Electronic Health Record
18
Citation
0
Reference
10
Related Paper
Citation Trend
Abstract:
The chapter covers the electronic health record and electronic health record system that facilitates the use of EHR. The EHR is compared with the traditional handwritten health care record. Definition of Electronic Health Records and its association with the terminology, classification and coding is presented. The architecture of the Electronic Health Record is of strong significance as well as its attributes. Strategic approaches of designing systems supporting the use of electronic health records are depicted. A short presentation of current state of implementation and the obstacles for further implementation are given in the final part of the chapter.Keywords:
Electronic health record
Health records
Medical record
Presentation (obstetrics)
Electronic health record (EHR) access and audit logs record behaviors of providers as they navigate the EHR. These data can be used to better understand provider responses to EHR-based clinical decision support (CDS), shedding light on whether and why CDS is effective.This study aimed to determine the feasibility of using EHR access and audit logs to track primary care physicians' (PCPs') opening of and response to noninterruptive alerts delivered to EHR InBaskets.We conducted a descriptive study to assess the use of EHR log data to track provider behavior. We analyzed data recorded following opening of 799 noninterruptive alerts sent to 75 PCPs' InBaskets through a prior randomized controlled trial. Three types of alerts highlighted new medication concerns for older patients' posthospital discharge: information only (n=593), medication recommendations (n=37), and test recommendations (n=169). We sought log data to identify the person opening the alert and the timing and type of PCPs' follow-up EHR actions (immediate vs by the end of the following day). We performed multivariate analyses examining associations between alert type, patient characteristics, provider characteristics, and contextual factors and likelihood of immediate or subsequent PCP action (general, medication-specific, or laboratory-specific actions). We describe challenges and strategies for log data use.We successfully identified the required data in EHR access and audit logs. More than three-quarters of alerts (78.5%, 627/799) were opened by the PCP to whom they were directed, allowing us to assess immediate PCP action; of these, 208 alerts were followed by immediate action. Expanding on our analyses to include alerts opened by staff or covering physicians, we found that an additional 330 of the 799 alerts demonstrated PCP action by the end of the following day. The remaining 261 alerts showed no PCP action. Compared to information-only alerts, the odds ratio (OR) of immediate action was 4.03 (95% CI 1.67-9.72) for medication-recommendation and 2.14 (95% CI 1.38-3.32) for test-recommendation alerts. Compared to information-only alerts, ORs of medication-specific action by end of the following day were significantly greater for medication recommendations (5.59; 95% CI 2.42-12.94) and test recommendations (1.71; 95% CI 1.09-2.68). We found a similar pattern for OR of laboratory-specific action. We encountered 2 main challenges: (1) Capturing a historical snapshot of EHR status (number of InBasket messages at time of alert delivery) required incorporation of data generated many months prior with longitudinal follow-up. (2) Accurately interpreting data elements required iterative work by a physician/data manager team taking action within the EHR and then examining audit logs to identify corresponding documentation.EHR log data could inform future efforts and provide valuable information during development and refinement of CDS interventions. To address challenges, use of these data should be planned before implementing an EHR-based study.
Audit trail
Electronic health record
Medical record
Cite
Citations (28)
Medical record
Health records
Electronic Records
Cite
Citations (26)
The electronic medical records and the electronic health records were two important parts of the hospital information system.The electronic health records were the advanced forms of the electronic medical records,and cannot be replaced by them.Those records were combined with all kinds of the information like the patients’ medical and personal health care records,family health records,public health information,chronic disease follow-up records and so on.It achieved the ’multi range in one file’ form in the health records of the residents.Those made it possible for different medical institutions to exchange,update and interactively apply the information and data;can also improve the utilization of information.It was the basis for community health services and a good tool of general medical service as well.It played an important role in regional health information.
Medical record
Health records
Cite
Citations (1)
Objective To investigate the problems in the establishment and application of electronic health records and to discuss how to solve these problems in order to achieve maximized medical resource application through survey on application of electronic health records in Guangwai community.Methods 115 744 electronic health records from the health service center of Guangwai community from November 2010 to December 2011 were selected to collect the prevalence of all kinds of chronic diseases and the application of health records.150 electronic medical records were selected from all the records to examine basic information,health management records for focus groups,healthy life styles and physical examination of the residents.Results In Guangwai area there were totally 186 000 residents(the sixth census results),and by December 2011,115 744 electronic health records were established,accounting for 62.23% of the population.Among these people,12 259(78.23%) out of the 15 717 cases of high blood pressure were filed,3 791(73.72%) out of the 5 142 cases of diabetes were filed,1 046(67.53%) out of the 1 549 cases of stroke were filed and 1 900(73.11%) out of the 2 599 cases of coronary heart disease were filed.13 316 records were used within one year with an utilization rate of 11.48%.150 records were randomly inspected and 135(90.0%) were qualified records,including 100.0%(150/150) qualified rate for basic information,87.3%(131/150) for health management records for focus groups,78.0%(117/150) for healthy life styles and 62.0%(93/150) for physical examination.Conclusion The file establishment rate and utilization rate of electronic health records in Guangwai community are low,so it should be enhanced,especially for people with high blood pressure,diabetes,stroke and coronary heart disease.
Medical record
Health records
Community Health
Community health center
Electronic Records
Cite
Citations (0)
The chapter covers the electronic health record and electronic health record system that facilitates the use of EHR. The EHR is compared with the traditional handwritten health care record. Definition of Electronic Health Records and its association with the terminology, classification and coding is presented. The architecture of the Electronic Health Record is of strong significance as well as its attributes. Strategic approaches of designing systems supporting the use of electronic health records are depicted. A short presentation of current state of implementation and the obstacles for further implementation are given in the final part of the chapter.
Electronic health record
Health records
Medical record
Presentation (obstetrics)
Cite
Citations (18)
The electronic world continues to advance in the 21st century. In 2009, the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act were enacted; in response, hospitals and oncology physician offices have or are implementing electronic health records (EHRs). As with any new technology or process, a steep learning curve is associated with the implementation of EHRs. Often, the full impact of a sweeping, nationwide change such as EHRs is not realized for many years after implementation, and many suppositions about the usefulness and benefits of EHRs still exist. The current article focuses on the initial impact of EHRs, their role in diagnosis, and the responses of healthcare providers in patient outcomes and in research.
Health records
Electronic health record
Health information technology
Cite
Citations (1)
A new study reports that the percentage of pediatricians using electronic health records (EHRs) has increased from 58% to 79% since 2009, when passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act implemented incentives for adopting EHRs.
Electronic health record
Health records
Health information technology
Meaningful use
Cite
Citations (0)
Health records
Electronic health record
Depression
Cite
Citations (0)
Electronic Health Record (EHR) is an umbrella term encompassing demographics and health information of a patient from many different sources in a digital format. Deep learning has been used on EHRs ...
Health records
Electronic health record
Demographics
Code (set theory)
Digital Health
Cite
Citations (1)
Health records
Electronic health record
Data extraction
Cite
Citations (3)