Optimum Structure of the EHR

1
Optimum Structure of the EHR

• Dr Ahmad Risk
• Head of Clinical Operations
• CMS (Clinical Records) Ltd
• London - Cairo
• risk_at_cmseg.com
• Editor Health Informatics Europe
• http//hi-europe.info
• 4th Regional eHealth Conference
• Tehran IRI
• September 2004

2
What I will talk about

• The vision
• EHR pre-structure critical factors
• EHR getting the right mix
• EHR purpose
• EHR the Big Question
• Data real life experience
• Questions and contacts

3
The Vision
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EHRPre-structure critical factors

• People
• Requirements and objectives
• Change management
• Interaction
• Process
• Business requirements and objectives
• Viability cost time scale
• Constraints
• Technology
• Technical requirements
• Availability of technology infrastructure
• Availability of know how

5
EHRGetting the right mix
Structure that focuses on what the users will
actually use is technically achievable and
meets business objectives
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EHRPurpose

• Clinical care
• Clinical governance

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EHR PurposeClinical care

• The consistent, protocol driven recording of
  machine-readable data will help HCPs to
• Elicit, recall, match, process, and apply large
  amount of complex information at the point of
  care
• Do it consistently and reliably
• Safeguard security and confidentiality
• But dont forget
• The need for information is often much more than
  a question about medical knowledge. Doctors are
  looking for guidance, psychological support,
  affirmation, commiseration, sympathy, judgement,
  and feedback (Richard Smith)

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EHR PurposeClinical Governance

• The consistent monitoring of explicit and agreed
  standards of care
• It has 2 elements that must be integrated within
  the structure of the EHR
• Care pathways that allow monitoring of variance
• Consistent, protocol driven extraction of
  machine-readable data that can be monitored and
  analysed

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EHRThe Big Question

• The EHR is DATA

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DATAReal life experience

• More than 5 million pages of historical
  paper-based records of UK patients
• Imaged, indexed and integrated
• Summarised remotely to consistent protocol
• More than 500,000 items of data extracted and
  coded
• Data inserted remotely into empty EHRs
• Due to start processing 20m pages
• Good for this Region as it is good for the Brits!

11
Questions

• Ahmad Risk
• risk_at_cmseg.com
• 44 (0) 7717 295 111