electronic health records
DESCRIPTION
What is EHR, related work and healthcare standards for EHR.TRANSCRIPT
Electronic Health Records &
Public Health Informatics
By Aakifa Ishtiaq, SEECS, NUST
Practitioners use records to capture their clinical findings and conclusions
Until recently, medical records have been captured on paper and are the property of the recording provider
“To Err Is Human” – many misconceptions resulting in lapse in patient care
Background
An evolving concept defined as the systematic collection of electronic health information about individuals and populations that can be transferred between health care centers.
Electronic Health Record
The systematic application of information science, computer science and technology to public health practice, research and learning
Public Health Informatics
Paper charts are neither interactive nor intuitively designed
Printed reminders and cautions can be easily overlooked
Physicians are notorious for illegible handwriting-as less as 65% of the written medical charts can be fully read
Disadvantages of Paper Records
No data sharing - written records remain in the providers office
Take a lot of space
Disorganization or disaster in office can result in information loss
Intuitive formatting and enhanced interaction
Eliminating unnecessary procedures reducing health care expenditures
Greater co-ordination and data sharing
No data loss
Helper applications-provide patient specific feedback in real time
Advantages of EHR
Provides alerts to the doctor to health needs or relevant research
Improved decisions on part of the clinician
Empowers patient in self management of chronic diseases
Helps track prior medical history and treatment of the patient
Collaboration between patient and doctor
Expensive software and computer purchase
Software maintenance expense
Dependent upon reliable operation
Disadvantages of EHR
Loss of revenue
Local vs. global perspective
Security
Learning curve
Overconfidence in personal physician skill
Factors for slow acceptance of EHR
Info-buttons
Computerized Provider Order Entry
Clinical Decision Support
Personal Health Record
Clinical Data Repository
Tools in EHR
Contact specific links from one information system to another resource
Provide relevant contextual information
significantly increase the percentage of met information needs at the point of care
Info-buttons
Allows provider orders to be written electronically either in the hospital or out-patient settings
Eliminates hand writing misinterpretation
Computerized Provider Order Entry(CPOE)
Provides intelligently filtered clinical knowledge and patient related information
Improves patient care
CPOE and CDS often work in tandem to ensure patient is being treated appropriately
Clinical Decision Support(CDS)
Enables the patient to keep track of their own personal health information
Provides educational material to assist in self management of chronic disease
Enables patients to take input from home monitoring devices such as glucometers, blood pressure monitors, etc
Personal Health Record(PHR)
Telemedicine allows communication of medical information to remote provider for consultation.
frequency of required appointments for a patient can be determined
Improves quality of care
Reduces cost through cost avoidance
The database that stores all the health information of the EHR
Clinical Data Repository(CDR)
One of the vital features of EHR
Readable data is dependent upon adherence to standards
Absence of robust standards could undermine the benefits of EHR adoption altogether
Standards have been developed for adoption by EHR vendors and RHIO members to allow data to be exchanged between systems in RHIO
Standardization
CCHIT - the only certification body endorsed to evaluate EHR’s for adherence to standards.
IHE Eye care Connectathons - test interoperability of equipment and EHR’s to determine how well they integrate
Health Level 7 (HL7) - a series of standards designed to allow data exchange and interoperability of EHR’s.
DICOM - centered on medical imaging
Standards in EHR
Registries
Disease Surveillance Systems
Geographic Information System
Tools in Public Health Informatics
Databases used to track patients:
a particular disease
exposure to risk factor
those who have undergone certain procedure
Registries
Estimating incidence
Providing a population for researchers to study
Trending a disease’s impact over time
Uses
Ongoing systematic collection, analysis and interpretation of health related data essential to planning, implementation and evaluation of public health practice
Disease Surveillance Systems
Evaluate threats to public health
Detect epidemics
Generate research questions
Assess current attempts to control health threats
To stay on top of changes in infectious agents or health practices
Uses
Tracking patients relative to their location
Ease spatial tracking in public health
Global Information System
In infectious disease tracking
Applications where spatial information is relevant e.g.
Sheen’s evaluation of costs
Benefits of optometric referrals in Wales
Uses
EHR will dramatically change the way in which clinicians practice
Enable creation of more legible records helpful for multiple practitioners
CDR and RHIO will act as a bridge enabling team work in patient care
Safeguarding populations from outbreaks
Conclusion
ELECTRONIC HEALTH RECORDS AND PUBLIC HEALTH INFORMATICS By Kevin M. Jackson, OD, MPH, FAAO, CDR, MSC, USN http://webpages.charter.net/oldpostpublishing/oldpostpublishing/Section%202,%20Principles%20of%20Public%20Health/Sect%202,%20Electronic%20Health%20Records%20and%20Public%20Health%20Informatics%20by%20Jackson.pdf
Reference