Electronic Medical Record (EMR)<br />PA657 Health Care Reimbursements<br />Prepared for: Rachael Leftridge<br />Prepared by: AkmamBintaChowdhury<br />
History of Electronic Medical Record<br />In the 1960s, a physician named Lawrence L. Weed first described the concept of computerized or electronic medical record which is a system to automate and reorganize patient medical records to enhance their utilization and thereby lead to improved patient care. <br />Weed's work was a collaborative effort between physicians and information technology experts started in 1967 to develop an automated electronic medical record system, which objectives were to develop a system that would provide timely and sequential patient data to the physician, and enable the rapid collection of data for epidemiological studies, medical audits and business audits. <br />In 1970, the problem-oriented medical record (POMR) was used in a medical ward of the Medical Center Hospital of Vermont for the first time. Over the next few years, drug information elements were added to the core program, allowing physicians to check for drug actions, dosages, side effects, allergies,interactions and diagnostic and treatment plans etc. common medical problems were devised. <br />During the 1970s and 1980s, several electronic medical record systems were developed and further refined by various academic and research institutions. Harvard's COSTAR system had records for ambulatory care, Duke's 'The Medical Record' is the example of early in-patient care systems. Indiana's Regenstrief record was one of the earliest combined in-patient and outpatient systems.<br />During the 1990s, electronic medical record systems became increasingly complex and more widely used by practices with advancements in computer and diagnostic applications. <br />In the 21st century, more and more practices are implementing electronic medical records. <br />
Definition:<br />An electronic medical record (EMR) is the legal patient record that is created in digital format in hospitals and ambulatory environments. Electronic medical records may include demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal stats like age and weight, and billing information.<br />Personal Information<br />______<br />Dr.<br />PMH<br />EMR<br />Server<br />Dx<br />EPM<br />Management system<br />30<br />$<br />Scheduling & Billing<br />
Type of EMR:1) Server Based EMR:<br />______<br />EMR<br />Server<br />WWW<br />Software as a Service<br />2) Web Based EMR:<br />http://clinicals.athenahealth.com/ehr%20?cmp=10006207&bmtn=10006207&HBX_PK=emr&utm_source=google&utm_medium=ppc&utm_term=emr&utm_campaign=2011%20Clinical%20Driver%20Terms&utm_adgroup=Clinicals%20Drivers -%20EMR&utm_salesforce=701A0000000VdB1&_kk=a1963806-448d-4b39-a6e3-bfea10505364&_kt=11952199399<br />Application Service Provider<br />Web based EMR<br />EMR<br />ACME<br />
Benefits of EMR:<br />Electronic Medical Records (EMR) is a software database application designed to organize and improve medical office workflow. Each phase of the patient encounter can be duplicated by the EMR system – increasing efficiency, productivity, and revenue.<br /><ul><li> Increased Revenues
Resistance by potential users - implied changes in working practices.
Certification, security, ethical matters; privacy and confidentiality issues
Incompatible with other systems.</li></li></ul><li>Usage:<br /><ul><li> Even though EMR systems with a computerized provider order entry (CPOE) have existed for more than 30 years, fewer than 10 percent of hospitals as of 2006 have a fully integrated system.
In the United States, 38.4% of office-based physicians reported using fully or partially electronic medical record systems (EMR) in 2008.
However, the same study found that only 20.4% of all physicians reported using a system described as minimally functional and including the following features: orders for prescriptions, orders for tests, viewing laboratory or imaging results, and clinical notes.
The CDC more recently reported that the EMR adoption rate has steadily risen to 48.3 percent at the end of 2009. </li></ul>Privacy Concern:<br />A major concern is adequate confidentiality of the individual records being managed electronically.<br />According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and over 600,000 payers, providers and other entities that handle providers' billing data have some access. <br />In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws. <br />
THE COST OF AN EMR SYSTEM:<br />The total cost for implementing the EMR system at Belleville Family Medical Clinic and one year of technical support was about $220,800 to $260,800. Although estimating the total cost of an EMR system prior to implementation is difficult, vendors can offer some help by providing hardware and training estimates. Another good resource is “How Much Will That EMR System Really Cost?”, givenspreadsheet can help calculate the initial purchase price and the annual and five-year operating costs of an EMR system.<br />