scholarly journals The Long-Term Financial and Clinical Impact of an Electronic Health Record on an Academic Ophthalmology Practice

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Michele C. Lim ◽  
Roma P. Patel ◽  
Victor S. Lee ◽  
Patricia D. Weeks ◽  
Martha K. Barber ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Work Productivity ◽  
Clinical Work ◽  
Health Record ◽  
Patient Visit ◽  
Clinical Encounters ◽  
Financial Gain ◽  
Time Period ◽  
Electronic Health ◽  
The Difference

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.

Ethics of Electronic Health Record Systems

2020 ◽  
pp. 1467-1484
Author(s):  
Brian J. Galli
Keyword(s):  
Electronic Health Record ◽  
Ethical Issues ◽  
Healthcare Providers ◽  
Meaningful Use ◽  
Health Record ◽  
Ethical Implications ◽  
Incentive Programs ◽  
Time Period ◽  
Electronic Health ◽  
The Government

This article describes how healthcare and IT are combatting the ethical implications of electronic health records (EHRs) in order to make them adopted by over 90% of small practices. There is a lack of trust in EHRs and uneasiness about what they will accomplish. Furthermore, security concerns have become more prevalent as a result of increased hacker activity. The objective of this article is to analyze these ethical issues in an effort to eliminate them as a hinderance to EHR implementation. As of now, 98% of all hospitals use EHRs. Between 2009 and 2015, the government allocated money and resources for incentive programs to get EHRs into every healthcare providers' office. During this time period, over $800 million dollars facilitated EHR implementation. Using this as a tool EHRs negative perception can be revitalized and combated with the meaningful use program. This article will highlight the ethical implications of EHRs and suggest ways in which to avoid them to make EHRs available in every healthcare provider.

Interventions to Increase Physician Efficiency and Comfort with an Electronic Health Record System

2015 ◽  
Vol 54 (01) ◽  
pp. 103-109 ◽  
Author(s):  
L. Jalota ◽  
M. R. Aryal ◽  
M. Mahmood ◽  
T. Wasser ◽  
A. Donato
Keyword(s):  
Electronic Health Record ◽  
Group Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Clinical Work ◽  
Educational Interventions ◽  
Health Record ◽  
Record System ◽  
Progress Note ◽  
Electronic Health

SummaryObjective: To determine comfort when using the Electronic Health Record (EHR) and increase in documentation efficiency after an educational intervention for physicians to improve their transition to a new EHR.Methods: This study was a single-center randomized, parallel, non-blinded controlled trial of real-time, focused educational interventions by physician peers in addition to usual training in the intervention arm compared with usual training in the control arm. Participants were 44 internal medicine physi cians and residents stratified to groups using a survey of comfort with electronic media during rollout of a system-wide EHR and order entry system. Outcomes were median time to complete a progress note, notes completed after shift, and comfort with EHR at 20 and 40 shifts.Results: In the intervention group, 73 education sessions averaging 14.4 (SD: 7.7) minutes were completed with intervention group participants, who received an average of 3.47 (SD: 2.1) interventions. Intervention group participants decreased their time to complete a progress note more quickly than controls over 30 shifts (p < 0.001) and recorded significantly fewer progress notes after scheduled duty hours (77 versus 292, p < 0.001). Comfort with EHRs increased significantly in both groups from baseline but did not differ significantly by group. Intervention group participants felt that the intervention was more helpful than their standard training (3.47 versus 1.95 on 4-point scale).Conclusion: Physicians teaching physicians during clinical work improved physician efficiency but not comfort with EHRs. More study is needed to determine best methods to assist those most challenged with new EHR rollouts.

scholarly journals 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 ◽  
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.

scholarly journals Assessing the impact of race on glomerular filtration rate (GFR) prediction

2021 ◽  
Author(s):  
Linying Zhang ◽  
Lauren R Richter ◽  
George Hripcsak
Keyword(s):  
Glomerular Filtration Rate ◽  
Electronic Health Record ◽  
Glomerular Filtration ◽  
Prediction Error ◽  
Filtration Rate ◽  
Health Record ◽  
Predictive Algorithms ◽  
Electronic Health ◽  
The Difference ◽  
The Impact

Background The appropriate use and the implications of using variables that attempt to encode a patient's race in clinical predictive algorithms remain unclear. The clinical algorithm for estimating glomerular filtration rate (GFR) adjusts for race, but the observed difference between Black and non-Black participants lacks biologically substantiated evidence. We investigated the impact of using a race variable on GFR prediction by race-stratified error analysis. Methods We implemented three predictive algorithms with varied amount of input information from an electronic health record database to estimate GFR. We compared the prediction error of the estimated GFR with and without the variable race between Black patients and White patients. Results The prediction error for patients coded as Black was higher than that for patients coded as White across all three algorithms. Removing race from the prediction algorithm did not lower the prediction error for patients coded as Black, neither did it decrease the difference in error between the two groups. The algorithm that included the most information with thousands of variables but excluding race produced the most accurate estimate for both groups and minimized the difference in performance between the two groups. Conclusion The prediction error for patients coded as Black was higher compared to those coded as White, regardless of inclusion of race as a variable. Using a large amount of information represented in electronic health record variables achieved a more accurate prediction of GFR and the least difference in prediction error across racial groups.

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

2015 ◽  
Vol 22 (4) ◽  
pp. 914-916 ◽  
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.

Business: The Electronic Health Record: Front Line Experience

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.

Sign in / Sign up

Export Citation Format

Share Document