Explains the various types of prevalent Digital Health Records. This presentation was presented at the 3rd International Conference on Transforming Healthcare through IT, 2012

1. Tutorial: BEYOND FEATURES: UNDERSTANDING DIGITAL HEALTH RECORDS
DIGITAL HEALTH RECORDS
Saurav Gupta
Team Lead, eSanjeevani
Technical Officer to Executive Director,
Centre for Development of Advanced Computing, Mohali
saurav@cdac.in
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

2. SCOPE of the TUTORIAL
Digital Health Records
Designing effective Health Information Systems
Case Study: MOTHER Project
Implementing EMR in India
Using Technology for creating PHRs
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

3. INDEX
Need: Advantage: Types
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

4. Need
•New information about disease and treatment is saving lives.
•Mobile populations make it difficult to transfer medical
records to the point of care.
•Collective Care makes the data distributed
•Paper-based record-keeping systems are adding to the
expense of healthcare
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

5. TECHNOLOGY i.e. Health Systems contributes to 29%
At the core of any Health System is a DIGITAL HEALTH RECORD
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

6. Advantage:
Reduced costs & time
Central updated Repository
Ease of Access / remotely used
Trend Analysis
Improves ‘Quality of Care’
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

7. 3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

8. Types
CMR: Computerized Medical Record
CCR: Continuity of Care Record
EHR: Electronic Health Record
EMR: Electronic Medical Record
EPR: Electronic Patient Record
PHR: Personal Health Record
PMRI: Patient Medical Record
Information
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

9. EMR?
•
Electronic Medical Record (EMR) :An application environment composed
of the clinical data repository, clinical decision support, controlled medical
vocabulary, order entry, computerized provider order entry, pharmacy, and
clinical documentation applications.
•
An EMR system helps physicians and hospitals function in a smoother,
safer, and more secure manner, allowing hospital personnel to retrieve
and update the information of any patient.
•
An EMR system promotes the evolution of healthcare transactions from
an inefficient, paper-based system to a more reliable, real-time paperless
system.
•
Transcription cost, dictation time, manual note taking, and prescription
writing are virtually eliminated.
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

10. EMR?
Doctors
Hospital
Administration
Hospital Medical
Department 1
Patients
EMR
Systems
Hospital Medical
Department 2
Laboratory
Pharmacy
Hospital Medical
Department 3
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

11. EMR: Flow
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

12. EHR?
An Electronic Health Record is - a repository of information regarding
the health of a subject of care, in computer process-able form.
An Electronic Health Record system encompasses:
• Longitudinal collection of electronic health information about and for
patients
• Electronic access to patient-and population-level information by
authorized users
• Provision of knowledge and decision support systems
• Support for efficient processes for healthcare delivery
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

13. 3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

14. Benefits of EHR
• The information gathered by the primary care provider tells the
emergency department clinician about the patient’s life threatening
allergy, so that care can be adjusted appropriately, even if the patient
is unconscious.
• A patient can log on to his own record and see the trend of the lab
results. Helps motivate him to take his medications and
keep up with the lifestyle changes that have improved the
numbers.
• Moving from one care setting to another:
The clinician’s notes from the patient’s hospital stay can help
inform
the discharge instructions and follow-up care.
• NO running duplicate tests.
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

15. Components of EHR
• Clinical Documentation (e.g., progress notes)
– Direct-entry
– Voice recognition
– Structured notes
• Summary Lists
– Allergies
– Medications
– Problem
• Dictation/Transcription
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

16. Components of EHR
• Physician Order Entry (POE)
– Diagnostic tests
– Prescriptions
• e-Prescribing (eRx)
– Drug interaction checking
– Formulary management
– Refills/repeats
• Clinical Workflow Tasking
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

17. Components of EHR
• Results Management
Abnormal results warning
Trending/graphing
•Charge Capture/Billing
Medical necessity
•Clinical Document Management
Document scanning
Import/export
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

18. PHR
•A Personal Health Record (PHR) contains information regarding
an individual’s medical history -- such things as vaccination
history, laboratory test results, allergies, medications, surgeries
and family history.
•Maintained by the patient.
•PHR can be tethered to an Electronic Health Record
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

19. PHR
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

20. PHR
PHRs can contain a diverse range of data, including but not
limited to:
•allergies and adverse drug reactions
•chronic diseases
•family history
•illnesses and hospitalizations
•imaging reports (e.g. X-ray)
•laboratory test results
•medications and dosing
•prescription record
•surgeries and other procedures
•vaccinations
•and Observations of Daily Living (ODLs)
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

21. ODLs
ODLs allow patients to contribute personally meaningful information to
clinicians.
ODLs can include:
•Quantity and quality of sleep
•Moods experienced in day-to-day life
•Level of pain experienced throughout the day
•Fluctuations in day-to-day stress
ODLs provide:
•Subtle clues that individuals pay attention to as they monitor their
health.
•A way for patients to gauge how their health is progressing.
•Cues that alert patients that they need to take health-related action.
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

22. eSanjeevani: EMR snapshots
www.eSanjeevani.in
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India

23. THANK YOU
saurav@cdac.in
3rd International Conference on Transforming Healthcare with IT
31st Aug.-1st Sep. 2012
Hyderabad, India