Electronic Health Records
Bruce Slater, MD, MPH
University of Wisconsin
School of Medicine and Public Health
[email protected]
Objectives
• Compare the History of Paper and
Electronic Patient Records
• Describe Major Elements of the Electronic
Health Record
• Explain how the Electronic Health Record
is Different to the Paper Patient Chart
Introduction
• Healthcare lags in information system use
• Computers are used in financial
transactions
• Some clinicians use the web for
information
• Only a few MDs store records
electronically
• Computers could solve efficiency, access
and quality needs for providers who adopt
Definitions
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EPR - Electronic Patient Record
EMR - Electronic Medical Record
CbPR - Computer-based Patient Record
CPRS - Computer Patient Record System
EHR – Electronic Health Record
Client-Server
ASP - Application Service Provider
History of Physical Records
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Shaman - oral traditions
Hospitals - written ward records
Florence Nightingale - patient records
Source Oriented Records
Problem Oriented Records
Lost & Incomplete Records
History of Virtual Records
• PROMIS - Problem Oriented Medical
Information System - Larry Weed, MD
• COSTAR - Computer Stored Ambulatory Record
• Practice Partner
• Medicalogic/Logician/GE Centricity
• EpicCare
• The Web
History of Virtual Records
• PROMIS - Problem Oriented Medical
Information System - Larry Weed, MD
• COSTAR - Computer Stored Ambulatory Record
• Practice Partner
• Medicalogic/Logician/Centricity
• EpicCare
• The Web
Elements of Paper Medical
Records
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Physical Folder
Labels and Flags
Demographic and Insurance Page
Problem and Medication/Allergy List
Dividers
Progress Notes and Consults
Results of Tests and Imaging
Elements of Paper Medical
Records
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Physical Folder
Labels and Flags
Demographic and Insurance Page
Problem and Medication/Allergy List
Dividers
Progress Notes and Consults
Results of Tests and Imaging
Elements of Paper Medical
Records
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Physical Folder
Labels and Flags
Demographic and Insurance Page
Problem and Medication/Allergy List
Dividers
Progress Notes and Consults
Results of Tests and Imaging
Elements of Electronic Health
Records
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No Physical Location - a Virtual Record
Multiple kinds of Labels and Flags
Demographic and Insurance Tables
Problem/Medication/Allergy Checking
Dividers of any kind imaginable
Progress Notes and Consults
Results and Actual Tests and Imaging
Elements of Electronic Health
Records
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No Physical Location - a Virtual Record
Multiple kinds of Labels and Flags
Demographic and Insurance Tables
Problem/Medication/Allergy Checking
Dividers of any kind imaginable
Progress Notes and Consults
Results and Actual Tests and Imaging
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Elements of Electronic Health
Records not in Paper Records
Security
Transportability
Flexibility
Consistency
Reminders
Intelligence
Link-Outs
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Provider Education
Patient Education
Patient Participation
Problem Orientation
Audit
Demand
Management
• Access Management
Elements of Electronic Health
Records not in Paper Records
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Security
Transportability
Flexibility
Consistency
Reminders
Intelligence
Link-Outs
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Provider Education
Patient Education
Patient Participation
Problem Orientation
Audit
Demand
Management
• Access Management
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Elements of Electronic Health
Records not in Paper Records
Security
Transportability
Flexibility
Consistency
Reminders
Intelligence
Link-Outs
•
•
•
•
•
•
Provider Education
Patient Education
Patient Participation
Problem Orientation
Audit
Demand
Management
• Access Management
Elements of Electronic Health
Records not in Paper Records
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•
•
•
•
•
•
Security
Transportability
Flexibility
Consistency
Reminders
Intelligence
Link-Outs
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•
•
•
•
•
Provider Education
Patient Education
Patient Participation
Problem Orientation
Audit
Demand
Management
• Access Management
Electronic Health Records in
Electronic Commerce
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Merge into Patient’s and Provider’s Lives
Create a Need
Fulfill the Need
Extend the Need
Assimilate Information into their Lives
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Electronic Health Records and
the Clinical Data Repository
Patient-centered Real-time
Operational Coded
Clinical Data
Data Dictionary
Provider Interface is Built on the
Repository
• Population based Care and Research
Examples
• Practice Partner
• Logician Internet
• Patient Profile v 4.0
Practice Partner
Screen shot
here then
demo
Logician Internet
Patient Profile v4.0
Summary/Conclusions
• Electronic Health Records will change
healthcare
• We have only seen the first engagements
of the war between the bricks and the
clicks
• The next conflict will be bricks versus
bricks with clicks.
• Patients may be able to shape the future
Questions and Discussion
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Electronic Health Records