1. 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)

2. Presentation Outline Introduction Research Methodology Results
Conclusions

3. 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.

4. 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

5. 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.

6. 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.

7. 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)

8. Results

9. 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

10. 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.

11. 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.

12. Thank You!

13. References
Tang, P. C. (2003). Key capabilities of an electronic health record system. Washington, DC, Institute of Medicine of the National Academies.
Bercovitz AR, Park-Lee E, Jamoom E. Adoption and use of electronic health records and mobile technology by home health and hospice care agencies. National health statistics reports (66):1-11.
Resnick HE, Alwan M. Use of health information technology in home health and hospice agencies: United States, Journal of the American Medical Informatics Association. 2010;17(4):
Pearson WS, Bercovitz AR. Use of computerized medical records in home health and hospice agencies: United States, Vital and health statistics. Series 13, Data from the National Health Survey (161):1-4.
Bercovitz A, Sengupta M, Jamison P. Electronic medical record adoption and use in home health and hospice. NCHS data brief (45):1-8.
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E. & Shekelle, P. G. (2006). Impact of health information technology on quality, efficiency, and costs of medical care. Annals of internal medicine, 144(10),
O’malley, A. S., Grossman, J. M., Cohen, G. R., Kemper, N. M., & Pham, H. H. (2010). Are electronic medical records helpful for care coordination? Experiences of physician practices. Journal of general internal medicine, 25(3),
Ghazisaeedi, M., Mohammadzadeh, N., & Safdari, R. (2014). Electronic Health Record (EHR) As a Vehicle for Successful Health Care Best Practice. Medical Archives, 68(6), 419.
Mantas, J., & Hasman, A. (2013). Informatics, Management and Technology in Healthcare (Vol. 190). IOS Press.
Hatcher, M., & Heetebry, I. (2004). Information technology in the future of health care. Journal of Medical Systems, 28(6),

14. References (Cont.)
Ward, R. (2013). The application of technology acceptance and diffusion of innovation models in healthcare informatics. Health Policy and Technology, 2(4),
Dolatabadi, N. D., Sadoughi, F., Ahmadi, M., & Shahi, M. (2013). Health information system to improve elderly health. Medicinski Glasnik/Medical Gazette, 18(50).
Nasrin, D., Farahnaz, S., & Maryam, A. (2013). Health information system to improve elderly health: Study of health information system in us to setup standard for developing countries. Medicinski glasnik Specijalna bolnica za bolesti štitaste žlezde i bolesti metabolizma Zlatibor, 18(50),
Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health care information systems: a practical approach for health care management. 2nd edition. San Francisco, CA.
Shortliffe, E.H., Cimino, J.J. (2014) Biomedical informatics: computer applications in health care and biomedicine. 4th edition. New York NY.