Transcript Week_5-1_Lecture_EHR_Notex

Electronic Health Records
LIS 4785 Introduction to Health Informatics
Fall 2015 Week 5-1
Instructor: Dr. Sanghee Oh
Top 100 EHR/EMR Vendors
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Cerner PowerChart Ambulatory HER
EpicCare Ambulatory - Core EMR
Allscripts Professional™ EHR“
NextGen Ambulatory HER
athenahealth athenaClinicals
GE Health Centricity
eClinicalWorkscare
McKesson iKnowMed EHR, Horizon Ambulatory, Paragon
Abraxas Medical Solutions (Merge Healthcare) iconnect Network
Vitera Healthcare Solutions Vitera Intergy, Vitera Stat, Vitera
Medical Manager
And more from
http://medicaleconomics.modernmedicine.com/medicaleconomics/news/top-100-ehr-companies-part-1-4
Cerner PowerChart Ambulatory EHR
Cerner PowerChart Ambulatory EHR
Cerner PowerChart Ambulatory EHR
Cerner EHR iPhone App
More screenshots of EHRs/EMRs
• http://www.ehrscreenshots.com/
EHR Elements
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Health information and data
Results management
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Electronic communication and connectivity
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Administrative processes
Reporting and population health management
• Find here for the details: http://ed-informatics.org/healthcare-itin-a-nutshell-2/emr-vs-ehr-vs-phr/
Major components of EHRs
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• An EHR feature that processes orders for medications, lab tests,
imaging, consults and other diagnostic tests.
Computerized Physician Order Entry (CPOE)
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– Outcomes the issue of ____________
– ______________ associated with ordering drugs with similar
names or trailing zeroes
– Able to link to ____________________________________
– Reduce _________________ prescribing
– Make prescriptions to reach the pharmacy ____________
– Identify the prescribing physicians
– Point out treatment and drugs of choice
– Easily integrated with clinical decision support systems (CDSS)
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• An electronic system to support a prescriber's ability to
electronically send an accurate, error-free and understandable
prescription directly to a pharmacy from the point-of-care.
E-Prescribing through an EHR
Source: http://dashboard.healthit.gov/
Advantages of e-prescribing
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____________________________ that help eliminate handwriting
errors and decrease pharmacy “callbacks” and rejected scripts
Abbreviations and unclear decimal points are avoided.
The wait to pick up prescriptions potentially is reduced
Fewer _________________________
Better compliance with fewer drugs not filled or picked up.
Potential to reduce workload for pharmacists
Timely notification of drug alerts and updates
Better use of generic or preferred drugs
The ability to check patient-level and patient-level formulary status
and patient copays
The process is secure and HIPPA compliant
Offer ability to look up drug history, drug-drug interactions, allergies
and compliance
Provide a single view of prescriptions from multiple clinicians
Issues/challenges associated with eprescribing
• Alerts, in general are viewed as nuisances, by physicians, unless
they are very specific, highly important and are educational.
Issues/challenges associated with eprescribing
• 11.7% error rates on e-prescribing from a report of outpatient
electronic prescription in 2011
– About a third had the potential to cause ADEs (No actual
ADEs)
– Two thirds of the errors due to omissions of drug does,
instructors, etc.
• The refill process had more problems and errors than the initial
new prescription process.
– Most of refills can be still done by fax.
• Some pharmacies don’t accept e-scripts because of the fees.
• Physicians write sigs(abbreviations) are not patient-friendly and
pharmacists have to rewrite them.
• Physicians often receive duplicate requests from pharmacies.
PERSONAL HEALTH RECORDS
Apple HealthKit
Class Activity
• What kinds of computerized/automated functions or features do
you want to make available from your PHR system? (List 3)
• What could be the benefits for individuals of using the functions
and features of your PHR? (List 3)
• What could be the challenges for individuals of using the
functions and features of your PHR? (List 3)
PHRs
• An electronic application used by patients to maintain and
manage their health information in a private, secure, and
confidential environment. PHRs:
– Are managed by ___________.
– Can include information from _______________, including
health care providers and patients themselves
– Can help patients securely and confidentially ________ and
_________ health information, such as diet plans or data
from home monitoring systems, as well as patient contact
information, diagnosis lists, medication lists, allergy lists,
immunization histories, and much more
– Are separate from, and ____________________ of any health
care provider
– Are ____________________ that simply allow patients to
view provider information or communicate with providers
American Health Information Management
Association (AHIMA)
• www.myphr.com
• A tool that you can use to collect, track and share past and
current information about your health or the health of someone
in your care.
– This information can save you the money and inconvenience
of repeating routine medical tests.
– Even when routine procedures do need to be repeated, your
PHR can give medical care providers more insight into your
personal health story.
• Take an active role in monitoring your health and healthcare by
creating your own PHR. PHRs are an inevitable and critical step in
the evolution of health information management (HIM).
PHR Elements
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Identification sheet
Problem list
Medication record
History and physical
Progress notes
Consultation
Physicians’ orders
Imaging and X-ray reports
Lab reports
Immunization Record
Consent and Authorization Forms
Operative Report
Discharge Summary
PHR Selection Criteria
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Paper-based PHR Forms
• AHIMA provides paper-based PHR forms for individual
management of health information.
– Health information form for adult:
http://www.myphr.com/PHR_Forms/adultform.pdf
– Health information form for child:
http://www.myphr.com/PHR_Forms/childform.pdf
– Authorization form:
http://www.myphr.com/PHR_Forms/Sample_Authorization.p
df
PHR Providers
• Employ Sponsored
• Insurance Sponsored
• Provider Sponsored
• Independent product
– HealthVault
– Healthy Circles
– MedHelp
– The 65 Best Health & Fitness Apps of 2014
– http://greatist.com/fitness/best-health-fitness-apps
PHR Challenges
• According a survey of the PHR use in 2011:
– Only seven percent of Americans had used online personal
health records, and less than 3.5 percent used them with any
frequency.
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