What is EHR, related work and healthcare standards for EHR.

2.  Practitioners use records to capture their
clinical findings and conclusions
 Until recently, medical records have been
captured on paper and are the property of the
recording provider
 “To Err Is Human” – many misconceptions
resulting in lapse in patient care

3. An evolving concept defined as the
systematic collection of electronic health
information about individuals and
populations that can be transferred between
health care centers.

4. The systematic application of information
science, computer science and technology to
public health practice, research and learning

5.  Paper charts are neither interactive nor
intuitively designed
 Printed reminders and cautions can be easily
overlooked
 Physicians are notorious for illegible
handwriting-as less as 65% of the written
medical charts can be fully read

6.  No data sharing - written records remain in
the providers office
 Take a lot of space
 Disorganization or disaster in office can
result in information loss

7.  Intuitive formatting and enhanced interaction
 Eliminating unnecessary procedures reducing
health care expenditures
 Greater co-ordination and data sharing
 No data loss
 Helper applications-provide patient specific
feedback in real time

8.  Provides alerts to the doctor to health needs
or relevant research
 Improved decisions on part of the clinician
 Empowers patient in self management of
chronic diseases
 Helps track prior medical history and
treatment of the patient
 Collaboration between patient and doctor

9.  Expensive software and computer purchase
 Software maintenance expense
 Dependent upon reliable operation

10.  Loss of revenue
 Local vs. global perspective
 Security
 Learning curve
 Overconfidence in personal physician skill

11.  Info-buttons
 Computerized Provider Order Entry
 Clinical Decision Support
 Personal Health Record
 Clinical Data Repository

12.  Contact specific links from one information
system to another resource
 Provide relevant contextual information
 significantly increase the percentage of met
information needs at the point of care

13.  Allows provider orders to be written
electronically either in the hospital or out-
patient settings
 Eliminates hand writing misinterpretation

14.  Provides intelligently filtered clinical
knowledge and patient related information
 Improves patient care
 CPOE and CDS often work in tandem to
ensure patient is being treated appropriately

15.  Enables the patient to keep track of their own
personal health information
 Provides educational material to assist in self
management of chronic disease
 Enables patients to take input from home
monitoring devices such as glucometers,
blood pressure monitors, etc

16.  Telemedicine allows communication of
medical information to remote provider for
consultation.
 frequency of required appointments for a
patient can be determined
 Improves quality of care
 Reduces cost through cost avoidance

17. The database that stores all the health
information of the EHR

18.  One of the vital features of EHR
 Readable data is dependent upon adherence to
standards
 Absence of robust standards could undermine
the benefits of EHR adoption altogether
 Standards have been developed for adoption by
EHR vendors and RHIO members to allow data to
be exchanged between systems in RHIO

19.  CCHIT - the only certification body endorsed to
evaluate EHR’s for adherence to standards.
 IHE Eye care Connectathons - test interoperability
of equipment and EHR’s to determine how well
they integrate
 Health Level 7 (HL7) - a series of standards
designed to allow data exchange and
interoperability of EHR’s.
 DICOM - centered on medical imaging

20.  Registries
 Disease Surveillance Systems
 Geographic Information System

21. Databases used to track patients:
 a particular disease
 exposure to risk factor
 those who have undergone certain procedure

22.  Estimating incidence
 Providing a population for researchers to
study
 Trending a disease’s impact over time

23. Ongoing systematic collection, analysis and
interpretation of health related data essential
to planning, implementation and evaluation
of public health practice

24.  Evaluate threats to public health
 Detect epidemics
 Generate research questions
 Assess current attempts to control health
threats
 To stay on top of changes in infectious
agents or health practices

25.  Tracking patients relative to their location
 Ease spatial tracking in public health

26.  In infectious disease tracking
 Applications where spatial information is
relevant e.g.
 Sheen’s evaluation of costs
Benefits of optometric referrals in Wales

27.  EHR will dramatically change the way in which
clinicians practice
 Enable creation of more legible records
helpful for multiple practitioners
 CDR and RHIO will act as a bridge enabling
team work in patient care
 Safeguarding populations from outbreaks

28.  ELECTRONIC HEALTH RECORDS AND PUBLIC HEALTH INFORMATICS
By Kevin M. Jackson, OD, MPH, FAAO, CDR, MSC, USN
http://webpages.charter.net/oldpostpublishing/oldpostpublishing/S
ection%202,%20Principles%20of%20Public%20Health/Sect%202,%20El
ectronic%20Health%20Records%20and%20Public%20Health%20Inform
atics%20by%20Jackson.pdf