Going digital: a checklist in preparing for hospital-wide electronic medical record implementation and digital transformation

2019 ◽  
Vol 43 (3) ◽  
pp. 302 ◽  
Author(s):  
Ian A. Scott ◽  
Clair Sullivan ◽  
Andrew Staib
Keyword(s):  
Information Technology ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Care ◽  
Digital Transformation ◽  
Technical Innovation ◽  
Evidence Based ◽  
Methodological Framework ◽  
Multidisciplinary Group ◽  
Interactive Workshop

Objective In an era of rapid digitisation of Australian hospitals, practical guidance is needed in how to successfully implement electronic medical records (EMRs) as both a technical innovation and a major transformative change in clinical care. The aim of the present study was to develop a checklist that clearly and comprehensively defines the steps that best prepare hospitals for EMR implementation and digital transformation. Methods The checklist was developed using a formal methodological framework comprised of: literature reviews of relevant issues; an interactive workshop involving a multidisciplinary group of digital leads from Queensland hospitals; a draft document based on literature and workshop proceedings; and a review and feedback from senior clinical leads. Results The final checklist comprised 19 questions, 13 related to EMR implementation and six to digital transformation. Questions related to the former included organisational considerations (leadership, governance, change leaders, implementation plan), technical considerations (vendor choice, information technology and project management teams, system and hardware alignment with clinician workflows, interoperability with legacy systems) and training (user training, post-go-live contingency plans, roll-out sequence, staff support at point of care). Questions related to digital transformation included cultural considerations (clinically focused vision statement and communication strategy, readiness for change surveys), management of digital disruption syndromes and plans for further improvement in patient care (post-go-live optimisation of digital system, quality and benefit evaluation, ongoing digital innovation). Conclusion This evidence-based, field-tested checklist provides guidance to hospitals planning EMR implementation and separates readiness for EMR from readiness for digital transformation. What is known about the topic? Many hospitals throughout Australia have implemented, or are planning to implement, hospital wide electronic medical records (EMRs) with varying degrees of functionality. Few hospitals have implemented a complete end-to-end digital system with the ability to bring about major transformation in clinical care. Although the many challenges in implementing EMRs have been well documented, they have not been incorporated into an evidence-based, field-tested checklist that can practically assist hospitals in preparing for EMR implementation as both a technical innovation and a vehicle for major digital transformation of care. What does this paper add? This paper outlines a 19-question checklist that was developed using a formal methodological framework comprising literature review of relevant issues, proceedings from an interactive workshop involving a multidisciplinary group of digital leads from hospitals throughout Queensland, including three hospitals undertaking EMR implementation and one hospital with complete end-to-end EMR, and review of a draft checklist by senior clinical leads within a statewide digital healthcare improvement network. The checklist distinguishes between issues pertaining to EMR as a technical innovation and EMR as a vehicle for digital transformation of patient care. What are the implications for practitioners? Successful implementation of a hospital-wide EMR requires senior managers, clinical leads, information technology teams and project management teams to fully address key operational and strategic issues. Using an issues checklist may help prevent any one issue being inadvertently overlooked or underemphasised in the planning and implementation stages, and ensure the EMR is fully adopted and optimally used by clinician users in an ongoing digital transformation of care.

scholarly journals 530 An Audit of Appropriate Documentation Following Urethral Catheterisation

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
I Dokubo ◽  
J Armitage
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Care ◽  
Medical Personnel ◽  
Urethral Catheter ◽  
Residual Volume ◽  
Urethral Catheterisation ◽  
Catheter Size ◽  
Medical Records System ◽  
Insertion Process

Abstract Introduction Urethral catheterisation is a procedure frequently done in the hospital by medical personnel. Appropriate documentation is necessary to ensure safe clinical care and to reduce the risk of litigation. Method We randomly reviewed electronic notes of patients seen by the on-call urology team who had a urethral catheter inserted in September 2020. Reviewing the trust’s guidelines, we considered that appropriate documentation should include reference to the following 10 items; indication, chaperone present, consent obtained, groin examination, catheter size, catheter type, insertion process, urine colour, water in balloon and residual volume were reviewed. Results A total of 50 patients were included. 72%(36/50) were inserted by a member of the urology team. Only 28%(14/50) had all 10 items documented. Indication for catheterisation was best documented at 94%(47/50) while presence of a chaperone and groin examination (i.e. presence of a foreskin and its replacement post-catheterisation) were the lowest at 44%(22/50). Conclusions This study shows there is low compliance to adequate documentation of urethral catheterisation. A ‘smart phrase’ has been developed for use with our Trusts electronic medical records system to assist clinicians with appropriate documentation. Clinicians that use the phrase ‘.icat’ are prompted to document all 10 requisite items. This uses the mnemonic i-CATHETAR [indication, Chaperone and consent, groin Assessment, Tube (catheter size and type), insertion process (Hard/Easy), urine Tint, Aqua in balloon, Residual volume]. A second audit cycle is currently being done to review the effectiveness of this intervention.

Future Health Services Managers' and Health Information Managers' Views on Information Technology: A Pilot Survey

1996 ◽  
Vol 26 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Johanna I Westbrook
Keyword(s):  
Information Technology ◽  
Health Service ◽  
Health Information ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Future Health ◽  
Disk Storage ◽  
Pilot Survey ◽  
Service Managers ◽  
Insight Into

This pilot survey examined the views of a sample of health service managers (HSMs) and health information managers (HIMs) undertaking tertiary studies about the application of information technology (IT) in health care. The survey was based on a questionnaire designed as part of a 1994 study of health service executives (HSEs) commissioned by the Australian College of Health Service Executives (ACHSE). We examined views about current and future IT expenditure, satisfaction with IT, impact of IT on quality and efficiency and the future use of electronic medical records and optical disk storage. Results identify differences and some similarities between respondent groups on these issues. The paper explores these differences and similarities and provides insight into the views held by future HSMs and HIMs.

scholarly journals The efficiency analysis and spatial implications of health information technology: A regional exploratory study in China

2019 ◽  
Vol 26 (3) ◽  
pp. 1700-1713
Author(s):  
Dan Li ◽  
Jianqian Chao ◽  
Jing Kong ◽  
Gui Cao ◽  
Mengru Lv ◽  
...  
Keyword(s):  
Information Technology ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Communication Systems ◽  
Spatial Association ◽  
Healthcare Information Technology ◽  
Healthcare Information ◽  
Frontier Analysis ◽  
Picture Archiving ◽  
Picture Archiving And Communication

The new adoption of healthcare information technology is costly, and effects on healthcare performance can be questionable. This nationwide study in China investigated the efficient performance of healthcare information technology and examined its spatial correlation. Panel data were extracted from the Annual Investigation Report on Hospital Information in China and the China Health Statistics Yearbook for 2007 through 2015 (279 observations). Stochastic frontier analysis was employed to estimate the technical efficiency of healthcare information technology performance and related factors at the regional level. Healthcare information technology performance was positively associated with electronic medical records, total input, and cost of inpatient stay, while picture archiving and communication systems and net assets were negatively related. Local Indicators of Spatial Association showed that there existed significant spatial autocorrelation. Governmental policies would best make distinctions among different forms of healthcare information technology, especially between electronic medical records and picture archiving and communication systems. Policies should be formulated to improve healthcare information technology adoption and reduce regional differences.

Informed Consent and Biobanks

2005 ◽  
Vol 33 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Ellen Wright Clayton
Keyword(s):  
Information Technology ◽  
Informed Consent ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Information ◽  
Information Resources ◽  
Biomedical Science ◽  
Research Setting ◽  
The Past

Biomedical research has always relied on access to human biological materials and clinical information, resources that when combined form biobanks. In the past, it appears that investigators sometimes used these resources with relatively little oversight, and without the consent of the individuals from whom these materials and information were obtained. Several developments in the last ten to fifteen years have converged to place greater emphasis on the role of individual consent in the creation and use of biobanks. The most important by far is the power of information technology, which has transformed our lives in almost every domain. In the research setting, it is now easy to abstract information from electronic medical records. Computers make it possible to analyze enormous datasets and have contributed in essential ways to the dramatic increases in our understanding of genomics and other areas of biomedical science.

Factors Influencing Diffusion of Electronic Medical Records: A Case Study in Three Healthcare Institutions in Japan

2005 ◽  
Vol 34 (4) ◽  
pp. 120-129 ◽  
Author(s):  
Otieno George Ochieng ◽  
Ryozo Hosoi
Keyword(s):  
Information Technology ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Healthcare Workers ◽  
Reminder Systems ◽  
Healthcare Environment ◽  
Factors Influencing ◽  
Positive Attitudes ◽  
It Skills

This study examines the effect of three factors: information technology (IT) skills of healthcare workers, present status of computerisation in their organisations, and workers' attitudes on the diffusion of electronic medical records (EMRs) in the healthcare environment. Data were obtained from a self-questionnaire distributed to 390 healthcare workers. The study finds that respondents need an expanded EMR capability to include decision support systems and reminder systems, and that diffusion of EMR is heavily influenced by attitudes of healthcare workers. However, targeted training of healthcare workers is needed to foster positive attitudes about EMR, and build confidence in the benefits of these systems.

scholarly journals Improvement of patient safety through implementation of electronic medical records

2017 ◽  
Vol 1 (4) ◽  
pp. 111-112
Author(s):  
Elahe Gozali ◽  
Marjan Ghazisaiedi ◽  
Malihe Sadeghi ◽  
Reza Safdari
Keyword(s):  
Patient Safety ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Access To Health Care ◽  
Clinical Care ◽  
Drug Management ◽  
Bar Code

Introduction: Today, with the complexity of the process of conducting activities, the increase in diversity and the number of hospital services, and the increase in the expectations of clients - consistent with the fast technological advances - most of the hospitals in Iran have turned to mechanized systems to organize their daily activities and to register the patients' information and the care provided. One of these technologies is electronic medical records, which is known as a valuable system to evaluate patients' information in hospitals. The purpose of this paper was to examine the advantages of running electronic medical records in patient safety. Methods: This study is a review paper based on a structured review of papers published in the Google Scholar, SID, Magiran, Pubmed, and Science Direct databases (from 2007 to 2015) and the books on the benefits of implementing electronic medical records in patient safety and the related keywords. Results: Clinical information systems can have a significant effect on the quality of the outputs and patient safety. Various studies have indicated that the physicians with access to clinical guidelines and features such as computer reminders, doctors who did not have these features, presented more appropriate preventive care. Studies show that electronic medical records play a crucial role in improving the quality of patient health and safety services. Moreover, electronic medical record system is usually in connection with other technological tools: electronic drug management records,  electronic record of time and date of drug management are usually associated with bar code technology. Among the benefits of this system is the possibility to record clinical care by the treatment team, which would be especially beneficial for patient's bedside record. If the treatment personnel forgets to ask the patient a particular question, system reminds him/her. Furthermore, electronic medical record is able to remind the nurses of the patient's allergic reactions and medical history without the need for the patient to remind, which improves patient safety. Conclusion: Implementation of electronic medical records boosts up the quality of health services, patient safety, people's access to health care services, and the speed of patients treatment, leading to lower healthcare costs. Thus, considering the benefits mentioned and some other benefits of this kind, one can use this technology in clinical care provided to patients to come up with a safe and effective clinical care.

scholarly journals An Intuitive and Secured Framework for Sharing Health-care Data using Block-chain Techniques

2020 ◽  
Vol 9 (4) ◽  
pp. 1948-1952
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Cloud Storage ◽  
Medical Service ◽  
Service Providers ◽  
Cyber Attacks ◽  
Health Care Data ◽  
Block Chain

Electronic Medical Records are now widely used by medical organizations as a replacement for physical manual records of the patients. These Electronic Medical Records (EMR) were effectively adopted as a result of the evolution in the field of Information technology supported by more innovative computer science engineering feats, as the EMR systems became more advanced it still had a drawback of being vulnerable to cyber attacks, which will eventually compromise the integrity and confidentiality. Hence the same EMR system is built along with the use of Block-chain technology on a cloud storage platform, this system will be integrated with various features compatible for the interoperability between the patients and medical service providers. The main objective of this project is to leverage maximum cyber protection to the EMR system.

scholarly journals Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records

2018 ◽  
Vol 69 (678) ◽  
pp. e33-e41 ◽  
Author(s):  
Dana Šumilo ◽  
Linda Nichols ◽  
Ronan Ryan ◽  
Tom Marshall
Keyword(s):  
Cohort Study ◽  
Electronic Medical Records ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Periodic Fever ◽  
Sleep Apnoea ◽  
Evidence Based ◽  
Research Database ◽  
Obstructive Sleep

BackgroundNeither the incidence of indications for childhood tonsillectomy nor the proportion of tonsillectomies that are evidence-based is known.AimTo determine the incidence of indications for tonsillectomy in UK children, and the proportion of tonsillectomies meeting evidence-based criteria.Design and settingA retrospective cohort study of electronic medical records of children aged 0–15 years registered with 739 UK general practices contributing to a research database.MethodChildren with recorded indications for tonsillectomy were identified from electronic medical records. Evidence-based indications included documented sore throats of sufficient frequency and severity (Paradise criteria); periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA); or tonsillar tumour. Other indications were considered non-evidence-based. The numbers of children subsequently undergoing tonsillectomy was then identified. The numbers with evidence-based and non-evidence-based indications for surgery among children who had undergone tonsillectomy were determined.ResultsThe authors included 1 630 807 children followed up for 7 200 159 person–years between 2005 and 2016. Incidence of evidence-based indications for tonsillectomy was 4.2 per 1000 person years; 13.6% (2144/15 760) underwent tonsillectomy. Incidence of childhood tonsillectomy was 2.5 per 1000 person years; 11.7% (2144/18 281) had evidence-based indications, almost all with Paradise criteria. The proportion of evidence-based tonsillectomies was unchanged over 12 years. Most childhood tonsillectomies followed non-evidence-based indications: five to six sore throats (12.4%) in 1 year, two to four sore throats (44.6%) in 1 year, sleep disordered breathing (12.3%), or obstructive sleep apnoea (3.9%).ConclusionIn the UK, few children with evidence-based indications undergo tonsillectomy and seven in eight of those who do (32 500 of 37 000 annually) are unlikely to benefit.

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