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Building Information Systems

Are Electronic Medical Records a Cure for

Health Care?

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Electronic Medical Record (EMR)

Collection of individual’s health information electronically. (Computer-Based Patient Record)

Contains individual’s vital medical data, personal information, medical history, test results, diagnoses, treatments, prescription medications, and the effect of those treatments.

integrated medical record that replaces paper-based record keeping.

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Usefulness of EMR

A physician would be able to immediately and directly access needed information from the EMR without having to pore through paper files.

If the record holder go to the hospital, the record and results of any tests performed at that point would be immediately available online.

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Three Essential Capabilities of EMR System

1. To capture data at the point of care,

2. To integrate data from multiple internal and external sources, and

3. To support caregiver decision making.

Evaluating EMR System

Advantages

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Disadvantages: Disadvantages

Enable to access patient’s past visit information, lab results, previous medications, and drug allergies instantly

Reduce medical errors

Create less paper work

Provide quicker service

Cost savings in the future

Higher costs

Less secure patients’ privacy concerns

Software bugs

Physician might consider system’s output rather than patient’s feeling

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Electronic Medical Record (EMR)

US government called for all health care providers in the United States to have functional EMR systems within year 2015.

And also govt pay out the stimulus money to hospitals and physicians to help set up electronic record.

Obstacles: Costs and Time commitment

Compatibility with one another

Present Situation: 80% of physicians and 90% of hospitals are still using paper base medical record keeping.

1. What management, organization, and technology factors are responsible for the difficulties in building electronic medical record system?

Paper-based medical record system is most preferable for data keeping as it doesn’t require precise knowledge and proficient in using it. EMR system would enable to shift from paper-based data recording state to digital data recording state so that change management is the most important part for this case as it would allow managing resistance to change when implementing management, technology, and organizational change. Management Factors: Change management that shifting from a current state to desired future state, Change in user attitude and behavior.

Organization Factors: Resources, Expenditure, Training/Re-training, Resistance from health care worker, Turn-over.

Technology Factors: Adequate Infrastructure, Compatibility and Data Quality, Data Security and Patient Privacy Concerns.Bringing advance technologies always required user’s higher knowledge, comfortable and proficient in use. And also need assurance of those technology.

1. What management, organization, and technology factors are responsible for the difficulties in building electronic medical record system?

The Right Human Factors

The Right System

The Right Training & Support

- Physicians and staff Motivation to use EMR- Collaboration with each other

2. What stages of system building will be the most difficult when creating electronic medical record systems? Explain your answer.

SYSTEMS ANALYSIS

SYSTEM DESIGN

PROGRAMMING

TESTING

CONVERSATION

PRODUCTION AND MAINTENANCE

2. What stages of system building will be the most difficult when creating electronic medical record systems? Explain your answer.

SYSTEMS ANALYSIS

SYSTEM DESIGN

PROGRAMMING

TESTING

CONVERSATION

PRODUCTION AND MAINTENANCE

Establish Information Requirements

The role of End Users

>>Identifying who needs what information, where, when, and how. (Road map of the org & system)

No manual system Complex function Poorly defined, unclear, disagree Cost that vastly exceed budget. Unexpected time slippage. Technical performance that is less than

expected. (poor user interface). Failure to obtain expected benefits. No centralize resource allocating.Faulty requirements analysis might lead to cause system failure and high system development cost.

Knowing what they want

2. What stages of system building will be the most difficult when creating electronic medical record systems? Explain your answer.

SYSTEMS ANALYSIS

SYSTEM DESIGN

PROGRAMMING

TESTING

CONVERSATION

PRODUCTION AND MAINTENANCE

Establish Information Requirements

The role of End Users

User information requirements drive the entire system-building effort. (Required more user participation in design than others)Insufficient user involvement in the design effort is a major cause of system failure.

>> Model or Blueprint of the system. It specifies managerial, organizational, and technological components of system solution.

Infrastructure of the organization, knowledge of IT staff and resources, installing and maintaining cost, physician’s time commitment.

Knowing how they want

2. What stages of system building will be the most difficult when creating electronic medical record systems? Explain your answer.

SYSTEMS ANALYSIS

SYSTEM DESIGN

PROGRAMMING

TESTING

CONVERSATION

PRODUCTION AND MAINTENANCE

Establish Information Requirements

The role of End Users

Moving from an old system to a new one requires That end users be trained to use the new system.Lack of proper training might leads to system failure. (Human Factors)

3.What is the business and social impact of not digitizing medical records (to individual physicians, hospitals, insurers, patients)?

What is the business of EMR?

The following three stages of economic return should help you decide whether there is a business case for a particular electronic medical records system. 

- The first stage is characterized by operational efficiencies and workflow automation achieved through process re-engineering and faster access to accurate information. The benefits gained in this stage include reduced overhead costs and professional liability rate reduction.- In the second stage, benefits are derived from increased clinic productivity and decision support at the point of care. As more information is entered into the EMR, standard care protocols, order management, and outcomes analyses can be supported. EMR customers experience quality improvements, compliance with regulatory requirements, and reduced exposure to risk.- In the longer term, investments in EMR software systems can provide health care organizations with a distinct competitive advantage. Looking forward, physicians should anticipate using an electronic medical records system as a tool to manage the business of delivering care efficiently and cost-effectively, and to provide more responsive care to an increasingly selective consumer.

3.What is the business and social impact of not digitizing medical records (to individual physicians, hospitals, insurers, patients)?

Doctors need complete and easily accessible data to make good decisions, government and regulatory organizations need good information to make the right policy decisions, and researchers need high quality and granular data to discover the treatments that result in the best outcomes at the lowest costs. Many continue to transcribe their charts and, as a result, critical information ends up being stored as text rather than as coded data that can be quickly accessed, easily understood, and used for query, reporting and analysis. Individuals only use technologies and tools that provide clear, personal advantage. To expand not only the breath, but also depth, of adoption, we have to make the techno-phobic and financially strapped doctors an offer they can't refuse. 

4. What are the business and social benefits of digitizing medical recordkeeping?

Social Benefits:- 1. Decreased probability of unnecessary treatments and tests. 2. Digitizing medical records can save lives as well by catching Prescription errors like

misdosing and drug-drug interactions.  3. Electronic medical record improves medical services by making them faster and

patients have less stress. Doctor can make prescriptions, make appointments and referrals at the same time through the digital EMR.

4. EMR may help patients to get access to personal health records conveniently on workstation and even on the mobile Phones too.

Business Benefits:- 1. EMR can cut down the cost by reducing less paper work. 2. Data can be very well protected with the EMR. 3. Up to date record maintenance is easier with the use of EMR. 4. Maintaining Patient data in Paper form always consume time but EMR can be

accessible from multiple locations and thus help in easy data retrieval and saves time too.

5. Name two important information requirements for physicians, two for patients, and two for hospitals that should be addressed by electronic medical records systems.

Important Information RequirementsFor physicians: diagnoses and treatmentsFor patients: personal information and a full medical historyFor hospital: prescription medications and the effect of those treatments

 

5. Name two important information requirements for physicians, two for patients, and two for hospitals that should be addressed by electronic medical records systems.

 Physicians, they provide diagnoses and prescription medication to those who in need to be provided by professional people. Diagnoses are first stage of all. It will tell the people what is going on with them bodies, what happened, and how to rescue. Physicians need to give out their judge, which is what we call diagnoses.Also physicians need to provide treatment. After judge, physicians need to give out conclusion and the way to solute problems. The personal information and full medical history need to be given by the patients. It’s impossible to find that information by someone else except patients. Prescription medications and the effect of those treatments will provide by hospital. According to FDA regulations, prescription medication just can be held by hospitals. Also after treatment, hospital has responsibility to record the effect after treatment.

6. Diagram the “as-is” and “to-be” processes for prescribing a medication for a patient before and after an EMR system is implemented?

Activity diagram for the traditional system

6. Diagram the “as-is” and “to-be” processes for prescribing a medication for a patient before and after an EMR system is implemented?

A simple EMR system

THANK YOU!