Utilisation of information technologies in ambulatory care in Switzerland (original) (raw)
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Electronic Health Records: Cure-all or Chronic Condition
Global Business and Organizational Excellence
Computer-based information systems feature in almost every aspect of our lives, and yet most of us receive handwritten prescriptions when we visit our doctors and rely on paper-based medical records in our healthcare. Although electronic health record (EHR) systems have long been promoted as a cost-effective and efficient alternative to this situation, clear-cut evidence of their success has not been forthcoming. An examination of some of the underlying problems that prevent EHR systems from delivering the benefits that their proponents tout identifies four broad objectives - reducing cost, reducing errors, improving coordination and improving adherence to standards - and shows that they are not always met. The three possible causes for this failure to deliver involve problems with the codification of knowledge, group and tacit knowledge, and coordination and communication. There is, however, reason to be optimistic that EHR systems can fulfil a healthy part, if not all, of their potential.
Information and Communication Technologies in Primary Healthcare
Despite the great expansion and many benefits of information and communication technologies (ICT) in healthcare, the attitudes of Polish general practitioners (GPs) to e-health have not been explored. The aim of this study was to determine the GPs' perception of ICT use in healthcare and to identify barriers to the adoption of EMR (Electronic Medical Records) in the Podlaskie Voivodeship. Online and telephone surveys were conducted between April and May 2013. Responses from 103 GP practices, 43% of all practices in the region, were analysed. The results showed that 67% of the respondents agreed that IT systems improve quality of healthcare services. In the GP group who declared at least partial EMR implementation, 71.4% see the positive impact of IT on practice staff processes and 66.1% on personal working processes. In this group, more than three-quarters of GPs did not see any positive impact of ICT on the average number of patients treated per day, number of patients within the practice or scope of services. The four most common barriers to EMR implementation were: lack of funds, risk of a malfunction in the system, resistance to change, and lack of training and proper information. Although the use of ICT by Polish GPs is limited, their attitude to e-health is generally positive or neutral and resembles the overall pattern in Europe. Barriers identified by GPs need to be taken into account to ensure the effective implementation of e-health across the country.
Charting a New Course: Practical Considerations for Implementing an Electronic Health Records System
2008
To a startling extent, physicians today document their work in much the same way that physicians did in the nineteenth century. 1 Often, those unfamiliar with the United States's healthcare system and physician practices will assume that all physicians and hospitals have electronic health record ("EHR") systems that seamlessly share data as in other industries. The healthcare industry, however, spends a meager amount on information technology ("IT") compared to other industries. For example, the industry, as a whole, spends approximately two percent of gross revenues on IT compared with other industries that spend upwards of ten percent. 2
The entrance of the information technology within health organizations has been causing a true revolution, with new proposals in order to become a new practical facilitator on daily basis of health professionals. This article has the objective to evaluate the Electronic Patient Record (EPR) – ALERT EDIS – at a University Hospital. It has been evaluated a sample of 1,226 medical-cards from patients that have been served by 13 different medical specialties. In 95% of the medical cards there has been an insertion of a responsible and a 100% insertion of a diagnostics, and in only 0.32% there has been no anamnese nor external cause information (when applicable). In 9.54% of the medical cards there has been no evolution and in 31% the requested exams results were not described. Considering an overall, the EPR presents a good completeness from the majority of the evaluated items (-10% of absence). The EPR with compulsory field fulfillment is very valuable for its own quality with benefits to the patient assistance.
21st Century Technology Used in Hospitals: An Assessment of Electronic Health Records
Purpose: The purpose of this research is three-fold. The first purpose is to establish a practical ideal model of Electronic Health Records (E.H.Rs) used in hospitals by reviewing relevant scholarly literature. The second purpose is to assess the extent Central Texas Medical Center (C.T.M.C) in San Marcos, Texas adheres to the elements of the ideal model. The final purpose is to provide recommendations for improving the current E.H.R system used at C.T.M.C. A thorough review of the literature identified eight key components of Electronic Health Records based on the Institute of Medicine Report, Key Capabilities of an Electronic Health Record, 2003. The components include: Health Information and Data, Results Management, Order Entry/Management, Decision Support, Electronic Communication and Connectivity, Patient Support, Administrative Processes, and Reporting and Population Health Management. Methodology: The components of an Electronic Health Record identified in the literature led to the development of the conceptual framework. The conceptual framework was the assessment tool used to gauge the Electronic Health Record (E.H.R) system used at Central Texas Medical Center (C.T.M.C). The methodology used to collect data and make assessments was structured interviews and direct observation. Findings: Structured interviews and direct observation revealed the E.H.R system used at C.T.M.C met all or the majority of components for Health Information and Data, Results Management, Order/Entry Management, and Patient Support. Components that were missing included reminders for preventive services for patients, epidemiologic data and automated real time surveillance in Decision Support, patient to provider communication and medical record integration across settings in Electronic Communication and Connectivity, clinical trial, drug recall and chronic disease management in eligibility determination in Administrative Processes.
Barriers to Implementing Electronic Health Information Management in Patient Care I. Background
This project assessed the barriers to implementation of electronic health information in Ife Central Local Government Area of Osun State. The study was conducted among 170 members of staff through the administration of questionnaire survey. Descriptive statistics was used to analyze the data collected for the study. The finding thus showed that 98.8% of the respondents agreed and strongly agreed that electronic health information works at a very high speed, 98.2% others agreed and strongly agree that electronic health records provide patient with quick and easy access to their health information, regarding to the barriers to the use of electronic health records management, 96.4% of the respondent agreed and strongly agreed that network problem, and poor internet connection are the main barriers to implementation of electronic health information management. The findings revealed further that although electronic health records is not in used in the two hospitals, majority of the respondent preferred electronic health information management. The study concluded that adequate funding,adequate power supply,internet connectivity should be adopted as well as staff training. The medical records, either paper-based or electronic is a communication tool that support clinical decision making, coordination of services, evaluation of the quality and efficacy of care, research, legal protection, education and accreditation and regulatory processes. It is the business record of the health care system, documented in the normal course of its activities.In the past, the medical record was a paper repository of information that was reviewed or used for clinical, research, administration and financial purpose. It was severely limited in terms of accessibility, available to only one user at a time. The paper-based record was updated manually, resulting in delays for record completion that lasted anywhere from 1 to 6 months or more. Most medical record departments were housed in institutions' basements because the weight of the paper precluded other locations. The physician was in control of the care and documentation processes and authorized the release of information. Patient rarely viewed their medical records. During the past era, access was controlled by doors, locks, identification cards and tedious sign-out procedures for authorized users. Unauthorized access to patient information triggered no alerts, nor was it known what information has been viewed.Today, the primary purpose of the documentation remains the same support of patient care. Clinical documentation is often scanned into an electronic system immediately and is typically completed by the time the patient is discharged. Record completion times must meet accrediting and regulatory requirements. The electronic health records are interactive, and there are many stakeholders, reviewers, and users of the documentation. Because the government is increasingly involved with funding health care, agencies actively review documentation of care. The electronic health record (HER) can be viewed by many simultaneously and utilizes a host of information technology tools. Patient routinely review their electronic medical records and are keeping personal health records (PHR), which contain clinical documentation about their diagnoses (from the physician or health care website). In recent years, the health care organizations have aim to provide more customers-oriented services, to achieve this goal, the quality of care needs to be improved which in turn requires timely access to high-quality information. However, because of limitations of paper based records, the required data may not be available to the health care providers at the point of need. To resolve this problem, health information system has been in development for the past 30 years, and the ultimate goal is the adoption of electronic health records (EHRs).Electronic health records system is an information system that helps to collect individual's health information from birth to death so that it can be registered, certified and shared in different places by health care providers. The main goal of implementing electronic health records is improving the
Electronic Health Records and Decision Support Local and Global Perspectives
2008
Safer, less expensive, and higher-quality health care can be achieved using clinical decision support (CDS), although the use of CDS often leads to disappointing results. Various problems and limitations can be pointed being the most frequently referred by the physicians the inadequate implementation of the clinical workflow. Electronic Health Records (EHR) and Patient Health Record Systems (PHRS) can play an important role in CDS mitigating those limitations and enabling the effective use of the archived information in the support of the clinical practice and generating the right knowledge to make decisions. The availability of such knowledge is crucial either, for the hospitals and for the government institutions. This brings new requirements for the EHR and PHRS conception and for the use of the information out of the boundaries of the hospitals and health centers. Interoperation and open models constitute the greater challenges that EHR enfaces in the very next future. This paper presents a survey on the design, development and implementation of PHRS in terms of organizational, regional, national and worldwide initiatives. Finally is presented the EHR implementation in the Hospital Geral de Santo António, EPE, one of the major hospitals in the North Region of Portugal.