Addressing Human Computer Interaction Issues of Electronic Health Record in Clinical Encounters

Purpose.To examine financial and clinical work productivity outcomes associated with the use of the electronic health record (EHR).Methods.191,360 billable clinical encounters were analyzed for 12 clinical providers over a 9-year study period during which an EHR was implemented. Main outcome measures were clinical revenues collected per provider and secondary outcomes were charge capture, patient visit coding levels, transcription costs, patient visit volume per provider, digital drawing, and digital imaging volume.Results.The difference in inflation adjusted net clinical revenue per provider per year did not change significantly in the period after EHR implementation (mean = $404,198; SD = $17,912) than before (mean = $411,420; SD = $39,366) (P=0.746). Charge capture, the proportion of higher- and lower-level visit codes for new and established patients, and patient visits per provider remained stable. A total savings of $188,951 in transcription costs occurred over a 4-year time period post-EHR implementation. The rate of drawing the ophthalmic exam in the EHR was low (mean = 2.28%; SD = 0.05%) for all providers.Conclusions.This study did not show a clear financial gain after EHR implementation in an academic ophthalmology practice. Ophthalmologists do not rely on drawings to document the ophthalmic exam; instead, the ophthalmic exam becomes text-driven in a paperless world.

Download Full-text

Automated interpretation of clinical encounters with cultural cues and electronic health record generation

10.3115/1706257.1706261 ◽

2006 ◽

Cited By ~ 2

Author(s):

Daniel T. Heinze ◽

Alexander Turchin ◽

V. Jagannathan

Keyword(s):

Electronic Health Record ◽

Health Record ◽

Clinical Encounters ◽

Automated Interpretation ◽

Electronic Health ◽

Cultural Cues

Download Full-text

Design and Implementation of a Novel Electronic Health Record Tool to Enhance the Care of Individuals with Cystic Fibrosis: The Cystic Fibrosis Note Template

ACI Open ◽

10.1055/s-0039-1688804 ◽

2019 ◽

Vol 03 (01) ◽

pp. e26-e36

Author(s):

David M. Leander ◽

Alex H. Gifford ◽

John N. Mecchella ◽

Kathryn A. Sabadosa ◽

Aricca Van Citters ◽

...

Keyword(s):

Cystic Fibrosis ◽

Electronic Health Record ◽

Premature Death ◽

Organ Damage ◽

The United States ◽

Ease Of Use ◽

Health Record ◽

Clinical Encounters ◽

Level Data ◽

Electronic Health

AbstractCystic fibrosis (CF) is a genetic disease in which dysfunction of a single protein channel leads to organ damage, resulting in chronic health problems and premature death. In the United States, medical care of individuals living with CF is delivered by care centers accredited and subsidized by the CF Foundation. CF outcomes have improved significantly through the use of collaborative networks, registry data, and research. CF clinicians are perpetually challenged to assimilate and act upon large quantities of data generated by the care of these individuals. CF Foundation accreditation also requires care centers to enter patient-level data from clinical encounters into the CF Foundation Patient Registry (CFFPR). Commercially available electronic health record systems often lack tools with sufficient context specificity and ease of use to facilitate productive interactions between clinicians and patients. We describe a CF-specific NoteWriter template built and implemented in Epic, which captures discrete data and simultaneously generates clinical documentation during ambulatory encounters. Unlike other examples of note templates in CF, this project involves SmartData Elements (SDEs) using the NoteWriter tool in Epic, which enables data to be entered in the exact way in which the CFFPR captures data. By conducting a pre-/poststudy of its use in our health system, we found that the template can expedite note completion when clinicians have adequate time to become familiar with the tool. We anticipate that the NoteWriter template will become a vehicle for delivering standardized, structured patient data to the CFFPR.

Download Full-text

Incorporating the patient’s voice into electronic health records through patient-reported outcomes as the “review of systems”

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocu007 ◽

2015 ◽

Vol 22 (4) ◽

pp. 914-916 ◽

Cited By ~ 18

Author(s):

Arlene E Chung ◽

Ethan M Basch

Keyword(s):

Electronic Health Record ◽

Patient Reported Outcomes ◽

Clinic Visit ◽

Health Record ◽

Symptom Experience ◽

Full Spectrum ◽

Clinical Encounters ◽

Patient Reported ◽

Electronic Health ◽

Competing Priorities

Abstract Owing to lack of standardization for eliciting patient symptoms, the limited time available during clinical encounters, and the often-competing priorities of patients and providers, providers may not appreciate the full spectrum of the patient’s symptom experience. Using electronically collected patient-reported outcomes to capture the review of system outside of the clinic visit may not only improve the efficiency, completeness, and accuracy of data collection for the review of system, but also provide the opportunity to operationalize incorporating the patient’s voice into the electronic health record. While the necessary technology is already available, multiple stakeholders, including electronic health record vendors, clinicians, researchers, and professional societies, need to align their interests before this can become a widespread reality.

Download Full-text

Business: The Electronic Health Record: Front Line Experience

Perspectives on Administration and Supervision ◽

10.1044/aas21.1.18 ◽

2011 ◽

Vol 21 (1) ◽

pp. 18-22

Author(s):

Rosemary Griffin

Keyword(s):

Health Care ◽

Information Technology ◽

Electronic Health Record ◽

Financial Incentives ◽

Best Practice ◽

Health Care Systems ◽

The United States ◽

Health Record ◽

Health Trends ◽

Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

Download Full-text