Clinical Governance and Laboratory Medicine: is the Electronic Medical Record our best friend or sworn enemy?

AbstractThis review attempts to address the question: is the Electronic Medical Record (EMR) our best friend or sworn enemy in the context of Clinical Governance and Laboratory Medicine? It provides a brief overview of the history and development of Clinical Governance before going on to define an EMR. It considers how EMRs could assist in delivering quality care in laboratory medicine. A number of outstanding issues regarding EMRs and electronic health records (EHRs) are identified and discussed briefly before the author provides a brief outlook on the future of clinical governance and EMRs in laboratory medicine.

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Supporting information retrieval from electronic health records: A report of University of Michigan’s nine-year experience in developing and using the Electronic Medical Record Search Engine (EMERSE)

Journal of Biomedical Informatics ◽

10.1016/j.jbi.2015.05.003 ◽

2015 ◽

Vol 55 ◽

pp. 290-300 ◽

Cited By ~ 144

Author(s):

David A. Hanauer ◽

Qiaozhu Mei ◽

James Law ◽

Ritu Khanna ◽

Kai Zheng

Keyword(s):

Information Retrieval ◽

Electronic Health Records ◽

Medical Record ◽

Electronic Medical Record ◽

Search Engine ◽

Health Records ◽

Electronic Health

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Digital Phenotypes for Personalized Medicine

10.3233/shti210587 ◽

2021 ◽

Author(s):

Carlos Molina ◽

Belén Prados-Suarez

Keyword(s):

Health Status ◽

Personalized Medicine ◽

Electronic Health Records ◽

Health State ◽

Health Records ◽

The Future ◽

Electronic Health ◽

Definition Of

In this paper we propose a new definition of digital phenotype to enrich the formulation with information stored in the Electronic Health Records (EHR) plus data obtained using wearables. On this basis, we describe how to use this formalism to represent the health state of a patient in a given moment (retrospective, present, or future) and how can it be applied for personalized medicine to find out the mutations that should be introduced at present to reach a better health status in the future.

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Abstract 266: No Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.266 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Karen E Joynt ◽

Deepak L Bhatt ◽

Lee H Schwamm ◽

Ying Xian ◽

Paul A Heidenreich ◽

...

Keyword(s):

Ischemic Stroke ◽

Length Of Stay ◽

Electronic Health Records ◽

Clinical Outcomes ◽

Quality Care ◽

Health Records ◽

American Hospital ◽

American Hospital Association ◽

Electronic Health

Background: Electronic Health Records (EHRs) may be a key tool for improving the quality of healthcare. They may be particularly important for conditions such as ischemic stroke, in which guidelines are rapidly evolving and timely care of the patient is critical. Methods: We used data from 1,236 hospitals participating in Get With The Guidelines-Stroke, representing 626,473 ischemic strokes between 2007 and 2010, and linked this with the American Hospital Association annual survey to characterize which study hospitals had an EHR. We conducted regression analyses to determine whether hospitals with an EHR demonstrated better performance on quality metrics, length of stay, discharge to home, and mortality. Results: 511 hospitals had an EHR by the end of the study period. Stroke patients at hospitals with EHRs were younger, more often male and non-white, and had a lower burden of medical comorbidities. Hospitals with EHRs were larger, and more often teaching hospitals and stroke centers than hospitals without EHRs. In unadjusted analyses, patients at hospitals with EHRs were more likely to receive “all-or-none” care (87.9% versus 82.6%, p<0.001), and less likely to have a length of stay over 4 days (42.4% versus 43.9%, p<0.001). However, there were no differences in discharge to a site other than home (50.9% versus 51.1%, p=0.12) or in-hospital mortality (5.3% versus 5.2%, p=0.40). In multivariate analyses, after controlling for patient and hospital characteristics, the presence of an EHR was no longer associated with better quality care, and continued to have no association with clinical outcomes (Table). Conclusions: In our sample of GWTG-Stroke hospitals, EHRs were not associated with higher-quality care or better clinical outcomes. Given that these systems often create significant added burden for clinicians, further work to ensure that they are better integrated with care and fully evidence-driven is critical.

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