Mandatory Use of EHR

Taiwo Babatope

EHR s
 Computerized patient records-computer version
of a record (like a PDF)
 Electronic Medical Records-Supports advanced
features(e-prescribing, decision support ,etc.)
allows for trend analyses, LIMITED TO ONE
ORGANIZATION.
 Electronic Health Records – Combines EMR
data with other clinical or patient data
collected elsewhere
‘ A paper record is a passive , historical
document . An EHR can be a vibrant tool that
reminds and advises doctors. It can hold cs.tcd.ie
information on a patient’s visits , treatments and
conditions , going back years, even decades’
‘ It can be summoned with a mouse click , not
hidden in a file drawer in a remote location and
thus useless in medical emergencies’
-Steve Lohr , New York Times, Dec 26,2008. Mandatory Use of EHR
 Institute of Medicine Report
-
Institute of Medicine Report(1999)
 Medical Errors kill 44,000-98,000 people
yearly.
 8th leading cause of death
 Annual cost $29billion
IOM “Optimal” EHR Core Functions
-Health Information and data: System holds
what’s normally in a paper chart-
diagnosis lists , medication lists and test
results.
-Results Management: EHRs lets you receive
lab results, radiology reports , and even
X-Ray images electronically.
-Order Entry: No more prescription pads . All
your orders are Automated.
-Decision Support : warn you about diagnosis
, and point out evidence-based
guidelines treatment options.
-Electronic communications and connectivity :
Secure email with patients, medical
assistants, referring doctors, hospitals, and
insurers.
-Patient Support: Patient can receive
educational material via the EHR and enter
data themselves through online
questionnaires and home monitoring
devices.
-Administrative processes : For example ,
patients can schedule their own
appointments and staffers check on
Insurance eligibility.
-Reporting and Population health
Management: How many patients treated
for tuberculosis in a particular year . An
EHR possesses this information because of
a searchable database.
Mandatory Use of EHR
President’s Goal

‘Obama and EHRs

‘To improve the quality of our health care while lowering its costs , we will
make the immediate investments necessary to ensure that within five
years , all of America’s medical records are computerized’

‘This will cut waste, eliminate red tape and reduce the need to repeat
expensive medical tests. But it just won’t save billions of dollars and
thousands of jobs, It will save lives by reducing the deadly but
preventable medical errors that pervade our Health care system’

- President Barak Obama 1/8/09

Tablet PC Enabled EHR

Pocket PC Enabled EHR

Mandatory Use of EHR
 Potential Benefits of EHRs
Hospital Benefits: EHR  Reduced costs (Wong et al,2003; Kilgore et
EHR reduces ‘bad’ outcomes in hospitals al,1998).
 Medical errors (Evans et al,1999)
 Number of unnecessary tests( Tierney et
al,1998,1990; Chin and Wallace,1999).
 Costs per admission ( Tierney et al,1993)
 Time needed for documentation( Wong et
al,2003; Pierpont et al,1995)
EHR increases ‘good’ outcomes in hospitals
 Influenza vaccinations( Dexter et al,2004;
Tierney,1986)
 Discussion of Advanced directives( Dexter et
al,1998).
 Adherence to protocols and ‘recommended
care’ ( McDonald et al,1980,1976,1976b;
Cannon et al,200; Demakis et al,1998).
 Staff Satisfaction (Kilgore et al,1998).

Mandatory Use of EHR

 EHRs Vendors
Physicians EHR Top Rated Vendors CCHIT Certified Companies
-Allscripts Healthcare Solutions (3 versions)
The list represents a wide range of vendors
that serve healthcare organizations small -Cerner Powerworks
to large. -e-MDs
Criteria: -eCast Corporation
-EHR is affordable to small and midsized -eClinicalWorks
physician practices -EHS
-EHR has achieved or is on track to achieve -GE Healthcare
CCHIT( Certification Commission for -Greenway Medical Technologies
Health Information Technology)
-Henry Schein Medical Systems/ MicroMD
Certification.
-LSS Data Systems
-It’s certified by an electronic prescribing
-Med3000,Inc.
network
-MedcomSoft Corporation
-It’s applicable to multiple specialties
-Medinotes Corporation
-Integrates with practice management
-Misys Healthcare Systems (4 versions)
systems
-NextGen Healthcare Information System, Inc.
-It can prove to be interoperable
-Noteworthy Medical Systems
Mandatory Use of EHR
Implementation Strategies
Implementation Consider Using if clinic is:
Strategy
Big Bang Straight Turnover: Very small ,confident in
Everyone goes live at once computerization clinic assured
and paper processes cease of adoption by all
after go-live

Hybrid; Everyone goes live Small, new to computerization

at once but paper
processes continue until
system works as planned

Incremental By Module: Start with one Medium-Large ,

module and add additional multispecialty , multisite ,
modules as decided upon complex EHR System

By Provider: Start with Medium-Large ,

one physician /week until multispecialty , Providers are
entire practice is on board. not IT-savvy

By functions: Start with a Medium-Large , New to

function(prescribing , computerization and staff
billing) ,add function as resistant to EHR
decided upon until all is
included.

Mandatory Use of EHR

References

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2232642/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC61334/?tool=pubmed

http://www.physiciansehr.org
http://www.ifqhc.org/provider/documents/ehr_implementation_strateg
ies.pdf

http://www.ncbi.nlm.nih.gov/pubmed/8320575/
http://www.ncbi.nlm.nih.gov/pubmed/7774218
http://www.ncbi.nlm.nih.gov/pubmed/8418345
http://www.ncbi.nlm.nih.gov/pubmed/14530756
http://www.ncbi.nlm.nih.gov/sites/entrez
http://www.ncbi.nlm.nih.gov/pubmed/10178729

Mandatory Use of EHR

Thank you!

Mandatory Use of EHR