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Electronic Medical ecords
While history counts the inventor of paper among the hundred most influential people in the history of mankind, the services of paper have proven to be doubtful during floods, earthquakes, fires and other disasters. With the invention of digital technology and computers, the man felt that possibly anything can be stored into data base in form of text, images and even voice. The electronic medical record offers the medical professionals a solution to keep the information of a patient including his family and medical history that can be shared among several different physicians. Such a system eliminates the need to regenerate paper work again and again.
The medical staff particularly and the public generally was unaware of use of computers some three decades ago. There was rarely a person in an institute who could use a PC in early 1990's. An average medical facility used to have…
Aickin, M., (2011), "Patient-Centered Research from Electronic Medical Records," The
Permanente Journal, 15(4): 89 -- 91
Dearen, J., (2012), "The rising risk of electronic medical records," Retrieved from:
Electronic Medical ecords (EM) has become one of the most famous topics in the healthcare industry in the recent years since the use of the Internet has extended into more areas. The popularity of electronic medical records has also been fueled by the recent increase in the need to lessen the costs of health care services. This record is an electronic information sharing system through the Internet for both providers and patients. Consequently, physicians can update their data, prescriptions, and research into these online systems as patients and doctors can access the information from anywhere in the world (Michael, n.d.). Electronic Medical ecords have both advantages and disadvantages though the merits are more than the demerits.
Advantages of EM:
As previously mentioned, the advantages associated with electronic medical records outweigh the disadvantages. Some of the major advantages of these systems include
Centralization of Patient Data:
EM are widely known for…
Gurley, L. (n.d.). Advantages and Disadvantages of the Electronic Medical Record. Retrieved September 19, 2012, from http://unosolution.co.in/pdf/Gurley_article.pdf
Michael, J. (n.d.). Advantages & Disadvantages of EMR. Retrieved September 19, 2012, from http://www.ehow.com/list_5974535_advantages-disadvantages-emr.html
"What are the Advantages of Electronic Medical Records?" (n.d.). Wise Geek -- Clear Answers
for Common Questions. Retrieved September 19, 2012, from http://www.wisegeek.com/what-are-the-advantages-of-electronic-medical-records.htm
These computerized systems provide a platform where hospitals, medical laboratories, and health care institutions can manage their important data and deal with their patients in a more effective and well-organized way. The implementation of EMRs in hospitals started in the late 1980s but they became popular in the beginning of the 21st Century.
Now EMRs are found in every large hospital, health care institution, and laboratory. They use these systems for various purposes; including editing, modification, storage, and retrieval of patients' information and medical records, management of database of employees and supply chain members, and bringing efficiency in day-to-day functions. ith the rapid technological advancements in the medical field, the applications of EMRs will also increase in the health care industry. In future, they will be available with super-intelligent features and automatic functions which will enable health care institutions to operate with more safety and efficiency.
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Medical ecords Software Comparison
Electronic Medical ecords Software Comparative Analysis
There are over 75 different vendors of Electronic Medical ecords (EM) software applications currently providing solutions to healthcare facilities in the U.S. alone as of 2011 (Ulutas, Ulutas, Nabiyev, 2011). The key design criteria for EM systems is security (Neupert, Mundie, 2009), usability (James, Garrett, Krevit, 2009) and the ability to be integrated with legacy systems (Agarwal, Milch, Van Kuiken, 2009). This comparison includes AllScripts, ChartLogic and eClinicalWorks, three of the leading EM software application providers offering software suites today.
Comparative Analysis of EM Software Applications
All three applications are first compared in terms of how these companies are delivering them, whether it is through licensed software or over the Internet via the Software-as-a-Service (SaaS) model. Each of these applications also supports databases, requires an operating system, and has varying degrees of functionality and performance. All are HIPAA complaint, which…
Agarwal, S., Milch, B., & Van Kuiken, S.. (2009). Health care: Taking medical records online. The McKinsey Quarterly,(3), 56.
Dean James, Michael Garrett, & Leah Krevit. (2009). Discovering discovery tools: Evaluating vendors and implementing Web 2.0 environments. Library Hi Tech, 27(2), 268-276.
Neupert, P., & Mundie, C.. (2009). Personal Health Management Systems: Applying The Full Power Of Software To Improve The Quality And Efficiency Of Care. Health Affairs, 28(2), 390-2.
Ulutas, M., Ulutas, G., & Nabiyev, V.. (2011). Medical image security and EPR hiding using Shamir's secret sharing scheme. The Journal of Systems and Software, 84(3), 341.
Electronic medical records have developed to become an important component of today's health care systems because they lie at the center of computerized health information systems. Actually, the lack of electronic medical systems contributes to numerous difficulties in effective integration of modern technologies like decision support systems into regular clinical workflow. The development of electronic medical records have been fueled by the focus on multi-discipline computerized medical record, paperless, multi-provider, interoperable, and multi-specialty systems by various politicians, health professionals, researchers, and administrators. The development of such a system has been the focus of these stakeholders in the past two decades and has recently become a reality across several countries (Haupt, 2011). The development of electronic medical records emerged from their possibility to make health care safer, better, and more efficient
Electronic medical records have been developed because of the expectation of physicians to document their encounters with patients to ensure…
Haupt, A. (2011, July 18). The Era of Electronic Medical Records. Retrieved June 29, 2012,
"History of the Electronic Medical Record System." (n.d.). National Assembly on School-Based
Health Care. Retrieved June 29, 2012, from http://www.nasbhc.org/atf/cf/%7BCD9949F2-2761-42FB-BC7A-CEE165C701D9%7D/TA_HIT_history%20of%20EMR.pdf
The probability that clinicians will be faced with the hazardous business of conducting a visit without a patient record, that pharmacists, auditors, and other clinicians will be hindered by sloppy handwriting, or that clinicians will prescribe a medication that the patient is allergic to will be greatly diminished (Buppert, 2010).
There are some that think that EMs may generate new calamities. The technology is seen by some as bringing about a new set of risks in that EMs do not eliminate a significant set of risks that are there whether one uses the pen or the keyboard. Some clinicians are going to be bad typists, just as some clinicians are known to have bad penmanship. Malpractice defense may be disadvantaged by an excess of meaningless documentation that is generated by the use of templates. Insurance auditors often doubt the reality of documentation because of thoughtless use of templates. In addition,…
Buppert, Carolyn. (2010). Electronic Medical Records: 18 Ways to Reduce Legal Risks.
Retrieved May 17, 2010, from Medscape Today Web site:
Electronic Health Record. (2010). Retrieved May 17, 2010, from Answers Web site:
Electronic Medical ecords Management and Personal Privacy
Electronic Medical ecords Management and the Control of Personal Privacy Information
The ethics and security of Electronic Medical ecords (EM) is acting as a catalyst of continual innovation today and will accelerate development in this industry over the next two decades. The continual improvements in technology, security and personalization are also being driven by the need for healthcare providers to stay in HIPAA compliance as well (Lorenzen-huber, Boutain, Camp, Shankar, Connelly, 2011). With compliance to HIPAA requirements combined with demographic trends favoring increasing research & development (&D) in Electronic Medical ecords management, the field is expected to grow at a compound annual growth rate surpassing nearly every other healthcare-related field through 2015
The ethics of EM systems and their use by healthcare professionals, treatment personnel and the control that patients have over their use and review is now a key criterion for the…
Rakesh Agrawal, Tyrone Grandison, Christopher Johnson, & Jerry Kiernan. (2007). Enabling the 21st century health care information technology revolution. Association for Computing Machinery. Communications of the ACM, 50(2), 34-42.
Bernd, D., & Fine, P.. (2011). Electronic Medical Records: A Path Forward. Frontiers of Health Services Management, 28(1), 3-13.
Harrington, L., Kennerly, D., Johnson, C., & Snyder, D.. (2011). Safety Issues Related to the Electronic Medical Record (EMR): Synthesis of the Literature from the Last Decade, 2000-2009/PRACTITIONER APPLICATION. Journal of Healthcare Management, 56(1), 31-44.
Lorenzen-huber, L., Boutain, M., Camp, L., Shankar, K., & Connelly, K.. (2011). Privacy, Technology, and Aging: A Proposed Framework. Ageing International, 36(2), 232-252.
I agree that the most serious problem with electronic medical record-keeping is the cut and paste dilemma. Repetition and cutting and pasting of notes by physicians can be extremely problematic, and cause inaccuracies to be passed on from record to record. But this problem can also occur with paper records.
In terms of the financial barriers, it is important to note that any shift to safer and more effective technology comes at a cost to the physician, and this is, to some extent, one of the 'hazards' of doing business. Shifting to more sanitary procedures, using machines that are less risky in terms of disseminating radiation, and other changes in medical technology have all been expensive, yet deemed necessary because of the resultant improvements in patient health. The same is true regarding medical record-keeping. Patient health and keeping accurate records must be the priority.
However, complaints from physicians…
Electronic Medical ecords
Electronic Medical ecords
According to research literature it has been proven that technological innovation in regards to electronic patient records has improved communication the safety of patients. This has all been done without having to increase medical costs. EM's assist in reducing preventable errors, controlling medical care costs, and improving communication amongst the health care facilities and providers. Any technological innovation is geared towards solving a specific need that is affecting a health care provider or the patients. Using technology allows a health care facility to improve on its quality of care to the patients. Technology has also ensured that patient information is readily available to the necessary people. Using EM's a patient does not have to worry about their records not been available when they visit a health care facility. EM's allow health care providers to have access to all the patient records including the…
Encinosa, W.E., & Bae, J. (2011). Health information technology and its effects on hospital costs, outcomes, and patient safety. Inquiry, 48(4), 288-303.
Giaedi, T. (2008). The Impact of Electronic Medical records on improvement of health care delivery. The Libyan journal of medicine, 3(1), 4.
Electronic Medical ecords
Over the years, with the technological development and digitalization of almost all the processes, there have been calls for the healthcare technology to be adopted in a wider sense of it. This has been mainly on the development of the appropriate chip and other electronic storage systems that can hold the information about each American's medical information and any other relevant data like the physical address and the migration trend if the person moves from one town to another or even across the borders. This has been argued to be aimed at ensuring that the information about the individual is readily available to help in medically assisting the individual incase anything happens. Several methods of fully digitalizing this process have been suggested, the adio Frequency Identification (FID) being one of the major methods thought of.
Purpose of the project
Many healthcare facilities of late turn to this…
Ball, Marion J., Weaver, Charlotte A. & Kiel, Joan M. (2004). Healthcare Information Management Systems: Cases, Strategies, and Solutions. Springer-Verlag: New York.
Robert E. et.al, (1997). Six Principles of High Performance IT. Retrieved April 17, 2015 from http://www.di.ufpe.br/~srlm/papers/SIX%20PRINCIPLES%20OF%20HIGH-PERFORMANCE%20IT%20mckinsey%20article15_9703.pdf
In case of referrals, the physicians are able to share information with ease allowing a more accurate diagnosis to be made and the sending of reports between the two physicians becomes easy since it is electronic. In these ways, electronic medical records systems help physicians and healthcare organization to improve the quality of care provided to patients as well as improving the relationship between the patient and the physician since the electronic medical records system allows a better organized and more efficient way of collecting and transmitting data aghupathi & Kesh, 2007()
Other advantages of electronic methods include the safety of medical records from disasters such as fires and water since the records are held electronically and it is easier to create secure backups offsite. They also enable the physician or medical organization to comply with HIPAA standards such as the ANSI 5010 which claims that all submissions and the…
Benin, a.L., Vitkauskas, G., Thornquist, E., Shapiro, E.D., Concato, J., Aslan, M., & Krumholz, H.M. (2005). Validity of Using an Electronic Medical Record for Assessing Quality of Care in an Outpatient Setting. Medical Care, 43(7), 691-698. doi: 10.2307/3768369
Bentley, T.G.K., Effros, R.M., Palar, K., & Keeler, E.B. (2008). Waste in the U.S. Health Care System: A Conceptual Framework. The Milbank Quarterly, 86(4), 629-659. doi: 10.2307/25434113
Choo, P.W., Rand, C.S., Inui, T.S., Lee, M.-L. T., Cain, E., Cordeiro-Breault, M., . . . Platt, R. (1999). Validation of Patient Reports, Automated Pharmacy Records, and Pill Counts with Electronic Monitoring of Adherence to Antihypertensive Therapy. Medical Care, 37(9), 846-857. doi: 10.2307/3767416
Dixon, B.E. (2007). A Roadmap for the Adoption of e-Health. e-Service Journal, 5(3), 3-13. doi: 10.2979/esj.2007.5.3.3
Electronic Medical ecords, Documentation, and the ole of the Nurse
Efficient use of time is one of the primary methods healthcare professionals use to save lives. When there is very little time available, and decisions have to be made with acute accuracy, it is of primary concern to have access to all necessary information immediately. Nurses and other healthcare professionals have long enjoyed this access due to charting procedures implemented by hospitals over a century ago (Bernd & Fine, 2011). However, the immediacy is has not been there because paper charts require some amount of access time. ecently, because of the advances in computer technology, nursing has seen a significant change in the type of charting that occurs. The same documents apply, but nurses have better access to a patients file because charts have entered the computer age. Thinking only of efficiency, electronic medical records (EM) have provided nursing…
Bernd, D.L. & Fine, P.S. (2011). Electronic medical records: A path forward. Frontiers of Health Services Management, 28(1), 3-10.
Evans, B.J. (2011). Much ado about data ownership. Harvard Journal of Law & Technology, 25(1), 69-121.
Kelsey-Sebold Clinic. (2009). Kelsey-Sebold clinic invests in electronic medical records. Retrieved April 8, 2010 from http://www.kelsey-seybold.com/news/press - releases/pages/kelsey-seybold-clinic-invests-in-electronic-medical-records.aspx
McCarthy, C.P. (2010). Personal health records and patient privacy. William and Mary Law Review, 51(6), 2243-2261.
The author of this report is to look at the theoretical test case and associated statistics of a medical facility known as Middleville egional Health Care. They are one of three hospitals serving a community of about 350,000 people. The statistics of Middleville have been provided as well as the details about its two competitors in the same metropolitan area. There are a couple of issues in play that the author of this report will address. First, there will be an explanation of the governing board's role in their overall strategic initiatives, the determining of its responsibility and its overall involvement in the same. Second, evidence-based management will be used to determine whether the actions chosen are yielding the results that they could or should reveal. Third, there will be an analysis of the aforementioned statistics of the three facilities in the area, including Middleville. Fourth, there will…
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Brands of Electronic Medical ecords:
Electronic Medical ecords (EM) are computerized medical systems that are created within a healthcare organization that allow the storage, retrieval and alteration of records. In most cases, these systems tend to be part of the local distinctive health information system within an organization that provides care like doctor's surgery or hospital. There are many brands of electronic medical records that are in existence today which are designed to eradicate many problems in the contemporary medical practice. These brands of electronic medical records include the following
NextGen Electronic Medical ecord is a resourceful, multi-module system which can be used to automate the workflow in medical practice regardless of the specialty and size of the particular practice (Corey, 2008). The system comes with pre-loaded specialty templates that contain detailed choices for documenting histories of patients, procedures and evaluations. In addition, this software contains applications that…
"Allscripts EMR Software." (n.d.). Microwize Technology: Delivering the Practice of the Future
… NOW. Retrieved June 3, 2011, from http://www.microwize.com/
"Allscripts Professional EHR Software." (n.d.). Software Advice: The Authority on Software
Selection. Retrieved June 3, 2011, from http://www.softwareadvice.com/medical/allscripts-ehr-profile/
Selecting the right vendor (background check)
Choosing the right vendor can be just as important as the system being setup and the software being utilized. Choosing the right vendor is just as important as choosing the right EMR software. Daniel Ray, in the article, "Electronic Medical Records (EMR) Vendors- Points to Consider," declares the following things are essential in choosing the right vendor for your business:
1. Checking the track record: evaluate the history of the company and their reputation in relation to the services being offered and the past service to other clients.
2. Evaluate your needs: start by making a detailed list of the features and services you require from the vendor. Compare this list to any services already being utilized by the practice.
3. Consultation: before deciding on a particular vendor and software, consult other practitioners that are already using EMR software, consult the references of previous…
Carter, J. Tips for evaluating electronic medical record software. 2004. Retrieved on June 12,
2010 from http://www.acpinternist.org/archives/2004/04/emrs.htm
Definition of: EHR. 2010. Retrieved on June 12, 2010 from http://www.pcmag.com/encyclopedia_term/0,2542,t=EHR&i=56664,00.asp
Docsboard.com. 2010. Retrieved on June 12, 2010 from http://www.docsboard.com/forums/faq.php?s=d2ab7458e23941a79b32bb34f4f293df&faq=pitfalls#faq_tips
Pulse of Electronic Medical ecords
Taking the Pulse
Dr. Cara is treating a patient for congestive heart failure in the hospital emergency room. The elderly female patient has made multiple trips to the E the last four months after suffering chest pains, palpitations and other health scares.
Before ending her 12-hour shift, Dr. Cara writes instructions on the patient's medical chart. Under the column that reads "medications," she writes "now nec,," an abbreviation for "now necessary."
An hour later, the next attending E physician reviews the chart -- and then, struggling for clarity, reads it several times again. Is that a "w" or a "t"? Is that word "now" or "not"? He cannot reach Dr. Cara by phone, but sees that she has been consulting with the patient's cardiologist. Assuming from this piece of information that the patient has been prescribed medication from the cardiologist, the physician reads Dr. Cara's…
Fonkych, K., & Taylor, R. (2005). The state and pattern of health information technology adoption. Santa Monica, CA: Rand Corporation.
Kazley, A.S. & Ozcan Y.A. (2008). Do hospitals with electronic medical (EMRs)
provide higher quality care? An Examination of Three Clinical Conditions. Medical Care Research and Review, 65, 496-513.
Kovnar, A.R. And Knickman, J.R. (2011). Health Care Delivery in the United States.
Reform and Electronic Medical Records
An Interview with Bernie Saunders
"Imagine a world where everything important about a patient is known to the physician the first time that patient presents," says Andrew Rubin, vice president for NYU Medical Center Clinical Affairs and Affiliates in New York City (Mann, N.d.).
hen doctors have complete and accurate record of the patient's medical health history they have the potential to reduce errors and improve patient care. There are many cases in which a patient may not be able to understand or recall many of the things that pertain to their own care. Having a comprehensive record that can be updated in real time and transferred to and from health care providers electronically could provide major improvements in the quality of care. There would be less chance that a diagnosis is missed because of missing information. "e need to be able to…
AP. (2014, July 28). Deal to improve veterans' health care costs $17 billion. Retrieved from Daily Herald: http://www.dailyherald.com/article/20140728/news/140728579/
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Training staff members requires additional costs. There is also the 'time' cost of using the system on a daily basis. Furthermore, many find the demands of using the system -- typing into a machine as the patient talks -- to be profoundly impersonal and contrary to the true nature of practicing medicine. Doctors and nurses want to focus on people, not on machines, and they view EM as a machine-driven intrusion into the way they practice medicine. However, supporters of electronic medical records contend that it is this desire to ignore the mundane side of medical record-keeping that often results in bad medicine. The great advantages of EM are that they do require that providers enter all relevant data and ensure that patients sign necessary request forms. And patient health as a whole will be improved if by using EM, there can be comparisons made between different patients. Data trends…
Koriwchak, Mike. (2010). Physician resistance to EMR and why CPT should be replaced.
Kevin MD. Retrieved: http://www.kevinmd.com/blog/2010/09/physician-resistance-emr-cpt-replaced.html
The resistance: Small practices reluctant to implement EMR. (2012). Hit Exchange Media.
Interoperability of Electronic Medical ecords
Electronic Health ecords (EHs) are patient-management tools that have been created in the health sector to help coordinate patient care. These tools or system focuses on capturing patient-generated health information from outside the clinical setting and incorporating it into the patient's medical history. Electronic health records were developed to help improve patient care through sharing patient information seamlessly. However, for EHs to have the ability to share patient information seamlessly, an interoperable health information technology environment should be established. This essentially means that an interoperable health IT environment is mandatory for electronic health records to be effective.
What is Interoperability?
Interoperability is a term used to refer to the level with which devices and systems can share data and interpret it (Healthcare Information and Management Systems Society, 2013). This means that two devices or systems are considered interoperable when they exchange data seamlessly and eventually…
Healthcare Information and Management Systems Society. (2013). What is Interoperability? Retrieved November 7, 2016, from http://www.himss.org/library/interoperability-standards/what-is-interoperability
Schiller, D. (2015, November 30). EHRs and Healthcare Interoperability: The Challenges, Complexities, Opportunities and Reality. Retrieved November 7, 2016, from http://www.healthcareitnews.com/blog/ehrs-healthcare-interoperability-challenges-complexities-opportunities-reality
Stroupe, M.P. (2011, May). What is EHR Interoperability and Why Should I Care? Retrieved November 7, 2016, from http://www.nethealth.com/wp-content/uploads/2013/11/What-is-EHR-Interoperability.pdf
HMS (healthcare management systems) and EMRs (electronic medical records) have been widely praised as significantly adding to patient safety and quality of care. They can permit healthcare institutions to keep more accurate databases on patients, all in one location, and can ensure that a patient’s full medical records are available, even if the patient is not responsive and the patient’s family is not available. Prior treatments, current and past medications, and patient allergies can all be easily accessed with a point and a click. But transitioning to such healthcare systems is not always without issues and often involves a significant investment of time and money.
First of all, from a staffing point of view, change management is needed to ensure that the transition is effective. One helpful way to view change of any kind within an organization is that of Lewin’s Change Management Model, which suggests that organizations must first…
large number of changes in the healthcare industry, largely due to globalization and technological improvements. Much of the change has been the result of the cost of healthcare and its continual rise. For example, in 1990 the average cost of care per person was $2,800, in 2000 it was $4,700 and then in 2010 close to $8,000. One way to reduce these costs and improve efficiency is to allow healthcare professionals to spend more time with their patients rather than filling out redundant paperwork, to increase information accuracy, and to provide a way for medical professionals in Emergency Rooms or other health care facilities to have access to critical patient information. his can be accomplished through the use of Electronic Medical Record Systems, or ERM systems.
Diabetes is a group of metabolic diseases that surround the body's ability to produce and use sugars and efficiently process those sugars. Globally, there…
The conclusions reached seemed robust and showed that the use of EHRs, particularly in the primary care system improves both the process of care and outcomes. This suggests that organizations should immediately implement EHR systems so that decision support, patient care, timing of appointments and efficiency of recording of data and tracking medications and treatment options is actually far more efficient in both monetary and patient centered outcomes. Certainly, room for improvement exists, and as EHRs become more sophisticated, it stands to reason that efficiencies, outcomes and improvements in decision support will also become expected by stakeholders.
Herrin, J., et al. (2012). The Effectiveness of Implementing and Electronic Health Record on Diabetes Care and Outcomes. Health Services Research, 47(4), 1522-40. doi:10.1111/j.l475-6773-2011-01370.x
Health Care continues to undergo fundamental change. Legislation such as the affordable care act has created a much higher percentage of insured citizens. Patent legislation is now allowing for much more competition for popular drugs. Generic drugs in particularly which are cheaper for consumers and much more profitable for producers are now eroding the market share of popular products. Even the use of cloud computing is changing the way care is administered within a facility. Even with these innovations, facilities still struggle with bloated cost structures, inefficient behavior, and lack of staffing. MGH is not different in this regard. It suffers from a large influx of patients with the inability to provide timely care. Below is a description of the issues combined with possible real world solutions.
Describe the current process and identify the specific areas that slow the process.
The current process has is inadequate primarily due to staffing…
1) Roukema, J.; Los, RK; Bleeker, SE; Van Ginneken, AM; Van Der Lei, J; Moll, HA (2006). "Paper vs. Computer: Feasibility of an Electronic Medical Record in General Pediatrics." Pediatrics 117 (1): 15-21
Organizational change plan
Introducing electronic medical records (EM)
Along with expanding health coverage to more Americans, one of the goals of recent federal policy has been the widespread adoption of electronic medical records (EM) by healthcare providers across the nation. "The federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records" (Abelson, Creswell, & Palmer 2012). Having EMs can be used by providers to gain swift access to comprehensive information about a patient's health history. Some patients forget their history of diagnoses or the medications they are on; sometimes patients must be treated when they are in a mental or physical state where they cannot be forthcoming with information and their friends and families are not nearby. Also, there is the problem of patients attempting to obtain more pharmaceuticals or drugs which they should not be taking. "Electronic…
Abelson, Reed, Julie Creswell, & Griff Palmer. (2012). Medicare bills rise as records turn electronic. The New York Times. Retrieved:
Change theory by Kurt Lewin. (2012). Current Nursing. Retrieved:
Electronic Medical ecords (E-SIHI) in King Khalid University Hospital on Patient Safety
The objective of this study is to demonstrate the impact of e-SIHI (Electronic Medical ecords) on patients with regards to their security and safety. The King Khalid University Hospital has implemented the e-SIHI since May 2015 for all departments. Two weeks after the implementation, QMD (Quality Management Department) conducted an audit to measure a compliance for the system and ascertain whether the e-SIHI can improve health and safety of patients. However, the QMD found that there are many areas requiring improvement in the system. The paper discusses the methodology used to evaluate the system to ascertain whether e-SIHI is beneficial to the patient.
The research methodology reveals research design discussing the method of data collection, sample population, sample size, and project tool.
Study Design: The team audits the e-SIHI using a checklist to verify whether the…
AlAswad, A.M. (2015). Issues Concerning the Adoption and Usage of Electronic Medical Records in Ministry of Health Hospitals in Saudi Arabia. School of Health and Related Research (ScHARR) the University of Sheffield.
Bowman, S. (2013). Impact of Electronic Health Record Systems on Information Integrity: Quality and Safety Implications. Perspectives in Health Information Management, 10.
Jang, J., Yu, S. H., Kim, C., Moon, Y. et al. (2013). "The effects of an electronic medical record on the completeness of documentation in the anesthesia record, International journal of medical informatics, 82(8):702-707.
Kazley, A. S. & Ozcan, Y. A. (2009). Electronic medical record use and efficiency: A DEA and windows analysis of hospitals, Socio-economic planning sciences, 43(3): 209-216.
Electronic Certificates of Medical Necessity: A Proposal
Medical billing can now become a relatively painless process for the personal in a medical facility through the electronic filing of certificates of medical necessity (e-CMN). Manually filling out paperwork is very time consuming, and is not very cost effective. However, the technological advancements created in the area of medical billing are very efficient. While many offices now fax the CMN's, the incorporation of e-CMN's into the medical office and billing process, decreases overhead costs, reduces paperwork, and helps substantially with the on-going battle to comply with the ever-changing Medicare requirements. While each of the previous reasons is enticing enough to consider incorporating e-CMN's into the office routine, the increase of revenue is certainly a major benefit and is the direct result of the time reduction with the filing process.
Billy Tauzin, chairman of the U.S. House Committee on Energy and Commerce, clarified…
Bachenheimer, C. (2001, Aug. 1). Something out of nothing. Home Care Magazine. Retrieved April 13, 2004 at http://homecaremag.com/ar/medical_something_nothing/index.htm .
Business Wire. (2004, Feb. 13). American association for homecare and Trac Medical Solution agree on industry wide ecmn solution. ProQuest Document: 545984641 http://gateway.proquest.com/openurl-url_ver=Z39.882004&res_dat=xri:pqd&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&rft_txri:pqd:did=000000545984641&svc_dat=xri:pqil:fmt
McClinton, D. (2001). E-CMN's. Home Care Magazine. Retrieved April 13, 2004, at http://homecaremag.com/ar/medical_ecmns/index.htm .
Barnsteiner JH. Medication reconciliation: transfer of medication information across settings -- keeping it free from error. Am J Nurs. 2005;05(3 Suppl):3-6.
This article evaluates the need for proper medication reconciliation across various nursing settings. This article is important as emphasis is placed on error free reconciliation which is very important for proper client service and treatment.
Bullough, Vern L. and Bonnie Bullough. The Emergence of Modern Nursing (2nd ed. 972)
This reference emphasized modern nursing and many of the practices and advances of nursing over the years. This is important as it provides a historical perspective of medical reconciliation. A historical perspective is needed to better understand improvements that will need to be made in the future.
D'Antonio, Patricia. American Nursing: A History of Knowledge, Authority, and the Meaning of Work (200), 272pp
This reference provides further evidence into the history of medical reconciliation and recommendations on improvements that should…
13. Rogers G, Alper E, Brunelle D, et al. Reconciling medications at admission: safe practice recommendations and implementation strategies. Jt Comm J Qual Saf. 2006;32:37-50
14. Snodgrass, Mary Ellen. Historical Encyclopedia of Nursing (2004), 354pp; from ancient times to the present
15. Sullivan C, Gleason KM, Rooney D, et al. Medication reconciliation in the acute care setting: opportunity and challenge for nursing. J Nurs Care Qual. 2005;20(2):95-98
Describe briefly your topic of interest (15 possible points):
According to the United States Department of Health and Human Services (2013), medical reconciliation is "the process of comparing a patient's medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions." The process of medical reconciliation falls within the rubric of electronic medical records, which enable medical reconciliation. Medical reconciliation saves lives, improves the efficiency of hospital administration and of the healthcare team, and is simply necessary for providing quality of care.
#1 Database (or collection) (30 possible points):
Title of source:
"Electronic Health ecord (HE)"
Location of source (UL): http://www.ihs.gov/ehr/index.cfm?module=medication_reconciliation
Owner or publisher:
Indian Health Service
The Indian Health Service (2013) offers an overview of what medical reconciliation is, and how it applies to both individual and community health.…
"Electronic Health Record (EHR)," (2013). Indian Health Service. Retrieved online: http://www.ihs.gov/ehr/index.cfm?module=medication_reconciliation
"Medical Reconciliation," (2013). Greater Baltimore Medical Center. Retrieved online: http://www.gbmc.org/body.cfm?id=617
United States Department of Health and Human Services (2013). Electronic health record (EHR). Retrieved online:
It maintains these features for health information under the authority of "covered" units such as health care centre, plan or provider. Online storages such as Google Health and Microsoft Health Vault do not lie within the bounds of such kinds of units. This implies that their data is not as safe as they expect or assume them to be. The best approach to stay safe is to manage the electronic medical records in an online patient portal which works within the confines of the health care provider's information system. The private data which exists there will be covered by the terms of HIPAA. The level of access can be moderated to comply with the laws of the state. An instance of such a portal is the "PatientSite" created at the eth Israel Deacon Medical Center, oston. This kind of forum provides services such as secure messaging, registering appointments and updating…
Steinbrook, Robert. "Personally Controlled Online Health Data -- The next big thing in medical care" The New England Journal of Medicine, (2008): 1653-1656
"Electronic Medical Records - The pros and cons," healthworldnet.com. 1 March, 2009,
McCullagh, Declan, "Q&A: Electronic Medical Records and you," cbsnews.com, 19 May, 2009,
Evolution of Health Care Information Systems Physician's Office Operation
Filling in the hole of health care information technology will endorse safe, capable, patient-centered, and patient care that is fruitful in a timely way. In this essay, the theme is to look into two modern health
care organizations and then compare and contrast many characteristics that will involve the kind of evidence systems are using at the moment, investigate the transmission of information 20 years ago and how the substitute of data today. Furthermore, this essay will cover two major events and technology developments that have inclined present Health Care Informational Services practices.
Compare and Contrast Doctor's Workplace Operation
These day's doctor's office operation is familiarizing to the health care reform that was sanctioned in 2010 by the Obama organization. During sometime in October of 2013, the exchanges in health insurance was available on the market for customers on order to…
Burke, D., Wang, B., & Wan T.T.H. & Diana, M. (2009). Exploring Hospitals' Adoptionof IT. Journal of Medical Systems, 21(9), 349 -- 355.
Callen, J., & Braithwaite, J. & . (2008). Cultures in Hospitals and TheirInfluence on Attitudes to, and Satisfaction with, the Use of Clinical InformationSystems. Social Science and Medicine, 65(4), 635-639.
Finchman, R., & Kohli, R. & . (2011). Editorial Overview -- The role of IS inHealthcare. Information Systems Research, 22(3), 419-428.
Adoption Of the EH Technology Systems
In a contemporary health environment, nurses have long been using the computer technology to achieve the health outcomes such as the laboratory tests, however, the EH (electronic health records) has become a revolutionary innovative technology for the enhancement of the healthcare system. It is very critical for nurses to understand their roles as an agent of changes and influence other to change the tradition way of doing things. My role as a nursing facilitator of a small hospital in New York is to prepare the implementation plan of a new EH system for the hospital. While the decision has been finalized for the implementation of the EH, nevertheless, there is still a resistance from the nurses of the hospital.
The objective of this paper is to use the five qualities of the oger (2003) model for the implementation of the new system.
Evans, S. & Stemple, C. (2008). Electronic Health Records and the Value of Health IT. Journal of Managed Care Pharmacy JMCP. 14 (6):S16-S18.
Lee, T. (2004). Nurses' adoption of technology: Application of Rogers' Innovation-diffusion Model. Applied Nursing Research. 17(4): 231-238.
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.
EH Assessment and Evaluation to Support Healthcare Outcome Objectives
The outcome-related goals that the tertiary care hospital seeks to achieve include the following: 1) Strengthen adult admissions screening at intake for pain, depression, and adverse health behaviors such as smoking, excess alcohol intake, and body mass index (BMI) greater than 30; 2) implement comprehensive geriatric assessment for all adults 65 years of age and over who are hospitalized for more than seven days or readmitted within less than three days following discharge; and 3) promote care team performance. The electronic health record (EH) is the default system for adult admissions, and it includes documentation standards and structures such as SOAP and checklists. Hospital staff are provided periodic guidelines through educational venues or through referral to the electronic policy and procedure manual. Given this information, the data elements that should be included in the EH assessment and evaluation screens are as…
Lowry, S.Z., Quinn, M.T., Ramaiah, M., Schumacher, Gibbons, M.C., Patterson, E.S., North, R., Zhang, J., and Abbott, P. (2012, February 21). NISTIR 7804: Technical evaluation, testing and evaluation of the usability of electronic health records. Retrieved from http://www.emrandhipaa.com/emr-and-hipaa/2013/10/22/turf-an-ehr-usability-assessment-tool/
' Since the paper is only used as 'back up' this means that the files are under lock and key, in a centralized location or in the department generating the data. They do not circulate throughout the facility, ensuring a greater chance of misplacement or security compromises. But even in this instance, errors can occur -- timely record-updating and writing times and dates next to new information when it is added to a patient's file is essential, to ensure that there is not a discrepancy between the patient's data kept in two different locations. In fact, one worker at one of the larger facilities expressed dissatisfaction with the paper back-up method: "Keeping everything together either electronically or on paper not both. Causes too much confusion," she or he wrote.
Unfortunately, in large and small facilities, even with security procedures such as password protections for digital data, safety concerns remain. Concerns…
None of the findings are not surprising to a lot of experts. Apart from large systems that are integrated, like Kaiser Permanente in California and the Veteran's Administration, a lot of doctor practices are adopting different EMs. Also in so many different situations they do not talk to one another (Sittig & Singh 2012). So, a doctor's record is not necessarily able to get access notes from his regional hospital if different systems were utilized. A lot of doctors in that condition could just re-order a test, instead of going through all of the changes of finding the records from the hospital.
Actually many experts make the point that the true power of digital records come when using a sole, unified system that can be retrieved by altered health sites. With the exclusion of large combined health arrangements, there sometimes can be fragmented EMs. Experts mention that perhaps with the…
Cook, P.J., Lawrence, B.A., Ludwig, J., & Miller, T.R. (1999). The medical costs of gunshot injuries in the United States. JAMA, 282(5), 447-54.
Eckman, B.A., Bennett, C.A., Kaufman, J.H., & Tenner, J.W. (2007). Varieties of interoperability in the transformation of the health-care information infrastructure. IBM Systems Journal, 46(1), 19-41.
Heselmans, a., Aertgeerts, B., Donceel, P., Geens, S., Van, d. V., & Ramaekers, D. (2012). Family physicians' perceptions and use of electronic clinical decision support during the first year of implementation. Journal of Medical Systems, 36(6), 3677-3684.
Simons, W.V., Mandl, K.D., & Kohane, I.S. (2005). The PING personally controlled electronic medical record system: Technical architecture. Journal of the American Medical Informatics Association, 12(1), 47-54.
Electronic communication has become one of the most important methods for people to communicate with one another in recent years. Spielberg (1999) noted that patients have sought to utilize electronic communication with their physicians. In the past, he argued, a variety of exchanges were utilized, including in-person visits, telephone, pagers and voicemail, so it was only natural that communication between patients and those within the medical profession would be extended to the realm of electronic communication. Thus, the market has driven the need for health care organizations to begin to explore how they can use electronic communication methods such as email, the Internet, online chats or even SMS messaging to bridge the communication gap with their patients. hile the market may demand new methods of communication be developed, there are risks inherent to the medical profession that present challenges or obstacles to facilitating the market-demanded electronic communication methods.
Spielberg, A. (1999). Online without a net: Physician-patient communication by electronic mail. American Journal of Law & Medicine. Vol. 15 (1999) 267-295.
Hassol, A.; Walker, J.; Kidder, D.; Rokita, K.; Young, D.; Pierdon, S.; Deitz, D.; Kuck, S. & Ortiz, E. (2004). Patient experiences and attitudes about access to a patient electronic health care record and linked web messaging. Journal of the American Medical Information Association. Vol. 11 (6) 505-513.
Winkelman, W.; Leonard, K. & Kossos, P. (2005). Patient-perceived usefulness of electronic medical records: Employing grounded theory in the development of information and communication technologies for use by patients living with chronic illness. Journal of American Medical Information Association. Vol. 12 (3) 306-314.
Wager, K.A., Lee, F.W., & Glaser, J.P. (2009). Health care information systems: A practical approach for health care management (2nd ed.). San Francisco, CA: Jossey-Bass.
In the formulating and implementing of strategies, the unique treatment plans for patients must also be taken into account. Only by combining electronic medical records and applying them to specific process areas can customization of treatment plans be created (Terrell, Terrell, 2009). The ability to selectively use medical records and continually refine processes to meet patients' expectations is critical for any strategic plan and continually executed tactics, initiatives and programs to be successful.
Anderson, C.. (2008). The Ins and Outs of Electronic Medical ecords. Applied Clinical Trials, 17(9), 50,52,54,56.
Miller, A., & Tucker, C. (2009). Privacy Protection and Technology Diffusion: The Case of Electronic Medical ecords. Management Science, 55(7), 1077-1093.
Terrell, G., & Terrell, T.. (2009). Cornerstone Health…
Anderson, C.. (2008). The Ins and Outs of Electronic Medical Records. Applied Clinical Trials, 17(9), 50,52,54,56.
Miller, A., & Tucker, C. (2009). Privacy Protection and Technology Diffusion: The Case of Electronic Medical Records. Management Science, 55(7), 1077-1093.
Terrell, G., & Terrell, T.. (2009). Cornerstone Health Care: From Paper to Digital in Record Time. Physician Executive, 35(2), 16-19.
Health Care Situation: Medical Error Due to Doctors' Bad Handwriting
Identify a health care news situation that affects a health care organization such as a hospital, clinic or insurance company.
I have identified the following health care news situation as the topic of my paper: "Poor Handwriting of Doctors and its implied risks for the Patient, Hospital and Medical Malpractice Insurance." Poor handwriting of physicians resulting in poor legibility of entries into patients' medical records carries very dramatic risks for all above-mentioned interest bearers. It can result in severe health danger for the patient and - in extreme situations - even cause a patient's death. Doctors' bad penmanship has long been seen a problem within organized medicine and the patient safety movement. Three American Medical Association (AMA) policies dating back to 1992, urge doctors to "improve the legibility of handwritten orders for medications" and review all orders for accuracy and…
Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.
Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.
1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.
Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.
ransformation of Electronic Billing Systems From Military Use to Public Medical Facilities
he advent of the twenty first century brings with the new dawning a time of extraordinary technological advancement, mega informational system development, and expanded scientific discovery. Without argument, these new developments bring with them an explosion in the informational database that must be reconciled and dealt with. No longer can service organizations and businesses rely on a central data base for gathering storing and retrieving information as these type of systems are unwieldy - and becoming more so. Individuals responsible for budgeting, marketing, invoicing, and consumer demographics are in need of immediate and accurate, ready-to-use, and updated information with respect to services and/or products offered. Unfortunately the healthcare industry has been slow in updating information retrieval systems in keeping with the need for immediate patient information retrieval and the dearth of new information being created.
he majority of…
The lack of any comparative assessment between electronic billing systems appears to be a result of not finding any well-grounded evaluation model (Dick & Andrew, 1995; Friedman & Wyatt, 1997). Whether or not electronic patient information systems are not fully utilized, regardless of system, is the result of the lack of training, unavailability of computer access, or reliance on old practices are areas that need investigation in order to assess the factual usefulness of any software system (Heeks, Mundy & Salazar, 1999). In fact, according to Cork, Detmer and Friedman (1998) many medical practitioners and registrants continue to use the paper method as doing so provides the practitioner an avenue of convenience in areas such as prescription writing, small group meetings, and portability of records. However, until there is developed a strong level of electronic integration, paper records will likely remain as a mainstay source for the completeness of patient records. Also, and oftentimes forgotten by healthcare organizations who implement electronic patient record systems, is the fact that any garnered usefulness of an electronic record system that can influence and manipulate large amounts of data will not occur until patient historical information has accumulated for an extensive period of time. Although paper records are still currently in use there must exist a discussion as to the pitfalls of such a system in light of the fact that software systems are more accurate, capable of housing more patient data, and can import patient data for port to port instantaneously.
The shortcomings of the paper patient record system are, according to Bleich (1993), is a discredit to the medical profession as patient charts are generally tattered, disorganized, illegible, disorganized, and confusing. As such information contained within medical patient records are susceptible to error, misleading information, and historically inaccurate. Further, and as a direct result of badly kept medical records users who are in need of different types and levels of information are generally hidden amongst clutter and trivia. When this happens key medical points are often missed and some required information might not have been collected or even recorded. Also, paper medical records are seriously deficient in terms of processing needed codes for contracts and statistical returns. With there being a growing need to share medical information between providers, provider and patient, and provider/patient and insurance carrier, the paper medical record program is extremely slow and deficient as paper records can only be in one place at a time. As such paper medical record keeping creates logistical issue that make moving materials around fast enough for immediate need. Serious problems are often created as each and every healthcare unit or organization has a separate record for each patient and oftentimes problems of continuity of patient care arise.
With so many problems existing in the paper record keeping process
Patient Electronic Access
The objective of this study is to investigate the application of the electronic health record at the inner City health hospital. The goal of implementing the program is to allow patients to have easy access to their health data and information to assist them sharing their health information with other healthcare and personal care providers. This study investigates the application of Measure 1 Stage 1 for the City Health organization. Following the benefits of the electronic health records, the City Health has decided to implement the new program. The program will allow patients to access their information on demand through PH (personal health record). However, the City Hospital will be able to derive benefits from the program by setting aside $170,000 for the implementation costs and $90,500 maintenance expenses. Moreover, the City Hospital should organize a training program for the staff to make the program be successful.…
ASCRS (2015). Patient Portal Requirement in Meaningful Use Guidance for Providers. ASOA.
CMS (2016). EHR Incentive Programs in 2015 through 2017 Patient Electronic Access. EHR.
Department of Labor (2015). Computer and Information Technology Occupations. Occupation Handbook Outlook.
Fleming, N.S. Culler, S.D. Mccorkle, R. et al. (2011). The Financial And Nonfinancial Costs Of Implementing Electronic Health Records In Primary Care Practices. Health Affairs. 30 (3): 481-489.
The theory has three factors:
Equity Theory -- Stated that a person compares their outcomes and inputs with others. Sarah has a meeting to discuss the salary of the whole entire organization. They realized that women were low paid in comparison to the men. Sarah started comparing herself with one of her colleagues saying that she worked harder than him and she has been there longer than him.
Satisfaction performance theory -- Porter and Lawler (1968a) state that it is not a motivational model that had dealt with the relationship between satisfaction and performance. Sometimes any reward that an employee may get is not related and how well he/she performs their job. Although this case does not tell us what type of reward Sarah was getting for her job we can see that her level of satisfaction she had when doing her job. She perceived that a…
Medical Affairs Department: Implementing Electronic Database Record Keeping
This project is very feasible as it is a standard updating of record keeping procedures from manual to electronic database -- which is common practice among most records departments today. There is nothing exceptional or impractical about this project and it can be accomplished with relatively little cost, little time devoted to the transition, and few risks.
Technical Feasibility: The project is technically feasible and depends only upon the assistance of the IT division and the training staff/support system to help in the going-online phase of the transition. The database technology is standard for the industry and will be easily obtained and implemented.
Economic Feasibility: The project is economically feasible with systems ranging from low-cost to higher-end or premium packages. A medium-range database system will be sufficient for this project and is within the budget of the Department and can…
These examples highlight that technology is always a tool, a way of enhancing human judgment -- we must not mistake it as a replacement for good nursing practice.
After all, the use of a computer is no substitute for a medical education. Anyone who works in a hospital can see this -- the increased accessibility of information through the Internet also means that patients often come in, convinced that they are suffering from a serious illness, allergy, or condition, based more upon a diagnosis Googled on WebMD, rather than upon the fact that they saw a doctor! If a computer alone was required to diagnose, everyone would have a degree!
Don't get me wrong -- I use technology every day in my life, and thank my lucky stars, and my patient's lucky stars, that it is so ubiquitous. When health care providers wish to communicate, the use of cell phones…
Medical ID Theft and Securing EPHI
Medical Identity Theft
Medical information can be stolen by 1) the bad guys getting sick and using a victim's information to obtain services, 2) friends or relatives use another friend's or relative's information to obtain treatment, 3) when professionals, such as physicians, fabricate services that did not exist, 4) organized crime, and 5) innocent or not so innocent opportunists (Lafferty, 2007). ad guys that get sick can take a victim's insurance information to obtain services for treatment. Professionals can fabricate false claims to cover medical errors. Opportunists have access to patient data and the ability to steal, use, or sell that information.
Effective security requires clear direction from upper management (Whitman). Assigning security responsibilities and access controls with audit controls to organizational elements and individuals helps to place accountability on individuals. They must formulate or elaborate security policies and procedures based on the organizational…
HIPAA Security Series. (n.d.). Retrieved from HHS.gov: http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf
Hoffman, S. & . (2007). SECURING THE HIPAA SECURITY RULE. Journal of Internet Law, 10(8), 1-16.
Lafferty, L. (2007). Medical Identity Theft: The Future Threat of Health Care Fraud is Now. Journal of Healthcare Compliance, 9(1), 11-20.
Whitman, M. & . (n.d.). Case B: Accessing and Mitigating the Risks to a Hypothetical Computer System, pages B1-B24 .
Government Created a Committee
An electronic health record is a digital record of a patient's health information generated from every medical visit a patient makes. This information includes the patient's medical history, demographics, known drug allergies, progress notes, follow up visits, medications, vital signs, immunizations, laboratory data and radiological reports. The EH automates and streamlines a clinician's workflow. (Himss, 2009)
Due to the multiple advantages of an EH, health care agencies have been aiming to push up this technology. In 2004, the FDA approved of an implantable EH microchip into patients. Each microchip has a specific code which is identified through sensors. The device is implanted under the skin, in the back of the arm, requiring a twenty minute procedure, without needing the use of sutures. ("Fda approves computer," 2004)
According to the Center for Disease Control and Prevention, deaths due to preventable medical errors rank as the fifth most…
CDC. (2011, October 24). Deaths and mortality. Retrieved from http://www.cdc.gov/nchs/fastats/deaths.htm
Fda approves computer chip for humans. (2004, October 13). Retrieved from http://www.msnbc.msn.com/id/6237364/ns/health-health_care/t/fda-approves-computer-chip-humans/
Himss. (2009, September 2). Implanet using ibm software to protect patients in the event of medical device recalls. Retrieved from http://www.healthcareitnews.com/press-release/implanet-using-ibm-software-protect-patients-event-medical-device-recalls
Prutchi, D. (2011, December 30). Verimed's human-implantable verichip patient rfid. Retrieved from http://www.implantable-device.com/2011/12/30/verimeds-human-implantable-verichip-patient-rfid/
Ethical Issues Surrounding the Adoption of Electronic Health Records (EHR) by Health Care Organizations and Meaningful Use
The objective of this work in writing is to examine why health care organizations are hesitant to adopt electronic health records (HER) in light of the potential of HER to improve quality, increase access, and reduce costs. This issue will be examined from a legal, financial, and ethical standpoint and in relation to 'meaningful use'.
The use of information technology in the health care field shows a great deal of potential toward improving quality, efficiency, and safety in medical care. (DeRoches, Campbell, and Rao, 2008, paraphrased; Frisse & Holmes, 2007, paraphrased; and Walker, et al., 2005, paraphrased) The American Recovery and Reinvestment Act (ARRA) of 2009 is reflective of the unprecedented interest of the Federal government in the area of bringing about increases in the use of IT in health care for system…
A New Hospital EMR Adoption assessment Tool (2012) HIMSS Analytics. Retrieved from: http://www.himss.org/content/files/EMR053007.pdf
American Recovery and Reinvestment Act of 2009. Available athttp://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h1enr.pdf. Accessed 5 August2010.
Daniel, J. And Goldstein, MM (2010) Consumer Consent Options for Electronic Health Information Exchange: Policy Considerations and analysis. 23 Mar 2010.
DesRoches CM, Campbell EG, Rao SR, et al. Electronic health records in ambulatory care -- a national survey of physicians. N Engl J. Med 2008; 359:50 -- 60.
Schneck Medical Center: The Baldrige Award
Schneck Medical Center: Overview
The Schneck Medical Center according to the National Institute of Standards and Technology -- NIST (2011) "is a 93-bed nonprofit hospital providing primary and specialized services to the residents of Jackson County, Ind., and surrounding communities." The facility as NIST (2011) further points out, offers a variety of primary care services including but not limited to cancer care, noninvasive cardiac care, and joint replacement.
Established in 1911, the facility was amongst four organizations selected by the President and the Commerce Secretary in 2011 to be awarded the Malcolm Baldrige Quality Award. This particular award in the words of NIST (2011) is "the nation's highest Presidential honor for performance excellence through innovation, improvement and visionary leadership." It is important to note that apart from the Baldrige Award, Schneck Medical Center has been a recipient of several other awards including the Outstanding…
Greene, A.H. (2012). HIPAA Compliance for Clinician Texting. Retrieved May 28, 2013, from: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_049460.hcsp?dDocName=bok1_049460
Hester, D.M. & Schonfeld, T., (Eds.). (2012). Guidance for Healthcare Ethics Committees. New York: Cambridge University Press.
Hernandez, S.R. & O'Connor, S.J. (2009). Strategic Human Resources Management in Health Services Organizations (3rd ed.). Clifton Park, NY: Cengage Learning.
Lyer, P.W., Levin, B.J. & Shea, M.A. (2006). Medical Legal Aspects of Medical Records. Tucson, AZ: Lawyers & Judges Publishing Company.
" (Harman, Flite, and ond, 2012) the key to the preservation of confidentiality is "making sure that only authorized individuals have access to that information. The process of controlling access -- limiting who can see what -- begins with authorizing users." (Harman, Flite, and ond, 2012) Employers are held accountable under the HIPAA Privacy and Security Rules for their employee's actions. The federal agency that holds responsibility for the development of information security guidelines is the National Institute of Standards and Technology (NIST). NIST further defines information security as "the preservation of data confidentiality, integrity, availability" stated to be commonly referred to as "the CIA triad." (Harman, Flite, and ond, 2012)
III. Risk Reduction Strategies
Strategies for addressing barriers and overcoming these barriers are inclusive of keeping clear communication at all organizational levels throughout the process and acknowledging the impact of the organization's culture as well as capitalizing on all…
Harman, LB, Flite, CA, and Bond, K. (2012) Electronic Health Records: Privacy, Confidentiality, and Security. State of the Art and Science. Virtual Mentor. Sept. 2012, Vol. 14 No. 9. Retrieved from: http://virtualmentor.ama-assn.org/2012/09/stas1-1209.html
Kopala, B. And Mitchell, ME (2011) Use of Digital health Records Raises Ethical Concerns. JONA's Healthcare Law, Ethics, and Regulation. Jul/Sep 2011. Lippincott's Nursing Center. Retrieved from: http://www.nursingcenter.com/lnc/cearticle?tid=1238212#P77 P85 P86 P87
Provider Document Guidelines)
Provider Documentation Responsibilities
Summary of Key Concepts
Authentication of patient record entries
All entries in the medical record must contain the author's identification. Author identification may be a handwritten signature, unique electronic identifier, or initials.
Abbreviations used in the patient record
All abbreviations use should be kept to an absolute minimum for effective and safe communication in patient care. Abbreviations should be avoided completely especially in drug prescriptions, operation lists and consent forms -- for example, the laterality of site of operation. Lists of approved abbreviations and their correct meaning should be established along with a list of 'Do not use' abbreviations to be followed by the healthcare professionals.
Legibility of patient record entries
The record must be legible to someone other than the writer. All entries must be legible to another reader to a degree that a meaningful review may be conducted. All notes should be…
Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma
Today, the Department of Veterans Affairs (VA) operates the nation's largest healthcare system through the Veterans Health Administration (VHA), including 152 medical centers (VAMCs), 800 community-based outpatient clinics and numerous state-based domiciliaries and nursing home care units (About VA, 2016). As the second-largest cabinet agency in the federal government, the VA's budget exceeds the State Department, USAID, and the whole of the intelligence community combined) with more than $60 billion budgeted for VHA healthcare (Carter, 2016). One of the VHA's largest medical centers that provides tertiary healthcare services to eligible veteran patients is the Oklahoma City VA Medical Center (OKC VAMC) in Oklahoma City, Oklahoma. Like several other VAMCs, the OKC VAMC has recently been implicated in a system-wide scandal concerning inordinately lengthy patient waiting times and misdiagnoses which may have contributed to the deaths of some veteran patients and jeopardized…
About the Oklahoma City VA Medical Center. (2016). Oklahoma City VA Medical Center. Retrieved from http://www.oklahoma.va.gov/about/ .
About VA. (2016). Department of Veterans Affairs. Retrieved from http://www.va.gov / about_va/vahistory.asp.
Breen, K. J. & Plueckhahn, V. D. (2002). Ethics, law, and medical practice. St. Leonards, NSW: Allen & Unwin.
Carter, P. (2016). How to fix the VA. Slate. Retrieved from http://www.slate.com/blogs / the_works/2016/03/25/slate_s_infinite_scroll_implementation_explained.html.
The author also explains that the data stored in the system can be used to help public health officials identify medical issues facing the community as well as track various trends from the community and public health perspectives.
(How does this article relate to you as doctor?)
As a physician, I recognize that my time will be in very short supply. Therefore, any system or resource capable of saving time and increasing the efficiency of the healthcare services that I provide will be greatly appreciated. Similarly, patient safety, elimination of medical errors, and patient outcome are always paramount concerns for any physician. Therefore, I would welcome the opportunity to use EHR systems to the extent they address those issues positively. Moreover, as a physician, I am always interested in any approach that might be beneficial to human welfare and community and public health issues. According to the article,…
I worked with MetroWest Medical Center, which is owned by Vanguard Health Systems. For this company, I developed a Transformation Plan that would improve the company's documentation and information systems. The company is a medium-sized health services provider that has operations in five different states, but there is a degree of autonomy in the different options. Transformation, however, is a department that overarches the organization.
The project was focused on the transformation of the company according to recent changes in the legislative environment. In particular, I was concerned with the updates to the Primary Care Payment Reform Initiative. Function updates for this plan would be posted regularly on a Mass Health website, and I would monitor this site for these updates, and then report them to senior management. The reform contained a number of elements for which the company had to apply and it was my role to put…
omen's Health -- Focused on prevention and care for breast health, mammography, etc.
Transplant Programs - Swedish is one of seven kidney transplant centers and one of just four liver transplant centers serving the entire Pacific Northwest. The Organ Transplant Program at Swedish is at the forefront of new advances in transplantation surgery, including pancreas transplants and transplants between unrelated living organ donors and recipients (Swedish Medical Center, 2011).
Service design, operational activities, strategic decisions- Swedish is nothing but on the move -- strategically and tactically. In October, 2011, Swedish opened a new full-care facility with a 550,000 square foot campus in the city of Issaquah, southeast of Seattle city proper. This new facility was designed to be an entirely new hospital experience. Some of the operational innovations include a new Childbirth Center with eight new Labor/Delivery/Recovery rooms that include sleeping areas for partners, iPod access and a hotel room…
Arnold, E. (2007). Service-Dominant Logic and Resource Theory. Journal of the Academy of Marketing Sciences, 36(1), 21-24.
Crosby, J. (2011, November). Human Resource - Swedish Hospital.
Institute of Medicine. (2000). To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press.
King, D. (2008). Designing the Digital Experience: How to Use Experience Design. Medford, NJ: Information Today Press.
Technology in Medicine: Distant Medical Surveillance Technology for Diabetics in the Less Developed Area of Texas
An estimated 26 million Americans live with diabetes. When not properly treated, diabetes could be fatal as it occupies the seventh position on the list of major mortality causes and it is also a strong causative factor of renal failures, sight damage and clinical limb removals among Americans. Diabetes occurrences are approximately 17% higher in less developed areas. Ethnicity and race are also major factors in determining the risk of suffering from the disease as it affects the smaller factions more. Distant medical surveillance can be very helpful in acquiring daily data about a diabetic's sugar levels, dangerous signs, feeding habits and therapy devotion. This method could help patients take their medications appropriately. Even though certain patients could decide not to adhere to their treatments and thus render this technology useless, the group who…
Balamurugan, A., Hall-Barrow, J., Blevins, M. A., et al. (2009). A pilot study of diabetes education via telemedicine in a rural underserved community -- opportunities and challenges: A continuous quality improvement process. The Diabetes Educator, 35(1), 147 -- 154.
Greenwood, D. A., Young, H. M., & Quinn, C. C. (2014). Telehealth Remote Monitoring Systematic Review: Structured Self-monitoring of Blood Glucose and Impact on A1C. Journal of Diabetes Science and Technology, 8(2), 378 -- 389.
Hale, N. L., Bennett, K. J., &Probst, J. C. (2010). Diabetes care and outcomes: disparities across rural America. Journal of community health, 35(4), 365-374.
Helseth, C. (2014). Diabetes Management in Rural Areas Takes Holistic, Community Approaches, Rural Health Information Hub. Retrieved from https://www.ruralhealthinfo.org/rural-monitor/rural-diabetes-management/ on February 18, 2017
medical home concept and describe the principles (operational characteristics mentioned above) of the PC-MH as defined by these organizations. How does this concept differ from the gatekeeper concept of Managed Care Organizations?
According to the 'gatekeeper' philosophy of health management organizations (HMOs), physicians are intentionally given incentives to reduce access to care. This is based upon the assumption that patients will want to obtain as much care as they can receive and physicians will want to bestow that care to please patients and incur more revenue. HMOs encourage physicians to do the opposite and often financially reward physicians for cost reductions and limiting access of patients to specialists or heroic treatments. In the HMO model, physicians try to restrict access to specialists when they do not deem it necessary.
In contrast, the medical home concept is viewed as a partnership between "individual patients, and their personal physicians, and when appropriate,…
Case for change to the PC-MH Model (2011). American Dietetic Association.
Retrieved October 19, 2011 at http://www.eatright.org/HealthProfessionals/content.aspx?id=7059
Joint Principles of the Patient-Centered Medical Home. (2007). American Academy of Family
Physicians (AAFP). American Academy of Pediatrics (AAP). American College of Physicians (ACP). American Osteopathic Association (AOA)
Portability vs. Privacy
Electronic Medical ecords (EM) refers to the digital version of papers containing all the medical history of a patient. EMs are mostly applied in healthcare institutions for treatment and diagnosis.
Benefits of Electronic Medical ecords
The following are some of the benefits associated with electronic medical records (Thede, 2010). EMs are more efficient than paper records because they encourage providers to:
Track patient's data over time
Spot clients who are due for screening and preventive visits
Conduct patient monitoring to measure their parameters including blood pressure and vaccinations
Improve the overall quality of service provision in the practice
Electronic medical records store information in a manner that makes it impossible for outsiders to access. It might be necessary to print patients' medical records and delivered through the mail to other health care members or specialists.
HIPAA egulations and EM
The federal government passed the Health Insurance Portability…
Thede, L. (2010). Informatics: Electronic health records: A boon or privacy nightmare? Online Journal of Issues in Nursing, 15(2), 8.
Jacques, L. (2011). Electronic health records and respect for patient privacy: A prescription for compatibility. Vanderbilt Journal of Entertainment & Technology Law, 13(2), 441-462. http://www.jetlaw.org/wp-content/journal-pdfs/Francis.pdf
Stanhope, M., & Lancaster, J. (2012). Public health nursing: Population-centered health care in the community. Maryland Heights, Mo: Elsevier Mosby.
Electronic Medical ecords
The use of electronic medical records (EM) to document patient encounters is an innovative way to keep complicated medical data easily available for all helping physicians of all kinds. Data can be shared between health facilities and physicians. It immediately allows for the transfer of previous health records to facilitate a faster sharing of documents in order to increase the quality of care. However, there are some downfalls from a perspective regarding the use of electronic medical records to document patient encounters. training may become an issue within the healthcare facility. EM technology is dependent on power and thus the power outage it may impact the patient encounter and the use of new technologies always comes a security risk. training may become an issue within the healthcare facility.
One of the biggest potential issues is the concept of effectively training staff to utilize the technology to its…
Women's Health Care Physicians. (2010). Patient safety and the electronic health record. Committee Opinion. Web. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Patient_Safety_and_Quality_Improvement/Patient_Safety_and_the_Electronic_Health_Record
There are several criteria by which the company can establish acceptability for the eCube system of EM that is available from Fresenius. The first stakeholder group consists of the patients, who will benefit from the enhanced functionality that comes from the eCube system, in particular the superior health outcomes that come from having accurate medical histories available to physicians and other practitioners while they are working with the patient. Management must strike a balance between business objectives and patient outcomes, and therefore there are multiple different acceptability measures that are possible, both based on profit and patient outcomes. Management will also want to know that the system is relatively easy to install, that there is training available from the vendor for the staff, and that the vendor will deliver full support of the system if there are any problems.
Another stakeholder group consists of the owners/shareholders of the health…
Jena, A., Seabury, S., Lakdawalla, D. & Chandra, A. (2011). Malpractice risk according to physician specialty. New England Journal of Medicine. Vol. 365 (7) 629-636.
Kalathil, R. (2011). Data management: New products: eCube combines clinical and billing applications. Neprhology News & Issues. Retrieved November 6, 2013 from http://www.nephrologynews.com/articles/data-management-new-products-ecube-combines-clinical-and-billing-applications
Self, D. & Schraeder, M. (2009). Enhancing the success of organizational change: Matching readiness strategies with sources of resistance. Leadership and Organizational Development Journal. Vol. 30 (2) 167-182.
Hand-held devices and portable digital assistants (PDAs) are being integrated into the health care setting in the United States. It is important to understand which devices are being used, how they are being used, what they are being used for, and why. Understanding the role that hand-held devices and other portable electronics play in health care can help to inform organizational policy, and help health care administrators better implement electronic medical records.
History of use
The first documented PDA was the Newton MessagePad, issued by Apple in 1993. It was described as being "revolutionary" (Wiggins, 2004, p. 5). Palm, Inc. developed the next big handheld device: the Palm Pilot, in 1996. By the late 1990s, PDAs were equipped for Internet access, and memory capacity and other features improved with each product release. Microsoft also entered the portable electronic devices marketplace in the 1990s. The devices were not yet being…
Alerndar, H. & Ersoy, C. (2010). Wireless sensor networks for healthcare. Computer Networks 54(15): 2688-2710.
Fornell, D. (2008). PDAs bring hand-held solutions to healthcare. Acuity Care Technology. Retrieved online: http://www.soti.net/PDF/PDAsBringHandHeldSolutionsToHealthcare_Article.pdf
Garritty, C. & El Emam, K. (2006). Who's using PDAs? Journal of Medical Internet Research 8(2).
Huang, V.W. (n.d.). PDAs in medicine. Power Point Presentation Retrieved online: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&ved=0CF4QFjAB&url=http%3A%2F%2Fwww.cs.princeton.edu%2Fcourses%2Farchive%2Fspr02%2Fcs495%2Fpda.ppt&ei=xxqAUsq_NtTFqQG25IHwAQ&usg=AFQjCNE4Wf4YrX7slTbcdYJwxujV3rwgog&sig2=Uee9rvdDYwY0uYM33n1ZBg&bvm=bv.56146854,d.aWM
RFP in Healthcare Industry
Request for proposal in health care industry
Request for Proposal (RFP) in Healthcare Industry
In order to continually provide adequate Medicare to patients, a review of the electronic health record options reveal that the appropriate strategy is to procure Electronic Medical Record software. The primary objective of this RFP is to implore bids from system integrators or commercial off the shelf software merchants to devise, install, construct and implement integrated EMR software solution. The health care system, Future Correctional Center seeks to procure a software solution including licenses, hardware (as recommend by the bidder), execution, and maintenance and support services. In addition, the software configuration should present a core set of EMR attributes that meet particular requirements such as order entry, outcome review, nursing and physician documentation, registration.
Something significant to note; Future Correctional Center will not consider proposals from bidders offering software as a service…
EMR System Implementation
The healthcare industry is increasingly impacted by advanced in Information Technology (IT). As our abilities to coordinate, interconnect and streamline the transmission of data through IT solutions improve so too do our abilities to provide efficient, safe and effective healthcare decisions for presenting patients. This is the notion that underscores the present discussion regarding Inter-Regional Health Systems, an organization identified specifically for the purposes of this discussion and approaching a proposed IT transformation. Inter-Regional is a multi-site healthcare complex with a wide variety of emergency room, clinic, specialist and outpatient facilities on each site. On the whole, the company has roughly 10,000 employees across its various sites. The private health firm is seeking to improve efficiency as a way of improving its economic performance and considers that it will likely benefit from the implementation of an Electronic Medical Records system. The discussion here evaluates this proposition.
AHIMA. (2008). Enterprise Content and Record Management for Healthcare. Journal of AHIMA, 79(10), 91-98.
Draper, J. (2012). Electronic Medical Records Can Mean Life or Death. San Francisco Chronicle.
McNamara, C. (2008). Organizational Change and Development. Management Help.
Medinformatix. (2010). Homepage. Medinformatix, Inc.
S.W.O.T. For Community South Medical Center
Needs of Community South Medical Center
The identified strength of Community South Medical Center is that of the array of services it offers and the level of excellence of those services. The weakness of Community South Medical Center is that of its older facilities and infrastructure. The Opportunity for Community South Medical Center is that of the potential of new program development and the abundance of physicians at the medical center. The Threat of Community South Medical Center is that of its lack of interfacing software and the new electronic record data that is being adopted by other medical facilities across the country. The conversion of paper files to digital records is reported as being expensive. There is presently federal stimulus bill funding funneled toward the institution of electronic medical records however, it is reported that this funding will be provided in "increments over…
EMR 2012: The Market for Electronic Medical Records (2012) TMC.net. Retrieved from: http://www.tmcnet.com/usubmit/2012/06/28/6403890.htm
Gambon, J. (2011) 5 key barriers to adopting electronic medical records today. Mass High Tech. Retrieved from: http://www.bizjournals.com/boston/blog/mass-high-tech/2010/04/5-key-barriers-to-adopting-electronic-medical.html?page=all
HIMSS Analytics (2008) The Premier EMR Adoption Assessment Tool. Retrieved from: http://www.himssanalytics.org/docs/emram.pdf
U.S. Electronic Medical Records (EMR - Physician Office & Hospital) Market - Emerging Trends (Smart Cards, Speech Enabled EMR), Market Share, Winning Strategies, Adoption & Forecasts till 2015 (2011) Markets and Markets. Retrieved from: http://www.marketsandmarkets.com/Market-Reports/us-emr-market-401.html