EMR

An electronic medical record record (EHR) (also electronic health record (EHR)) is a data repository that digitally collects the medical reports of patients, exchanges such information with other healthcare provides, and makes a personal health record (PHR) for the patient to share with their doctor and other providers.

Electronic Medical Record (EMR) or Electronic Healthcare Record (EHR)

EMR benefits

Electronic Medical Records have many benefits over an analogous paper record.

• See also: more in-depth discussion of EMR benefits

Privacy and security

Electronic objects enhance privacy by providing different levels of security access to different governmental groups and individuals. However, it also lends itself to some false sense of security in that it doesn’t prevent humans from mislabeling, incorrectly granting access, or malicious tampering. A digital data trail is very durable and more difficult to erase than a paper trail. However, privacy breaches are possible.

Financial

Computer systems are more efficient and can save time and money. Some practices have shown that an electronic medical system saves cost. [1] EMR systems can eliminate the paper chart. [2] Hard drives take up less space. Shared databases reduces the need for paper. [3]

Billing is also easier, as files are claimed faster, and bills are done optimally. Patients can be informed of generic drugs and doctors can know if insurances do not cover patients. Insurance and malpractice premiums can also be lowered. [4]) [5] The computer also can point out different drugs that can save hospitals money [6].

Man hours are also reduced. Dictation is automatic, e-prescribing reduces number of phone calls and visits, [7] [8] [9] and patients are automatically notified of test results and appointment times.

Clinical

EMRs make the hospital staff more productive.

• Nurses are more efficient (Evidence on the Costs and Benefits of Health Information Technology, Stuart Hagen and Peter Richmond, Congressional Budget Office, May 2008)
• Clinicians can view all angles of radiology pictures (Joan Breuer, Ph.D. 01/22/2010 20:00)
• Graphs
• Reduce medication errors and check for drug-drug interactions [10] [11] [12] [13]

• Increase underused preventative measures (Dexter PR, Perkins S, Overhage JM, Maharry K, Kohler RB, McDonald CJ. A computerized reminder system to increase the use of preventive care for hospitalized patients. N Engl J Med. 2001;345:965-70.)

• reduce duplicate laboratory tests [14] [15]

• reminders increase compliance(Gilad Kuperman, M.D., P.h.D., Richard Gibson, M.D., P.h.D. Ann Intern Med. 2003; 139:31-39.) and (Timm JA, Chick KL, Peterson JA, Epps SI, Bleimeyer RR, Harris M. Using expert rules to automate pressure ulcer alerts for the clinical nurse specialist. AMIA Annu Symp Proc. 2008 Nov 6:1154.) and (Teich JM, Merchia PR, Schmiz JL, Kuperman GJ, Spurr CD, Bates DW. Effects of computerized physician order entry on prescribing practices. Arch Intern Med. 2000;160:2741-7.)

Patient internet portal allows for most up to date information about healthcare. [16]

EHR system Selection

See more for in depth discussion of EHR system selections

Waiting room solutions

See more for in depth discussion of Waiting room solutions

• 1. OmniMD
• Vendor Selection Criteria
  1. Request for Proposal
  2. Comparing Vendors
• EMR Components
  1. Problem List
  2. Medication List
• EMR Training
  1. Physician Help Desks
  2. Post-live Physician Training & Support
• Strategies for Improving EMR Adoption
  1. Recent Changes to Support EHR Adoption in Solo/Small Practices
• Clinician Sign-out applications
• Free and Open Source EMRs
• Integrating Medical Devices into EMRs
  1. EMR Introduction and Background
  2. EMR Current Practices
  3. EMR Connectivity Requirements
  4. EMR (EHR) Available Solutions and How to Choose the Right One
• Remote Access
• Considerations for Specialists
  1. Special considerations for Pediatric Practices
  2. Special considerations for Ophthalmologists
• Models for Adoption by Small - Medium size practices
  1. Application Service Providers - ASP
  2. Utility Model
• EMR and Biometrics
• Socio-technical Issues
  • Privacy of Patient Data: Genetic Non-Discrimination
  • Definitions of Terms related to Patient Privacy, Confidentiality, and Security
• Business Case for Improving Usability
• New Technologies
  1. WiSPER™ (Wireless Standardized Portable Electronic Records)
  2. Vocera -- Hands-free, wireless communication device
  3. Aionex PatientBoard -- a HIPAA-compliant, secure, web-based, patient status board
  4. FastAccess -- a biometric facial recognition solution to the repeat login problem
  5. Biometric Resource -- information about existing and cutting edge biometric technologies

• 1. Omron Wrist Blood Pressure Monitor
  2. Iniatite Systems Identity Hub
  3. Internet Based EMR: Benefits & Costs
• Strategies of Clinical Data Entry
  1. Natural Language Processing (NLP)
  2. Coding Data
• Historically Important Electronic Medical Record Systems