scholarly journals Have you got the time? Challenges using vendor electronic health record metrics of provider efficiency

2020 ◽  
Vol 27 (4) ◽  
pp. 644-646 ◽  
Author(s):  
Jonathan D Hron ◽  
Eli Lourie
Keyword(s):  
Data Entry ◽  
Health Record ◽  
Longitudinal Assessment ◽  
Health Records ◽  
Provider Behavior ◽  
Time Motion ◽  
Industry Standards ◽  
Electronic Health ◽  
Motion Studies ◽  
The Impact

Abstract The rise of clinician burnout has been correlated with the increased adoption of electronic health records (EHRs). Some vendors have used data entry logs to measure the amount of time spent using the EHR and have developed metrics of provider efficiency. Initial attempts to utilize these data have proven difficult as it is not always apparent whether variations reflect provider behavior or simply the metric definitions. Metric definitions are also updated intermittently without warning, making longitudinal assessment problematic. Because the metrics are based on proprietary algorithms, they are impossible to validate without costly time–motion studies and are also difficult to compare across institutions and vendors. Clinical informaticians must partner with vendors in order to develop industry standards of EHR use, which could then be used to examine the impact of EHRs on clinician burnout.

Electronic Health Record

2012 ◽  
pp. 34-56
Author(s):  
Janine R. A. Kamath ◽  
Amerett L. Donahoe-Anshus
Keyword(s):  
Electronic Health Records ◽  
Personal Health Records ◽  
Health Record ◽  
Healthcare Industry ◽  
Future Directions ◽  
Health Records ◽  
Key Stakeholders ◽  
Electronic Personal Health Records ◽  
Electronic Health ◽  
The Impact

Over the last two decades there has been considerable deliberation, experience, and research in the arena of Health Information Technology (HIT), Electronic Medical Records (EMR), Electronic Health Records (EHR), and more recently, Electronic Personal Health Records (PHR). Despite the challenges involved in adopting these systems and technologies, there is consensus that they bring significant value to the delivery of trusted and affordable healthcare. The investment involved and the impact on customers, clinical and non-clinical staff, and processes are significant and far reaching. This chapter attempts to synthesize the vast amount of information, experience, and implementation perspectives related to Electronic Health Records with the intent of assisting healthcare institutions and key stakeholders make informed choices as they embark on designing, developing, and implementing an EHR. EHR considerations, challenges, opportunities, and future directions are also addressed. The chapter highlights the power of management engineering to facilitate planning, implementation, and sustainability of the EHR, a critical asset for a healthcare organization and the overall healthcare industry.

Electronic Health Record for Forensic Dentistry

2008 ◽  
Vol 47 (01) ◽  
pp. 8-13 ◽  
Author(s):  
T. Dostálová ◽  
P. Hanzlíček ◽  
Z. Teuberová ◽  
M. Nagy ◽  
M. Pieš ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Data Entry ◽  
Structured Data ◽  
Health Record ◽  
Forensic Dentistry ◽  
Disaster Victim Identification ◽  
Health Records ◽  
Victim Identification ◽  
Electronic Health

Summary Objectives: To identify support of structured data entry for electronic health record application in forensic dentistry. Methods: The methods of structuring information in dentistry are described and validation of structured data entry in electronic health records for forensic dentistry is performed on several real cases with the interactive DentCross component. The connection of this component to MUDR and MUDRLite electronic health records is described. Results: The use of the electronic health record MUDRLite and the interactive DentCross component to collect dental information required by standardized Disaster Victim Identification Form by Interpol for possible victim identification is shown. Conclusions: The analysis of structured data entry for dentistry using the DentCross component connected to an electronic health record showed the practical ability of the DentCross component to deliver a real service to dental care and the ability to support the identification of a person in forensic dentistry.

Characterizing Multitasking and Workflow Fragmentation in Electronic Health Records among Emergency Department Clinicians: Using Time-Motion Data to Understand Documentation Burden

2021 ◽  
Vol 12 (05) ◽  
pp. 1002-1013
Author(s):  
Amanda J. Moy ◽  
Lucy Aaron ◽  
Kenrick D. Cato ◽  
Jessica M. Schwartz ◽  
Jonathan Elias ◽  
...  
Keyword(s):  
Emergency Department ◽  
Electronic Health Records ◽  
Average Duration ◽  
Clinical Information ◽  
Future Research ◽  
Clinical Workflow ◽  
Health Records ◽  
Time Motion ◽  
Electronic Health ◽  
The Impact

Abstract Background The impact of electronic health records (EHRs) in the emergency department (ED) remains mixed. Dynamic and unpredictable, the ED is highly vulnerable to workflow interruptions. Objectives The aim of the study is to understand multitasking and task fragmentation in the clinical workflow among ED clinicians using clinical information systems (CIS) through time-motion study (TMS) data, and inform their applications to more robust and generalizable measures of CIS-related documentation burden. Methods Using TMS data collected among 15 clinicians in the ED, we investigated the role of documentation burden, multitasking (i.e., performing physical and communication tasks concurrently), and workflow fragmentation in the ED. We focused on CIS-related tasks, including EHRs. Results We captured 5,061 tasks and 877 communications in 741 locations within the ED. Of the 58.7 total hours observed, 44.7% were spent on CIS-related tasks; nearly all CIS-related tasks focused on data-viewing and data-entering. Over one-fifth of CIS-related task time was spent on multitasking. The mean average duration among multitasked CIS-related tasks was shorter than non-multitasked CIS-related tasks (20.7 s vs. 30.1 s). Clinicians experienced 1.4 ± 0.9 task switches/min, which increased by one-third when multitasking. Although multitasking was associated with a significant increase in the average duration among data-entering tasks, there was no significant effect on data-viewing tasks. When engaged in CIS-related task switches, clinicians were more likely to return to the same CIS-related task at higher proportions while multitasking versus not multitasking. Conclusion Multitasking and workflow fragmentation may play a significant role in EHR documentation among ED clinicians, particularly among data-entering tasks. Understanding where and when multitasking and workflow fragmentation occurs is a crucial step to assessing potentially burdensome clinician tasks and mitigating risks to patient safety. These findings may guide future research on developing more scalable and generalizable measures of CIS-related documentation burden that do not necessitate direct observation techniques (e.g., EHR log files).

Electronic Health Record

2011 ◽  
pp. 309-332 ◽  
Author(s):  
Janine R. A. Kamath ◽  
Amerett L. Donahoe-Anshus
Keyword(s):  
Electronic Health Records ◽  
Personal Health Records ◽  
Health Record ◽  
Healthcare Industry ◽  
Future Directions ◽  
Health Records ◽  
Key Stakeholders ◽  
Electronic Personal Health Records ◽  
Electronic Health ◽  
The Impact

Over the last two decades there has been considerable deliberation, experience, and research in the arena of Health Information Technology (HIT), Electronic Medical Records (EMR), Electronic Health Records (EHR), and more recently, Electronic Personal Health Records (PHR). Despite the challenges involved in adopting these systems and technologies, there is consensus that they bring significant value to the delivery of trusted and affordable healthcare. The investment involved and the impact on customers, clinical and non-clinical staff, and processes are significant and far reaching. This chapter attempts to synthesize the vast amount of information, experience, and implementation perspectives related to Electronic Health Records with the intent of assisting healthcare institutions and key stakeholders make informed choices as they embark on designing, developing, and implementing an EHR. EHR considerations, challenges, opportunities, and future directions are also addressed. The chapter highlights the power of management engineering to facilitate planning, implementation, and sustainability of the EHR, a critical asset for a healthcare organization and the overall healthcare industry.

scholarly journals Personal Electronic Health Record for Patients with Diabetes; Health Technology Assessment Protocol

2017 ◽  
Vol 2 (4) ◽  
pp. 132
Author(s):  
MasoomehRahimi Alami ◽  
Mahdieh Nemayande ◽  
Omid Yousefianzadeh ◽  
Mahnaz Samadbeik ◽  
Amir Abbas Azizi ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Cochrane Library ◽  
Health Record ◽  
Health Records ◽  
Electronic Health ◽  
The Impact

Introduction: In recent decades, diabetes has contributed significantly to the burden of disease in developed and developing countries, due to the considerable prevalence and involvement of various age groups in the communities.Today, a variety of ways to manage and control the disease are used, one of which is the use of personal electronic health records. Recently there has been a remarkable upsurge in activity surrounding the adoption of personal electronic health records systems for patients and consumers. personal electronic health records systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care.The present study was conducted with the goal of Health Technology Assessment the impact of personal electronic health records in Patients with Diabetes.Methods: Writing is based on PRISMA standards.  This was a Health Technology Assessment  study. It aimed to evaluate the technology of personal electronic health record . The scoping review was conducted to evaluate 8 dimensions (Health Problem and Current Use of the Technology, Description and technical characteristics of technology, Safety, Costs and economic evaluation, Ethical analysis, Organisational aspects, Patients and Social aspects, Legal aspects) of  Personal electronic health record . This study was based on answering questions which were developed based on Health Diagnostics Technology Assessment Documents Framework and HTA Core Model 3.0 . A systematic review was conducted to evaluate the Clinical Effectiveness dimension of personal electronic health record  in controlling diabetes. In order to gather evidences, Ovid databases, Cochrane Library, PubMed, CRD, Trip database and EMBASE, and Randomized Controlled Trial Registries, such as the Clinical Trial and Trial Registry, were searched using specific keywords and strategies. .Articles are evaluated on the basis of the quality criteria of JADAD.The data is analyzed by the STATA software.Dissemination:The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.Policy makers and healthcare decision-makers can use these results.

scholarly journals The impact of adoption of an electronic health record on emergency physician work: A time motion study

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Samantha Calder‐Sprackman ◽  
Glenda Clapham ◽  
Trisha Kandiah ◽  
Jade Choo‐Foo ◽  
Simran Aggarwal ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Emergency Physician ◽  
Health Record ◽  
Time Motion ◽  
Motion Study ◽  
Electronic Health ◽  
The Impact ◽  
Physician Work

Electronic Health Records Implementation in Jordan: Perceptions of Healthcare Providers and Determinant Factors (Preprint)

2020 ◽  
Author(s):  
Tamadur Shudayfat ◽  
Çağdaş Akyürek ◽  
Noha Al-Shdayfat ◽  
Hatem Alsaqqa
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Healthcare Providers ◽  
Health Record ◽  
Health Records ◽  
Context Factors ◽  
Electronic Health ◽  
Acceptance Model

BACKGROUND Acceptance of Electronic Health Record systems is considered an essential factor for an effective implementation among the Healthcare providers. In an attempt to understand the healthcare providers’ perceptions on the Electronic Health Record systems implementation and evaluate the factors influencing healthcare providers’ acceptance of Electronic Health Records, the current research examines the effects of individual (user) context factors, and organizational context factors, using Technology Acceptance Model. OBJECTIVE The current research examines the effects of individual (user) context factors, and organizational context factors, using Technology Acceptance Model. METHODS A quantitative cross-sectional survey design was used, in which 319 healthcare providers from five public hospital participated in the present study. Data was collected using a self-administered questionnaire, which was based on the Technology Acceptance Model. RESULTS Jordanian healthcare providers demonstrated positive perceptions of the usefulness and ease of use of Electronic Health Record systems, and subsequently, they accepted the technology. The results indicated that they had a significant effect on the perceived usefulness and perceived ease of use of Electronic Health Record, which in turn was related to positive attitudes towards Electronic Health Record systems as well as the intention to use them. CONCLUSIONS User attributes, organizational competency, management support and training and education are essential variables in predicting healthcare provider’s acceptance toward Electronic Health records. These findings should be considered by healthcare organizations administration to introduce effective system to other healthcare organizations.

scholarly journals Management of a parenteral opioid shortage using ASHP guidelines

2021 ◽  
Vol 78 (5) ◽  
pp. 426-435
Author(s):  
Peter Vo ◽  
Daniel A Sylvia ◽  
Loay Milibari ◽  
John Ryan Stackhouse ◽  
Paul Szumita ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Drug Product ◽  
Health Record ◽  
Large Hospital ◽  
Hospital Administrators ◽  
Utilization Data ◽  
Electronic Health ◽  
Opioid Medications ◽  
American Society ◽  
The Impact

Abstract Purpose Management of an acute shortage of parenteral opioid products at a large hospital through prescribing interventions and other guideline-recommended actions is described. Summary In early 2018, many hospitals were faced with a shortage of parenteral opioids that was predicted to last an entire year. The American Society of Health-System Pharmacists (ASHP) has published guidelines on managing drug product shortages. This article describes the application of these guidelines to manage the parenteral opioid shortage and the impact on opioid dispensing that occurred in 2018. Our approach paralleled that recommended in the ASHP guidelines. Daily dispensing reports generated from automated dispensing cabinets and from the electronic health record were used to capture dispenses of opioid medications. Opioid prescribing and utilization data were converted to morphine milligram equivalents (MME) to allow clinical leaders and hospital administrators to quickly evaluate opioid inventories and consumption. Action steps included utilization of substitute opioid therapies and conversion of opioid patient-controlled analgesia (PCA) and opioid infusions to intravenous bolus dose administration. Parenteral opioid supplies were successfully rationed so that surgical and elective procedures were not canceled or delayed. During the shortage, opioid dispensing decreased in the inpatient care areas from approximately 2.0 million MME to 1.4 million MME and in the operating rooms from 0.56 MME to 0.29 million MME. The combination of electronic health record alerts, increased utilization of intravenous acetaminophen and liposomal bupivacaine, and pharmacist interventions resulted in a 67% decline in PCA use and a 65% decline in opioid infusions. Conclusion A multidisciplinary response is necessary for effective management of drug shortages through implementation of strategies and practices for notifying clinicians of shortages and identifying optimal alternative therapies.

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