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Electronic Health Records, Personal Health Records & Meaningful Use นพ.นวนรรน ธีระอัมพรพันธุคณะแพทยศาสตร์ รพ.รามาธิบดี 2 พฤศจิกายน 2557 http://www.slideshare.net/nawanan

EHRs, PHRs and Meaningful Use

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  • 1. Electronic Health Records,Personal Health Records &Meaningful Use. .2 2557http://www.slideshare.net/nawanan

2. (Electronic Health Records) (Electronic Medical Records) 3. (Medical Records) 4. ? (Medical Records) vs. (Health Records) Health Records 5. Class Discussion #1 ? ? 6. (Continuity of Care) (chronic diseases) (follow-up) (drug allergies), list of current medications,problem list 7. (Consultation) (Medico-legal purposes) 8. (Claims & Reimbursements) (Audit) 9. Electronic Medical Records Electronic documentation of health care provided to patients, asrecorded by providers Ideally longitudinal (e.g., life-long) records Electronic Medical Records vs. Electronic Health Records EMRs snapshot 1 EHRs (longitudinal records) 10. Example of a Longitudinal Record 11. EHRs vs. EMRs 2 EMRs EHRs (Scanned Medical Records) (Fully-Electronic or Structured EHRs) 12. EHRs 13. Class Exercise #2 ? 14. (EHRs) (anytime, anywhere, everyone ) !!!!! () workflow Process improvement business process reengineering/redesign !!!!! 15. Are they just electronic documentation?Diag-nosisHistory& PETreat-ments Or do they have some other values?EHR Systems... 16. Functions that Should be Part of EHR Systems Computerized Medication Order Entry (IOM, 2003; Blumenthal et al,2006) Computerized Laboratory Order Entry (IOM, 2003) Computerized Laboratory Results (IOM, 2003) Physician Notes (IOM, 2003) Patient Demographics (Blumenthal et al, 2006) Problem Lists (Blumenthal et al, 2006) Medication Lists (Blumenthal et al, 2006) Discharge Summaries (Blumenthal et al, 2006) Diagnostic Test Results (Blumenthal et al, 2006) Radiologic Reports (Blumenthal et al, 2006) 17. EHR Systems EHR system function EHR system Clinical Information System HospitalInformation System 18. (Personal Health Records) Consumer HealthInformatics 19. Consumer Health Informatics (CHI) The field devoted to informatics from a consumerview. (Hersh, 2009) 20. M/B/H Informatics As A Field(Hersh, 2009) 21. Examples of Areas withinConsumer Health InformaticsImage Source: http://www.webmd.com/ 22. Examples of Areas withinConsumer Health Informatics:Health LiteracyImage Source: http://nutrition.about.com/od/recipesmenus/ss/learnlabels.htm 23. Examples of Areas withinConsumer Health Informatics:Health LiteracyImage Source: http://www.hon.ch/, http://socialmarketing.blogs.com/r_craiig_lefebvres_social/2007/02/health_literacy.html 24. Examples of Areas withinConsumer Health Informatics:Social Media & Social Networking SitesImage Source: http://michaelcarusi.com/2012/01/01/when-you-should-not-become-a-social-media-manager/ 25. Examples of Areas withinConsumer Health Informatics:Consumer-oriented m-HealthImage Source: http://ucedtech.wikispaces.com/Welcome 26. mHealthhttp://whqlibdoc.who.int/publications/2011/9789241564250_eng.pdf 27. Class ExerciseAS A HEALTHCARE CONSUMER,WHAT WOULD YOU WANT FROM ICT?EXAMPLES? 28. Roles of ICT inConsumer Health Informatics Access to information Networking opportunities Education/Self-study Personalization Effective & efficient communications Empowerment User Experience 29. Issues in Consumer Health Informatics Health literacy & IT literacy Cultural diversity & sensitivity Usability, information presentation Impact of ICT on behavioral modifications Integration with providers systems Information exchange & interoperability Business model Privacy & security 30. (Personal Health Records) 31. Personal Health Records (PHRs) An electronic application through which individuals canaccess, manage and share their health information, and thatof others for whom they are authorized, in a private, secure,and confidential environment. (Markle Foundation, 2003) A PHR includes health information managed by theindividual... This can be contrasted with the clinicians recordof patient encounterrelated information [a paperchart orEHR], which is managed by the clinician and/or health careinstitution. (Tang et al., 2006) 32. Types of PHRs Patient portal from a providers EHRs (tethered PHRs) Online PHRs Stand-alone Can be integrated with EHRs from multiple providers(unidirectional/bidirectional data sharing) Stand-alone PHRs PC-based applications USB Drive CD-ROM or other data storage devices Paper 33. PHRs and Other Systems(Tang et al., 2006) 34. Ideal PHRs Integrated Accessible Secure Comprehensive Accurate & current Patient able tomanage sharing &update information Engaging &educational User-friendly,culturally & literacyappropriateThe Hub and Spoke Model(Kaelber et al., 2008) 35. Use Cases of PHRs Data entry/update by patients Data retrieval by providers With patients consent Break-the-glass emergency access Data update from EHRs Privacy settings Personalized patient education Communications with providers 36. Data in PHRs(Tang et al., 2006) 37. Other IT for Consumer HealthTraditional Web MedlinePlus Other sitesSocial Media The Usuals: MySpace, Facebook, Twitter Blogs, forums PatientsLikeMeTelemedicine & Telehealth Home monitoring/recording devices Tele-consultations, virtual visits http://media.nstda.or.th/video/viewVideo.php?video_id=1273 38. The FutureMicrosoft Health: Future Visionhttp://www.microsoft.com/showcase/en/us/details/b112da1c-c918-41ee-bb45-d6a553496168 39. Next:Meaningful Use of EHRs 40. References Blumenthal D, DesRoches C, Donelan K, Ferris T, Jha A, Kaushal R, Rao S, Rosenbaum S.Health information technology in the United States: the information base for progress[Internet]. Princeton (NJ): Robert Wood Johnson Foundation; 2006 [cited 2010 Oct 14].81 p. Available from: http://www.rwjf.org/files/publications/other/EHRReport0609.pdf Hersh W. A stimulus to define informatics and health information technology. BMC MedInform Decis Mak. 2009;9:24. Institute of Medicine, Board on Health Care Services, Committee on Data Standards forPatient Safety. Key Capabilities of an electronic health record system: letter report[Internet]. Washington, DC: National Academy of Sciences; 2003 [cited 2010 Oct 14]. 31p. Available from: http://www.nap.edu/catalog/10781.html