Electronic Health Records
Margret Amatayakul, MBA, RHIA, CHPS, CPHIT, CPEHR, FHIMSS
Community Hospital has a single-vendor hospital information system (HIS) that provides typical financial and administrative information systems services, including laboratory, radiology, and pharmacy information systems, and order-entry/results review. Other ancillary departments such as dietary, physical therapy, nursing, and others are not online. The hospital participates in a cardiac care registry but abstracts data from their paper charts to contribute to the registry. The health plans servicing the community are starting to offer incentives for use of health information technology if positive patient outcomes can be identified. Community hospital is considering acquiring a CPOE system to reduce medication errors.
Physicians who are affiliated with Community Hospital have expressed interest in acquiring EHR systems for their practices but are waiting for the hospital to make a vendor decision concerning CPOE. They believe that if they acquire an EHR from the same vendor as the hospital, they will be able to write orders from their offices for patients who are in the hospital, have better access to the information they need to monitor their patients, and be able to tap into other providers’ EHR systems when they are covering in the emergency department.
The hospital and representative physicians are reviewing vendor products but are confused by what various vendors are telling them. One vendor has suggested that the hospital does not have the type of pharmacy information system that would support CPOE and thus would have to also buy a new pharmacy system. A vendor selling EDMS has suggested scanning and COLD feeding all the current chart forms from all provider settings into one repository so that they would be readily available when needed in an emergency. In the meantime, a couple of physicians purchased a stand-alone electronic prescribing device. They can send prescriptions to the major chain pharmacies in the community, but not to the community pharmacy, nor are they told they can get an interface written between the device and the clinical pharmacy in the hospital that would be needed for CPOE.
Real-World Case Discussion Questions
What are the physicians trying to accomplish through buying the same EHR product as their hospital? What are the pros and cons?
Why can’t the physicians send a medication order to the hospital from their e- prescribing device?
What is the difference between scanning, COLD feeding, and point-of-care (POC) data entry?
How could the hospital improve upon its data quality?
Application Exercise: #3
Search the web for information on the issue of usability and making the EHR more user friendly. What are some of the key issues clinicians have using today’s EHRs and what are some of the proposed means to overcome these issues?