References:
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Revision as of 23:35, 13 September 2013
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==More effective urgent care==
==More effective urgent care==
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EMR systems have the potential to facilitate and enhance urgent care when the emergency room or urgent care physician has access to the patient’s EMR file as would occur when a patient seeks urgent care within the healthcare system where the patient receives routine care or when the patient’s EMR file is available in a local, regional, national EMR system [19]. In such a scenario, the emergency room or urgent care physician could consult the patient’s EMR file to view the patient’s current medications, diagnoses, recent surgeries or procedures, and medical history, allowing the emergency physician to be better informed about the patient’s status and urgent needs [19]. Information security and privacy concerns will have to be addressed, however, in order for shared EMRs to gain widespread public acceptance [19]
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EMR systems have the potential to facilitate and enhance urgent care when the emergency room or urgent care physician has access to the patient’s EMR file as would occur when a patient seeks urgent care within the healthcare system where the patient receives routine care or when the patient’s EMR file is available in a local, regional, national EMR system [19]. In such a scenario, the emergency room or urgent care physician could consult the patient’s EMR file to view the patient’s current medications, diagnoses, recent surgeries or procedures, and medical history, allowing the emergency physician to be better informed about the patient’s status and urgent needs [19].
In terms of specific chronic illnesses such as heart failure, an EHR may have the potential to be a valuable adjunct in the care of heart failure patients [28].
Information security and privacy concerns will have to be addressed, however, in order for shared EMRs to gain widespread public acceptance [19]
== Patient Safety Outcomes ==
== Patient Safety Outcomes ==
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These are directly and indirectly attributed to the technology but are more difficult to quantify. E.g. implementation of a clinical nursing system may lead to increased case in recruiting efforts, better nurse retention, more rapid access to clinical nursing data, and decreased charting time. Quantification and measurement – of benefits usually is difficult because of the task complexity of the nursing function.
These are directly and indirectly attributed to the technology but are more difficult to quantify. E.g. implementation of a clinical nursing system may lead to increased case in recruiting efforts, better nurse retention, more rapid access to clinical nursing data, and decreased charting time. Quantification and measurement – of benefits usually is difficult because of the task complexity of the nursing function.
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An
overview of
attempts
to quantify quality outcomes and cost reporting measures benefits of EHRs was published by the Healthcare Information and Management Systems Society in 2010 and can be found here: http://www.himss.org/content/files/QPRWhitePaper.pdf
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Pinsonneault and associates found that data from before and after EHR integration, from a matched set of 15,626 patients with electronic integration and 15, 626 patients in a control group, who visited over 95 physicians in a large North American health network, show that patients treated through the electronically integrated system had better quality of care in the follow-up period and a higher continuity of care, compared to the control group [29].
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Another
overview of
an attempt
to quantify quality outcomes and cost reporting measures benefits of EHRs was published by the Healthcare Information and Management Systems Society in 2010 and can be found here: http://www.himss.org/content/files/QPRWhitePaper.pdf
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# Public grants – government initiatives
# Public grants – government initiatives
# State legislative initiatives – local and state initiatives
# State legislative initiatives – local and state initiatives
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== System Selection ==
== System Selection ==
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==Barriers of EMR Implementation==
==Barriers of EMR Implementation==
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The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health professional interaction, and lack of time and workload. Each user group also identified factors specific to their professional and individual priorities [30].
* In order for an EMR to be truly successful, proper and timely training must be administered to all who will interact with the system.
* In order for an EMR to be truly successful, proper and timely training must be administered to all who will interact with the system.
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# http://www.ncbi.nlm.nih.gov/pubmed/9576410
# http://www.ncbi.nlm.nih.gov/pubmed/9576410
# Study of the factors that promoted the implementation of electronic medical record on iPads at two emergency departments. Rao AS, Adam TJ, Gensinger R, Westra BL. AMIA Annu Symp Proc. 2012;2012:744-52. Epub 2012 Nov 3.
# Study of the factors that promoted the implementation of electronic medical record on iPads at two emergency departments. Rao AS, Adam TJ, Gensinger R, Westra BL. AMIA Annu Symp Proc. 2012;2012:744-52. Epub 2012 Nov 3.
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# Connelly, D. P., Park, Y. T., Du, J., Theera-Ampornpunt, N., Gordon,B. D., Bershow, B. A., ... & Speedie, S. M. (2012). The impact of electronic health records on care of heart failure patients in the emergency room. Journal of the American Medical Informatics Association, 19(3), 334-340.
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# Pinsonneault, A., Dakshinamoorthy, V., Reidel, K., & Tamblyn, R. (2012, January). The impact of IT on quality of care: Evaluation of an integrated chronic disease management system. In System Science (HICSS), 2012 45th Hawaii International Conference on (pp. 2947-2956). IEEE.
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# McGinn, C. A., Grenier, S., Duplantie, J., Shaw, N., Sicotte, C., Mathieu, L., ... & Gagnon, M. P. (2011). Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review. BMC medicine, 9(1), 46.