Proposing an Intelligent Cloud-Based Electronic Health Record System

2012 ◽  
Vol 8 (3) ◽  
pp. 57-71 ◽  
Author(s):  
Lara Khansa ◽  
Jonathan Forcade ◽  
Girivaraprasad Nambari ◽  
Saravanan Parasuraman ◽  
Patrick Cox
Keyword(s):  
Best Practices ◽  
Electronic Health Record ◽  
Service Level ◽  
Health Record ◽  
Healthcare Organizations ◽  
Privacy And Security ◽  
Private Patient ◽  
Record System ◽  
Electronic Health ◽  
Reducing Costs

With the aging United States population, healthcare costs have considerably increased and are expected to keep rising in the foreseeable future. In this paper, the authors propose an intelligent cloud-based electronic health record (ICEHR) system that has the potential to reduce medical errors and improve patients’ quality of life, in addition to reducing costs and increasing the productivity of healthcare organizations. They developed a set of best practices that encompass end-user policies and regulations, identity and access management, network resilience and service level agreements, advanced computational power, “Big Data” mining abilities, and other operational/managerial controls that are meant to improve the privacy and security of the ICEHR, and make it inherently compliant to healthcare regulations. These best practices serve as a framework that offers a single interconnection agreement between the cloud host and healthcare entities, and streamlines access to private patient information based on a unified set of access principles.

scholarly journals Essential activities for electronic health record safety: A qualitative study

2019 ◽  
Vol 26 (4) ◽  
pp. 3140-3151 ◽  
Author(s):  
Joan S Ash ◽  
Hardeep Singh ◽  
Adam Wright ◽  
Dian Chase ◽  
Dean F Sittig
Keyword(s):  
Best Practices ◽  
Electronic Health Record ◽  
Rapid Assessment ◽  
Clinical Decision ◽  
Assessment Process ◽  
Health Record ◽  
Healthcare Organizations ◽  
Safety Risks ◽  
Electronic Health ◽  
Clinical Systems

Electronic health record-caused safety risks are an unintended consequence of the implementation of clinical systems. To identify activities essential to assuring that the electronic health record is managed and used safely, we used the Rapid Assessment Process, a collection of qualitative methods. A multidisciplinary team conducted visits to five healthcare sites to learn about best practices. Although titles and roles were very different across sites, certain tasks considered necessary by our subjects were remarkably similar. We identified 10 groups of activities/tasks in three major areas. Area A, decision-making activities, included overseeing, planning, and reviewing to assure electronic health record safety. Area B, organizational learning activities, involved monitoring, testing, analyzing, and reporting. Finally, Area C, user-related activities, included training, communication, and building clinical decision support. To minimize electronic health record-related patient safety risks, leaders in healthcare organizations should ensure that these essential activities are performed.

scholarly journals Facilitating Ambulatory Electronic Health Record System Implementation: Evidence from a Qualitative Study

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Ann Scheck McAlearney ◽  
Cynthia Sieck ◽  
Jennifer Hefner ◽  
Julie Robbins ◽  
Timothy R. Huerta
Keyword(s):  
Electronic Health Record ◽  
Resistance To Change ◽  
Implementation Process ◽  
Unintended Consequences ◽  
Successful Implementation ◽  
Health Record ◽  
System Implementation ◽  
Healthcare Organizations ◽  
Record System ◽  
Electronic Health

Background. Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR) systems, but little information is available documenting how organizations have successfully implemented these systems.Objective. To characterize elements of successful electronic health record (EHR) system implementation and to synthesize the key informants' perspectives about successful implementation practices.Methods. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods.Results. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during “go-live” and, subsequently, when users had more experience with the system.Conclusion. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success.

scholarly journals Functionalities of free and open electronic health record systems

2010 ◽  
Vol 26 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Alejandro Enrique Flores Zuniga ◽  
Khin Than Win ◽  
Willy Susilo
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Security Requirements ◽  
Health Record ◽  
Reference Architecture ◽  
Functional Requirements ◽  
Privacy And Security ◽  
Record System ◽  
Iso Standards ◽  
Electronic Health

Objectives: The aim of this study was to examine open-source electronic health record (EHR) software to determine their level of functionalities according to the International Organization for Standardization (ISO) standards.Methods: ISO standards were used as a guideline to determine and describe the reference architecture and functionalities of a standard electronic health record system as well the environmental context for which the software has been built. Twelve open-source EHR systems were selected and evaluated according to two-dimensional criteria based on ISO/TS 18308:2004 functional requirements and ISO/TR 20514:2005 context of the EHR system.Results: Open EHR software programs mostly fulfill structural, procedural, evolutional, and medicolegal requirements at the minimal and full functionality levels. Communication, privacy, and security requirements are accomplished in less than 23 percent of the cases, mainly at minimal functional level. Ethical, cultural, and consumer requirements still need to be fulfilled by free and open-source EHR applications.Conclusions: Most analyzed systems had several functional limitations. Nevertheless, especially for clinicians and decision makers in developing countries, open-source EHR systems are an option. The limited functionalities are likely to become requirements for further releases of open-source EHR systems.

Why Do Physicians Reject the Electronic Health Record: A Theoretical Perspective? (Preprint)

2018 ◽  
Author(s):  
Weam Alfayez ◽  
Arwa Alumran ◽  
Dr Saja A. Al-Rayes
Keyword(s):  
Information Technology ◽  
Electronic Health Record ◽  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Health Record ◽  
Record System ◽  
Factors Influencing ◽  
Tam Model ◽  
Electronic Health ◽  
Acceptance Model

BACKGROUND Many theories/ models adopted from behavioral sciences literature or developed within the field of information technologies could help in understanding the technology acceptance, usage, and effective adoption. OBJECTIVE The main aim of this paper is to review the different theories/ models that can help in understanding information technology/system acceptance and use, and to choose the most appropriate theoretical framework that could be applied to understand the factors influencing physicians’ use of the Electronic Health Record system (EHR) at King Fahd Military Medical Complex (KFMMC) in Dhahran city, Saudi Arabia. METHODS The theories/ models were reviewed using scientific databases. The inclusion criteria were if the theories/ models used to explain individual behaviors toward accepting and using of information technology including the once conducted within the healthcare. RESULTS The review showed that there were five theories/ models were used within information technology studies to understand the technology acceptance and used. There were Theory of Reasoned Action, Theory of Planned Behaviour, Innovation Diffusion Theory, Unified theory of acceptance and use of technology, and Technology Acceptance Model. Each has different explanatory power of technology use. The most appropriate theoretical framework to understand the reason behind physician use of the EHR at KFMMC would be the Technology Acceptance Model (TAM). TAM model could explain up to 75% of the variation in the behavioral intention (acceptance), and up to 62% of the variation in the actual use. It is the gold standard for assessing the usage of health technologies and systems. In fact, the TAM model is one of the core models used to explore the physician’s perceptions of the Electronic Health Record system adoption. CONCLUSIONS This review showed that there are different theories available in the literature can be used to justify the reason behind electronic health record acceptance. TAM is one of the effective, simplest models used to understand the factors influencing physicians to use the EHR-system. Further studies need to apply the TAM model to check its ability in explaining the reason behind EHR within different hospitals in Saudi Arabia

Transitioning from one Electronic Health Record (EHR) to Another: A Narrative Literature Review

2018 ◽  
Vol 62 (1) ◽  
pp. 489-493 ◽  
Author(s):  
Jason J. Saleem ◽  
Jennifer Herout
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Electronic Health Record ◽  
Health Care Systems ◽  
Health Care Organization ◽  
Data Migration ◽  
Health Record ◽  
Care Organization ◽  
Healthcare Organizations ◽  
Electronic Health

This paper reports the results of a literature review of health care organizations that have transitioned from one electronic health record (EHR) to another. Ten different EHR to EHR transitions are documented in the academic literature. In eight of the 10 transitions, the health care organization transitioned to Epic, a commercial EHR which is dominating the market for large and medium hospitals and health care systems. The focus of the articles reviewed falls into two main categories: (1) data migration from the old to new EHR and (2) implementation of the new EHR as it relates to patient safety, provider satisfaction, and other measures pre-and post-transition. Several conclusions and recommendations are derived from this review of the literature, which may be informative for healthcare organizations preparing to replace an existing EHR. These recommendations are likely broadly relevant to EHR to EHR transitions, regardless of the new EHR vendor.

scholarly journals Developing Clinical Decision Support within a Commercial Electronic Health Record System to Improve Antimicrobial Prescribing in the Neonatal ICU

2014 ◽  
Vol 05 (02) ◽  
pp. 368-387 ◽  
Author(s):  
K. Cato ◽  
B. Sheehan ◽  
S. Patel ◽  
J. Duchon ◽  
P. DeLaMora ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Antimicrobial Prescribing ◽  
Neonatal Icu ◽  
Electronic Health

SummaryObjective: To develop and implement a clinical decision support (CDS) tool to improve antibiotic prescribing in neonatal intensive care units (NICUs) and to evaluate user acceptance of the CDS tool.Methods: Following sociotechnical analysis of NICU prescribing processes, a CDS tool for empiric and targeted antimicrobial therapy for healthcare-associated infections (HAIs) was developed and incorporated into a commercial electronic health record (EHR) in two NICUs. User logs were reviewed and NICU prescribers were surveyed for their perceptions of the CDS tool.Results: The CDS tool aggregated selected laboratory results, including culture results, to make treatment recommendations for common clinical scenarios. From July 2010 to May 2012, 1,303 CDS activations for 452 patients occurred representing 22% of patients prescribed antibiotics during this period. While NICU clinicians viewed two culture results per tool activation, prescribing recommendations were viewed during only 15% of activations. Most (63%) survey respondents were aware of the CDS tool, but fewer (37%) used it during their most recent NICU rotation. Respondents considered the most useful features to be summarized culture results (43%) and antibiotic recommendations (48%).Discussion: During the study period, the CDS tool functionality was hindered by EHR upgrades, implementation of a new laboratory information system, and changes to antimicrobial testing methodologies. Loss of functionality may have reduced viewing antibiotic recommendations. In contrast, viewing culture results was frequently performed, likely because this feature was perceived as useful and functionality was preserved.Conclusion: To improve CDS tool visibility and usefulness, we recommend early user and information technology team involvement which would facilitate use and mitigate implementation challenges.Citation: Hum RS, Cato K, Sheehan B, Patel S, Duchon J, DeLaMora P, Ferng YH, Graham P, Vawdrey DK, Perlman J, Larson E, Saiman L. Developing clinical decision support within a commercial electronic health record system to improve antimicrobial prescribing in the neonatal ICU. Appl Clin Inf 2014; 5: 368–387 http://dx.doi.org/10.4338/ACI-2013-09-RA-0069

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