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Electronic Health Records: The Next Frontier in Medicine

Electronic Health Records: The Next Frontier in Medicine. Variations on the Theme. Computerized physician order entry Integrated Results Reporting Information Systems Clinical Decision Support Systems. It’s Coming…. And Here’s Why. To Err Is Human….

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Electronic Health Records: The Next Frontier in Medicine

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  1. Electronic Health Records: The Next Frontier in Medicine

  2. Variations on the Theme • Computerized physician order entry • Integrated Results Reporting Information Systems • Clinical Decision Support Systems

  3. It’s Coming… And Here’s Why

  4. To Err Is Human… • 98,000 Americans die each year from medical errors. • The cost to the nation may be as much as 29 billion dollars. • Suggested that IT could improve safety • The powers that be bought in…

  5. Big Brother is Watching Us… • 2004 State of the Union address • Call for widespread use of EHR by 2014 • Call for interoperability • Executive order to create National Health Information Technology Coordinator

  6. …And So is Big Business • LeapFrog Group is a group of companies that buy healthcare • Their mission • Their “leaps” (criteria for rating hospitals) • Speculation about future “leaps”

  7. What’s all the fuss about anyway?....Advantages of the EHR • “Ensures that appropriate information to guide medical decisions is available at the time of care” • “Improves health care quality” • “Reduces medical errors”

  8. I told you it was great…More Advantages • “Advances the delivery of appropriate, evidence-based medical care” • “Reduces health care costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information” • “Promotes a more effective marketplace, greater competition, and increased choice…”

  9. Still Going… • “Improves the coordination of care and information among hospitals” • “Ensures that patients’ individually identifiable health information is secure and protected.”

  10. In Depth: How the EHR addresses medication errors • Prescribing • Transcribing • Dispensing • Administration • Monitoring

  11. Barriers to Implementation • Cost, Cost, Cost • Lack of support from medical staff • Difficulty in finding an all inclusive solution from one vendor • Difficulty in planning for the conversion • Lack of set standards

  12. About the Cost…Is it worth it? • Estimated net benefit per provider over 5 years was $86,400 • Payer-independent, capitated, and fee-for-service benefits were reported • Benefits increased in proportion to the features included in the EHR • Sounds great…but more study is needed.

  13. The Final Frontier? • Patients interacting with their own EMR via the Internet • Computer triage • Computers taking the place of physicians…

  14. Sources Cited • William Bria II, MD and M. Michael Shabot, MD. “The electronic medical record, safety, and critical care.” Critical Care Clinics 21 (2005) 55-79. • James J. Cimino, MD and others. “An Evaluation of Patient Access to their Electronic Medical Records via the World Wide Web.” http://www.amia.org/pubs/symposia/D200410.PDF. • Mark H. Ebell, MD, MS. “Integrating Information Technology into Clinical Practice.” Clinics in Family Practice. Volume 5, Number 4, Dec 2003. • Joshua Freedman, MD. “The role of information technology in evidence-based practice.” Psychiatric Clinics of North America 26 (2003) 833-850. • LT Kohn, JM Corrigan, MS Donaldson. “To Err is Human: Building a Safer Health System.” Institute of Medicine, National Academy Press, 1999. • Christoph U. Lehmann, MD, and George R. Kim, MD. “Prevention of Medication Errors.” Clinics in Perinatology 32 (2005) 107-123. • Howard A. Peth, Jr., MD, JD. “Medication errors in the emergency department: A systems approach to minimizing risk.” Emergency Medicine Clinics of North America 21 (2003) 141-158. • Rick Rutherford, CMPE. “Medical Records Management – Steps Toward a Paperless Environment.” Urologic Clinics of North America 32 (2005) 275-284. • Samuel J. Wang, MD, PhD and others. “A Cost-Benefit Analysis of Electronic Medical Records in Primary Care.” The American Journal of Medicine. April 1, 2003, Vol. 114: 379-403. • www.leapfroggroup.org • www.whitehouse.gov

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