Electronic Health Records LIS 4785 Introduction to Health Informatics Fall 2015 Week 5-1 Instructor: Dr. Sanghee Oh

Top 100 EHR/EMR Vendors 1.Cerner PowerChart Ambulatory HER 2.EpicCare Ambulatory - Core EMR 3.Allscripts Professional™ EHR“ 4.NextGen Ambulatory HER 5.athenahealth athenaClinicals 6.GE Health Centricity 7.eClinicalWorkscare 8.McKesson iKnowMed EHR, Horizon Ambulatory, Paragon 9.Abraxas Medical Solutions (Merge Healthcare) iconnect Network 10.Vitera Healthcare Solutions Vitera Intergy, Vitera Stat, Vitera Medical Manager And more from economics/news/top-100-ehr-companies-part economics/news/top-100-ehr-companies-part-1-4

Cerner PowerChart Ambulatory EHR

Cerner EHR iPhone App

More screenshots of EHRs/EMRs

EHR Elements Health information and data Results management _______________________ Electronic communication and connectivity _______________________ Administrative processes Reporting and population health management Find here for the details: in-a-nutshell-2/emr-vs-ehr-vs-phr/ in-a-nutshell-2/emr-vs-ehr-vs-phr/

Major components of EHRs ______________________________

An EHR feature that processes orders for medications, lab tests, imaging, consults and other diagnostic tests.

Computerized Physician Order Entry (CPOE) ____________________________ – Outcomes the issue of ____________ – ______________ associated with ordering drugs with similar names or trailing zeroes – Able to link to ____________________________________ – Reduce _________________ prescribing – Make prescriptions to reach the pharmacy ____________ – Identify the prescribing physicians – Point out treatment and drugs of choice – Easily integrated with clinical decision support systems (CDSS) ______________________

______________________________ An electronic system to support a prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care.

E-Prescribing through an EHR Source:

Advantages of e-prescribing ____________________________ that help eliminate handwriting errors and decrease pharmacy “callbacks” and rejected scripts Abbreviations and unclear decimal points are avoided. The wait to pick up prescriptions potentially is reduced Fewer _________________________ Better compliance with fewer drugs not filled or picked up. Potential to reduce workload for pharmacists Timely notification of drug alerts and updates Better use of generic or preferred drugs The ability to check patient-level and patient-level formulary status and patient copays The process is secure and HIPPA compliant Offer ability to look up drug history, drug-drug interactions, allergies and compliance Provide a single view of prescriptions from multiple clinicians

Issues/challenges associated with e- prescribing Alerts, in general are viewed as nuisances, by physicians, unless they are very specific, highly important and are educational.

Issues/challenges associated with e- prescribing 11.7% error rates on e-prescribing from a report of outpatient electronic prescription in 2011 – About a third had the potential to cause ADEs (No actual ADEs) – Two thirds of the errors due to omissions of drug does, instructors, etc. The refill process had more problems and errors than the initial new prescription process. – Most of refills can be still done by fax. Some pharmacies don’t accept e-scripts because of the fees. Physicians write sigs(abbreviations) are not patient-friendly and pharmacists have to rewrite them. Physicians often receive duplicate requests from pharmacies.

PERSONAL HEALTH RECORDS

Apple HealthKit

Class Activity What kinds of computerized/automated functions or features do you want to make available from your PHR system? (List 3) What could be the benefits for individuals of using the functions and features of your PHR? (List 3) What could be the challenges for individuals of using the functions and features of your PHR? (List 3)

PHRs An electronic application used by patients to maintain and manage their health information in a private, secure, and confidential environment. PHRs: – Are managed by ___________. – Can include information from _______________, including health care providers and patients themselves – Can help patients securely and confidentially ________ and _________ health information, such as diet plans or data from home monitoring systems, as well as patient contact information, diagnosis lists, medication lists, allergy lists, immunization histories, and much more – Are separate from, and ____________________ of any health care provider – Are ____________________ that simply allow patients to view provider information or communicate with providers

American Health Information Management Association (AHIMA) A tool that you can use to collect, track and share past and current information about your health or the health of someone in your care. – This information can save you the money and inconvenience of repeating routine medical tests. – Even when routine procedures do need to be repeated, your PHR can give medical care providers more insight into your personal health story. Take an active role in monitoring your health and healthcare by creating your own PHR. PHRs are an inevitable and critical step in the evolution of health information management (HIM).

PHR Elements Identification sheet Problem list Medication record History and physical Progress notes Consultation Physicians’ orders Imaging and X-ray reports Lab reports Immunization Record Consent and Authorization Forms Operative Report Discharge Summary

PHR Selection Criteria _______________________

Paper-based PHR Forms AHIMA provides paper-based PHR forms for individual management of health information. – Health information form for adult: – Health information form for child: – Authorization form: df df

PHR Providers Employ Sponsored Insurance Sponsored Provider Sponsored Independent product – HealthVault – Healthy Circles – MedHelp – The 65 Best Health & Fitness Apps of 2014 –

PHR Challenges According a survey of the PHR use in 2011: – Only seven percent of Americans had used online personal health records, and less than 3.5 percent used them with any frequency. _________________________