how do you solve a problem like an ehr?
Post on 29-Jun-2015
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How do you solve a
problem like an EHR?
EHR in the primary care setting in the
Philippines
Rene James P. Balandra Jr
MS Health Informatics (Bioinformatics Track)
HI 201 – Overview of Health Informatics
Primary health care
(Declaration of Alma-Ata)
• Reflects and evolves from the economic conditions and sociocultural and
political characteristics of the country and its communities and is based
on the application of the relevant results of social, biomedical and health
services research and public health experience;
• Addresses the main health problems in the community, providing
promotive, preventive, curative and rehabilitative services accordingly;
• Includes at least: education concerning prevailing health problems and
the methods of preventing and controlling them; promotion of food
supply and proper nutrition; an adequate supply of safe water and basic
sanitation; maternal and child health care, including family planning;
immunization against the major infectious diseases; prevention and
control of locally endemic diseases; appropriate treatment of common
diseases and injuries; and provision of essential drugs;
Primary health care
(Declaration of Alma-Ata)
• involves, in addition to the health sector, all related sectors and
aspects of national and community development, in particular
agriculture, animal husbandry, food, industry, education, housing,
public works, communications and other sectors; and demands
the coordinated efforts of all those sectors;
• requires and promotes maximum community and individual self-
reliance and participation in the planning, organization, operation
and control of primary health care, making fullest use of local,
national and other available resources; and to this end develops
through appropriate education the ability of communities to
participate;
• should be sustained by integrated, functional and mutually
supportive referral systems, leading to the progressive
improvement of comprehensive health care for all, and giving
priority to those most in need;
Primary health care
(Declaration of Alma-Ata)
• Relies, at local and referral levels, on health workers, including
physicians, nurses, midwives, auxiliaries and community workers
as applicable, as well as traditional practitioners as needed,
suitably trained socially and technically to work as a health team
and to respond to the expressed health needs of the community.
The Electronic Health Record
• Contains all personal health information belonging to an
individual
• Is entered and accessed electronically by healthcare
providers over the person’s lifetime
• Extends beyond acute inpatient situations including all
ambulatory care settings at which the patient receives
care.
Issues and Challenges
• Clinical Data Entry Issues
– How to translate diagnosis into standards formats in which
resulting data can be analyzed and electronically recorded?
– Lack of familiarity with existing clinical data standards
• Manpower issues
– Lack of Computer Literacy
– Lack of staff with adequate skills
Solutions
• Clinical Data Entry Issues
– Include the health professional in trainings that can enhance
their skills on standards
• Manpower issues
– Capacity building for health care staff
– Use younger and more tech-savvy staff as “force multipliers” in
encouraging and teaching non tech-savvy people
– Use of technological platforms that can be easily taught and
learned by less experienced users
Issues and Challenges
• Strong Resistance to Change by Many Healthcare Providers
– Familiarity to Manual-based systems
– Manual-based reporting systems to comply with
– Double work resulting from implementing both the existing
manual system and an electronic health record system
– Possibility of having an EHR that is different from their usual
workflow
Solutions
• Strong Resistance to Change by Many Healthcare Providers
– EHRs should be able to produce reports compatible with those
required from the health care providers
– Involve healthcare providers in the implementation and design
phase of an HER
Issues and Challenges
• Quality, Privacy and Confidentiality of electronic healthcare
information
– Are outcomes accurately recorded?
– How is the data protected?
– Who can view specific patient data?
– Who can add records?
Solutions
• Quality, Privacy and Confidentiality of electronic healthcare
information
– Privileges should be granted with respect to existing roles in
the current setup of primary care facilities.
– Provide the ability to log and track the addition and update of
patient records as means of accountability.
– Have policies that will serve as guidelines in implementing
EHRs
References
• http://www.who.int/publications/almaata_declaration_en.pdf
• http://www.wpro.who.int/publications/docs/EHRmanual.pdf
THANK YOU!
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