Healthcare informatics
Capabilities of various decision support
Computerized physician order entry
Allows entry of medical order and instructions for treatment of patient by a doctor
Medication reconciliation
Allows matching and verification of the current medications with the patient record or
medication order
Computerized prescribing
Helps to keep track of the kind of prescriptions of the medical practitioner
Clinical decision support
Helps clinicians to make decision based on the patient information input in the
computer by refereeing to the existing medical evidence
Benefits of the support system
Computerized physician order entry
Decrease delay in order completion as well as errors related to handwriting
Challenge
It requires proper implementation and application
Resolving the challenge
Proper implementation
Training to medical practitioner on its use
Needs assessment
Area requiring assessment is health information
exchanges
Functional needs
Computers
Manual guides
Training kit
Skills and knowledge on how to use the system to
share information
Staff concerns
Requisite skills to use the platform- Require
additional training
EHR comparison
HER affects privacy when information of the patient is not protected
The system should be protected with antivirus to avoid data loss
Physical security to deter thieves from carrying the machines
Using of passwords to restrain access by unauthorized persons
The system should meet the recommended standards
They should be authorized by the government to ascertain their
authenticity
Project plan elements
The goals and the objectives
The project manager and team members
Financial requirement
Time for implementation
Project team
Team will be formed based on the kind of the project
The skills required among team members
The duration the project will take
Team members must be competent with requisite skills
Team members’ value
Team members must bring value to the entire team
Team leaders ensures that the team is united and with similar goals
Team members cooperate with each other to ensure the project
succeeds
Practice benefits
Facilitate efficiency and accuracy in business function and
management of aspects of health care
Provide decision support to medical staffs hence enhance quality
and patient safety
Functional application
EHR that can be implemented:
Hospital: Clinical decision
Nursing home: Medication reconciliation
Dental office: Computerized prescribing
Justification on cost-benefit analysis
Allows assessment of the benefits of the system compared to the cost incurred
It is a decision strategy
Low cost vendor with high quality services is selected
Difference
A request for information aims to get more information about a particular issue
Request for proposal is a request for ideas and opinions about how something should be done
Preferred
One of the above may be proffered based on the nature or stage of implementation.
Information is request for clarification and for improvement
Proposal is requested before implementation of the project
Use
Both may b used because they help in successful completion of a project.
Ideas are required as well as information on the implementation of a project
Writing
Information include
The aim of the proposal
The benefit for the proposal
The kind of the project
The team to implement
Resources availability
Time allocated
Contact person
Information is key to success of the project
Contact person coordinate communication
Team members will be appointed to assume the role
Working relationship
Members will work with each other
Cordial relationship builds on trust and honest
Leadership will unite the members
Positive relationship with the stakeholders
Acute are applications
Computerized physician order entry
Medication reconciliation
Computerized prescribing
Clinical decision support
Acute are applications
Computerized physician order entry: Proper record management
Medication reconciliation: Decision-making
Computerized prescribing: Proper medical prescription
Clinical decision support: Clinical reporting quality management
Acute care human resources
Competent and qualified staffs to operate the systems
Introducing new technology
Introduction should be systematic and piecemeal
It allows the staffs to learn the new technology as they still use the old system
His reduces inconveniences incase of failure of the new system
Outpatient application
Medication reconciliation: Decision-making
Computerized prescribing: Proper medical prescription
Computerized physician order entry: Proper record management
Outpatient application use
Medication reconciliation: Decision-making
Computerized prescribing: Proper medical prescription
Computerized physician order entry: Proper record management
Outpatient human resources
Competent staffs to enhance the changes
Model comparisons
Consolidate/centralized mode data stored in a single warehouse
Decentralized model/federated/distributed model
Data is a the point of service
Members share communication with others.
Exchange benefits of health information exchanges
Ensures similarities in the information hence enhancing quality of care
Enhances efficiency
Exchange challenges
It is a complex and expensive to maintain
Failure in one system may hamper operation of the other system
Providing health records
Factors to consider
The security
The privacy- gets informed consent
The legality question complaisance to the law on
information disclosure
Organizations
Examples of organizations include
John Hopkins
Mayo clinic
Qualities of personal health records
Should be accurate
Based on the evidence of the information provided
Should be authentic
Activity
Duration
Planning
2 month
Team formation
1 month
Commencing time
Implementation
Evaluation
Timeline implementation
Timeline development
Calculation
Sharing
Brainstorming
Based on the nature of the tasks
Project member roles
Team members play various roles
Ensure that the system is well implemented
Work closely with one another
Ensure that the workers are able to operate-training
Ensure that there is monitoring and evaluation
Ensure that resources are utilized well
Team manager role
Overseas the overall project
Provide guidance
Ensure the project runs smoothly
Solves conflicts
Work flow
EHR will improve on flow of work
Less staff will execute roles
Will enhance efficiency
The work load will also reduce
Challenges in implementing HER
Financial support
Lack of support
Adamant to change
Lack of people with information on their operation
Recommended solutions
Training of employees
Convincing the people to accept change
Implementing the project piecemeal
Using example of other organization with the system
Utilizing resources well
Organizational impact
Will improve service delivery
Makes the organization to be perceived positively
S improve the profitability of the organization through service efficiency
Enhance medical decision-making process
Inclusion of quality data in the system
Enhances strategic planning
References
Bredfeldt, C., Awad, E., Joseph, K., & Snyder, M. (2013).Training providers: beyond the basics of electronic health records. BMC Health
Services Research, 13(1):1-14.
Davidson, R., Fletcher, S., & Retchin S, et al. (1990). A nurse-initiated reminder system for the periodic health examination.
Implementation and evaluation. Arch Intern Med. 44:2167–70.
Francis, T. (2013). Electronic Health Records: Where we are and where we’re going. Physician Executive, 39(4): 82-84.
Friedman, D., Parrish, R., & Ross, D. (2013). Electronic Health Records and US Public Health: Current Realities and Future Promise.
American Journal of Public Health, 103(9): 1560-1567.
Healthcare IT news. (2014). Computerized physician order entry (CPOE). Retrieved from:
http://www.healthcareitnews.com/directory/computerized-physician-order-entry-cpoe
HIE answers. (2014). Health information exchange models. Retrieved from: http://www.hieanswers.net/hie-fundamentals/hie-models/
King, J., Paice, N., & Rangrej, J. et al. (2003). The effect of computerized physician order entry on medication errors and adverse drug
events in pediatric inpatients. Pediatrics,112:506–9
Lee, A. (2013). 5 Things to Know About Electronic Health Records, 42( ): 1-10.
Nancy, S., Charle, C., & Shobha, P. (2010). Chapter 47Patient Safety and Health Information Technology: Role of the Electronic Health
Record, patient Safety and Quality: An Evidence-Based Handbook for Nurses