciplinary assessment forms, medical notes, and clinical decision support where their documentation is guaranteed. The implementation of the unified system will enhance improved performance of the hospital in several departments. The new EHR system becomes of great importance to the hospital since there is a reduction of medical errors, reduction of the rate of the safety events of each patient, improving the quality of healthcare, deterrence of sentinel events, reduced patients readmissions as well as impact spending. Another reason for choosing the scenario is that the new system will enhance while fulfilling the requirements of meaningful use as stipulated in the HITECH (Health Information Technology for Economic and Clinical Health) Act. Therefore, the need for evaluation regarding the EHR implementation becomes paramount since it will help to identify the associated risks while adjusting the modules required when offering the medication services to the patients (Lanham, Leykum & McDaniel, 2012).
Summary of Research Findings on Similar HIT Implementations
Several evaluations are analogous to the HIT system implementation of the unified system with related differences regarding the outcomes based on the primary goals. For instance, some of the implemented systems fail to meet one hundred percent ...
Application Evaluation Project Part 1 Evaluation Plan FocusTec.docxalfredai53p
Application: Evaluation Project Part 1: Evaluation Plan Focus
Technology increases human effectiveness. Using a lever, you can move an object several times your size. In an airplane, you can move exponentially faster than on foot. Using the Internet, you can access information much more quickly than at a library. What possibilities like this exist in the nursing field? What health information technologies can amplify your impact as a nurse far more than ever before? In this Evaluation Project, you will have the opportunity to answer these questions.
Because of the great differences between HIT systems and different goals of an evaluation, there is no one-size-fits-all evaluation plan. Different technologies require different evaluation methods. Consequently, in this part of your Evaluation Project, you will conduct research on how system implementations similar to the one you select have been previously evaluated. After exploring similar system implementations, you will select one research goal and viewpoint to use in the evaluation.
Read the following three scenarios, and select the one that is of most interest to you:
Scenario 1:
Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also intended to fulfill the “Meaningful Use” requirements stipulated in the Health Information Technology for Economic and Clinical Health (HITECH) Act. As the hospital’s lead nurse informaticist, you have been tasked with planning the evaluation of the EHR implementation.
Scenario 2:
As the lead nurse informaticist in your hospital, you have been given the task of planning an evaluation for a soon-to-be launched computerized provider order entry (CPOE) system. The CPOE system is designed to replace conventional methods of placing medication, laboratory, admission, referral, and radiology orders. CPOE systems enable health care providers to electronically specify orders, rather than rely on paper prescriptions, telephone calls, and faxes. The intended goal of a CPOE system is to improve safety by ensuring that orders are easily comprehensible through the use of evidence-based order sets. In addition, the CPOE system has the potential for improving workflow by avoiding duplicate orders and reducing the steps between those who place medical orders and their recipients.
Scenario 3:
You are the lead nurse informaticist in a large urban hospital that has recently implemented a new .
Virtual clinical trials utilize emerging technologies like mobile apps, remote monitoring devices, and online platforms to conduct clinical trials remotely with participants in their homes. This allows trials to have more convenient participation, potentially improving enrollment, retention, and compliance. However, virtual trials also face challenges like developing patient trust in internet-based data collection and ensuring appropriate populations are selected. Early case studies provided lessons about balancing technology with human support. Overall, virtual trials may become a more important model as patients expect remote participation options and for certain study types and populations.
STUDY PROTOCOL Open AccessSafety Assurance Factors for Ele.docxhanneloremccaffery
STUDY PROTOCOL Open Access
Safety Assurance Factors for Electronic Health
Record Resilience (SAFER): study protocol
Hardeep Singh1*, Joan S Ash2 and Dean F Sittig3
Abstract
Background: Implementation and use of electronic health records (EHRs) could lead to potential improvements in
quality of care. However, the use of EHRs also introduces unique and often unexpected patient safety risks.
Proactive assessment of risks and vulnerabilities can help address potential EHR-related safety hazards before harm
occurs; however, current risk assessment methods are underdeveloped. The overall objective of this project is to
develop and validate proactive assessment tools to ensure that EHR-enabled clinical work systems are safe and
effective.
Methods/Design: This work is conceptually grounded in an 8-dimension model of safe and effective health
information technology use. Our first aim is to develop self-assessment guides that can be used by health care
institutions to evaluate certain high-risk components of their EHR-enabled clinical work systems. We will solicit input
from subject matter experts and relevant stakeholders to develop guides focused on 9 specific risk areas and will
subsequently pilot test the guides with individuals representative of likely users. The second aim will be to examine
the utility of the self-assessment guides by beta testing the guides at selected facilities and conducting on-site
evaluations. Our multidisciplinary team will use a variety of methods to assess the content validity and perceived
usefulness of the guides, including interviews, naturalistic observations, and document analysis. The anticipated
output of this work will be a series of self-administered EHR safety assessment guides with clear, actionable,
checklist-type items.
Discussion: Proactive assessment of patient safety risks increases the resiliency of health care organizations to
unanticipated hazards of EHR use. The resulting products and lessons learned from the development of the
assessment guides are expected to be helpful to organizations that are beginning the EHR selection and
implementation process as well as those that have already implemented EHRs. Findings from our project, currently
underway, will inform future efforts to validate and implement tools that can be used by health care organizations
to improve the safety of EHR-enabled clinical work systems.
Keywords: Electronic health records, Health information technology, Patient safety, Risk assessment, Resilience
Background
Several countries have made recent multi-billion dollar
investments in electronic health record (EHR) infra-
structure to transform their health care delivery systems.
However, implementation of EHR-related initiatives has
encountered greater than expected challenges [1-4].
Although successful transformations have occurred in a
few pioneering healthcare organizations across the globe,
[5,6] the vast majority of organizations are still in the
process of implementing.
The document discusses the development and findings of a pilot Electronic Care Record (ECR) project in Northern Ireland. The key points are:
1) The pilot integrated clinical information from 16 existing health systems and allowed clinicians to access patient data via a single login.
2) Evaluation found the ECR improved clinical outcomes and decision making. 97% of users were satisfied with ease of use and found it useful.
3) The pilot demonstrated that a regional ECR is achievable and could help improve patient safety, quality of care and reduce costs across Northern Ireland.
February 10, 2011 BDPA Charlotte Program meeting.
Presented by:
Karen D. Hill, RHIA
Recruitment/Placement Specialist
ONC HIT Grant
Health Sciences Division
Central Piedmont Community College
Health Information Technology Workforce Development Program
Central Piedmont Community College
The document is a presentation about polyclinic waiting time problems and solutions at Tawam Hospital in the UAE. It introduces the presenter and states that the presentation will be divided into four parts: an overview, study results, current and proposed processes, and recommendations/conclusions. It provides background on Tawam Hospital and defines waiting time. It discusses implementation of a Health Information System (HIS) and benefits, as well as research aims, methodology involving questionnaires, and results showing specialists are satisfied with HIS but it is not the main cause of delays. Results of patient questionnaires show waiting times at various stages with most waiting over 60 minutes for required service.
The document summarizes the process of implementing an integrated electronic health record (IEHR) system in a university exercise physiology teaching clinic. Key steps included procuring practice management software with IEHR capabilities, developing condition-specific protocols, designing clinical interfaces, and configuring the system for data entry via questionnaires and during consultations. Interviews found that staff and students perceived more advantages than disadvantages to adopting IEHR, such as improved patient care, progress tracking, and the ability to engage in research. The new system aims to enhance student learning and patient outcomes by allowing access to health information and progress data.
1. Ahmed Sharaf Eldin, Doaa Saad, Ghada.A.Samie / International Journal of Engineering
Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
Vol. 3, Issue 1, January -February 2013, pp.1131-1134
Evaluation of Electronic Health Records Adoption in Egypt
1
Ahmed Sharaf Eldin, 2Doaa Saad, 3Ghada.A.Samie
1
Medical and Bio-Informatics Department, Faculty of Computers and Information, Helwan University, Cairo,
Egypt
2, 3
Information Systems Department, Faculty of Computers and Information, Helwan University, Cairo, Egypt
ABSTRACT
Information technology offers a lot of Authority for Health Insurance under supervision of
systems to develop and facilitate work in different Ministry of Health.
areas. Electronic Health Records system is The private sector supervised by Ministry of Health
relevant in providing support and development of is divided into three types: hospitals, medical centers
work in the medical field, This paper presents the The questionnaire designed to cover all the above
current state of Electronic Health Records in areas of health.
Egypt. It Surveys a sample of public, private, and
educational hospitals in Egypt. IV. QUESTIONNAIRE DESIGN PROCESS
Keywords: Electronic Health Records. Questionnaire, is the data gathering
technique used in surveying EHR adoption in area of
I. INTRODUCTION hospitals. The Questionnaire method can be
Electronic Health Records(EHR) is one of answered quickly, relatively inexpensive way to
the information technology mechanism in healthcare gather data from a large number and allow people to
environments that can improve patient safety and provide real facts. The questionnaire used here is
increase practice efficiency[1,4] and can provide designed through three Stages as follows:
positive returns on investment[5-7]. Due to these
advantages, governments in many countries have Stage 1: Questionnaire Design
tried to encourage the adoption of EHR in clinical This stage determines what facts needs to be
practice, but the rate at which these technologies have surveyed about EHR and who employees will be
been adopted remains low. involved in the survey inside hospitals. A Fixed-
format questionnaire is used where Closed-ended
II. BEHIND ELECTRONIC HEALTH RECORDS questions are presented to make it easier to answer .
The Health Information Management
Systems Society’s (HIMSS) define EHR as : Stage 2: Pre-Testing
The Electronic Health Record (EHR) is a longitudinal Pre-testing is one of the most important
electronic record of patient health information stages in designing a Questionnaire. The purpose of
generated by one or more encounters in any care this stage is testing and ensuring the efficiency of
delivery setting. Included in this information, are the questionnaire to collect data and how it is easy to
patient demographics, progress notes, problems, understand.
medications, vital signs, past medical history, Pre-testing can be done in several ways:
immunizations, laboratory data and radiology reports. - Testing the initial design decisions and items to
The EHR automates and streamlines the clinician's determine how well the process is working.
workflow. The EHR has the ability to generate a - Reviewing past studies with the same or similar
complete record of a clinical patient encounter - as research problems; this enable to develop initial
well as supporting other care-related activities drafts of questionnaires by borrowing and modifying
directly or indirectly via interface - including validated questions from previous studies.
evidence-based decision support, quality - Conducting pre-test interviews with several
management, and outcomes reporting. healthcare professionals, expert researchers and
colleagues until feeling comfortable with the
III. SURVEY AREA questionnaires.
The Healthcare Sector in Egypt is divided - Conducting pre-test questionnaires on sample of
into two main categories public and private, The people in order to ensure that the respondents
public hospitals in Egypt are three different types, the understand the questions.
first one is directly controlled by Ministry of Health,
the second type involves the hospitals of Stage 3: Final Questionnaire Refining
universitieswhich is controlled by medicine colleges The results from pre-testing stage are used to:-
in each university, and the third type is the health Improve the Questionnaire design and
insurance hospital which is controlled by the General implementation of plans of analyzing data.
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2. Ahmed Sharaf Eldin, Doaa Saad, Ghada.A.Samie / International Journal of Engineering
Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
Vol. 3, Issue 1, January -February 2013, pp.1131-1134
- Estimate how long it takes to complete a Major Minor
Barriers
Questionnaire. barrier barrier
- Discover factors that affect response rates & data Access to technical support 44% 36
quality, and make adjustments accordingly.
The final changes of the questionnaires and plans for Computer skills 17% 48
analyzing the data should be made in this stage Lack of uniform industry
standards 44% 49
V. THE FINAL INSTRUMENT Technical limitations of
The questionnaire was distributed to all the systems 21.4% 58
chosen hospitals and the responses were received Privacy or security
from (60%) of the surveyed hospitals. The concerns 3.57% 17
percentage of hospitals that adopted EHR was Start-up financial costs 81% 17
6.67 % .The most common reason given for not Ongoing financial costs 63% 35
introducing EHR was: “The cost is high” ,which Training and productivity
was observed in 38.1% of the hospitals that didn't loss 15.5% 65
introduce the system and have plans to introduce it Table1: EHR Barriers
in the future .
All the above stages are distributed to get three … Training and
different questionnaires: Ongoing financial costs
- Questionnaire dedicated to doctors " 9 pages,
24 questions" Start-up financial costs
Not a barrier
- Nurses " 5 pages,12 questions"
Minor barrier … Privacy or security
- Administrators " 5 pages,12 questions"
Every questionnaire is divided into three sections:
Major barrier
- Demographic data section
- Hospitals didn’t adopt EHR section
- Hospitals that adopt EHR section
Computer skills
VI. RESULTS
After designing questionnaires and
distributing it, comes the analyzing of the collected 100 80 60 40 20 0
data. The questionnaires were distributed on
50 hospitals but the responses obtained from only 60
percent of them because the percentage of the Figure1: Graphical representation of Barriers in
hospitals that adopt the system is only 6.67%. EHR adoption
The questionnaires targeted three sectors of VIII. EVALUATION OF THE EFFECTIVENESS
the hospital staff, doctors, nurses and administrators, OF ELECTRONIC HEALTH RECORDS
as explained in the previous section. In hospitals that adopted HER, we can
Barriers prevented the system adoption, measure its effectiveness. In terms of the
effectiveness of EHR, cost-effectiveness of EHR, effectiveness of EHR in hospitals, the most common
real use of system functions response is "EHR is adopted to increase Quality of
services" which is (100%). This is followed by "
VII. BARRIERS EHR accelerates and improves Performance " which
Many reasons exist when it comes to the is (67%). Most notable was the response “time
barriers that prevented the system adoption , such as efficiency of physicians " which is 50% . This is
lack of computer skills or Access technical support shown in table2 and Figure2.
but the most common reason is " The cost is high"
that’s clear in 81.0% of the hospitals that didn’t Functionality Usage
adopt the system yet. By analyzing the collected Demographic functionality 100%
data,
some barriers that prevented the adoption of the Clinical documentation functionalities 66%
system are shown in table 1 and are graphically Order management functionalities 66.7%
represented in Figure1. Reporting functionalities 50%
Results management functionalities 37.5%
Table2: Effectiveness of HER
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3. Ahmed Sharaf Eldin, Doaa Saad, Ghada.A.Samie / International Journal of Engineering
Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
Vol. 3, Issue 1, January -February 2013, pp.1131-1134
Second Envision the Future
The application in future can be examined by
notifying the difference between the current state of
the staff and the patients, and the practice leadership
plans for them in the future.
A. Third Set Goals
Decision making need's to document Goals and
needs, throughout the EHR implementation process ,
goals must be important and meaningful to the
practice , These goals may be clinical goals,
revenue goals, or goals around work environment,
Figure 2: Effectiveness of EHR the goals must be specific, measurable , Attainable ,
Relevant and Time bound.
IX. EVALUATION OF THE COST- Step 2: Plan The Approach
EFFECTIVENESS OF ELECTRONIC MEDICAL Good EHR implementation plan will guide to
perform the efficient tasks
RECORDS
In the right order, there are some tactical
With regard to the cost-effectiveness of steps during the EHR implementation planning
EHR, 33% of the sample gave responses of either phase like:
“strongly agree” or “somewhat agree.” With regard - Workflow and work processes Analysis and
to the necessity of promoting computerization of mapping.
healthcare information in Egypt in the future, the - Create new workflow patterns to improve
combined responses of “strongly agree” and inefficiency.
“somewhat agree” amounted to 50%. - Create back-up plan to combat issues that
may arise throughout the implementation process.
X. EVALUATING REAL USE OF SYSTEM - Create a project plan for transitioning from
FUNCTIONS paper to EHR.
EHR has five types of functionalities: - Transform information from paper charts to
1. Demographic functionality electronic charts.
2. Clinical documentation functionalities - Understand what data elements may be
3. Order management functionalities migrated from the paper system to EHR.
4. Reporting functionalities - Create a plan to address the concerns and
5. Results management functionalities obstacles regarding privacy and security.
Step 3: Select or Upgrade to a Certified EHR
Table 3 shows the functionalities
One of the critical decisions in the EHR
implementation process is system Vendor selection,
Table3: EHR functionalities.
it can be selected through the planning process and
accordingly develop the selection criteria or select
EHR software and then begin the planning to
XI. EHR Adoption support the selected EHR system.
As shown from the results presented, the
Step 4: Conduct Training & Implement an EHR
proportion of hospitals that have implemented the
System
system was too small about 7% There are some activities come after the installation
approximately, which means that the development of the EHR system such as training, mock “go-live,”
of the system in Egypt is less than 10%, which and pilot testing, these activities are mostly done in
requires to be applied more in all hospitals. this phase .
The following steps are needed to adopt the
Step 5: Continue Quality Improvement
system[9]: This final phase refers to reassessing what have
Step 1: Assess Practice Readiness learned from training and everyday use of the
This Step determines if the readiness exist to make system. It emphasizes continuous evaluation of
the change from paper records to electronic health
practice’s goals and needs to post EHR
records or not.
implementation to continue improving workflows
First Determine the current state in hospitals that achieve the individual practice’s goals and
The current state of hospitals can be determined by needs while leveraging the functionality of EHR.
assessing the administrative processes, the linical
workflows, data collection and reporting processes,
Internet connectivity, staff member's computer skills
and the budget required.
1133 | P a g e
4. Ahmed Sharaf Eldin, Doaa Saad, Ghada.A.Samie / International Journal of Engineering
Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
Vol. 3, Issue 1, January -February 2013, pp.1131-1134
XII. CONCLUSION
Still a long way to go to get Egypt's
electronic health records system adopted in all
hospitals, Coherent and conforms to international
standards.
Our study clearly demonstrated that the current
status of EHR adoption in Egypt has Fallen away
from the desired, just few hospital apply the system
And a lot of workers in the medical sector are
unaware of what system and what are its benefits.
XIII. REFERENCES
[1] D.W. Bates, L.L. Leape, D.J. Cullen, N. Laird,
L.A. Petersen, J.M., Teich, E. Burdick, M.
Hickey, S. Kleefield, B. Shea, M. Vander,
Vliet, D.L. Seger, Effect of computerized
physician order entry and a team intervention
on prevention of serious, medication errors,
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[2] D.W. Bates, M. Ebell, E. Gotlieb, J. Zapp,
H.C. Mullins, A proposal for electronic
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Med. Inform. Assoc. 10 (January–February
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[3] B. Chaudhry, J. Wang, S. Wu, M. Maglione,
W. Mojica, E. Roth, S.C. Morton, P.G.
Shekelle, Systematic review: impact of health
information technology on quality, efficiency,
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[4] J.S. Einbinder, D.W. Bates, Leveraging
information technology to improve quality and
safety, Yearb. Med. Inform. (2007) 22–29.
[5] S.J. Wang, B. Middleton, L.A. Prosser, C.G.
Bardon, C.D. Spurr, P.J. Carchidi, A.F. Kittler,
R.C. Goldszer, D.G. Fairchild, A.J. ,Sussman,
G.J. Kuperman, D.W. Bates, A cost-benefit
analysis of electronic medical records in
primary care, Am. J. Med., 114 (April (5))
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[6] R. Kaushal, A.K. Jha, C. Franz, J. Glaser, K.D.
Shetty, T. Jaggi, B., Middleton, G.J.
Kuperman, R. Khorasani, M. Tanasijevic,
D.W., Bates, Brigham and Women’s Hospital
CPOE Working Group, Return on investment
for a computerized physician order, entry
system, J. Am. Med. Inform. Assoc. 13 (May–
June (3)), (2006) 261–266.
[7] P.G. Shekelle, S.C. Morton, E.B. Keeler, Costs
and benefits of health information technology,
Evid. Rep. Technol. Assess, (Full Rep.) April
(2006) 1–71.
[8] HIMSS (Healthcare Information and
Management Systems
Society) http://www.himss.org/ASP/index.asp.
[9] Advancing America's Health Care
http://www.healthit.gov/
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