Physician Service Research Paper

electronic health record (EHR) A secure real-time, point-of-care, patient centric information resource for clinicians allowing access to patient information when and where needed and incorporating evidence-based decision support.

Equally impressive is the implementation of Computerized Physician/provider Order Entry or CPOE. CPOE is known as one of three key patient safety initiatives by Leapfrog Group, a conglomeration of non-health care Fortune 500 company leaders committed to modernizing the current healthcare system (Huston, 2014; The Leapfrog Group, 2013). CPOE is a type of software designed to reduce errors in transcription due to illegible physician handwritings or wrongly placed decimals in dosage and strengths of medications. CPOE also gives the clinician access to Clinical Decision Support, or CDS, which is a database to assist clinicians and providers to health related information for certain patient diagnosis with care planning assistance and direction. (Huston, 2014; The Leapfrog Group, 2013). CPOE and CDS will likely be streamlined and commonly used in healthcare in the next decade which appears will likely improve patient safety as well as vastly reduce medication and

Electronic health records (EHR) are health records that are generated by health care professionals when a patient is seen at a medical facility such as a hospital, mental health clinic, or pharmacy. The EHR contains the same information as paper based medical records like demographics, medical complaints and prescriptions. There are so many more benefits to the EHR than paper based medical records. Accuracy of diagnosis, quality and convenience of patient care, and patient participation are a few examples of the

After decades of paper based medical records, a new type of record keeping has surfaced - the Electronic Health Record (EHR). EHR is an electronic or digital format concept of an individual’s past and present medical history. It is the principle storage place for data and information about the health care services provided to an individual patient. It is maintained by a provider over time and capable of being shared across different healthcare settings by network-connected information systems. Such records may include key administrative and clinical data relevant to that persons care under a particular provider. Examples of such records may include: demographics, physician notes, problems or injuries, medications and allergies, vital

EHR was created to have a technical way to securely exchange private and personal medical health information in hopes to improve the quality of care, decrease medical errors, limiting paper use, reduction of health care cost, and increasing a person access to affordable health care. A mandate was created for EHR stating that health records can be accessible to all facilities with patients having the capability to access their own health records at any time. Ameliorating the quality and convenience of care given to a patient, allow for cost saving measures, engage the patient and family to participate in their care, improve accuracy of medical diagnosis, and enhance the efficiency of the overall outcome of the patients’ health.

EHRs display vital patient data and clinical information. Data and information include diagnosis, medications, procedures, test results, assessments, problems list, consents, and directives (Barey, McGonigle, & Mastrian, 2018). EHRs allow all healthcare professionals on the treatment team to access data to provide safe and quality care (Rocha & Rocha, 2014). EHRs not only provide pertinent patient data, but also assist in addressing the underuse or misuse of healthcare services. The response to EHRs has raised mixed emotions and positive and negative feedback from healthcare professionals. However, overall, research reveals EHRs can positively impact healthcare (Kutney-Lee & Kelly, 2011). EHRs continue to influence the healthcare system, and make a vital impact on healthcare quality and safety.

An Electronic Health Record is a computerized form of a patient’s medical chart. These records allow information to be readily available to authorized providers during a patient’s encounter with the healthcare system. These systems do not only contain medical histories, current medications and insurance information, they also track patients’ diagnoses, treatment plans, immunization dates, allergies, radiology images and lab tests/results (source). The fundamental aspect of EHRs is that they are able to share a patient’s information quickly across service lines and even between different healthcare organizations. Information is at the fingertips of lab techs, primary care physicians, pharmacies, clinics, etc. The

The Electronic Health Record (EHR) is a benefit to providers and patients in several ways.

An Electronic Health Record (EHR) is a real time digital version of a patient’s paper chart that make information available instantly and securely to authorized users. EHR contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results. Allow access to evidence-based

Electronic health records (EHRs): Medical records are now kept in an electronic versus a paper chart. All health information regarding past and current medical history, treatment plans, and medications are kept in the EHR. The system also allows sharing of medical information from provider to provider as needed. Many HER systems have a feature to allow patients to log into a patient portal to review lab results, diagnostic tests, plans of care, and email access to the provider

Over the years, several studies have discussed the high rates of safety problems that patients experience during hospital stays. A particular study found that adverse events occur in as many as one-third of hospital patients (Classen et al., 2011). This regularly occurs in Jones Hospital. An additional benefit of the EHR, according to the Agency for Healthcare Research and Quality (2009), includes the ability to improve safety and overall care through clinical decision support (CDS) functionality. CDS can provide support to clinicians at various stages in the care process. It can be used to ensure accurate diagnoses, screen for preventable diseases, or avoid adverse drug events. CDS can alert a clinician to errors such as duplicate testing or drug interaction during the prescribing process.

“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an

EHR has been proposed for a solution to increase the quality of health care. Patients in the United States are receiving recommended medical care, and there have been calls to improve health care quality. Electronic health records (EHRs) has been touted as cost-effective and sustainable solutions for improving quality in medical care. EHR is still controversial and very important topic in health informatics. There is no universally accepted definition for electronic health records. In 2008 National Alliance for Health Information Technology released definition for EHR “An electronic record of health-related information on an individual that can be created, gathered, managed and consulted by authorized clinicians and staff within one healthcare

Electronic health records are revolutionizing how patients access their healthcare information. Most major insurance companies offer online platforms that allow patients to conveniently view

The World Health Organization, 2016 defines “eHealth is the use of information and communication technologies for health”. An electronic health record (eHR) is the electronic collection, management, use, storage and sharing of healthcare information and is envisioned to assist in the delivery of safe, efficient, effective healthcare (RACGP, 2016).