DON

BOSCO
TECHNICAL
INSTITUTE
VICTORIAS
WHERE SOUL EMPOWERS TECHNOLOGY
 Medical Informatics
Electronic Health
Records

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

Wher e So u l E mpo wer s Techn o lo gy

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
ELECTRONIC HEALTH
RECORD ADOPTION

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
 OUTPATIENT (AMBULATORY) EHR ADOPTION

10-20% - range of the adoption rate of ambulatory

EHRs

It is also important to realize that many outpatient

practices may have EHRs but continue to run dual paper
and electronic systems or may use only part of the EHR

2006 (Center for Disease Control)

29% of respondents had a partial EHR
12% had a truly comprehensive EHR.

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
 INPATIENT EHR ADOPTION

2006 (American Hospital Association)

- use of EHRs with more than 1,500 community hospitals

68%- hospitals implementing inpatient EHR

11%- fully implemented HER and these were mainly by
large ubran/teaching hospitals.
10%- physicians used computerized physician order entry
(CPOE) to order medications

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
Why do we need
Electronic
Health Record?

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
1. THE PAPER RECORD IS SEVERELY LIMITED

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
1. THE PAPER RECORD IS SEVERELY LIMITED
Other shortcomings of paper:

expensive to copy, transport and store

easy to destroy
difficult to analyze and determine who has seen it

negative impact on the environment

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
2. THE NEED FOR IMPROVED EFFICIENCY AND
PRODUCTIVITY

GOAL: to have patient information available to anyone

who needs it, when they need it and where they need
it.

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
3. QUALITY OF CARE AND PATIENT SAFETY
EHR should improve patient safety through:

(a) Improved legibility of clinical notes

(b) Improved access anytime and anywhere

(c) Reduced duplication

(d) Reminders that tests or preventive services are overdue
(e) Clinical decision support that reminds us of patient
allergies, the correct dosage of drugs, etc.

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
4. PUBLIC EXPECTATIONS
2006 Harris Interactive Poll for the Wall Street Journal
Online

55% of adults thought an EHR would decrease medical errors

60% thought an EHR would reduce healthcare costs

54% thought that the use of an EHR would influence their

decision about selecting a personal physician.

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
5. OLDER AND MORE COMPLICATED PATIENTS REQUIRE MORE
COORDINATED CARE

No physicians—3%
o 1 physician—16%
o 2 physicians—26%
o 3 physicians—23%
o 4 physicians—15%
o 5 physicians—6%
o 6+ physicians—11% 34

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
Electronic
Health Record Key
Components?

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
1. Clinical Decision Support Systems (CDSS)

include alerts, reminders and clinical practice guidelines

CDSS is associated with computerized physician order entry

(CPOE)

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
2. Secure messaging (e-mail) for communication
between patients and office staff and among office
staff.

3. interface with practice management software,

scheduling software and patient portal

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
4. Referral management feature

5. Retrieval of lab and x-ray reports electronically

6. Retrieval of prior encounters and medication

history

7. Computerized Physician Order Entry (CPOE).

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
8. Electronic patient encounter

9. Multiple ways to input information into the

encounter should be available

10. The ability to input or access information via a

PDA, smart phone or tablet PC

11. Remote access from the office or home

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
 Summary

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y
1. Electronic health records are central to creating a national
interoperable system of electronic health records

2. The current paper-based system is fraught

with multiple shortcomings

3. In spite of the potential benefits of electronic health

records, obstacles and controversies persist

D O N B O S C O T E C H N I C A L I N S T I T U T E — V I C T O R I A S

W h e r e S o u l E m p o w e r s Te c h n o l o g y