Electronic Health Records

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Electronic Health Records

• Based on Alliance for Health Reform Toolkit on
  Health Information TechnologyNarrated by Leonel
  V. Baliton

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Credit
For the source see http//www.allhealth.org/Public
ations/Health_information_technology/health_info
rmation_technology_toolkit.aspkeyfacts
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Health Information Technology (HIT)

• Information processing
• Hardware and software
• For
• Entry
• Storage
• Retrieval
• Sharing
• Use
• Components
• Electronic Medical Records
• Computerized Physician Order Entry

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Electronic Medical Record (EMR)

• Patient's legal medical record
• Stored in digital format

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Electronic Health Record (EHR)

• Subset of EMR
• Integrated into a larger network
• Owned by the patient

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Fully Operational Electronic Health Record

• Core functionality
• Storage retrieval
• Result management
• Order entry support
• Decision support
• Other functionality
• Electronic communication
• Patient access
• Administrative support
• Population reporting

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Personal Health Record (PHR)

• Owned by a patient
• Maintained by a patient

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Health Information Exchange (HIE)

• Move clinical information across organizations
• Maintain the meaning of the information

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Regional Health Information Network (RHIO)

• Multi-stakeholder organization
• Operating in a specific geographical area
• Enables the exchange of health information

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National Health Information Network (NHIN)

• Technologies
• Standards
• Laws
• Policies
• Programs
• Practices

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Computerized Physician Order Entry (CPOE)

• Computerized system
• Physicians to enter their own orders

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Consumers can maintain a personal health record
From Blumenthal and Glaser, New England Journal
of Medicine Vol. 356 24, June 2007
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Clinicians maintain an Electronic Health Record
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Health Information Exchanges
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This creates a Regional Health Information
network
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Several RHIOs make up elements of the National
Health Information Network
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High Hopes for HIT

• Hospitals want to reduce medical errors
• Providers hope to work easily
• Governments and businesses hope to save money
• Save 77 billion per year after a 15-year
  adoption period

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CPOE Reduced Medication Errors

• 55 percent

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Adoption Rate of Physicians and Health Centers
(2005-2006 Data)
"Health Information Technology in the United
States The Information Base for Progress"
Robert Wood Johnson Foundation, October 2006
www.rwjf.org/newsroom/newsreleasesdetail.jsp?id10
439
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Adoption Rate of Physicians by Practice Size
(2005-2006 Data)
"Health Information Technology in the United
States The Information Base for Progress"
Robert Wood Johnson Foundation, October 2006
www.rwjf.org/newsroom/newsreleasesdetail.jsp?id10
439
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Why Adoption Has Been Slow?

• Interoperable
• Cost
• Privacy

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Why Adoption Has Been Slow?

• Interoperable
• Cost
• Privacy

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Why Adoption Has Been Slow?

• Interoperable
• Cost
• Privacy

44,000 per full-time provider
8,500 annual maintenance
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Why Adoption Has Been Slow?

• Interoperable
• Cost
• Privacy

Who Should Pay?
Lack of a business case for HIT
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Why Adoption Has Been Slow?

• Interoperable
• Cost
• Privacy

150 Billion
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Why Adoption Has Been Slow?

• Interoperable
• Cost
• Privacy

Stark Law Privacy and security
obligations Liability exposure
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Lack of trained IT personnel

• People who understand both the technology and the
  business

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Jury is Still Out Examples of Success Exist

• Department of Veterans Affairs
• Improved quality of care
• Easy recovery

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Take Home Lesson

• Health IT may reform the entire health care
  system.