Healthcare Informatics Response
Healthcare Informatics Response
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Healthcare Informatics Response
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Apply a biblical integration.
Gregory Buczek
Discussion Week 7
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According Braunstein there are substantial historical and practical differences between the two dominant electronic medical records. The electronic medical record is an “electronic medical record (EMR) used [almost exclusively] by licensed providers” in the primary physician domain whereas the electronic health record (EHR) “is a stakeholder-wide record of a patient’s complete health situation” (Braunstein, 2014, page 242). What does this difference mean in the practical quotidian use of electronic records for patient documentation? First, the EMR largely mimics the use of traditional paper records that dominated physician practices up until the turn of the century. That is to say, even though they have data points, they exist for that bespoke place of care and are mostly intimate in that setting of patient/provider exchange and documentation. They have little to no data hooks that could be mined or exported for the larger healthcare delivery system.
EHRs, by contrast are designed to track all data points of care and can be utilized by healthcare organization and informaticists to use it examine larger healthcare trends and adjust treatment accordingly. We are talking single patient healthcare as the locus in the EMR and aggregation of healthcare aimed not only at the single patient but the patient population with the adoption and meaningful use f EHRs. The healthcare delivery system in no longer strapped to geography limitations as curated electrons can be exchanged mush easier and frequently at much less cost and time. First, let’s take a look to see if there is a place for EMR and EHRs to coexist and, second, let’s examine an example of how EHRs data can be used for much greater population health: medical surveillance.
EMR are not new and were invented to bridge the gap in the physician space between the cumbersome paper records and the digital record that corresponds to the analog-to-digital shift that has been taking place during the last couple of decades. That said, most healthcare workers who utilize these records largely view it as a digital version of a paper record…with just a little more flexibility for edit, manipulation, update, and filing. But there are numerous data sets that reside in these records that get unrealized. Most of this has to do with lack of interoperability and the many different EMR systems for different vendor that do not matriculate with one another. One Canadian study in 2018 examined 10 functional differences that exist between traditional paper records and seemingly similar electronic versions. This was everything form health information to decision support to administrative process. The researchers concluded that even though EMR were largely adopted three themes of use emerged to explain under-utilization of said features 1) general ceiling effect of current technology 2) lack of awareness of EMR capability and 3) perceived poor data quality. EMR function for the patient and to document but struggle to “break out” (Price & Kim, 2013).
Contrast EMRs, which are the source of most data collected that is “aggregated across providers and form the patient, via health information exchanges, to create the HER [which] then also can be aggregated for population health management and for secondary use, such as clinical research and public surveillance” (Braunstein, 2014, page 38). Public health surveillance is remarkably more effective and possible now that EHRs dominate the healthcare delivery system. And such surveillance does not intrude on patient privacy. In fact, there are at least 120 different conditions tracked, with the bulk being infectious diseases. How is this done? Surveillance studies “leveraged ESP, which is an open-sourced surveillance platform developed in partnership with public health officials, researchers, and clinicians” (Willis et al, 2019). From this perspective health surveillance can examine previously unknown health population trends and react accordingly. Mark 3:10 says “for he had healed many, so that all who had diseases pressed around him to touch him.” EHRs continue to provide large data sets on public health that will provide public health initiatives going forward.
References:
Braunstein, M. L. (2014). Contemporary health informatics. Chicago, IL: AHIMA Press.
Price, M., Singer, A., & Kim, J. (2013). Adopting electronic medical records: are they just electronic paper records? Canadian family physician Medicin de famille canadien, 59(7), e322-e329.
Willis, S., Cocoros, N., Randall, L., Ochoa, A., Haney G., Hsu, K., DeMaria, A., & Klompas, M. (2019). Electronic Health Record Us in Public Health Infectious Disease Surverillance. Current Infectious Disease Reports. 21: 32.
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Laura
Discussion 7
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Electronic Health records and electronic medical records are often terms used interchangeably when they actually have many differences. In our text by Shanholtzer electronic health records (EHRs) are defined as having: “Capture more detailed information than the traditional chart and are designed to be exchanged and used at any point of care, If certified, meet Meaningful Use standards; support data following the patient, providing more patient-centric care, Designed to contain all of a patient’s medical care and history across all specialties in one place, Provide a broader range of data and are designed to support advanced analytics and decision support, and Interoperability with other EHRs through health information exchange.” (Shanholtzer & Ozanich, Gary, 2016) In the text electronic medical records (EMRs) are defined as:” Digital record of the traditional chart used within one location, Do not meet the Meaningful Use certification requirements for greater functionality and interoperability, Focused on episodes within a single specialty or single health system, Limited data analytics; used primarily for encounter capture and data viewing and Not designed to be part of a larger system.” (Shanholtzer & Ozanich, Gary, 2016)
Biblical Integration
“If the whole body were an eye, where would the sense of hearing be? If the whole body were an ear, where would the sense of smell be? But in fact God has placed the parts in the body, every one of them, just as he wanted them to be. If they were all one part, where would the body be? As it is, there are many parts, but one body.” -1 Corinthians 12:17-20 I interpret this to mean that we all cannot perform the same duties but we must all work together to create a complete product. As in physician and nurse relationships we have different roles but together we provide complete care for our patients, ensuring their well-being.
The tracking of electronic records is imperative to keeping all information accessible and private. In the article, “Clutter in Electronic Medical Records: Examining Its Performance and Attentional Costs Using Eye Tracking,” located in the journal “Human Factors: The Journal of the Human Factors and Ergonomics Society,” discusses the need for tracking records. This article states, “Clutter degraded performance in terms of response time and noticing accuracy. These decrements were largely accentuated by high stress and task difficulty. Eye tracking revealed the underlying attentional mechanisms, and several display-independent metrics were shown to be significant indicators of the effects of clutter.” (Moacdieh & Sarter, 2015) Making sure all information stays private is the number one concern with electronic records. In the article, “Secure Scalable Disaster Electronic Medical Record and Tracking System” it states, “Electronic medical records (EMRs) are considered superior in documentation of care for medical practice. Current disaster medical response involves paper tracking systems and radio communication for mass-casualty incidents (MCIs). These systems are prone to errors, may be compromised by local conditions, and are labor intensive. Communication infrastructure may be impacted, overwhelmed by call volume, or destroyed by the disaster, making self-contained and secure EMR response a critical capability. Report: As the prehospital disaster EMR allows for more robust content including protected health information (PHI), security measures must be instituted to safeguard these data.” (DeMers, Kahn, & Johansson, 2013) The advancements in making sure all electronic records are secure and private will always be necessary.
References
DeMers, G., Kahn, C., & Johansson, P. (2013). Secure Scalable Disaster Electronic Medical Record and Tracking System. Prehospital and Disaster Medicine.
Moacdieh, N., & Sarter, N. (2015). Clutter in Electronic Medical Records: Examining Its Performance and Attentional Costs Using Eye Tracking. Human Factors: The Journal of the Human Factors and Ergonomics Society.
Shanholtzer, M. B., & Ozanich, Gary. (2016). Health Information Management and Technology. McGraw Hill.
