Professional Documents
Culture Documents
EHR8
EHR8
Topics covered
Impetus for EHR Adoption
Benefits/challenges
Doctor and patient opinions
CDS, HIE, disasters
Nursing informatics
Survey
What is your view of EHRs?
18 favorable, 2 neutral
Terms
Electronic health record (EHR) - a longitudinal collection of the health
information of an individual.
EHRs focus on total health going beyond standard clinical data collected
in the providers office and inclusive of a broader view on a patients care.
EHRs are designed to reach out beyond the health organization.
Other Terms
Patient registry a collection of standardized information about
a group of patients who share a condition (disease)
Chronic disease management system (CDMS) a system used to
capture, manage and provide information on specific conditions
to support organized care management for patients
Even more
Provides ubiquitous access to patient data (anywhere,
anytime)
Allows multiple views of data
Lists, tables, flow charts, graphs (trends)
Codifies clinical guidelines (CDS)
Facilitates communication with other providers, including
allied health providers, and with patients
HIE, PHR
Benefits of EHRs
Quality of care assessments
Clinical decision support or CDS (MU) facilitates diagnosis
and treatment
Health information exchange or HIE (MU) facilitate
coordinated care
PHRs allow more patient participation in their healthcare
Data for clinical research and public health (MU)
EHR implementation:
what will it cost?
-HealthIT.gov
Implementation strategies
Parallel keep new and old systems running
Phased add modules sequentially across organization
Pilot install full system in one unit at a time; may
overlap
Big bang all at once; has risks but has been used
successfully with proper planning
Implementation reports
It is well-known that physician productivity (patient volume) dips upon
adoption on an EHR, but it is recovered once users get used to the
system.
Small-practice: four-physician practice encountered many challenges.
Needed to re-design office workflow;costs higher than budgeted; would
not return to paper (Baron 2005, 2010)
Big hospital: transition from standalone to institutional EHR in OHSU
Emergency Department (ED) found workflow issues most essential
(Handel, 2009)
Of 58% of physicians who either dislike their EHRs or are lukewarm about
them, 85% said they are spending more time documenting patient visits,
and 66% said they are seeing fewer patients. More than half called their
software difficult to use.
Among satisfied EHR users, the thing they like the most are charts that
never get lost (82%), the ability to access charts remotely (75%), and
meaningful-use bonuses (56%). (International Data Group, 2013)
Typhoon Haiyan
Large numbers of medical groups post-disaster
Very few were willing to share data afterwards for analysis
of the disaster medical response.
Could EHRs be useful for the next typhoon?
Typhoon Lando
60% believe that informatics nurses have a high degree of impact on the quality of care
provided to patients.
Informatics nurses bring value to the implementation phase (85%) and optimization phase
(83%) of clinical systems processes.
Informatics nurses are beginning to play a critical role in ensuring user acceptance (75%)
and the appropriate adoption of emerging technologies; 70% agreed that nurses play an
important role in medical device integration.
Thank You!
BSP/PCHRD/DOST
UP Manila, Mapua, PCG-ELSI (Drs. Badong Caoili, Lemuel
Tayo and Peter Sy)
Dr. Bill Hersh, OHSU
Colleagues at Charles Drew Center for Biomedical
Informatics (Drs. Lola Ogunyemi, Robert Jenders, Sheba
George, Paul Robinson)
MSU hosts Dr. Arnold Lubguban and Dean Clowe
Jondonero