Professional fission in medical routines: medical scribes and physicians in two US hospital departments

2020 ◽  
Author(s):  
Ann L Bryan ◽  
John C Lammers
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Community Hospital ◽  
Health Record ◽  
Health Departments ◽  
Health Records ◽  
The Us ◽  
Electronic Health ◽  
Medical Scribes ◽  
Digestive Health

Abstract In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US’ federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes’ roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians’ work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.

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 Pilot Study of Meaningful Use of Electronic Health Records in Radiation Oncology

2012 ◽  
Vol 8 (4) ◽  
pp. 219-223 ◽  
Author(s):  
Xinglei Shen ◽  
Adam P. Dicker ◽  
Laura Doyle ◽  
Timothy N. Showalter ◽  
Amy S. Harrison ◽  
...  
Keyword(s):  
Pilot Study ◽  
Electronic Health Records ◽  
Electronic Health Record ◽  
Radiation Oncology ◽  
Meaningful Use ◽  
Health Record ◽  
Health Records ◽  
Widespread Adoption ◽  
Electronic Health

Most large academic radiation oncology practices have incorporated electronic health record systems into practice and plan to meet meaningful use requirements. Further work should focus on needs of smaller practices, and specific guidelines may improve widespread adoption.

Electronic Health Record System using Blockchain

2019 ◽  
Vol 1 (2) ◽  
pp. 57-61
Author(s):  
Sangeetha R ◽  
Harshini B ◽  
Shanmugapriya A ◽  
Rajagopal T.K.P.
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Family Health ◽  
Health Record ◽  
Medical Organization ◽  
Record System ◽  
Health Records ◽  
Related Information ◽  
Health Related ◽  
Electronic Health

This paper deals with the Electronic Health Records for storing information of the patient which consist of the medical reports. Electronic Health Records (EHRs) are entirely controlled by Hospitals instead of patients, which complicates seeking medical advices from different hospitals. In the existing system of storing details of the patients are very dependent on the servers of the organization. In the proposed all the information of the patient are stored in the blockchain by using the Metamask and these details are stored in the block chain as a blocks of data. Each block consists of the data which is encrypted data. Electronic Health Record (EHR) systems record health-related information on an individual so that it can be consulted by clinicians or staff for patient care. The data is encrypted by the algorithm known as SHA-256 which is used to encrypt all the data of the patients into a single line 256 bit encrypted text which will be stored in the block at etherscan. These records for not only useful for the consultation but also for creation of historic family health information tree that keeps track of genetic health issues and diseases it can also be used for any health service with the authorization from both the patient and medical organization.

scholarly journals Phenotyping issues for exploring electronic health records to design clinical trials

2020 ◽  
Vol 17 (4) ◽  
pp. 402-404
Author(s):  
Jill Schnall ◽  
LingJiao Zhang ◽  
Jinbo Chen
Keyword(s):  
Clinical Trials ◽  
Electronic Health Records ◽  
Electronic Health Record ◽  
Statistical Methods ◽  
Gold Standard ◽  
The Other ◽  
Health Record ◽  
Health Records ◽  
Electronic Health ◽  
Downstream Analysis

For utilizing electronic health records to help design and conduct clinical trials, an essential first step is to select eligible patients from electronic health records, that is, electronic health record phenotyping. We present two novel statistical methods that can be used in the context of electronic health record phenotyping. One mitigates the requirement for gold-standard control patients in developing phenotyping algorithms, and the other effectively corrects for bias in downstream analysis introduced by study samples contaminated by ineligible subjects.

scholarly journals From screening to ascertainment of the primary outcome using electronic health records: Challenges in the STRIDE trial

2020 ◽  
Vol 17 (4) ◽  
pp. 346-350
Author(s):  
Denise Esserman
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Health Care Systems ◽  
Health Record ◽  
Electronic Health Record Data ◽  
Health Records ◽  
Record Data ◽  
Care Systems ◽  
Electronic Health ◽  
Data Elements

Electronic health record data are a rich resource and can be utilized to answer a wealth of research questions. It is important when using electronic health record data in clinical trials that systems be put in place and vetted prior to enrollment to ensure data elements can be collected consistently across all health care systems. It is often overlooked how something conceptualized on paper (e.g. use of the electronic health record in a study) can be difficult to implement in practice. This article discusses some of the challenges in using electronic health records in the conduct of the STRIDE (Strategies to Reduce Injuries and Develop Confidence in Elders) trial, how we handled those challenges, and the lessons we learned for the conduct of future trials looking to employ the electronic health record.

Electronic health record use among cancer patients: Insights from the Health Information National Trends Survey

2017 ◽  
Vol 25 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Yulia A Strekalova
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Cancer Patients ◽  
Health Information ◽  
Information Seeking ◽  
Health Record ◽  
Online Information ◽  
Health Records ◽  
Electronic Health ◽  
National Trends

Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute’s Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access. Specifically, higher income, prior online information seeking, interest in accessing health information online, and normative beliefs were predictive of electronic health record access. Conversely, poorer general health status and lack of health care provider encouragement to use electronic health records were associated with lower utilization rates. The current findings provide theory-based evidence that contributes to the understanding of the explanatory factors of electronic health record use and suggest future directions for research and practice.

scholarly journals Do provider attitudes about electronic health records predict future electronic health record use?

Healthcare ◽  
2015 ◽  
Vol 3 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Tara F. Bishop ◽  
Mandy Smith Ryan ◽  
Colleen M. McCullough ◽  
Sarah C. Shih ◽  
Lawrence P. Casalino ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Health Record ◽  
Provider Attitudes ◽  
Health Records ◽  
Electronic Health

Use of instrumental variables in electronic health record-driven models

2016 ◽  
Vol 27 (2) ◽  
pp. 608-621 ◽  
Author(s):  
Luca Salmasi ◽  
Enrico Capobianco
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Instrumental Variables ◽  
Treatment Effects ◽  
Ad Hoc ◽  
Health Record ◽  
Health Records ◽  
Negative Effect ◽  
Electronic Health ◽  
High Degree

Precision medicine presents various methodological challenges whose assessment requires the consideration of multiple factors. In particular, the data multitude in the Electronic Health Records poses interoperability issues and requires novel inference strategies. A problem, though apparently a paradox, is that highly specific treatments and a variety of outcomes may hardly match with consistent observations (i.e., large samples). Why is it the case? Owing to the heterogeneity of Electronic Health Records, models for the evaluation of treatment effects need to be selected, and in some cases, the use of instrumental variables might be necessary. We studied the recently defined person-centered treatment effects in cancer and C-section contexts from Electronic Health Record sources and identified as an instrument the distance of patients from hospitals. We present first the rationale for using such instrument and then its model implementation. While for cancer patients consideration of distance turns out to be a penalty, implying a negative effect on the probability of receiving surgery, a positive effect is instead found in C-section due to higher propensity of scheduling delivery. Overall, the estimated person-centered treatment effects reveal a high degree of heterogeneity, whose interpretation remains context-dependent. With regard to the use of instruments in light of our two case studies, our suggestion is that this process requires ad hoc variable selection for both covariates and instruments and additional testing to ensure validity.

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