Electronic health records
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Electronic Health Records. Presented by Jerome Scott. Objectives. Describe the common components of Electronic Health Records (EHR). Assess the benefits of an EHR. Evaluate outcomes of EHR use in meeting needs of healthcare staff and patients. Electronic Health Record (EHR).

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Electronic health records

ElectronicHealthRecords

Presented by

Jerome Scott


Objectives

Objectives

  • Describe the common components of

    Electronic Health Records (EHR).

  • Assess the benefits of an EHR.

  • Evaluate outcomes of EHR use in meeting needs of healthcare staff and patients.


Electronic health record ehr

Electronic Health Record (EHR)

The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. (Electronic Health Record, 2010)

Click for Reference


The benefits of ehr

The benefits of EHR

  • Avoid duplication of tests

  • Reduce medical errors

  • Make surgery safer

  • Encourage better self-care

  • Improve care of chronic illness

  • Identify proper medication dosages


Ehr components

EHR Components

  • Hardware

  • Software


Hardware

Hardware

The physical or tangible parts of the EHR computer system

  • Computer terminals in patient care areas

  • Tablet PC’s

  • Handheld devices


Hardware example

Hardware example

Tablet PC

  • High mobility PC

  • Lightweight and high durability

  • Slim, flat battery is hot-swappable

  • Thin dimensions can be easily gripped

  • Three input modes (pen, voice & keyboard)


Electronic health records

EHR software offers integrated clinical and administrative capabilities and provides quick access to patient information

  • Computer Physician Order Entry

  • Security software

  • Lab Test Results

  • Patient-specific Educational Resources

  • Electronic Syndrome Surveillance

  • Immunization registries


Security software

Security software

Software protection of sensitive patient

Information


Security access control

Security access control

  • Individual-based access

  • Role-based access

  • Context-based access


Individual based access control

Individual-based access control

Each user’s information needs is individually evaluated and access is provided accordingly.


Role based access control

Role-based access control

Users with common jobs and/or access needs

  • Nurses

  • Administrators

  • Secretaries


Context based access control

Context-based access control

Users who serve in a common context

  • Specific discipline

  • Legal entity


Software

Software

Healthcare information systems:

  • Clinical

  • Pharmacy

  • Laboratory

  • Radiology


Software must address the three axioms of usability

Software must address the three axioms of usability

  • Early and central focus on users in the design, development and purchase of systems

  • Iterative design

  • Empirical usability measures of observations of users and information systems (Staggers, 2003)

Click for Reference


Patient care team

PATIENT CARE TEAM

Laboratory

Physicians office

Emergency Services

EHR= Continuity of care

Pharmacy

Hospital

Specialist

Home Health

Radiology


Clinical information systems

Clinical Information systems

Enhancing care by providing data at the bedside

  • Containing observations

  • Interventions

  • Clinical notes

  • Hemodynamic data

  • Lab results


Chronic care management software

Chronic care management software

Electronic chronic care management is aimed at improving the health of patients with chronic illness


Chronic care management software areas

Chronic care management software areas

  • Heart disease

  • Hypertension

  • Chronic Obstructive Pulmonary Disease (COPD)

  • Asthma

  • Diabetes


Ehr package examples

EHR package examples

MedicsDocAssistant Electronic Health Records software

  • Physicians Quality Reporting Initiative (PQRI)

  • Computer Based Provider Order Entry (CPOE)

  • Evidence-Based Medicine

  • MedicsRX e-prescribing Solution

  • Medics On-Call™ for iPhone™

  • Virtual "sticky notes“ (MedicsDocAssistant Electronic Health Records, 2010)

Click for Reference


Nurse informatics competencies

Nurse informatics competencies

  • Systems analysis, design, and implementation

  • Database management

  • Specialization in health care informatics

  • Current issues and trends in health care informatics

  • Health care informatics internship


Nurse informatics responsibilities

Nurse informatics responsibilities

  • Clinician computer education coordination

  • Project management for clinical systems

  • Supervises clinical informatics analysts

  • Leads nursing informatics vision and strategic plan


Disadvantages of ehr

Disadvantages of EHR

  • Start up costs

  • Transition period from paper to electronic

  • Feelings of depersonalization

  • Distraction from the patient

  • Computer problem delays

  • Security


Ethical and legal issues with her

Ethical and legal issues with HER

  • Third party access

  • Confidentiality

  • Beneficence and nonmaleficence

  • Value conflicts


References

References

Electronic Health Record. (2010). Retrieved February 25, 2010, from Healthcare Information and Management Systems Society (HIMSS) Web site: http://www.himss.org

Staggers, N. (2003). Human factors: Imperative concepts for critical care. AACN Clinical Issues , 310-319.

MedicsDocAssistant Electronic Health Records. (2010). Retrieved March 2, 2010, from Advanced Data Systems Corporation: http://www.adsc.com

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