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