Transcript: Facts Unconditional cooperation with all other vendors Ability to quickly adapt to unexpected social, financial or legal situations Manageable growth cost Full and Immediate Access to Data EHR Full Control over EHR Evolution Irreversible Path Decreased Reliability Migrating from older IBM hardware to newer IBM hardware takes the least amount of effort: Application code performs identical on old hardware and new hardware, except the new hardware is faster. Testing effort is minimum . Risk to lose application functionality is zero. May Be Cheaper ? High Risks Data access will be limited by: Technical factors: - Network bandwidth limitations - Storage I/O limitations - CPU/Memory limitations Administrative factors: - In general, RHO clients do not have privileged access - If a client insists to get privileged access than it must sign a waver that Vendor is no longer responsible for data loss or system malfunction. Huge Irreversible Detour Path Vendor's migration project from Locally Hosted to RHO typically lasts 9 months. During the last 3 months no changes are allowed This does not include any prior testing -- Any testing would add more months to the duration of the project Considering the migration includes a platform change from IBM Power Systems to Linux x86 systems and testing is omitted than there will be no way to detect in advance issues caused by this major code change. x86 Servers are known to be less reliable tan IBM Power Systems. Vendor is certifying a small number of x86 server models. Using a model certified by Vendor may conflict with existing x86 structure. Using a model not certified by Vendor will increase the risk of application malfunction. Patient Comfort Running for about 10 years on IBM hardware with 100% up time -- No downtime ever caused by a hardware failure. All other applications running on x86 hardware (Linux or Windows) experienced downtime caused by hardware failures. IBM Power Systems are well known to be much more reliable than x86 systems. May Be Expensive ? Most Friendly Solution x86 configuration requires physical servers -- no virtualization. No virtualization means increased effort for vertical scaling. Horizontal scaling requires more maintenance effort because more servers have to be modified at each software upgrade. Final Question Flexible Configuration (*) Notes: - The vendor's website mentions "263 RHO Environments" - One hospital could have many environments - For example, we have 7 environments - Surely 200 is a number much larger than the actual number of hospitals currently RHO clients. - There are 5,723 registered US hospitals, so over 5,500 have chosen not to be RHO clients... Limited Access to Data EHR integrates data from multiple systems Ability to export/import/exchange data with any other system or organization Ability to enhance EHR structure as needed Increased Effort Continue with IBM Hardware This particular RHO has only two data centers: - Located only 17 miles apart in seismic area 2. - Less than 90 miles from a nuclear power plant. - Both data center buildings are adjacent to public roads with open access to all vehicles. Local authorities acknowledged the risk of a local disaster caused by natural causes as earthquakes or extreme weather, by human errors or terrorist actions. In addition, all Remote Hosting Centers are the target of International hackers -- as big is a center as big is the risk to be hacked. Q: What business would take the risk to lose everything just to save 0.1% of its annual revenue? A: Only a business that has a higher risk to lose everything. This is unsure until Total Cost of Ownership (TCO) is known. TCO includes: - Business loss caused by hardware failures. - Extra-license cost caused by less computing power. Vendor is not offering any services for migrating out of an RHO configuration In the past, Vendor used all its available options to stop our migration from Vendor Managed Operations to Locally Managed Operations -- Vendor ceased any technical assistance for more than two months! There is no client yet that could migrate out of RHO. Once skilled staff is lost it's very hard to rebuild a new team with necessary skills for managing the EHR system. Due to high risks associated with this particular RHO, Vendor can not offer any warranties. Vendor has no liability what ever would happen, including: One or all RHO clients experience prolonged unplanned downtime. One or all RHO clients suffer partial or even total data loss. One or all RHO clients experience a poor response time. Switch to Linux x86 In order to simplify the management of hundreds of systems, Vendor is requiring: All RHO clients must obey standardization rules. All RHO clients must follow a strict time line in taking new code. If a client misses a time line then it loses it's place in line and will have to wait a very long time until upgrade resource are once again available If a client project takes longer than planned than Vendor will charge additional fees.
Transcript: The EHR/EMR system will: Give suggestions for possible diagnosis, helps lessen the diagnosis time=time efficiency Gives patient summary, history which provides a better diagnosis= less labs required Allow clinicians to enter diagnosis right into the system which will allow to process your insurance claims with less errors. LESS ERRORS, ERRORS, ERRORS = MORE $$$ Thank You! Thank you to: Tristin Carmichael and Aise Cannon for assisting with vignette Barri Dean and Tricia Reed for use of lab coat and rooms Meghan DiRito for office space http://healthit.gov/patients-families/basics-health-it Why is it IMPORTANT? Why is it important? How is it going to improve efficiency? They will be able SHOW offices how it will save them MONEY! There are several areas of Health IT: Public Health Project Management IT, software installation and maintaince Electronic Health Record (EHR) Patient Electronic Medical Record (EMR) Clinic Can provide summaries of your patient Create efficiency in time management Less wait time for patient Helps patient movement Quicker Lab response Assists with insurance claims Electronic Health/Medical Records Efficiency...HOW? What is Health IT? EHR: The Pulse of your Office EHR/EMR Health IT Trena J Gologan SHOW ME THE MONEY! Technology to: Store Share Analyze health information Workflows created: When the patient arrives in the office, ask them if they updated their EHR with chief comlaints prior to arrival? Yes Alerts the clinician that the patient has arrived and EMR is updated Clinician can review patient EHR/EMR for possible lab tests needed prior to consultation No Have the patient sit at the computer kiosk to update their record Once complete, will respond with Yes For further questions contact: Gologan Consultations firstname.lastname@example.org To improve PATIENT CARE Health IT Definition 62 ECG bpm
Transcript: EHR EHR Electronic health record. EHR Definition: It is an electronic file that includes medical, nursing and administrative information covering all aspects related to the patient's condition. Response to these interventions and treatments as well as patient-specific information. EHR Why patient electronic file? The electronic patient's medical file has many advantages, which make every medical institution do not give up its application. EHR Benefits EHR: 1 1-Fewer paperwork and less storage issues: In the health care sector, administrative tasks represent a significant amount of time and costs. Doctors and staff can spend a large part of filling out and processing work forms. Because EHR medical records are paperless, they simplify a number of routine tasks. As the amount of leaves decreases, the required storage space also decreases. 2 Increased quality of care: EHRs provide the ability to exchange complete health information about the patient in real time. Accurate, up-to-date and comprehensive information naturally leads to higher quality of care; by sending automatic reminders for visits and preventive actions, EHR records can also help patients better manage their conditions and participate more in health care. When it comes to medications, prescriptions can be lost or misunderstanding, leading to dosage errors or even the distribution of the wrong drugs. Electronic prescriptions allow doctors to communicate directly with the pharmacy, reduce errors and save time by eliminating lost prescriptions. Patient safety has been improved. 3 3- Efficiency and productivity: EHRs can be more efficient than paper records by allowing central schemes to be managed, as well as quick access to patient information from anywhere with special queries about a specific situation with other doctors, insurance providers, pharmacies and diagnostic centers are faster and more scalable. For tracking, which reduces lost messages and follow-up calls, resulting in increased productivity. 4 4. Better patient care: What is good for health care providers is also beneficial for patients. Simplifying access to the patient's complete records means no need to fill in the same papers at the doctor's office. The service provider can identify the diagnostic tests performed by the patient, as well as successful and unsuccessful treatments. Patients are less likely to double test or imaging procedures, because the results and images are all in one place. Improved coordination among providers leads to a more accurate diagnosis, better management of chronic conditions and better patient care in general, which should always be the main focus of health care delivery. EHR The challenges faced by medical record systems are summarized in five key points: 1 1. Users need information, which is the basic approach to systems development, has been tried together in the field of health care, where developers are brought together to what needs to provide medical care 2 2 - ease of use, which is primarily in the contracting that helps doctors and specialists in the use of information systems. 3 3 - Standards, one of the most important challenges facing the development of medical information systems - as mentioned earlier - they help us to increase the accuracy and integration between institutions and costs. 4 4. Social and legal challenges, which relate to the privacy and security of medical information 5 5 - Costs versus advantages, which are the most important economic challenges for the manufacture of medical records systems. Video ? Any Question? The End The names of the students: Hanan Hilan 201604455 Maram Salem 201506267 Dr.Aisha Alshammari Noura Obeed 201510534
Transcript: another problem that complicates google and microsoft's involvement is that third-party medical record services are no covered by (HIPAA) 1.why dose the U.S federal government want to move health records to electronic systems ? 2.what benefits and risks are offered by web-based health records management systems like google health ? provides strict standards for keeping medical records private Risks 1. how might google and microsoft reassure users about the privacy and security issues posed in this sidebar ? 2. would you consider registering for google health ?why or why not? Microsoft's tool is named HealthVault Google's tool is named Google Health Web-Based Electronic Health Record Systems Team members :- ->Rana alkafry ->salyar magaira the U.S federal government is pushing for most americans to have their medical records stored in electronic form by 2014 privacy and security concerns are raised both by corporate access to privte records by Microsoft and Google and out-sider access by hackers EHR : Systems store patient records in a central database that can be accessed by many doctors at more than one location The cost of moving to electronic systems is expensive Discussion Questions reduces errors made by incorrectly deciphering handwritten notes and prescriptions approximately 52 percent of adults look to web when seeking health advice google agree that patients should be in charge of their health information and should be able to grant their health care provider Microsoft and google Critical thinking Questions HIPAA Electronic health record (EHR) google and Microsoft believe that they can better assist health consumers by providing them with a robust tool for managing their health records The benefits of (EHR) this system eliminates problems caused by duplicate records at different doctors offices avoids having to fill out a new patient history with each new doctor visited by the patient if patient chooses to use microsoft or google to store medical records, those records would no longer be protected by standards imposed by HIPAA in it's current form The risk of (EHR)
Transcript: Goals: -A patient with CHF will be closely monitored to prevent complications -The Android App is a way of communication with other nurses. Description: Nurses unable to access and know how to manage the app. Nurses would be educated on how to use to cell phone and how to type in the patient's information Android App to Help the CHF Population Hardware and software: A description of how this project will accomplish the purposes of meaningful use By: Angela Hanning Bryana Ettinger Jane Osborn Christine Degrazia The app will give other nurses the high alert for the patient when they visit the patient's home. The patient's information will be stored into the app such as vital signs, and weight. The information will be available to be sent to doctor offices. Barriers: Ethical or legal issues that must be addressed with the development and implementation of this meaningful use application. Recruitment criteria for nurses who will need to be employed to work with this project. (Including the informatics competencies required by the professional nurse working with the specified population and technology). The nurse doesn't have an android cell phone. The home health agency would provide the nurses with the cell phone and the company will pay for the monthly fees. How the android app integrates with electronic health record: The Android App serves the purpose as being able to monitor CHF patients. A Home Health nurse would be the one utilizing the app. A patient with CHF would be considered a High Risk Alert and the protocol of the android phone would be taken into affect. When the nurse enters into their android app that the patient is High Risk and it then it alerts every nurse who would enter the home to take care of the patient. A visit protocol is taken into affect and the patient is seen every other day for the first 2 weeks of service with phone call checkups in between. The alerts and scheduling in the android app assure that high risk patients will get the monitoring they require to prevent readmission into the hospital. The hardware needed is the droid cell phone. The software needed is the android system with the CHF high risk app stored into the phone. Recruitment criteria for an informatics nurse specialist ( INS) who will need to be employed to oversee the development, implementation, and evaluation of this project. (focus on the functions and responsibilities of informatics nurse
Transcript: EHR Personal Health Records Repository for patient data that is maintained and updated by the patient Tools for a more active lifestyle Electronic Medical Records Electronic Health Records What Is Its Function? EMR Electronic Health Records Computerized, long-standing legal clinical records created in inpatient and outpatient environments Demographics Vital signs Past medical history Immunizations Laboratory reports PHR What Is It? Mary Hayes
Transcript: EHR SYSTEMS Health Information Mangement Project Created by : Erica Croom , Camille Moss , Kayla Newton, Brianna Simpson , La'Haua Thomas and Katherine Wilkins. What is a EHR system ? Definition An electronic version of a patient's medical history, kept over time by the provider, is known as an electronic health record (EHR). It contains all of the important administrative and clinical data pertinent to that person. EHR gives physicans and care providers tools to help them make better decisions regarding patients care Contains Medical History Medications Allergies Radiology images Treatment Plans Laboratory Results Can be accesed in REAL time by authorized users Consolidates patient information into digitial form More about EHR EHR Benefits Accessing patient information is made simpler The risk of sensitive data being stolen and handwriting errors is decreased. Benefits Key Advantages Additonal Advantages Ehr systems help provide better quality care for patients. They improve the practice's operational effectiveness while also assisting with treatment effectiveness. The majority of EHRs offer doctors health analytics that support pattern recognition, diagnosis prediction, and treatment suggestion. These analytics result in better overall patient outcomes. Examples My Chart NextGen athenaOne Meditech Examples of EHR use How it's used: Being able to go back years or months prior and access needed patient records Accessing patient medication records Keep patient health history on file such as surgeries and procedrues performed over years Inputting patient records and information without having to keep phsyical records Being able to diagnose patients based on past and present medical history It allows you to keep up with laboratory and test results Being able to track allergies and health conditions Sources References What is an electronic health record (EHR)? What is an electronic health record (EHR)? | HealthIT.gov. (2019, September 10). Retrieved April 17, 2023, from https://www.healthit.gov/faq/what-electronic-health-record-ehr Wuerth, R., Campbell, C., & King, W. J. (2014, March). Top 10 tips for effective use of electronic health records. Paediatrics & child health. Retrieved April 17, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959973/ The Ease of an EHR System Ease of which an EHR can be used Working an EHR system provides efficiency and easier access within the organzation. A few ways that this is implemantated and made possible is: Reducing paper work needed Better and quicker acess to information Easy to learn and follow system References References Charles, D., Gabriel, M., Searcy T. Adoption of Electronic Health Record Systems among U.S. Non-Federal Acute Care Hospitals: 2008-2014. ONC Data Brief, no.23. Office of the National Coordinator for Health Information Technology: Washington DC. Retrieved 4/16/23 from https://www.healthit.gov/sites/default/files/data-brief/2014HospitalAdoptionDataBrief.pdf. Centers for Disease Control and Prevention. (2020, March 3). Electronic Health Records (EHRS). Centers for Disease Control and Prevention. Retrieved April 16, 2023, from https://www.cdc.gov/niosh/topics/ehr/default.html Polner, M. (2022, August 29). What is an ehr? everything you need to know. Forbes. Retrieved April 16, 2023, from https://www.forbes.com/advisor/business/software/electronic-health-record-ehr/ Practice, S. (2023). What is an EHR system? SimplePractice. Retrieved April 16, 2023, from https://www.simplepractice.com/resource/what-is-an-ehr-system/?utm_source=google&utm_medium=cpc&network=x&utm_campaign=PMAX_Wiley&utm_term=&device=c&matchtype=&gclid=CjwKCAjwue6hBhBVEiwA9YTx8EGVgO-F1_pdPfsBdXMNQbRS8BKMzwrlAFBEraRfWNihThkXD01GKhoClisQAvD_BwE How can electronic health records improve the efficiency of my staff? How can electronic health records improve the efficiency of my staff? | HealthIT.gov. (2019, July 9). Retrieved April 17, 2023, from https://www.healthit.gov/faq/how-can-electronic-health-records-improve-efficiency-my-staff How an EHR caters to all patients How an EHR caters to all patients Undoubtedly, an EHR provides a substantial amount of benefits to healthcare providers, but it also benefits patients in numerous ways. Patients with various priorities or conditions are benefitted; for example, patients with disabilities or elderly patients. Additionally, EHRs even benefit patients who are limited on time, want to be more involved with their own healthcare plan decisions, or want to make sure their private health information is secure. Time & Cost-Efficient Time & Cost-Efficient Reduces the need for patients to continuously fill out the same information form (provide the same general information) at every visit Quick and reliable E-prescriptions automatically sent to the pharmacy Allows more accurate coding and billing due to reduced errors Easy and quick follow-up care with electronic referrals Patient Engagement Patient Engagement Why
Transcript: INTRO . The purpose of electronic health records is to allow the physicians to automate the workflow. It also assists in customizable and flexible documentation of the patients. This is configured to compliment the physicians clinical approach and their work style. INTRO Thesis The problem with EHR is that it's not safe because of WI- FI issues, Technology issues, medical and coding issues. ABOUT ABOUT EHR What it is What exactly is EHR Electronic Health Records of a patients medical history, that is maintained by the provider over time, and may include all of the clinical data relevant to that persons care, including demographics, progress notes, problems, medications. History The first EHRs appeared in the 1960s. A doctor named Lawrence L. Weed first to break the concept for the automated. Weed described a system to automate and re-organize to improve patient medical records to their use and which contributing to improving the patient care (Healthit, 2005). Remember: It's all about safety in the Medical Field. Problems We risk wi-fi issues like, hackers can hack into the healthcare systems, and hold patients information hostage until they get what they want in return as in money. When there is someones information in another persons hands, the patient suffers from identity theft, which can destroy the persons finances, credit, and reputation. When the EHR system does back up, the information can be retrieved wherever it can be back up into (O'Connor, 2016). Wi-Fi Issues There will always be technology issues because technology is always changing in the world today. The issue with that is, sometimes exchanging patient information from one hospital to the next, not all the information transfers over. Improperly configured software or upgrades and out-of-date software can also cause problems. So, if the physician is helping a patient out, there could be a random software update. Plus it also takes up the physician and patients time. E- messaging between providers can become a risk also, because there is no real contact, communication is easily misconstrued if you are not talking face to face, miscommunication is a major contributor to treatment and diagnostic mistakes (Bond, 2017). Technology Issues The Affordable Act are expecting big changes for the EHR with this topic because it is not a good thing Cloning is a buzzword for copying, forwarding, cutting, and pasting of the data to the record. Allowing the provider to update a record. When cloning is done and sent to the insurers the large insurers can digital expertise and can uncover the cloning of the facility. Sometimes doing this and sending it through billing it does not get transferred and causes errors ( Bond, 2017). Medical Billing & Coding Issues The cost to switch over from paper file records to EHR is way too much. Several studies estimate the cost of purchasing and installing an electronic health record (EHR) ranges from $15,000 to $70,000 per provider ( Bond, 2017). Switching over to EHR Solution It will cost way cheaper for not even switching it to the EHR environment. There will not be any worries about how hackers can take over hostage of client’s information for money. They would not have to worry about when the EHR must have it is software updates. Moving back to paper files Rebuttal Why people do not want to move back to paper files Reason 1 The doctor does not have to go through paper documents with his patient. All they must do is go through the tabs on the EHR on what they are talking about. EHR makes everything nice and neat, and easy to find when it comes to talking with the patient (Study, 2017). Reason 2 This also saves the office space, as there is not big folders taking up a bunch of space on the shelves in the office (Bond, 2017). Or, in a hospital setting, they have computers in the patient’s room. So, the nurse or physician can go into the patients room and get on the computer and access the patients chart by the bedside (Study, 2017). Medical field is a major field with peoples personal information, and EHR is at a high risk on peoples health information on safety as stated above. If it happens, health information privacy and portability (HIPPA) gets into the situation which turns into a very big lawsuit (Bond, 2017). It may be great that the physicians, and doctors have enough time with their clients, and that they have more time to spare at work. Safety of the patient and the patient’s personal information is the number one priority always in the healthcare field. Conclusion Bond, A. (2017). Retrieved April 17, 2018, from https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/consumers/privac y-security-electronic-records.pdf Health IT Bibliography. (n.d.). Retrieved April 17, 2018, from https://healthit.ahrq.gov/health-it-tools-and-resources/health-it-bibliography O'Connor, S. (n.d.). Pros and Cons of Electronic Health Records. Retrieved April 17, 2018, from https://www.youtube.com/watch?v=36EBkO1Jjo8 Video
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