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High-Yield Facts

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  • Electronic Health Records (EHRs) are evolving as an integral technology for use in medical practice. They have the potential to improve quality and safety in modern health care, and reduce cost.

  • “Meaningful use” is the set of standards, defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that must be met by eligible providers and hospitals to earn incentive payments.

  • Clinical decision support (CDS) is an important element in improving healthcare delivery. It is also a measure of “meaningful use.”

  • The emergency department electronic medical records (ED EMRs) should be integrated with the hospital EHR, preferably as different faces or displays of the same EHR system.

  • The ED EMR module must have additional special features to optimally match the workflow of the ED, including a dynamic status board and ability to create a chart quickly.

  • ED EMR documentation for teaching physicians must comply with CMS regulations.

  • The ED is a 24/7 dynamic service. It is important to have a clear down time policy and procedure in case the system fails partially or completely.

  • There is a large gap between the postulated and empirically demonstrated benefits of eHealth technologies. It is vital that future eHealth technologies are evaluated against a comprehensive set of measures.

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Introduction

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Implementation of potentially transformative electronic health technologies are underway both nationally and internationally, often with significant impact on national expenditures. The US Federal Government committed to a $38 billion eHealth investment in health care. Similarly, England invested at least £12.8 billion in the National Program for Information Technology (NPfIT) for the National Health Service (NHS).1

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Such large-scale expenditures have been justified based on the belief that technology can help address the problems of variable quality and safety in modern health care through the use of electronic health records (EHRs), picture archiving and communication systems (PACS), electronic prescribing (ePrescribing), computerized provider (or physician) order entry (CPOE) systems, and computerized decision support systems (CDSs). However, there is a gap between the postulated and empirically demonstrated benefits of eHealth technologies. Despite being frequently promoted by policymakers and “techno-enthusiasts,” there is little convincing research demonstrating that these technologies are cost effective. To maximize the likelihood of successful implementation and adoption of an electronic system, these assessments should pay careful attention to sociotechnical factors that occur throughout all stages of a technology's life cycle.2

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Electronic Medical Record Versus Electronic Health Record
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The electronic medical record (EMR) is an application environment, composed of clinical data repositories, clinical documentation, CDS tools, controlled medical vocabulary order entry, and pharmacy systems. This environment supports the patient's EMR across both inpatient and outpatient settings and is used by healthcare practitioners to document, monitor, and manage healthcare delivery within a care-delivery organization. The data in the EMR is the legal record of what happened to a patient during his or her encounter at the organization and ...

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