scholarly journals The long-term financial impact of electronic health record implementation

2014 ◽  
Vol 22 (2) ◽  
pp. 443-452 ◽  
Author(s):  
Michael J Howley ◽  
Edgar Y Chou ◽  
Nancy Hansen ◽  
Prudence W Dalrymple
Keyword(s):  
Electronic Health Record ◽  
Wound Care ◽  
Financial Impact ◽  
Health Record ◽  
Bottom Line ◽  
Productivity Losses ◽  
Electronic Health ◽  
The Right ◽  
Observation Period

Abstract Objective To examine the financial impact of electronic health record (EHR) implementation on ambulatory practices. Methods We tracked the practice productivity (ie, number of patient visits) and reimbursement of 30 ambulatory practices for 2 years after EHR implementation and compared each practice to their pre-EHR implementation baseline. Results Reimbursements significantly increased after EHR implementation even though practice productivity (ie, the number of patient visits) decreased over the 2-year observation period. We saw no evidence of upcoding or increased reimbursement rates to explain the increased revenues. Instead, they were associated with an increase in ancillary office procedures (eg, drawing blood, immunizations, wound care, ultrasounds). Discussion The bottom line result—that EHR implementation is associated with increased revenues—is reassuring and offers a basis for further EHR investment. While the productivity losses are consistent with field reports, they also reflect a type of efficiency—the practices are receiving more reimbursement for fewer seeing patients. For the practices still seeing fewer patients after 2 years, the solution likely involves advancing their EHR functionality to include analytics. Although they may still see fewer patients, with EHR analytics, they can focus on seeing the right patients. Conclusions Practice reimbursements increased after EHR implementation, but there was a long-term decrease in the number of patient visits seen in this ambulatory practice context.

scholarly journals Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report

2015 ◽  
Vol 23 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Christopher A Harle ◽  
Alyson Listhaus ◽  
Constanza M Covarrubias ◽  
Siegfried OF Schmidt ◽  
Sean Mackey ◽  
...  
Keyword(s):  
Case Report ◽  
Electronic Health Record ◽  
Patient Reported Outcomes ◽  
System Development ◽  
Lessons Learned ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health ◽  
Clinical Tools ◽  
The Right

Abstract In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden.

The Importance of Electronic Health Record Access For Accurately Completing Drug Regimen Reviews

2021 ◽  
Vol 36 (7) ◽  
pp. 350-356
Author(s):  
Kaylee A. Mehlman ◽  
Victoria Cho ◽  
Timothy W. Meyers
Keyword(s):  
Electronic Health Record ◽  
Long Term Care ◽  
Health Record ◽  
Current Standard ◽  
Term Care ◽  
Medication Therapy ◽  
Increased Risk ◽  
Standard Of Practice ◽  
Electronic Health

OBJECTIVE: To challenge the standard of practice by evaluating the identification of medication discrepancies found depending on type of access to an electronic health record (EHR). In other words, is there a difference in the number of discrepancies between a pharmacist with only access to the postacute long-term care (PALTC) EHR (ie, single-access pharmacist [SAP]) compared with a pharmacist with access to both the PALTC and hospital EHRs (ie, dual-access pharmacist DAP) In October 2018, the Improving Medicare PostAcute Care Transformation (IMPACT) Act mandated admission drug review (DRR) upon admission to a postacute, long-term care (PALTC) facility.<br/> SUMMARY:This was a prospective study investigating the occurrence of medication therapy problems (MTP) identified by two different DRR processes; SAP versus DAP. Data were collected in a community hospital and a stand-alone PALTC facility. It was found that the DAP identified more safety-related medication needs and medication omissions than an SAP. There was a significant association between the type of access and whether a MTP (ie, yes or no) was discovered, the type of medication-related need, and MTP category.<br/> CONCLUSION: These results strongly suggest that current standard of practice should change to require access to both hospital and PALTC EHR systems for a pharmacist completing the medication reconciliation. Until the gap in EHR interoperability is closed, the potential breakdown in communication associated with SAP places patients transitioning from hospital to PALTC facilities at increased risk for medication problems and accompanying adverse medication events.

Electronic Health Record Proposal for Long-Term Preservation

2013 ◽  
pp. 529-548
Author(s):  
Juanjo Bote
Keyword(s):  
Information System ◽  
Electronic Health Record ◽  
Digital Libraries ◽  
Reference Model ◽  
Digital Preservation ◽  
Health Record ◽  
Information Unit ◽  
Term Basis ◽  
Electronic Health

This chapter introduces a model approach to long-term digital preservation of Electronic Health Record (EHR). The long-term digital preservation is an emerging trend in the environment of digital libraries. However, legal or business needs may cause the use of digital preservation strategies in different fields. This is the case of the EHR as part of the information system of a healthcare institution. After a reasonable space of time without activity, an EHR becomes a passive information unit. Consequently, this passive information unit remains safe in a separate information system where the main purpose is digitally preserving this information on a long-term basis. There are two appropriate methodologies, Trustworthy Repository Audit and Certification Criteria (TRAC) and a Reference Model for Open Archival Information System (OAIS). These methodologies can widely be adopted by health care organizations to preserve EHR in the long-term.

One System of Care, One Electronic Chart

2013 ◽  
pp. 55-69
Author(s):  
Jennifer Gholson ◽  
Heidi Tennyson
Keyword(s):  
Electronic Health Record ◽  
Electronic Record ◽  
System Of Care ◽  
Health Care Facilities ◽  
Health Record ◽  
Electronic Chart ◽  
Electronic Health ◽  
The One ◽  
Area Health

Regional Health made a commitment as part of quality and patient safety initiatives to have an electronic health record before the federal government developed the concept of “meaningful use.” The “One System of Care, One Electronic Chart” concept was a long-term goal of their organization, accomplished through electronically sharing a patient’s medical record among Regional Health’s five hospitals and other area health care facilities. Implementing a hybrid electronic record using a scanning and archiving application was the first step toward the long-term goal of an electronic health record. The project was successfully achieved despite many challenges, including some limited resources and physician concerns.

One System of Care, One Electronic Chart

2015 ◽  
pp. 1052-1063
Author(s):  
Jennifer Gholson ◽  
Heidi Tennyson
Keyword(s):  
Electronic Health Record ◽  
Electronic Record ◽  
System Of Care ◽  
Health Care Facilities ◽  
Health Record ◽  
Electronic Chart ◽  
Electronic Health ◽  
The One ◽  
Area Health

Regional Health made a commitment as part of quality and patient safety initiatives to have an electronic health record before the federal government developed the concept of “meaningful use.” The “One System of Care, One Electronic Chart” concept was a long-term goal of their organization, accomplished through electronically sharing a patient's medical record among Regional Health's five hospitals and other area health care facilities. Implementing a hybrid electronic record using a scanning and archiving application was the first step toward the long-term goal of an electronic health record. The project was successfully achieved despite many challenges, including some limited resources and physician concerns.

The Importance of Electronic Health Record Access For Accurately Completing Drug Regimen Reviews

2021 ◽  
Vol 36 (7) ◽  
pp. 350-356
Author(s):  
Kaylee A. Mehlman ◽  
Victoria Cho ◽  
Timothy W. Meyers
Keyword(s):  
Electronic Health Record ◽  
Long Term Care ◽  
Health Record ◽  
Current Standard ◽  
Term Care ◽  
Medication Therapy ◽  
Increased Risk ◽  
Standard Of Practice ◽  
Electronic Health

Objective: To challenge the standard of practice by evaluating the identification of medication discrepancies found depending on type of access to an electronic health record (EHR). In other words, is there a difference in the number of discrepancies between a pharmacist with only access to the postacute long-term care (PALTC) EHR (ie, single-access pharmacist [SAP]) compared with a pharmacist with access to both the PALTC and hospital EHRs (ie, dual-access pharmacist DAP) In October 2018, the Improving Medicare Post-Acute Care Transformation (IMPACT) Act mandated admission drug review (DRR) upon admission to a post-acute, long-term care (PALTC) facility. Summary: This was a prospective study investigating the occurrence of medication therapy problems (MTP) identified by two different DRR processes; SAP versus DAP. Data were collected in a community hospital and a stand-alone PALTC facility. It was found that the DAP identified more safety-related medication needs and medication omissions than an SAP. There was a significant association between the type of access and whether a MTP (ie, yes or no) was discovered, the type of medication-related need, and MTP category. Conclusion: These results strongly suggest that current standard of practice should change to require access to both hospital and PALTC EHR systems for a pharmacist completing the medication reconciliation. Until the gap in EHR interoperability is closed, the potential breakdown in communication associated with SAP places patients transitioning from hospital to PALTC facilities at increased risk for medication problems and accompanying adverse medication events.

Impact of smart pump-electronic health record interoperability on patient safety and finances at a community hospital

2021 ◽  
Author(s):  
Wenfei Wei ◽  
William Coffey ◽  
Mobolaji Adeola ◽  
Ghalib Abbasi
Keyword(s):  
Patient Safety ◽  
Electronic Health Record ◽  
Community Hospital ◽  
Financial Impact ◽  
Health Record ◽  
Current Procedural Terminology ◽  
Smart Pumps ◽  
Final Article ◽  
Electronic Health ◽  
Smart Pump

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Integrating smart pumps with an electronic health record (EHR) reduces medication errors by automating pump programming and EHR documentation. This study describes the patient safety and financial impact of pump-EHR interoperability at a community hospital. Methods A 316-bed community hospital in Sugar Land, TX, went live with pump-EHR interoperability in October 2019. Data were collected from April 1, 2019, to June 30, 2019 (before implementation) and from April 1, 2020, to June 30, 2020 (after implementation). Rates of drug library compliance, alert firing, alert override, override within 2 seconds, high-risk alert override, and alert resulting in pump reprogramming were measured. Financial impact was measured by Current Procedural Terminology code capture per kept appointment in the infusion center. Results Drug library compliance increased from 73.8% to 82.9% with pump-EHR interoperability (P &lt; 0.001). Infusions generating alerts among all infusions programmed with the drug library decreased from 3.5% to 2.6% (P &lt; 0.001), overridden alerts increased from 64.8% to 68.9% (P &lt; 0.001), alerts overridden within 2 seconds decreased from 17.3% to 13.8% (P &lt; 0.001), and reprogrammed alerts decreased from 20.7% to 18.3% (P = 0.002). Conclusion Pump-EHR interoperability leads to safer administration of intravenous medications based on improved drug library compliance and more accurate smart pump programming.

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