1 / 16

C. Peter Waegemann CEO, Medical Records Institute (MRI)

Electronic Health Record Systems: What are They, Why have They Failed for so Long, and What Progress is Being Made Now?. C. Peter Waegemann CEO, Medical Records Institute (MRI)

mina
Download Presentation

C. Peter Waegemann CEO, Medical Records Institute (MRI)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Electronic Health Record Systems: What are They, Why have They Failed for so Long, and What Progress is Being Made Now? C. Peter Waegemann CEO, Medical Records Institute (MRI) Chairman and Acting Director, Centre for the Advancement of Electronic Health Records (CAEHR)Chair, Standards Committee ASTM E31 on Healthcare InformaticsChair, US TAG to ISO TC 215 on Health InformaticsChair, ISO TC 215 Task Force on Consumer InterestsVice Chair, Mobile Healthcare Alliance (MoHCA)

  2. Seven Key Issues in Health Informatics • Practitioners Can No More Rely on Memory Alone • Provide Access to Knowledge Bases • Health Information To Be Shared Among Authorized Persons • Continuity of Care • Patient Information Should be Available to Any Authorized Healthcare Professional • Patient Safety • Leveraged Skill and Knowledge • Changing Provider/Patient Relationship • Efficiency (Clinical, Financial, Administrative) EHR Systems Should Provide Solutions to All Six Issues

  3. History of Computer-based Patient Record Systems 1960s First Attempts 70s and 80s Progress slowed 1991 IOM Study 95-98 Failures and Decline of Interest 1999 Focus on Personal Web-based Records 2002- Back to the Top of the List

  4. How have vendors and users built upon this vision? They have created: • Clinical Data Repositories • Clinical Work Stations • Clinician Order Entry and Results Reporting Applications • Clinical Decision Support • Clinical Data Warehouses • Master Person Indices • Other Systems

  5. Lots of Pressure to Create it Order Entry Reduction of Medical Errors Many Organizations Working Are Making it Priority Standards Organizations HIMSS CHI ISO TC 215 EHI IHE HL7 AMIA Various Countries Mobile Health Care EHR • No Consensus on Definitions • No Common Vision • Uncertainty About Benefits to Practitioners and Providers • Complete Lack of Standards • What is Success? HIPAA – Control over Systems Charge Capture Applications

  6. What Has Changed? • ROI for Components • Focus on Doable Applications • Continuity of Care: Interoperability Inside and Outside the Provider • Movement on Architecture Issues • Movement on Terminology Issues • Outside Pressure: Patient Safety, Inefficiencies, Patients, Etc.

  7. Where is the Roadmap? Lack of consensus on • A Definition that works for all domains and concepts • Functions • Necessary Building Blocks • Essential Functional Requirements

  8. What is an Electronic Health Record? • CPR - Computer-based Patient Record • CMR – Computerized Medical Record • PMRI – Patient Medical Record Information • ICRS – Integrated Care Record Services • PCR – Patient-carried (Card-based) Patient Record • PHR – Personal Health Record • EMR – Electronic Medical Record • DMR – Digital Medical Record • EPR – Electronic Patient Record • EHR – Electronic Health Record

  9. Why Has There Been So Little Success?

  10. Federal Government • No Mandate at this time • VA shows that costs come down with IT Systems: Incentives • Consideration of Encouragement • Depending on Consensus of Fair Criteria • AHRQ – Funding • Medicare Bill: e-Prescribing by 2006/7

  11. Understanding Principles • National Patient ID • Ownership/Guardianship/Stewardship • Compatibility/Interoperability • Continuity of Care

  12. Clinics Hospitals Physician Offices Home Healthcare Long-term Care Facilities Medical Research Public Health Patients/Consumers Health Planning Central Database • Centralized System (CPR Model) – Depending on a • National Patient Identifier • Central Infrastructure that Allows Integration (Terminology, Architecture, Technical/Systems Interoperability)

  13. Current US Approach Clinics Physician Offices Hospitals CCR CCR CCR Long-term Care Facilities Home Healthcare CCR CCR Confederated System: Every Provider has a Patient Database Only Relevant Care Data are Exchanged Patients/Consumers CCR

  14. Organizations Pushing For IT • American Academy of Family Practitioners • American Academy of Pediatrics • Other Medical Specialty Associations • Payers • American Health Care Association • State Legislatures: 21 States

  15. What Can be Expected? Near Term: 2004/2005 • Hospital Field – Complex Improvements of Components • Ambulatory Care - Major Change Expected • Long-term Care - Major Change Expected • Home Health Care Integration? • Personal Health Beginning But Education Record Needed

  16. Thank You TEPR 2004 May 17-21 Fort Lauderdale, Florida Survey on Electronic Health Record Usage and Trends http://www.medrecinst.com/resources/survey2003/index.shtml www.medrecinst.com Copies of these slides may be obtained by emailing peterw@medrecinst.com

More Related