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Electronic Health Records and CPOE

Hayley, Vanessa, Dina, & Tori

Activity

Activity

Objectives

Student will be able to answer the following:

Objectives

  • Be able to explain the difference between EHR and CPOE.
  • Aprehend at least one historical fact of both EHR and CPOE.
  • Comprehend the IOM's three components that make EHR.
  • Understand the role and responsibilities of EHR and CPOE
  • Comprehend S.W.O.T analysis and its significance
  • Engage in interactive activities

History of Health Records

History of Health Records

  • 1991 & 1997-The IOM issued reports that focused on the impact of computer-based patients’ records as important technology for improving healthcare.
  • 2001- Crossing the quality chasm: A new health system for the 21st century was published
  • 2003- The U.S. DHHS began to promote the use of HIT, including the use of the EHR.

IOM defined EHR as these three components

IOM defined EHR as these three components

1.The collection of longitudinal data on a person’s health;

2.Immediate electronic access to this information;

3. Establishment of a system that provides decision support to ensure the quality, safety, and efficiency of patient care.

Electronic Health Records

Electrontic Health Records are defined as information on a patient that can create, gather, and manage one's healthcare information and data.

Electronic Health Records

EMR vs. EHR

Electronic Medical Record and Electronic Health Record can be used interchangbly but mean different things.

EMR is a digital version of the paper charts and contains the medical and treatment history of the patient, a list of medications and allergies

EMR vs. EHR

EHR contains patient data, but focuses on the patient’s total health, and has all information from all the health care providers the patient has.

Key Functions

There are eight key functions that the EMR should support:

1. Physician access to patient information

2. Acess to new and pass test results

3. Computerized provider order entry

4. Computerized decision systems to prevent

drug interactions

5. Secure electrontic communication

6. Patient access to health records

7. Computerized administraion processes

8. Standard based electronic data storage

Key Functions

Benefits of EHR's

There some basic benfits of the electronic health records, these include easy access to records and elminate poor penminship.

Benefits of EHR's

Three functionalities have the ability to improve the quality of care and reduce cost:

1. Clinical decision support (CDS) assists

the provider in making desicions

2. CPOE allows providers to entry orders

into a computer rather than paper

3. Health information exchange (HIE) is the

process of sharing patient records

between different organizations

Disadvantages of EHR's

Potential disadvantages of EHR's include

* financial issues

-implementation cost and ongoing maintaince

cost which can be costly

*changes in workflow and the temporary loss of

productivity

- medical staff and providers need to learn how

to use the new programming and now takes

time away from giving quality care to the

patient

*privacy concerns

- privacy violations due to the increase in health

inforamtion exchanged electrontically

Examples

All these examples use E-prescribing which is a form of CPOE. They consists of medication history, benefits information, and processing new and existing prescriptions. With E-prescribing the nurse or physician signs into the system that is being used at the hopsital with a password to verify identify.

Examples

Epic

Epic

Meditech

Millinium

InVision

SCM

Horizon

Centricity

History of CPOE

History of CPOE

Surescript issued an update on industry progress in implementing E-prescribing. CPOE was mandated in by Obama as part of PPACA and is consistly updating and improving

http://clinfowiki.org/wiki/index.php/E-prescribing#History

In this time CPOE required a keyboard input. It allowed automatic reordering and alerts for known adverse interactions.

1994-2004

1971

1984/1988

2012-Now

"CPOE grew quickly over the next few years. Cerner came out with Millenium, Eclipsys changed their E7000 line into SCM, Siemens launched InVision, Meditech announced Magic, Epic Systems released Epic, McKesson developed Horizon, and GE was just finishing Centricity."

Lockheed Martin developed the first CPOE system in a small hospital in California. The system allow physicians to quickly order medications with a few simple clicks.

Computerized Physician Order Entry

Computerized Physician Order Entry (CPOE) allows physicians to enter orders into a computer rather than in handwritting. The CPOE can help reduce factors that may lead to errors in an order.

Benefits of CPOE

Benefits of CPOE

CPOE is an improvement over paper based ordering and helps to reduce medication errors.

CPOE works by:

1. making sure order is legible and complete

2. checking for problems

3. provide dosage adjustment calculations

4. check for approprate baseline laboratory

results

5. computing drug-laboratory interactions

6. update prescriber with lastest drug

information

Drawbacks of CPOE

In the 2014 Leapfrog Hospital Survey, found that there were wisespread safety gaps in CPOE. Other problems that were found in the CPOE system were inconsistant medication naming, poor medication search, wrong patient orders when multiple orders were open, and a lack of standards alerts.

Drawbacks of CPOE

Costs

Cost

  • Technical Cost

  • Cost of Process Redesign

  • Cost of implemation and Support

  • 50-bed hospital = approx. 8 million in network updates + 1.35 million in maintanence

Effect on Medication errors

Effect on Medication errors

  • Medication errors are estimated to harm at least 1.5 million patients per year

  • Has helped enhance patient safety

  • Has reduced medication errors by as much as 80%

  • Helps physicians order entry with decision support

  • Bar-coded medication administrration (BCMA)

Role & Responsibility in Healthcare

Role & Responsibility in Healthcare

EHR and CPOE are responsible for clear and legible patient records and prescriptions, which results in less error.

S.W.O.T. Analysis

Strengths

  • Reduction of prescription errors
  • Better communication
  • Improved patient safety

Strengths

Weaknesses

  • Multiple CPOE systems
  • Unable to optimize medication safety
  • Alerts within the systems

Opportunities

  • Creating a Universal CPOE system
  • Eliminating the use of multiple records

Opportunities

Threats

  • Computer crashing
  • Computer Viruses
  • Having multiple screens open
  • Funding

Threats

Kahoot

Kahoot Time!!

Take out any electronic devices

Go to Kahoot.it

Kahoot

References

References

  • https://psnet.ahrq.gov/perspectives/perspective/191/computerized-provider-order-entry-and-patient-safety
  • http://clinfowiki.org/wiki/index.php/EMR_v._EHR
  • https://healthit.ahrq.gov/key-topics/electronic-medical-record-systems
  • https://healthit.ahrq.gov/key-topics/electronic-medical-record-system
  • Agrawal, Abha. "Medication errors: prevention using information technology systems." Journal complication. The British Pharmacological Society.2009.
  • Am J Health-syst Pharm-. "Effects of cpoe on medication errors. Vol63 Mar 1, 2006.
  • Kuperman, Gilad J. "Computer Physician Order Entry: Benefits, Cost, and Issues. American College of Physicians. 2003.

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