Unit 6 - EMR

1
ELECTRONIC HEALTH
RECORD(EHR)
FEDILA Y (MPH/BHI)
Learning Outcomes
2
After completing this topic you should be able to:

 Define EHR
 Identify the benefits of EHRs
 List the key components of an EHRs
 Define patient monitoring system
 Describe the purpose of patient monitoring system
 Define CDSS
 Discuss the purpose of CDSS
Electronic Health Record (EHR)
3
 The term EHR is widely used in many countries with variation

in definitions and the extent of coverage.
 EHR is generally accepted as a longitudinal health record with
entries by healthcare practitioners in multiple sites where care
is provided patient’s (total health experience over the life span)
 EHR contains all personal health information belonging to an
individual & it is entered & accessed electronically by
healthcare providers over the person’s lifetime.
Advantages Disadvantages
Low starting cost Difficult to retrieve, store
Paper & share
based
4
Simple staff training Illegibility

Medical
Record Less technically Difficult to abstract
System trained staff information
No Downtime(always Easy to destroy/damage
working)
Electroni Enhanced Patient Selection and development

c Health information security of system is time
Components of EHR system
5
 There are many types of EHRS used in healthcare facilities.

However, in all EHR systems, there are two major
components of the system:
1. The administrative modules: support patient registration,

scheduling/appointment, admission/discharge, financial
and other management processes.
2. The clinical modules: enable the users to collect, store

and display clinical information related to preventive and
curative healthcare services.
Benefits of EMR for Health care Practice
6
1. Quality of Care and Patient Safety Benefits. EMRs improve the

quality of patient care by:
 Improving the quality of & access to patient information.
 Reducing clinical errors.
 Helping doctors keep more complete records.
 Giving decision support to practitioners.
 Helping to improve clinical practices.

2. Cost-of-Care Benefits. EMRs can reduce costs by:
 Reducing redundant tests due to unavailability of test
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results.
 Generating & submitting reports automatically.(saving

administrative cost)
 Enhancing productivity through reducing:

 The time spent searching for records.
 Redundant data entry.
 Reducing risks to the patient, and thus unnecessary costs of

care arising out of:
 Decisions that are delayed due to inability to access information.

3. Communication Benefits. EMRs improve
communication by:
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 Improving access to clinical information.
 Improving the sharing of health information among

primary care professionals.
 Improving the flow of information with secondary and

tertiary care teams.
 Providing patients with better access to their own records.

4. Analysis benefits. EMRs improve analysis of health
related data by:
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 Providing easier observation of trends and patterns in

the health of a patient, making clinical audit, outcome
assessment, and research easier.
 Enhancing the ability to analyze data to support

management decision making.
 Enabling the demonstration of clinical competence for

revalidation and certification purposes.
Patient Monitoring Systems
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 What is patient monitoring

 Continuous measurement of patient parameters
such as :
 Heart rate and rhythm
 Respiratory rate
 Blood pressure
 Blood oxygen saturation
 And other parameters in critically ill patients
Cont…
11
patient monitoring can be rigorously defined as

 “repeated or continuous observations or
measurement of the patient physiological

function.
 the function of life supporting equipment, for
the purpose of guiding management

decisions ,including when to make therapeutic
interventions
Cont…
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There are at least five categories of patients who needs

physiological monitoring:
1. Patient with unstable physiological regulatory systems.eg. a pt
whose respiratory system is suppressed by a drug over dose or
anesthesia.
2 A patient with a suspected life threatening conditions.eg.a pt

who has findings indicating an acute myocardial infarction
(heart attack)
3 A pt at high risk of developing a life threatening condition.eg.

Pts immediately after open heart surgery or a premature infant
whose heart and lungs are not fully developed
Cont..
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4.A pt in critical physiological state .e.g.. Pts with

multiple trauma or septic shock.
5.mother and baby during the labor and delivery

process
Cont..
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uses computers in ICU for the following purposes :

 To acquire physiological data frequently or
continuosly.eg BP reading
 Communicate information from data producing
systems to remote locations. E.g. lab department.

 To store ,organize and report data
 To integrate and correlate data from multiple
sources.
Cont..
15
 To provide clinical alert and advisors based on

multiple sources of data
 To function as a decision tool that health

professionals may use in planning the care of
critical ill patients.
 To measure the severity of illness for patient

classification purposes
Advantages of using micro processors
16
in bedside monitors Cont…
 The digital computers ability to store pt wave form
information such as ECG permits sophisticated
pattern recognition and physiological signal feature
extraction. This is used to classify ECG arrhythmias.
 Physiological signals can be acquired more
efficiently by converting them to digital form early
in the processing cycle. This process simplifies the
nurse’s task of setting up and operating the bed side
monitor by eliminating the manual calibration step.
Clinical Decision Support Systems (CDSS)
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 CDSS is an interactive decision support system,

which is designed to assist physicians and other
health professionals with decision making tasks,
as determining diagnosis of patient data.
 CDSS is an application that analyzes data to help

healthcare providers make clinical decisions.
Purpose/Goal
 To assist clinicians at the point of care. This means that a
clinician would interact with a CDSS to help determine
diagnosis, analysis, etc of patient data.
 Previous theories of CDSS were to use the CDSS to

literally make decisions for the clinician. The clinician
would input the information and wait for the CDSS to
output the “right” choice and the clinician would simply
act on that output.
 These tools include alerts, reminders and documentation
templates aimed at improve clinical processes and outcomes
Purpose…
 Alerts and reminders deliver information at the

point of care in a way that gets the provider’s
attention
• Alerts and reminders can appear as pop-up boxes,
strategically placed reminder lists, or changes in

visual presentation such as font or color
• The design of an alert or reminder will vary with
the type of information being presented and its

relative importance
Purpose …
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 The new methodology of using CDSS to assist forces

the clinician to interact with the CDSS utilizing both
the clinician’s knowledge and the CDSS to make a
better analysis of the patients data than either human or
CDSS could make on their own.
 Typically the CDSS would make suggestions of

outputs or a set of outputs for the clinician to look
through and the clinician officially picks useful
information and removes erroneous CDSS suggestions.
Functional view

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1

After completing this topic you should be able to:

 The term EHR is widely used in many countries with variation

Simple staff training Illegibility

Electroni Enhanced Patient Selection and development

 There are many types of EHRS used in healthcare facilities.

1. The administrative modules: support patient registration,

2. The clinical modules: enable the users to collect, store

1. Quality of Care and Patient Safety Benefits. EMRs improve the

 Improving the quality of & access to patient information.

 Reducing clinical errors.

 Helping doctors keep more complete records.

 Giving decision support to practitioners.

 Helping to improve clinical practices.

 Generating & submitting reports automatically.(saving

 Enhancing productivity through reducing:

 Reducing risks to the patient, and thus unnecessary costs of

 Improving access to clinical information.

 Improving the sharing of health information among

 Improving the flow of information with secondary and

 Providing patients with better access to their own records.

 Providing easier observation of trends and patterns in

 Enhancing the ability to analyze data to support

 Enabling the demonstration of clinical competence for

 What is patient monitoring

patient monitoring can be rigorously defined as

measurement of the patient physiological

the purpose of guiding management

There are at least five categories of patients who needs

2 A patient with a suspected life threatening conditions.eg.a pt

3 A pt at high risk of developing a life threatening condition.eg.

4.A pt in critical physiological state .e.g.. Pts with

5.mother and baby during the labor and delivery

uses computers in ICU for the following purposes :

systems to remote locations. E.g. lab department.

 To integrate and correlate data from multiple

 To provide clinical alert and advisors based on

 To function as a decision tool that health

 To measure the severity of illness for patient

 CDSS is an interactive decision support system,

 CDSS is an application that analyzes data to help

 Previous theories of CDSS were to use the CDSS to

 Alerts and reminders deliver information at the

strategically placed reminder lists, or changes in

the type of information being presented and its

 The new methodology of using CDSS to assist forces

 Typically the CDSS would make suggestions of

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