Florence F. Odekunle, MD, MS, PhD (c) Current Roles and Applications of Electronic Health Record in the Home Healthcare System Florence F. Odekunle, MD, MS, PhD (c)

Presentation Outline Introduction Research Methodology Results Conclusions

Introduction Electronic health record (EHR) has been shown to play major roles in the home healthcare system. The main drivers for the increasing roles and applications of an EHR in the home healthcare system include the need to improve efficiency in the home care service delivery and patient safety.

Introduction Cont. The Institute of Medicine (IOM) has identified the following as EHR functionalities for healthcare settings. 1 Health information and data Results management Patient support Decision support management Electronic communication Order entry/management Administrative processes Clinical research Reporting & population health Note: The first six EHR capabilities are grouped as clinical care application

Introduction (Cont.) - However, it is less clear how many of these EHR functionalities/applications/capabilities are applicable in the home health care system. Therefore, the main goal of this paper was to review the current roles and applications of EHR in home healthcare.

Methods A comprehensive search was conducted on the PubMed, Google scholar, and OvidSP electronic databases. In order to facilitate the search, the following keywords were adopted: clinical application of EHR, administrative applications of EHR, uses/roles/applications of EHR and home healthcare. Original research papers and articles available in full text published in English were included. Sixty-seven papers were initially retrieved. However, only 13 met the inclusion criteria and were finally reviewed.  

Search Strategies and Search Outcomes PubMed n=26) Total articles (n= 67) n = 31 Duplicates (n = 36) OvidSp (n=21) Did not meet inclusion criteria (n= 18) Articles included (n = 13) Google Scholar (n=20)

Results

Results Currently, the roles and applications of EHR in the home healthcare system include clinical care application2-5 and administrative function.2-5,6 Many home health care providers have reported using an EHR system to provide clinical care, such as documentation of clinical notes (health information and data), 2- 5 test results management, 7-8 computerized order entry, 2-5 and decision support systems. 9-13 The second major application of EHRs in the home health care system was for administrative processes (e.g., appointment scheduling, billing and reimbursement).2- 5

Results Cont. In the reviewed articles, there was no mention of the use of EHR in regards to clinical research using the query and surveillance facilities in the EHRs. The query systems are used to identify patients who meet the eligibility requirements for prospective clinical trials.14, 15 Furthermore, there was no study on disease reporting and population health application of EHR in the home health care system.

Conclusions EHR is not just a digital form of a paper medical record, but it provides the following clinical functions such as an integrated view of patient information and data, order entry, access to knowledge resources, clinical decision support and integrated communication. It also provides administrative functionality, clinical research and reporting capabilities. However, in the home health care system, the applications of EHR have been limited to administrative and clinical functions. This calls for the use of other EHR functionalities in home healthcare so as to experience the maximum benefits offered by the EHR. Further research is needed on the clinical research use of EHR in home healthcare.

Thank You!

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