Electronic Health Record and Web-Based Resources

AbstractFollowing the Great East Japan Earthquake on March 11, 2011, the Japan Medical Association deployed medical disaster teams to Shinchi-town (population: approximately 8,000), which is located 50 km north of the Fukushima Daiichi nuclear power plant. The mission of the medical disaster teams sent from Fukuoka, 1,400 km south of Fukushima, was to provide medical services and staff a temporary clinic for six weeks. Fear of radiation exposure restricted the use of large medical teams and local infrastructure. Therefore, small volunteer groups and a cloud-hosted, web-based electronic health record were implemented. The mission was successfully completed by the end of May 2011. Cloud-based electronic health records deployed using a “software as a service” model worked well during the response to the large-scale disaster.NagataT, HalamkaJ, KennochiH, HimenoS, HimenoA, HashizumeM. Using a cloud-based electronic health record during disaster response: a case study in Fukushima, March 2011. Prehosp Disaster Med. 2013;28(4):1-5.

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Insulin Infusion Computer Calculator Programmed Directly Into Electronic Health Record Medication Administration Record

Journal of Diabetes Science and Technology ◽

10.1177/1932296820966616 ◽

2020 ◽

pp. 193229682096661

Author(s):

Kristen Kulasa ◽

Brittany Serences ◽

Michael Nies ◽

Robert El-Kareh ◽

Kirk Kurashige ◽

...

Keyword(s):

Electronic Health Record ◽

Insulin Infusion ◽

Medication Administration ◽

University Of California ◽

Health Record ◽

Staff Satisfaction ◽

Web Based ◽

Period 2 ◽

Integration Period ◽

Electronic Health

Background: Computerized insulin infusion protocols have demonstrated higher staff satisfaction, better compliance with protocols, and increased time with glucose in range compared to paper protocols. At University of California San Diego Health (UCSDH), we implemented an insulin infusion computer calculator (IICC) and transitioned it from a web-based platform directly into the electronic medication administration record (eMAR) of our primary electronic health record (EHR). Methods: This is a retrospective analysis of 6306 adult patients at UCSDH receiving intravenous (IV) insulin infusion from March 7, 2013 to May 30, 2019. We created three periods of the study—(1) the pre-eMAR integration period; (2) the eMAR integration period; and (3) the post-eMAR integration period—and looked at the percentage of readings within goal range (90-150 mg/dL for intensive care unit [ICU], 90-180 mg/dL for non-ICU) in patients with and without hyperglycemic emergencies. As our safety endpoints, we elected to look at incidence of blood glucose (BG) readings <70 mg/dL, <54 mg/dL, and <40 mg/dL. Results: Pre-eMAR 69.8% of readings were in the 90-150 mg/dL range compared to 70.2% post-eMAR ( P = .03) and 82.7% of readings were in the 90-180 mg/dL range pre-eMAR versus 82.9% ( P = .09) post-eMAR in patients without hyperglycemic emergencies. Rates of hypoglycemia with BG <70 mg/dL were 0.43%, <54 mg/dL were 0.07%, and <40 mg/dL were 0.01% of readings pre- and post-eMAR. Conclusions: At UCSDH, our IICC has shown to be safe and effective in a wide variety of clinical situations and we were able to successfully transition it from a web-based platform directly into the eMAR of our primary EHR.

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Implementation of Electronic Health Record as a Clinical Information Tool to Improve Gastric Cancer Care

Applied Health Information Technology ◽

10.18502/ahit.v1i1.5255 ◽

2021 ◽

Author(s):

Leila Shahmoradi ◽

Rogayeh KhoramiMoghadam ◽

Marjan Ghazisaeedi ◽

Marsa Gholamzadeh

Keyword(s):

Gastric Cancer ◽

Electronic Health Record ◽

Cancer Care ◽

Clinical Information ◽

Health Record ◽

Functional Requirements ◽

Record System ◽

Web Based ◽

Electronic Health ◽

And Performance

Aim: According to the high prevalence of gastric cancer in Iran, this study aimed to develop a gastric cancer electronic health record (EHR) to improve outpatient gastric cancer care. Method: This study represented the stepwise process used to develop a web-based gastric cancer EHR to overcome the documentation problems and cancer care complications. These iterative phases included determining the required minimum data sets (MDS), designing, developing and implementation, and usability evaluation. The system functional and non-functional requirements were determined using needs assessment. The MDSs were identified through consensus by a multidisciplinary expert panel. Finally, the web-based system was implemented in PHP language. Results: Initially, the required datasets were verified by experts. Later, an EHR-based gastric cancer system was implemented successfully to support outpatient cancer care. Based on the analysis, the functional requirements and main modules of the system were specified. The designed system reached an acceptable level of usability and performance. Conclusion: The system was successfully implemented in the gastric cancer clinic. Implementation of an electronic health record system can not only provide ease of access to clinical information, but also improve the quality of complicated cancer care.

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Exploring a Clinically Friendly Web-Based Approach to Clinical Decision Support Linked to the Electronic Health Record: Design Philosophy, Prototype Implementation, and Framework for Assessment

JMIR Medical Informatics ◽

10.2196/medinform.3586 ◽

2014 ◽

Vol 2 (2) ◽

pp. e20 ◽

Cited By ~ 7

Author(s):

Perry Miller ◽

Michael Phipps ◽

Sharmila Chatterjee ◽

Nallakkandi Rajeevan ◽

Forrest Levin ◽

...

Keyword(s):

Decision Support ◽

Electronic Health Record ◽

Clinical Decision Support ◽

Clinical Decision ◽

Health Record ◽

Web Based ◽

Prototype Implementation ◽

Design Philosophy ◽

Electronic Health

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Web-based personal health records: the personal electronic health record (pEHR) multicentred trial

Journal of Telemedicine and Telecare ◽

10.1258/135763307781645086 ◽

2007 ◽

Vol 13 (1_suppl) ◽

pp. 32-34 ◽

Cited By ~ 7

Author(s):

George E Karagiannis ◽

Vasileios G Stamatopoulos ◽

Michael Rigby ◽

Takis Kotis ◽

Elisa Negroni ◽

...

Keyword(s):

Health Care ◽

Electronic Health Record ◽

Health Care Professionals ◽

Large Scale ◽

Study Groups ◽

Third Party ◽

Health Record ◽

User Friendliness ◽

Web Based ◽

Electronic Health

A multicentre trial of a Web-based personal electronic health record (pEHR) service was conducted in three different European hospitals. A total of 150 patients and 22 health-care professionals were involved. The service was customised according to the needs of three groups of patients who had congenital heart disease, Parkinson's disease and type 2 diabetes. Two structured questionnaires, one for patients and one for health-care professionals, were used to collect their views on the pEHR service. The questions were about usability and user friendliness, safety and trustworthiness, reliability, functionality, satisfaction and the potential revenue model of the service in the case of future deployment. Patients perceived the service as very motivating and felt that it could help them in managing their clinical information. Health-care professionals showed a very positive attitude towards the use of the service and its potential for future large-scale deployment. They were also keen to recommend the service to their patients. Both study groups were unwilling to pay for the service and preferred it to be sponsored by a third party (e.g. the National Health Service).

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