Electronic Health Record

Author: Alexander Scarlat, MD
Publisher: CRC Press
ISBN: 1466559225
Size: 37.64 MB
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An accessible primer, Electronic Health Record: A Systems Analysis of the Medications Domain introduces the tools and methodology of Structured Systems Analysis as well as the nuances of the Medications domain. The first part of the book provides a top-down decomposition along two main paths: data in motion—workflows, processes, activities, and tasks in parallel to the analysis of data at rest—database structures, conceptual, logical models, and entities relationship diagrams. Structured systems analysis methodology and tools are applied to: electronic prescription, computerized physician order entry, drug dispensation, medication administration, and clinical decision support. Assuming no previous clinical and/or informatics knowledge, the book supplies a comprehensive view of the EHR/EMR with dedicated chapters on: user interface considerations, reporting requirements, and standards and vocabularies for meaningful use. Containing clear language and more than 170 figures and 100 review questions with answers—this book is a great companion for Healthcare IT professionals and an ideal resource for clinical informatics students. Praise for the book: ... a common sense guide to this new world of informatics ... should prove invaluable to the clinician making his/her way past the commercial hype into the realm of true understanding of the systems of medical informatics. ... strongly recommended ... . —William F. Bria MD, CMIO Shriners Hospitals for Children, President of the Board, Association of Medical Directors of Information Systems Finally, here’s a textbook that the market and the industry have been looking for. The author has captured the details of the information flows involved in the EHR while processing an order or prescription from inception to completion. —Joseph T. Finn, RPh, MBA ... a thoughtful and well-constructed manual to understanding and incorporating the complex and many-sided aspects of medication concepts ... a clear and accessible entry to this challenging topic. —Don Martin, Managing Consultant ... encompasses high-value, high-volume therapeutic transactions of indescribable complexity that touch nearly every licensed professional in a hospital ... I’m hoping the vendors of my own hospital’s systems take its recommendations to heart. —Mr. HIStalk, Healthcare IT Blogger .... a very useful guide ... provides the necessary detail that is often missing in many books... very useful in health informatics education at universities and courses within community colleges. —Jane M. Brokel, PhD, RN ... a welcome and valuable addition to the toolkit for IT professionals and clinicians participating in the design or implementation of EHR systems. —Christine Greifzu, RN-BC, MBA, MSIS

Process Improvement With Electronic Health Records

Author: Margret Amatayakul
Publisher: CRC Press
ISBN: 1439872333
Size: 13.86 MB
Format: PDF, ePub
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Although physicians and hospitals are receiving incentives to use electronic health records (EHRs), there is little emphasis on workflow and process improvement by providers or vendors. As a result, many healthcare organizations end up with incomplete product specifications and poor adoption rates. Process Improvement with Electronic Health Records: A Stepwise Approach to Workflow and Process Management walks you through a ten-step approach for applying workflow and process management principles regardless of what stage your organization is in its EHR journey. Introducing workflow and process mapping as essential elements in healthcare improvement, it includes detailed guidance, helpful tools, and case studies in each chapter. It also: Compares EHR workflow and process management to other continuous quality improvement methodologies Highlights the processes that need to be addressed in EHR workflow and process redesign Describes the level of detail necessary for workflow and process mapping to be effective Explains how to create change agents and offers time-tested change management tools The book describes the process for getting stakeholders to create, document, and validate new workflows and processes. Using case studies to illustrate the unique requirements of health information technology (HIT) and EHR acquisition, this reference provides you with simple yet powerful tools—along with step-by-step guidance—for the effective use of workflow and process mapping within healthcare.

The Lean Electronic Health Record

Author: Ronald G. Bercaw
Publisher: Taylor & Francis
ISBN: 1351850954
Size: 72.20 MB
Format: PDF, Kindle
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The Electronic Health Record (EHR) is a reflection of the way your organization conducts business. If you’re looking to make lasting improvements in the delivery of care, you must start with looking at the system from your patient’s perspective to understand what is of value and what is simply waste. When you begin seeing in this way, you’ll begin building in this way. When you begin building in this way, you’ll begin driving improvements in your care delivery. Only then will your EHR be able to support lasting improvements, driving better patient care and outcomes at lower costs.? Healthcare organizations are under increasing pressure to improve on all fronts. This can be achieved, but only by changing the very way we look at care. No longer can we look at care just from the organization or provider’s perspective; we must start with the end in mind – the patient. Compelling case studies, discussed throughout this book, demonstrate that modifying processes and workflows using Lean methodologies lead to substantial improvements. These changes must be undertaken in a clear, consistent, and methodical manner. When implementing an EHR based on existing workflows and sometimes antiquated processes, organizations struggle to sustain improvements. Many organizations have deployed an EHR and now face optimization challenges, including the decision to move to a new EHR vendor. The financial implications of upgrading, optimizing or replacing an EHR system are significant and laden with risk. Choose the wrong vendor, the wrong system, or the wrong approach and you may struggle under the weight of that decision for decades.? Organizations that successfully leverage the convergence of needs – patients demanding better care, providers needing more efficient workflows and organizations desiring better financials – will survive and thrive. This book ties together current healthcare challenges with proven Lean methodologies to provide a clear, concise roadmap to help organizations drive real improvements in the selection, implementation, and on-going management of their EHR systems. Improving patient care, improving the provider experience and reducing organizational costs are the next frontier in the use of EHRs and this book provides a roadmap to that desired future state.

Better Ehr

Author: Jiajie Zhang (Professor of biomedical informatics)
Publisher:
ISBN: 9780692262962
Size: 72.83 MB
Format: PDF, Docs
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Electronic Health Records (EHR) offer great potential to increase healthcare efficiency, improve patient safety, and reduce health costs. The adoption of EHRs among office-based physicians in the US has increased from 20% ten years ago to over 80% in 2014. Among acute care hospitals in US, the adoption rate today is approaching 100%. Finding relevant patient information in electronic health records' (EHRs) large datasets is difficult, especially when organized only by data type and time. Automated clinical summarization creates condition-specific displays, promising improved clinician efficiency. However, automated summarization requires new kinds of clinical knowledge (e.g., problem-medication relationships).

Improving Population Health Using Electronic Health Records

Author: Neal D. Goldstein
Publisher: CRC Press
ISBN: 1498759122
Size: 63.43 MB
Format: PDF, Mobi
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Electronic health records (EHRs) have become commonplace in the medical profession. Health data are readily captured and permanently stored in a digital fashion, and consequently, are increasingly being utilized in health research. The quality of this research depends upon the investigator’s ability to obtain the correct data to answer the correct question. It is easy to churn out poor quality research from the EHR; it is much harder to produce meaningful results that influence the population’s health. Improving Population Health Using Electronic Health Records takes the reader through the process of conducting meaningful research from data in the EHR. It de-mystifies the entire research process, from how to ask the right kind of research questions, to obtaining data with particular emphasis on data management and manipulation, to performing a valid statistical analyses, and interpreting and presenting the results in a clear, concise fashion that has the potential to improve population health. This book can be used as a hands-on how-to guide of performing research from EHR data in either a piece-meal fashion, selecting only the topics of greatest interest, or a complete guide to the entire research process. Readers will benefit from the intuitive presentation of complex methods with a multitude of examples. It is invaluable reading for researchers and clinicians who are not otherwise familiar with the complexities of working with large data sets.

Secondary Analysis Of Electronic Health Records

Author: MIT Critical Data
Publisher: Springer
ISBN: 3319437429
Size: 63.47 MB
Format: PDF
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This book trains the next generation of scientists representing different disciplines to leverage the data generated during routine patient care. It formulates a more complete lexicon of evidence-based recommendations and support shared, ethical decision making by doctors with their patients. Diagnostic and therapeutic technologies continue to evolve rapidly, and both individual practitioners and clinical teams face increasingly complex ethical decisions. Unfortunately, the current state of medical knowledge does not provide the guidance to make the majority of clinical decisions on the basis of evidence. The present research infrastructure is inefficient and frequently produces unreliable results that cannot be replicated. Even randomized controlled trials (RCTs), the traditional gold standards of the research reliability hierarchy, are not without limitations. They can be costly, labor intensive, and slow, and can return results that are seldom generalizable to every patient population. Furthermore, many pertinent but unresolved clinical and medical systems issues do not seem to have attracted the interest of the research enterprise, which has come to focus instead on cellular and molecular investigations and single-agent (e.g., a drug or device) effects. For clinicians, the end result is a bit of a “data desert” when it comes to making decisions. The new research infrastructure proposed in this book will help the medical profession to make ethically sound and well informed decisions for their patients.

Capturing Social And Behavioral Domains In Electronic Health Records

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309301130
Size: 57.83 MB
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Substantial empirical evidence of the contribution of social and behavioral factors to functional status and the onset and progression of disease has accumulated over the past few decades. Electronic health records (EHRs) provide crucial information to providers treating individual patients, to health systems, including public health officials, about the health of populations, and to researchers about the determinants of health and the effectiveness of treatment. Inclusion of social and behavioral health domains in EHRs is vital to all three uses. The Health Information Technology for Economic and Clinical Health Act and the Patient Protection and Affordable Care Act place new importance on the widespread adoption and meaningful use of EHRs. "Meaningful use" in a health information technology context refers to the use of EHRs and related technology within a health care organization to achieve specified objectives. Achieving meaningful use also helps determine whether an organization can receive payments from the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program. Capturing Social and Behavioral Domains in Electronic Health Records is the first phase of a two-phase study to identify domains and measures that capture the social determinants of health to inform the development of recommendations for meaningful use of EHRs. This report identifies specific domains to be considered by the Office of the National Coordinator, specifies criteria that should be used in deciding which domains should be included, identifies core social and behavioral domains to be included in all EHRs, and identifies any domains that should be included for specific populations or settings defined by age, socioeconomic status, race/ethnicity, disease, or other characteristics.

Systems Practices For The Care Of Socially At Risk Populations

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309391970
Size: 11.50 MB
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The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

Medical Information Extraction And Analysis

Author: Alexander Scarlat
Publisher: Createspace Independent Publishing Platform
ISBN: 9781544093376
Size: 23.70 MB
Format: PDF, ePub, Docs
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Book introduces clinicians to SQL and using hands on examples on MIMIC2 - a publicly available, de-identified ICU database from Beth Israel Deaconess Medical Center and MIT Physionet - it enables care providers to query any database of an Electronic Health Record (EHR) and create meaningful reports to support their quality initiatives. IT professionals will benefit from a structured analysis of the main parameters that interest clinicians: diagnosis, procedure, lab, meds, imaging reports, nursing assessments and interventions, scoring systems, mortality, length of stay, readmissions' rate, costs, etc. Using this book, both clinicians and IT professionals can easily retrieve any information from the data in their EHR and discover new clinical insights hidden in their database. 1. A Brief Database Primer 1 2. MIMIC2 Clinical Database 9 3. MySQL Workbench 12 4. Introduction to the Mighty SELECT 21 5. Aggregate / Summary Functions 48 6. Querying Multiple Tables 63 7. Entity Relationship Diagram - ERD 76 8. Systematic information extraction 91 9. Patient 102 10. Mortality 125 11. Length of stay (LOS) 139 12. Readmissions 145 13. Diagnosis 153 14. Sepsis profile 174 15. Lab 200 16. Drug 217 17. Procedure 230 18. Chart, note and much more 239 19. Provider and care unit 248 20. Nursing 259 21. Fluid 267 22. Score and scale 274 Appendix Answers to Questions

Key Advances In Clinical Informatics

Author: Aziz Sheikh
Publisher: Academic Press
ISBN: 0128095253
Size: 66.90 MB
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Key Advances in Clinical Informatics: Transforming Health Care through Health Information Technology provides a state-of-the-art overview of the most current subjects in clinical informatics. Leading international authorities write short, accessible, well-referenced chapters which bring readers up-to-date with key developments and likely future advances in the relevant subject areas. This book encompasses topics such as inpatient and outpatient clinical information systems, clinical decision support systems, health information technology, genomics, mobile health, telehealth and cloud-based computing. Additionally, it discusses privacy, confidentiality and security required for health data. Edited by internationally recognized authorities in the field of clinical informatics, the book is a valuable resource for medical/nursing students, clinical informaticists, clinicians in training, practicing clinicians and allied health professionals with an interest in health informatics. Presents a state-of-the-art overview of the most current subjects in clinical informatics. Provides summary boxes of key points at the beginning of each chapter to impart relevant messages in an easily digestible fashion Includes internationally acclaimed experts contributing to chapters in one accessible text Explains and illustrates through international case studies to show how the evidence presented is applied in a real world setting