Electronic Health Record

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Electronic Health Record by Mind Map: Electronic Health Record

1. Description of purposed learning resource

1.1. Within the context of the healthcare industry, it is critical to understand how health information technologies (HITs) such as electronic health records (EHRs) are impacting the delivery of patient care.

1.1.1. More specifically, EHRs are a “repository of patient data in digital form, stored and exchanged securely, and accessible by multiple authorized users” (Häyrinen, Saranto, & Nykänen, 2007:2008)

2. Definition

2.1. “a longitudinal record in digital format containing a range of patient data including demographics, medical history, radiology images, medications and allergies, generated by one or more clinical encounters in various health care delivery settings” (American Optometric Association, 2011; Heart, Ben-Assuli, & Shabtai, 2017)

3. Concept

3.1. EHR can be used in an ambulatory care setting, providing physicians with the ability to carefully monitor their patients health over time, and allowing them to prevent medical errors, including misdiagnoses (Coughlin, 2013).

3.2. EHR when used in an inpatient setting, like a hospital, typically serves as a ‘hub’ for all the information health care providers need. An EHR in this setting will be interoperable with other systems within the setting (and not external connections) such as a radiology information system, laboratory information system, and a billing system (Rowley, 2017).

4. Misconception

4.1. One of the common misconceptions with EHRs includes how they are commonly used interchangeably with electronic medical records (EMRs), even though the two terms are entirely different from one another.

4.1.1. With EHRs, these contain a more complete record of patient data and allows for the sharing of data across multiple healthcare providers (Heart, Ben-Assuli, & Shabtai, 2017).

4.1.2. Whereas with EMRs, these platforms are utilized to only store institutional data which means that they only contain limited patient medical history (Heart, Ben-Assuli, & Shabtai, 2017).

4.2. Another misconception involves how some individuals believe that there is a one-size fits all approach with EHRs that can be utilized in any given healthcare setting.

4.2.1. This misconception is far from the truth, as each EHR has to be tailored to meet the needs of the setting in which it is implemented.

5. Essential Features

5.1. 1. Requires a secure internet connection

5.1.1. Without this feature, an EHR will be unable to successfully bring in data from other systems.

5.2. 2. Charting patient records

5.2.1. Being one of the primary features of an EHR, the absence of charting patient records would make using an EHR impractical.

5.3. 3. Accessible 24/7 by authorized users

5.3.1. This feature is necessary due to situations of emergency when providers must pull up a patient’s file to check their health history, including medications and allergies. (i.e. in instance of emergency being able to pull up a patient’s file immediately to check what medication they are currently on and if they have any allergies - authentication)

6. Accidental Features

6.1. 1. Interoperability

6.1.1. Facilitates secure information sharing between healthcare networks

6.1.1.1. In doing so, this accidental feature “enable(s) the sharing of data and information about patients׳ medical and health history” (Heart, Ben-Assuli, & Shabtai, 2017).

6.1.2. Extremely situational and depends on the available resources of the healthcare setting

6.1.2.1. For example, if a hospital does not have strong Wi-Fi connection around the entire facility, then the feature of an EHR being compatible on mobile devices would likely not be possible.

6.2. 2. Mobile compatibility

6.3. 3. Clinical Decision Support

6.3.1. A potential feature within EHRs that enhances clinical decision based on predefined algorithms and rules to assist providers in the delivery of care (Jannetti, 2013).

7. Learning Outcomes

7.1. 1. The role EHRs play to impact patient outcomes

7.2. 2. Identify the barriers and challenges associated with the hesitance to use EHRs

7.3. 3. Understanding the difference between an EMR and EHR

7.4. 4. Realize the importance behind proper standardized training protocols with EHRs to ensure their optimal effectiveness

8. Sub-topics

8.1. 1. Benefits of EHRs

8.2. 2. Challenges and barriers to EHR adoption

8.3. 3. Where does B.C. currently stand in the EHR movement across Canada? (adoption rates, etc.)

9. Rationale for choosing EHR

9.1. To provide the opportunity to further educate others on the importance of understanding the relationship between emerging information technology solutions and healthcare

10. Learning Resources

10.1. 1. YouTube videos

10.1.1. Sharing Your Electronic Health Record (EHR) https://www.youtube.com/watch?v=88XuX-AFBwY

10.1.2. EMR/EHR Done Right https://www.youtube.com/watch?v=97v5p9Nk2_I

10.1.3. EHRs in 2028 - What should the future look like? - 2018 EHR National Symposium -Stanford Medicine https://www.youtube.com/watch?v=CtsUtqdFNCo

10.1.4. Why electronic health records? https://www.youtube.com/watch?v=Lo_3qOejQzI

10.1.5. Electronic Health Records: Usability and Unintended Safety Issues https://www.youtube.com/watch?v=SlQ60KaLeHg

10.2. 2. Scholarly articles (accessible through the UVic library)

10.2.1. Measuring interoperable EHR adoption and maturity: a Canadian example http://web.b.ebscohost.com.ezproxy.library.uvic.ca/ehost/pdfviewer/pdfviewer?vid=2&sid=4bfb2b80-4311-45e4-bb89-336530bd226e%40pdc-v-sessmgr02

10.2.2. Users' perspectives of barriers and facilitators to implementing EHR in Canada: A study protocol https://implementationscience-biomedcentral-com.ezproxy.library.uvic.ca/articles/10.1186/1748-5908-4-20

10.2.3. The value of connected health information: perceptions of electronic health record users in Canada http://web.b.ebscohost.com.ezproxy.library.uvic.ca/ehost/pdfviewer/pdfviewer?vid=1&sid=ebf35305-22f3-4f50-9038-4cb452466a9a%40pdc-v-sessmgr02

10.2.4. Adoption of electronic health records and barriers https://www.tandfonline.com/doi/full/10.3402/jchimp.v6.32643?scroll=top&needAccess=true

10.2.5. Educating Health Professionals about the Electronic Health Record (EHR): Removing the Barriers to Adoption https://dspace.library.uvic.ca//handle/1828/6519

10.3. 3. 'Grey Literature' (professional resources, blogs, videos, etc.)

10.3.1. Electronic Health Records - Canada Health Infoway - https://www.infoway-inforoute.ca/en/solutions/digital-health-foundation/electronic-health-records

10.3.2. Understanding EHRs, EMRs and PHRs - Canada Health Infoway - https://www.infoway-inforoute.ca/en/solutions/digital-health-foundation/understanding-ehrs-emrs-and-phrs

10.3.3. A national electronic health record for all Canadians https://www.cbc.ca/radio/whitecoat/a-national-electronic-health-record-for-all-canadians-1.4976932

10.4. 4. Technology tools (WordPress, Etherpad, Moodle, etc.)

10.4.1. OpenEMR (Open source platform) https://www.open-emr.org/demo/

10.4.2. WordPress

11. References

11.1. Association, A. O., & AOA Health Information Technology Subcommittee. (2011). Electronic health records definitions and acronyms. Optometry - Journal of the American Optometric Association, 82(1), 46-47. doi:10.1016/j.optm.2010.11.002

11.2. Coughlin, B. (2013, March 28). EHR Case Studies. Retrieved from: https://www.healthit.gov/ buzz-blog/ehr-case-studies/ meaningful-ehr-ehr-preventing- hospital-readmissions

11.3. Häyrinen, K., Saranto, K., & Nykänen, P. (2007;2008;). Definition, structure, content, use and impacts of electronic health records: A review of the research literature. International Journal of Medical Informatics, 77(5), 291-304. doi:10.1016/ j.ijmedinf.2007.09.001

11.4. Heart, T., Ben-Assuli, O., & Shabtai, I. (2017). A review of PHR, EMR and EHR integration: A more personalized healthcare and public health policy. Health Policy and Technology, 6(1), 20-25. doi:10.1016/ j.hlpt.2016.08.002

11.5. Jannetti, M. (2013). In focus: Incorporating clinical decision support into EHRs. AORN Journal, 98(4), C7-C8. doi:10.1016/ S0001-2092(13)00943-5

11.6. Rowley, R. (2017, January 02). Ambulatory EHR vs. Inpatient EHR. Retrieved from: https://www.practicefusion.com/blog/ emrs-hospital-vs-ambulatory-solutions/