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).
Factors Affecting the Adoption of Electronic Health Records by Nursepaperpublications3
Abstract: Electronic Health Record has potential to improve patient care by managing patient’s medical and personal information efficiently and effectively. It is easy to maintain patient information electronically compared to paper based records. Many studies have been done in other countries to study the effective use of Electronic Health Record, but a small number of studies exist in Indian situation. This study is a footstep in this route. This study has been done to know the use of electronic health records among nurses in private medium sized hospitals of Tamil Nadu, India. The objective of the study is to explore the use of Electronic Health Records and barriers in using it among nurses. This study also analyzes the factors affecting nurses to adopt electronic health record. Only a third of the nurses (33%) use electronic health record. Lack of training is the major hindrance in use electronic health record among nurses.
Summary
Goals: Seeking an opportunity in administrative healthcare where I can utilize what I have learned through education and life-long experiences.
I would like to use knowledge of healthcare management, health law, leadership in healthcare administration, medical care organization, and public healthcare policy. Studied analysis, planning, design, and management of healthcare institutions and organizations. Built focus on achieving quality patient care through increased efficiency and accessibility. Used Care MedX (an electronic medical record system) and trained other staff members on how to use the system properly.
• Effectively researched and analyzed an electronic medical records implementation at a long-term care facility for a case study. Implementation was managed in stages due to fiscal restraints.
• Researched health care system of the state of Indiana, including Medicaid, waivers, Indiana Senate Bill 327, Children’s Health Insurance Program, and managed care and single payer systems.
• Assessed technical and organizational requirements for developing electronic medical records, including client/server applications, vendor selection, implementation, and training.
Specialties: Project Management, Case Studies, Quantitative/ Qualitative Analysis, Customer Service, Inventory Control, Staff Management, Information Systems
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).
Factors Affecting the Adoption of Electronic Health Records by Nursepaperpublications3
Abstract: Electronic Health Record has potential to improve patient care by managing patient’s medical and personal information efficiently and effectively. It is easy to maintain patient information electronically compared to paper based records. Many studies have been done in other countries to study the effective use of Electronic Health Record, but a small number of studies exist in Indian situation. This study is a footstep in this route. This study has been done to know the use of electronic health records among nurses in private medium sized hospitals of Tamil Nadu, India. The objective of the study is to explore the use of Electronic Health Records and barriers in using it among nurses. This study also analyzes the factors affecting nurses to adopt electronic health record. Only a third of the nurses (33%) use electronic health record. Lack of training is the major hindrance in use electronic health record among nurses.
Summary
Goals: Seeking an opportunity in administrative healthcare where I can utilize what I have learned through education and life-long experiences.
I would like to use knowledge of healthcare management, health law, leadership in healthcare administration, medical care organization, and public healthcare policy. Studied analysis, planning, design, and management of healthcare institutions and organizations. Built focus on achieving quality patient care through increased efficiency and accessibility. Used Care MedX (an electronic medical record system) and trained other staff members on how to use the system properly.
• Effectively researched and analyzed an electronic medical records implementation at a long-term care facility for a case study. Implementation was managed in stages due to fiscal restraints.
• Researched health care system of the state of Indiana, including Medicaid, waivers, Indiana Senate Bill 327, Children’s Health Insurance Program, and managed care and single payer systems.
• Assessed technical and organizational requirements for developing electronic medical records, including client/server applications, vendor selection, implementation, and training.
Specialties: Project Management, Case Studies, Quantitative/ Qualitative Analysis, Customer Service, Inventory Control, Staff Management, Information Systems
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
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.
CONCEPTUAL MODEL FOR ELECTRONIC CLINICAL RECORD INFORMATION SYSTEMijistjournal
This study 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 model. 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.
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
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.
CONCEPTUAL MODEL FOR ELECTRONIC CLINICAL RECORD INFORMATION SYSTEMijistjournal
This study 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 model. 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.
An overview of ChangeMedium and the ChangeMediumToronto pilot.
A charitable initiative provoking the medium for change.
Evemts >> infrastructure + applications
Overview of the Ecologos Institute and its program for regional
renewal featuring the Toronto Regional Renaissance Collaboration and
the Universarium Travelling Fair.
Pg2 Beginning in 1991, the IOM (which stands for the Institute o.docxrandymartin91030
Pg2 Beginning in 1991, the IOM (which stands for the Institute of Medicine of the National Academies) sponsored studies and created reports that led the way toward the concepts we have in place today for electronic health records. Originally, the IOM called them computer-based patient records.1 During their evolution, the EHR have had many other names, including electronic medical records, computerized medical records, longitudinal patient records, and electronic charts. All of these names referred to essentially the same thing, which in 2003, the IOM renamed as the electronic health records, or EHR.
Note: EHR
The acronym EHR is commonly used as shorthand for Electronic Health Records, and will be used in the remainder of this book.
Institute of Medicine (IOM)
The IOM report2 put forth a set of eight core functions that an EHR should be capable of performing:
Health information and data
This function provides a defined data set that includes such items as medical and nursing diagnoses, a medication list, allergies, demographics, clinical narratives, and laboratory test results. Further, it provides improved access to information needed by care providers when they need it.
Result management
Computerized results can be accessed more easily (than paper reports) by the provider at the time and place they are needed.
· Reduced lag time allows for quicker recognition and treatment of medical problems.
· The automated display of previous test results makes it possible to reduce redundant and additional testing.
· Having electronic results can allow for better interpretation and for easier detection of abnormalities, thereby ensuring appropriate follow-up.
· Access to electronic consults and patient consents can establish critical links and improve care coordination among multiple providers, as well as between provider and patient
Order management
Computerized provider order entry (CPOE) systems can improve workflow processes by eliminating lost orders and ambiguities caused by illegible handwriting, generating related orders automatically, monitoring for duplicate orders, and reducing the time required to fill orders.
· CPOE systems for medications reduce the number of errors in medication dose and frequency, drug allergies, and drug–drug interactions.
· The use of CPOE, in conjunction with an EHR, also improves clinician productivity.
Decision Support
Computerized decision support systems include prevention, prescribing of drugs, diagnosis and management, and detection of adverse events and disease outbreaks.
· Computer reminders and prompts improve preventive practices in areas such as vaccinations, breast cancer screening, colorectal screening, and cardiovascular risk reduction.
Electronic communication and connectivity
Electronic communication among care partners can enhance patient safety and quality of care, especially for patients who have multiple providers in multiple settings that must coordinate care plans.
· Electronic co.
CONCEPTUAL MODEL FOR ELECTRONIC CLINICAL RECORD INFORMATION SYSTEMijistjournal
This study 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 model. 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.
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 ...
Respond to at least two of your colleagues offering additionalal.docxaudeleypearl
Respond to at least two of your colleagues* offering additional/alternative ideas regarding opportunities and risks related to the observations shared.
Eliverta
Discussion - Week 6
Top of Form
Electronic Health Record (EHR) is continuing to evolve in today’s medical facilities. The American Recovery and Reinvestment Act mandated health organizations to transition to Electronic Medical Records (EMR) by January 1, 2014 in order to maintain Medicaid and Medicare reimbursement (USF Health, 2019). For this week’s discussion I will reflect on the module resources on digital information tools and technologies. I will discuss the healthcare technologies used in the health organization I work for. Lastly, I will reflect on any possible health technologies and the impact it has on nursing practice and healthcare delivery.
The health organization I work for switched to EPIC software for EMR two years ago. EPIC is user friendly for nurses as well as patients. EPIC corresponds to MyChart giving patients access to on their medical records (MyChart, 2019). I work in outpatient Endoscopy clinic where part of patient After Visit Summary (AVS) we educate patients on the use of MyChart and provide them with a code so they can access MyChart from home. Patients can access their medical records, and view lab results, make appointments, communicate with their provider, and pay their medical bills with MyChart (2019). ProVation is another form of technology used in the facility I work for. ProVation is used by the physicians where they document the Endoscopy procedure outcomes and results noted by the physician (ProVation, 2019). The physicians can document their findings as well as list out orders or management solutions for the patients (ProVation, 2019).
EHR has made it possible for nurses to provide efficient patient care as it has given us the ability to share patient information with other providers and health care organization departments, such as pharmacy, laboratory, etc (HealthIT, 2018). Patient care and experiences are improving because patients are being included in their care and they can make decisions in the plan of care. Having quick access to medical records and information results in increased patient satisfactions. Also, by combining patient portals inpatient healthcare facilities has resulted in a decrease of medical errors and adverse events (Dyes et al, 2017).
EHR poses a list of challenges with the main one being security safety. Web-based technology does put us at increased risk of breach of information by hackers. It can also be challenging for individuals to navigate web-based health technology, resulting in decreased patient satisfaction. Our older population is reluctant when it comes to using technology, they prefer paper written information. Documentation errors are associated with improper utilization, due to insufficient training (David, 2017).
In conclusion, EHR comes with many benefits as well as challenges. It has improved qu ...
1. Exploring Barriers to
Implementing Electronic
Medical Records in
Primary Care Practices
Amrita Parmar
HIMA 5060- Final
Fall 2012-Dr. Zeng
2. Introduction
Obesity and chronic disease are major concerns faced
by primary care physicians. CDC (Centers of Disease
Control and Prevention) reports one third of the adult
population in the United States is obese (35.7%) 1
Health conditions are a burden in terms of cost, providing
care, and patient management. 1 Primary care physicians
are first contacts for patients, resulting in health burden
placed upon primacy care physicians 2
Adoption of health information technology may solve this
increasing pressure2
Electronic Medical Record (EMR) is a systematic
collection of health information pertaining to individual
patients medical history. 3
3. Background
Many advantages to implementing EMR found in literature
however, implementation is very low. Only 4% of primary care
providers have fully functional EMR systems and 13% have a
more basic system. 12
Implementation of EMR systems could lead to efficiency,
quality and quantify of care provided
Traditional method: paper-based medical record; leading to
space consumption and delay access to medical care. 4
Paper-based method less efficient due to increase of health
burden and need for care
The EMR system allows multiple users to access the patient
record creating legible and organized recordings of a
patients medical history. 4
4. Findings
Barriers to implementing an EMR system in a
primary care practice:
Financial Cost
Technology
Time
Patient Record Privacy
Quality of Patient-Physician Interaction
5. Financial Cost
Physicians weigh the cost of implementing EMR with benefits and return on
investment
Start-up cost (purchase of hardware and software, installation cost)
Ongoing cost (technological support, administration of system and maintenance)
Return on investment is not seen until months into implementation
Primary care facilities may have to put in a large sum of money at start-up
McGinn, C. A., et al. (2011) reported 19 (out of 52 studies corresponding to
60 publications) considered cost as a major issue of EMR implementation
in their systematic review
Training healthcare professionals can require cost to hire system
operations personnel
Size of practice (smaller primacy care practices may be more reluctant to
implement EMR due to high costs)
6. Technology
Basic computer skills are necessary in operating an EMR
system
Primary care physicians may lack technical skills
Physicians need to quickly record information that the
patient is providing to decrease (or keep the same) the
time spent on each patient, prior to implementation of
the system
Issues: hardware, server, network malfunctions, system not
providing the promised results can cause delay 7
Difficulty in reaching support personnel leading to Primary
care physicians getting technical support from other
support agencies at a higher cost. 2
7. Time
Two parts:
Physicians believe EMR system will increase time
spent on each patient and the system may not be
as reliable, efficient has completing paper charts.
Time needed for implementing the EMR system into
the practice and time taken to start using the system
efficiently. Even after implementation access to
technical support, incase issues arise, can also affect
time.
8. Patient Record Privacy
Primary care physicians concern for patient
record privacy:
Lack of overall clear security standards that can be
followed upon implementation. 4
Inappropriate disclosure of medical records leading
to legal issues. 4 McGinn et al. reported that
physicians reported patient record security as the
second most mentioned factor in the systematic
review (21 of the 52 studies). 5
9. Quality of Patient-Physician
Interactions
Quality of are may decrease due to the use of an
EMR system
Physicians inputting detailed notes while in the
examination room with the patient
Impact the amount of attention provided by the
physician to the patient 5
Paper-based system allows physicians to write as
much or as little and they think necessary
Loss of individual practice style for the physician
due to following EMR template
10. Conclusions
In order to meet the needs of an increasingly unhealthy
population, EMR systems need to be implemented
Barriers faced by primary care practices must be assessed
and successful implementation strategies need to be
found
Health system stakeholders cannot expect our healthcare
systems to perform if solutions to barriers do not exist. 6
This paper explored barriers to EMR system
implementation in primary care practices. The barriers
reported on included: financial cost, technology, time,
patient record privacy and quality of patient-physician
interaction.
11. Recommendations
Financial cost could be government funding or subsidized cost for
practices that treat Medicare and or Medicaid patients
Primary care physicians that provide care to state or federal plan carriers
could be compensated for implementing EMR systems. 4
EMR system developing companies, offering better customer support,
could resolve technological issues
Primary care physicians should look into systems that are best suited for
their practice.
Patient privacy can be protected under the Health Insurance Portability
and Accountability Act (HIPPA). 4 This act can protect the handing and
transporting of health records from physician to patient, one medical
facility to another, or anywhere where records need to be transported
Physician patient interaction can be improved by proper position of
monitor in the examination room
If funds are available purchasing a tablet could be effective in entering
data while providing care to patients
12. References
The Centers of Disease Control and Prevention. (2012). Overweight and Obesity. Adult Obesity Facts. Retrieved from: http://www.cdc.gov/obesity/data/adult.html
1
Ludwick, D. A., and Doucette, J.(2009). Primary Care Physicians’ Experience with Electronic Medical Records: Barriers to Implementation in a Fee-for-Service
2
Environment. International Journal of Telemedicine and Applications. 853524(9). Retrieved from: http://www.hindawi.com/journals/ijta/2009/853524/
3
Vanek, V. W.,(2012). Providing Nutrition Support in the Electronic Health Record Era: The Good, the Bad, and the Ugly. Nutritional in Clinical Practice. 27(718). Retrieved
from: http://ncp.sagepub.com/content/27/6/718.full.pdf+html
Boonstra, A. and Broekhuis, M.,(2010). Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions.
4
BMC Health Services Research. 10(231). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924334/pdf/1472-6963-10-231.pdf
McGinn, C. A. et al.,(2011).Comparison of user groups’ perspectives of barriers and facilitators to implementing electronic health records: a systematic review. BMC
5
Medicine. 9(46). Retrieved from: http://www.biomedcentral.com/1741-7015/9/46
Ludwick, D. A. and Doucette, J.,(2009). Adopting electronic medical records in primary care: Lessons learned from health information systems implementation
6
experience in seven countries. International Journal of Medical Informatics. 78(22-31). Retrieved from:
http://www.mece.ualberta.ca/~doucette/Publications/Ludwick-Doucette-IJMI-2009-EMR.pdf
Tonnesen, A. S.,(1999).Electronic Medical Record Implementation Barriers Encountered During Implementation. AMIA, Inc. 1091-8280(99). Retrieved from:
7
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2232660/pdf/procamiasymp00004-0661.pdf
Pizziferri, L. et al.,(2005). Primary care physician time utilization before and after implementation of an electronic health record: A time-motion study. Journal of
8
Biomedical Information. 38(176-188). Retrieved from: http://ww.marcomannino.com/healthcare/articles/time_motion_emr.pdf
Rind, D. M. and Safran, C.,(1994).Real and imagined Barriers to an Electronic Medical Record. AMIA, Inc. 92(0195-4210). Retrieved from:
9
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2248479/pdf/procascamc00002-0100.pdf
McDonald, C. J.,(1997). The Barriers to Electronic Medical Record Systems and How to Overcome Them. Journal of the American Medical Informatics Association. 4(3).
10
Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC61236/pdf/0040213.pdf
Were, M. C. et al.,(2010).Evaluating a scalable model for implementing electronic health records in resource-limited settings. Journal of the American Medical
11
Informatics Association. 17(237). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995711/pdf/amiajnl2303.pdf
Mostashari, F. et al.,(2010).A Tale Of Two Large Community Electronic Health Record Extension Projects. HealthAffairs. 28(2). Retrieved from:
12
http://content.healthaffairs.org/content/28/2/345.full