PRESENTED BY:
WILLIAM LAMBERTON, RN
NURS 457PENNSYLVANIA STATE UNIVERSITY
FEBRUARY 7, 2010
Electronic Medical Records
Objectives
Describe electronic medical records (EMRs)
List and describe EMR hardware List and describe EMR software Evaluate software used with
EMRs Describe and review an EMR
information system
Objectives—con’t
Examine advantages and disadvantages of EMRs
Discuss legal and ethical issues associated with EMRs
What is an EMR?
Electronic database of a individual medical information
Information entered by health care providersFrom the inpatient settingFrom ambulatory care
Not interactiveOwned by the care provider
(HIMSS, 2010)
What is an EMR? (con’t)
Makes orders easier to manageProvides care prompts to providers
Eases administrative tasksSchedulingBilling
Enables organizations to report to regulatory organizations
(OpenClinical, 2009)
Hardware Used with an EMR
The ServerWireless Tablet Personal Computers (PCs)
Work StationsComputer on Wheels (COW)Personal Digital Assistants (PDAs)
Photo from www.tabletpc2.com
About EMR Hardware
Wireless Tablet PCsCan be taken from room-to-roomInformation is entered at the bedside.
Work StationsWired to the serverFound at the Nurse’s StationCan be found in or between patient
rooms(EMR Experts, 2009)
Example of EMR Software
EpicCompassSoarianE-Record
About E-Record
Allows for complete chartingDate Entry by nursesData Entry by ancillary staff
Viewing of all clinical resultsElectronic Medication Administration Record (eMAR)
(UPMC, 2010)
Evaluation of E-Record Usability
Improving the human-technology interface
Based on Staggers three axiomsFocus on usersIterative designEmpirical usability measures(Staggers, 2003 and
Effken, 2009)
Healthcare information system—a description
E-RecordEnd usersPoint of service devicesData storageAncillary support
(UPMC, 2010 and Hassett, 2002)
Information System Review
E-RecordUsed by all members of the care teamFunctions performedConfigurationDisease ClassificationNursing Practice Standards
ClassificationsRecommendations
(Hardiker, 2009)
Advantages of the EMR
Information stored securely and viewed later
Information can be viewed off siteReduces redundant chartingEliminates the risks of sloppy handwriting
Portable, bedside charting(HIMSS, 2010)
Disadvantages of EMRs
Nurses must be computer savvyOlder nurses are resistant to change
Security of information on computer screens
Downtime
(HIMSS, 2010)
Ethical and Legal Issues
PrivacySecurity
(Hasssett, 2010)
Informatics Competencies
Ability to enter, view, and manipulate information
Ability to navigate sections of the EMR system
Ability to transmit information
(EMR Experts, 2009)
Functions of the Informatics Nurse
Support for new usersContinuing support of the system
(UPMC, 2010)
In summary…
EMRs as a healthcare technology trend
References
Effken, J.A. (2009). Improving the human-technology interface. In D. McGonigle and K. Mastrian (Ed.), Nursing informatics and the foundation of knowledge (pp. 61-76). Sudbury, Massachusetts: Jones and Bartlett.
EMR Experts (2009). Selecting the right hardware configuration for your EMR Software. Retrieved February 24, 2010, from http://www.emrexperts.com/articles/emr-hardware-buying.php
Hardiker, N. (2009). Developing standardized terminologies in nursing infomatics. In D. McGonigle and K. Mastrian (Ed.), Nursing informatics and the foundation of knowledge (pp. 97-106). Sudbury, Massachusetts: Jones and Bartlett.
References—con’t
Hassett, M. (2002). Applications for health care information systems [Health care informatics: an interdisciplinary approach. Englebardt, Sheila P. and Ramona Nelson, eds. St. Louis. Mosby. 2002. pp. 148-157.]. Retrieved March 20, 2010 from http://reserve.libraries.psu.edu.ezaccess.libraries.psu.edu/nurs
HIMSS (2010). Electronic Medical Records versus Electronic Health Records. Retrieved February 2, 2010, from www.himssanalytics.org/docs/wp_emr_ehr.pdf
OpenClinical (2009). Electronic Medical Records. Retrieved February 2, 2010, from http://www.openclinical.org/emr.html
References-con’t
Staggers, N. (2003). Human factors: imperative concepts for information systems in critical care. AACN Clinical issues, 14(3), Retrieved February 22, 2010 from http://reserve.libraries.psu.edu.ezaccess.libraries.psu.edu/nurs/457/45721.pdf
UPMC (2010). UPMC Creates Electronic Health Record. Retrieved February 25, 2010, from http://www.upmc.com/aboutupmc/QualityInnovation/ExcellenceInPatientCare/Pages/eRecord.aspx