OPTIMIZING HEALTHCARE DELIVERY: THE ROLE OF ELECTRONIC MEDICAL RECORDS (EMRS) IN STREAMLINING PROCESSES
Main Article Content
Keywords
Electronic medical records and primary healthcare.
Abstract
Electronic medical records are seen as a potential solution to healthcare system problems. The purpose of this article is to this article reviews relevant literature and offers advice based on decades of experience using medical records in primary care. These recommendations can assist primary care doctors in organizing their work processes and improving patient care. The lack of interoperability and standardization of interfaces across these systems hinders effective collaboration and information exchange for complex patient care. Establishing regional and national health policy ensures system uniformity and interoperability. Lack of interoperability leads to fragmentation in the information environment. The electronic medical record (EMR) has the potential to significantly improve patient care. When implemented correctly, electronic medical records (EMRs) can enhance healthcare service quality and reliability. To maximize the potential of EMRs to improve patient care, it's crucial to consider their impact on clinical workflows. This is a significant takeaway from our experience with their deployment and use.
Downloads
References
1. Dick RE. The Computer-Based Patient Record. Washington:National Academies Press; 1997. 2. National Coordinator for Health Information Technology (ONC). HealthIT.gov. (2017, October 5).Health IT and Health Information Exchange Basics.[cited Sept 10, 2019]. Available from: https://www.healthit.gov/topic/health-it-basics/benefits-ehrs 3. Hillestad RE, Bigelow J, Bower A, Girosi F, Meili R,Scoville R, Taylor R. Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, and Costs. Health Affairs 2005;24(5):1103-1117. 4. Schulte F, Frye E. Death by a Thousand Clicks. Fortune2019; Mar 18. 5. Gorn D. These doctors think electronic records arehurting their relationships with patients. 2017, July 21.[cited Sept 10, 2019]. Available from: https://www.pbs.org/newshour/health/doctors-think-electronic-health-records-hurting-relationships-patients 6. Peikes DE. Independent Evaluation of Comprehensive Primary Care Plus (CPC+). Princeton: Mathematics Policy Research; 2019. 7. World Health Organization (WHO). WHO Frameworkon Integrated Person Centered Health Services.Geneva: WHO; 2019. [cited Sept 10, 2019]. Availablefrom: https://www.who.int/servicedeliverysafety/areas/people-centred-care/en/ 8. American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians,American Osteopathic Association. (2017,March). Joint Principles of the Patient Centered Medical Home. [cited Sept 10, 2019]. Available from: http:// www.aafp.org/dam/AAFP/documents/practice management/ pcmh/initiatives/PCMHJoint.pd 9. Wagner ECK. Guiding Transformation: How Medical Practices Can Become Patient Centered Medical Homes. New York: The Commonwealth Fund; 2012. 10. Holroyd-Leduc JL, Straus S, Sykes L, Quan H. The impact of the electronic medical record on structure, process, and outcomes within primary care: a systematic review of the evidence. J Am Med Inform Assoc 2011; 18(6):732-737. 11. Kemper A., Uren R, Clark S. Adoption of electronic health records in primary care pediatric practices. Pediatrics 2006; 118(1):e20-24. 12. Chen C, Garrido T, Chock D, Okawa G, Liang L. The Kaiser Permanente Electronic Health Record: transforming and streamlining modalities of care. Health Aff (Millwood) 2009; 28(2):323-333. 13. Zhou Y, Garrido T, Chin H, Wiesenthal A, Liang L. Patient access to an electronic health record with secure messaging: impact on primary care utilization. Am J Manag Care 2007; 13(7):418-424. 14. Fleming N, Culler S, McCorkle R, Becker E, Ballard D.The financial and nonfinancial costs of implementing electronic health records in primary care practices. Health Aff (Millwood) 2011; 30(3):481-489. 15. Gallego A, Gagnon M, Desmartis M. Assessing the cost of electronic health records: a review of cost indicators. Telemed J E Health 2010; 16(9):963-972. 16. Pizziferri L, Kittler AF, Volk LA, Honour MM, Gupta S, Wang S, Wang T, Lippincott M, Li Q, Bates DW. Primary care physician time utilization before and after implementation of an electronic health record: a time-motion study. J Biomed Inform 2005; 38(3):176- 188. 17. O’Donnell A, Kaner E, Shaw C, Haighton C. Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework. BMC Med Inform Decis Mak 2018 13; 18(1):101. 18. Saleem JJ, Flanagan ME, Russ AL, McMullen CK, Elli L, Russell SA, Bennett KJ, Matthias MS, Rehman SU, Schwartz MD, Frankel RM. You and me and the computer makes three: variations in exam room use of the electronic health record. J Am Med Inform Assoc 2014; 21(e1):e147-151. 19. Rathert C, Mittler J, Banerjee S, McDaniel J. Patient-centered communication in the era of electronic health records: What does the evidence say? Patient Educ Couns 2017; 100(1):50-64. 20. Montague E, Asan O. Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention. Int J Med Inform 2014; 83(3):225-234. 21. Alkureishi MA, Lee WW, Lyons M, Press VG, Imam S, Nkansah-Amankra A, Werner D, Arora VM. Impact of Electronic Medical Record Use on the Patient-Doctor Relationship and Communication: A Systematic Review. J Gen Intern Med 2016; 31(5):548-560. 22. Irani JS, Middleton JL, Marfatia R, Omana ET, D’Amico F. The use of electronic health records in the exam room and patient satisfaction: a systematic review. J Am Board Fam Med 2009; 22(5):553-562. 23. Shachak A, Reis S. The impact of electronic medical records on patient-doctor communication during consultation: a narrative literature review. J Eval Clin Pract 2009; 15(4):641-649. 24. Kruse C, Stein A, Thomas H, Kaur H. The use of Electronic Health Records to Support Population Health:A Systematic Review of the Literature. J Med Syst 2018; 42(11):214. 25. Campanella P, Lovato F, Marone C, Fallacara L, Riocciardi W, Specchia M. The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. Eur J Public Health 2016; 26(1):60-64. 26. Ojeleye O, Avery A, Gupta V, Boyd M. The evidence for the effectiveness of safety alerts in electronic patient medication records systems at the point of pharmacy order entry: a systematic review. BMC Med Inform Decis Mak 2013; 13:69. 27. Gill J, Ewen E, Nsereko M. Impact of an electronic medical record on quality of care in a primary careoffice. Del Med J 2001; 73(5):187-194. 28. Ruffin M, Plegue M, Young A, Patel D, Yeazel M. Impact of an Electronic Health Record (EHR) Reminder on Human Papillomavirus (HPV) Vaccine Initiation and Timely Completion. J Am Board Fam Med 2015; 28(3):324-333. 29. Moody-Thomas S, Nasuti L, Yi Y, Celestin MD Jr,Horswell R, Land TG. Effect of systems change and use of electronic health records on quit rates among tobacco users in a public hospital system. Am J Public Health 2015; 105(Supl. 2:e1-7). 30. Huber M, Highland J, Krshnamoorthi V, Tang J. Utilizing the Electronic Health Record to Improve Advance Care Planning: A Systematic Review. Am J Hosp Palliat Care 2018; 35(3):532-541. This is an Open Access article distributed under the terms of CC BY the Creative Commons Attribution License 31. Cebul R, Love T, Jain A, Hebert C. Electronic health records and quality of diabetes care. N Engl J Med 2011; 365(24):2338-2339. 32. Kuo A, Dang S. Secure Messaging in Electronic Health Records and its Impact on Diabetes Clinical Outcomes: A Systematic Review. Telemed J E Health 2016; 22(9):769-777. 33. Lessing SE, Hayman LL. Diabetes Care and Management Using Electronic Medical Records: A Systematic Review. J Diabetes Sci Technol 2019; 13(4):774-782. 34. Menachem N, Collum T. Benefits and drawbacks of electronic health systems. Risk Manag Healthc Policy 2011; 4:47-55. 35. Howe J, Adams K, Hettinger A, Ratwani R. Electronic Health Record Usability Issues and Potential Contribution to Patient Harm. JAMA 2018; 319(12):1276-1278. 36. Agency for Healthcare Research and Quality (AHRQ). Patient Safety Primer--Ambulatory Care Safety. (2019,January). [cited Sept 10, 2019]. Available from: https://psnet.ahrq.gov/primers/primer/16/patient-safety-in-ambulatory-care 37. American College of Physicians. Patient Safety in the Office-Based Practice Setting. Philadelphia: American College of Physicians; 2017. 38. Sinsky C, Bodenheimer T. Powering-Up Primary Care Teams: Advanced Team Care with in-room support. Annals of Family Medicine; 2019. 39. Bodenheimer T. Building Powerful Primary Care Teams. Mayo Clin Proc 2019; 94(7):1135-1137. 40. Misra-Herbert A, Amah L, Rabovsky A, Morrison S,Cantave M, Hu B, Rothberg M. Medical scribes: How do their notes stack up? J Fam Pract 2016; 65(3):155-159. 41. Anderson P, Halley M. A New Approach to Making Your Doctor-Nurse Team More Productive. Fam Pract Manag 2008; 15(7):35-40. 42. Solet DJ, Norvell JM, Rutan GH, Frankel RM. Lost in translation: challenge and opportunities in physician- to-physician communication during patient hand-offs. Acad Med 2005; 80(12):1094-1099. 43. The Joint Commission. (2018, January). Transitions of Care: The need for a more effective approach to continuing patient care. [cited Sept 10, 2019]. Available from: https://www.jointcommission.org/assets/1/18/ Hot_Topics_Transitions_of_Care.pdf
Issue
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.