Medical Records

Big Data and Public Health – POST Note – Parliament [UK] – 22 July 2014

Posted on August 1, 2014. Filed under: Health Informatics, Medical Records, Research |

Big Data and Public Health – POST Note – Parliament [UK] – 22 July 2014

“Patient health records and other large scale medical and administrative datasets are increasingly being considered as a valuable tool for the study and improvement of health. This POSTnote examines the sources of data, their current and potential uses for health improvement, and the legal and practical issues raised by data use for public health or research purposes.”

 

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NLM [US National Library of Medicine] Eligible Hospital Clinical Quality Measure Value Sets – Value Set Authority Center Publishes Annual Update for 2014

Posted on April 14, 2014. Filed under: Clin Governance / Risk Mgmt / Quality, Health Informatics, Medical Records |

NLM [US National Library of Medicine] Value Set Authority Center Publishes Annual Update for 2014

“Eligible Hospital Clinical Quality Measure Value Sets

The National Library of Medicine (NLM) Value Set Authority Center (VSAC), in collaboration with the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), has published the annual update for the 2014 Eligible Hospital Clinical Quality Measure (CQM) Value Sets. The update includes revised value sets to address deleted and remapped codes in the latest terminology versions, as well as new codes for addressing CQM logic corrections and clarifications. The Centers for Medicare & Medicaid Services (CMS) updates these electronic reporting specifications annually to ensure that the specifications align with current clinical guidelines and terminologies, and that they remain relevant and actionable within the clinical care setting.

The VSAC offers a Downloadable Resource Table, accessible from the Download tab on the VSAC Web page, that provides prepackaged downloads for the most recently updated and released 2014 CQM Value Sets, as well as for previously released versions. Access to the Value Set Authority Center requires a free Unified Medical Language System® Metathesaurus License. NLM also provides the Data Element Catalog that identifies data element names (value set names) required for capture in electronic health record technology certified under the 2014 Edition of the ONC Standards and Certification Criteria.”

… continues on the site

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Security risk assessment – HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR) – 28 March 2014

Posted on April 1, 2014. Filed under: Health Informatics, Medical Records | Tags: |

Security risk assessment – HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR) – 28 March 2014

Press release: HHS releases security risk assessment tool to help providers with HIPAA compliance – HHS.gov – 28 March 2014

“A new security risk assessment (SRA) tool to help guide health care providers in small to medium sized offices conduct risk assessments of their organizations is now available from HHS.

The SRA tool is the result of a collaborative effort by the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR). The tool is designed to help practices conduct and document a risk assessment in a thorough, organized fashion at their own pace by allowing them to assess the information security risks in their organizations under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The application, available for downloading at http://www.HealthIT.gov/security-risk-assessment also produces a report that can be provided to auditors.

HIPAA requires organizations that handle protected health information to regularly review the administrative, physical and technical safeguards they have in place to protect the security of the information. By conducting these risk assessments, health care providers can uncover potential weaknesses in their security policies, processes and systems. Risk assessments also help providers address vulnerabilities, potentially preventing health data breaches or other adverse security events. A vigorous risk assessment process supports improved security of patient health data.”

… continues on the site

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Health sector data protection audits highlight areas for improvement – Information Commissioner’s Office [UK] – 18 March 2014

Posted on March 21, 2014. Filed under: Health Informatics, Medical Records |

Health sector data protection audits highlight areas for improvement – Information Commissioner’s Office [UK] – 18 March 2014

“An Information Commissioner’s Office report today gives a snapshot of organisations providing secondary health care and how they are complying with the Data Protection Act.

The report summarises key findings from 19 audits carried out primarily with NHS Trusts by the ICO. The audits looked at how personal data is handled by the organisation, and fit alongside NHS information governance guidelines. The organisations voluntarily agreed to work with the ICO to identify good practice and, where necessary, improve procedures relating to the handling of personal data.

The Audits found:”

… continues on the site

 

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Patient Consent for Electronic Health Information Exchange – Office of the National Coordinator for Health Information Technology

Posted on September 19, 2013. Filed under: Health Informatics, Medical Records, Patient Participation | Tags: , , |

Patient Consent for Electronic Health Information Exchange – Office of the National Coordinator for Health Information Technology

“Electronic health information exchange (eHIE) — the way that health care providers share and access health information using their computers — is changing rapidly. One way some providers share and access information is through a third-party organization called a health information exchange organization (HIE).

HIEs help route information among various participating providers. In some HIEs, a provider can send out an electronic broadcast query that asks all provider participants whether they have information on a specific patient.

As eHIE increases, patient trust in HIEs must be ensured and patients may more often be asked to make a “consent decision.” This consent decision concerns the sharing and accessing of the patient’s health information through an HIE for treatment, payment, and health care operations purposes. When patients are asked to make consent decisions, we encourage providers, HIEs, and other health IT implementers to help patients make the consent decision meaningful.

Implementers can enable meaningful consent by ensuring they consider the key parts displayed in the image to the right.”

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New records standards body launched – eHealth Insider – 17 April 2013

Posted on April 17, 2013. Filed under: Health Informatics, Medical Records | Tags: |

New records standards body launched – eHealth Insider – 17 April 2013

“A major new Professional Records Standards Body has been launched to promote the development of health and care records based on common record keeping standards.

The PRSB, which is intended to become the primary source of knowledge and expertise on health and social care record keeping standards, is backed by nearly all the royal medical colleges.

The new body will be officially launched at a joint Royal College of Physicians / CCIO Leaders Network session at HC2013 in Birmingham on Wednesday.

A central aim of the PRSB will be to make sure that the requirements of those who provide and receive care can be fully expressed in health and social care records.

It will also provide guidance for those working on technical implementation of the standards, and on their maintenance.”

… continues on the site

“Founding members of the PRSB include: the Royal College of Physicians, National Voices, the Allied Health Professions Federation, Royal College of Nursing, Association of Directors of Adult Social Services, Royal College of General Practitioners, The BCS, the Chartered Institute for IT, the Academy of Royal Medical Colleges, the Royal College of Pathologists, the Royal College of Psychiatrists, the Royal College of Surgeons of England, and the Royal College of Paediatrics and Child Health.”

Health and Social Care Information Centre – HSCIC supports new independent Professional Records Standards Body

“The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England’s trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 130 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.”

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Transforming Health information Management: The Evolution of the HIM Professional – Canadian Health Information Management Association (CHIMA) – 2012

Posted on January 22, 2013. Filed under: Health Informatics, Medical Records | Tags: , |

Transforming Health information Management: The Evolution of the HIM Professional – Canadian Health Information Management Association (CHIMA) – 2012

CHIMA is pleased to present to you our paper on the future of the HIM profession in Canada. Within the report, Transforming Health information Management: The Evolution of the HIM Professional, you will learn how we plan to prepare and educate HIM professionals in all aspects of the health information management lifecycle.

The purpose of this report is to educate members and key stakeholders regarding the importance of the evolving and expanding role of the certified HIM professional and to increase awareness about the competencies that a HIM professional brings to the clinical field. We cannot move this plan forward without your support and involvement.”

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2014 [EHR] Clinical Quality Measures – Centers for Medicare and Medicaid Services [US]- October 2012

Posted on October 30, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Health Informatics, Medical Records | Tags: |

2014 [EHR] Clinical Quality Measures – Centers for Medicare and Medicaid Services [US]- October 2012

“Beginning in 2014, the reporting of clinical quality measures (CQMs) will change for all providers. EHR technology that has been certified to the 2014 Edition standards and certification criteria will have been tested for enhanced CQM-related capabilities, Eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) will be required to report using the new 2014 criteria regardless of whether they are participating in Stage 1 or Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Although clinical quality measure (CQM) reporting has been removed as a core objective for both Eligible Professionals (EPs) and eligible hospitals and CAHs, all providers are required to report on CQMs in order to demonstrate meaningful use.”

… continues on the site

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Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition Draft Test Procedures – Office of the National Coordinator for Health Information Technology – September 2012

Posted on September 10, 2012. Filed under: Health Informatics, Medical Records | Tags: , |

Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition Draft Test Procedures – Office of the National Coordinator for Health Information Technology – September 2012

“The Office of the National Coordinator for Health Information Technology (ONC) has posted the first wave of draft Test Procedures and applicable test data files for the 2014 Edition EHR certification criteria. The Test Procedures, once finalized and approved by the National Coordinator, will be used for testing and certifying EHR technology under the ONC HIT Certification Program (formerly referred to as the Permanent Certification Program or PCP). The Test Procedures are being developed in collaboration with the National Institute of Standards and Technology (NIST).

General Purpose

The Test Procedures will be used by testing laboratories and certification bodies to evaluate conformance and functionality of Complete Electronic Health Records (EHRs) or EHR Modules against the standards, implementation specifications, and certification criteria adopted by the HHS Secretary for 2014 certification. The Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology, Final Rule [PDF – 1.25MB], published September 4, 2012, establishes the 2014 Edition EHR Certification Criteria used to develop draft Test Procedures.”

… continues

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The Trillion Dollar Conundrum: Complementarities and Health Information Technology – National Bureau of Economic Research – August 2012

Posted on August 21, 2012. Filed under: Health Economics, Health Informatics, Medical Records |

The Trillion Dollar Conundrum: Complementarities and Health Information Technology – National Bureau of Economic Research – August 2012

David Dranove, Christopher Forman, Avi Goldfarb, Shane Greenstein
NBER Working Paper No. 18281
Issued in August 2012
NBER Program(s):   IO   PR

“We examine the heterogeneous relationship between the adoption of electronic medical records (EMR) and hospital operating costs at thousands of US hospitals between 1996 and 2009. Combining data from multiple sources, we first identify a puzzle that has been seen in prior studies: Adoption of EMR is generally associated with a slight increase in costs. We draw on the literature on information technology as a business process innovation to analyze why this average effect arises, and explain why it masks important differences over time, across locations, and across hospitals. We find evidence consistent with this approach, namely, that: (1) EMR adoption is initially associated with a rise in costs; (2) EMR adoption at hospitals in favorable conditions – such as urban locations – leads to a decrease in costs after three years; and (3) Hospitals in unfavorable conditions experience a sharp increase in costs even after six years.”

Media on this
from Hospital EMR and EHR

CMIO

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A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care – National Institute of Standards and Technology – June 2012

Posted on July 20, 2012. Filed under: Child Health / Paediatrics, Health Informatics, Medical Records | Tags: , , , , |

A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care – National Institute of Standards and Technology – June 2012 NIST

“Executive Summary

Adoption of electronic health record (EHR) systems in hospitals and physician practices is accelerating. Usability of EHRs has been identified as an important factor impacting patient safety, and recommendations for improvement have been provided. Pediatric patients have unique characteristics that translate into unique EHR usability challenges. It is not surprising, then, that the adoption of EHRs by pediatric care providers has lagged behind adoption for adult care providers. In this document, we highlight important user interactions that are especially salient for pediatric care and hence to the EHR user-centered design process. These interactions and associated usability recommendations were identified by consensus during a series of teleconferences with experts representing the disciplines of human factors engineering, usability, informatics, and pediatrics in ambulatory care and pediatric intensive care. In addition, extensive peer review was provided by experts in pediatric informatics, emergency medicine, neonatology, pediatrics, human factors engineering, usability engineering,and software development and implementation.

This report details recommendations to enhance EHR usability when supporting pediatric patient care and also identifies promising areas for EHR innovation. Finally, we illustrate unique pediatric considerations in the context of representative clinical scenarios which may be helpful for formative user-centered design approaches and summative usability evaluations.”

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An Interactive Preventive Care Record (IPHR): A Handbook for Using Patient-Centered Personal Health Records to Promote Prevention – AHRQ – June 2012

Posted on July 20, 2012. Filed under: Chronic Disease Mgmt, Health Informatics, Medical Records, Preventive Healthcare | Tags: |

An Interactive Preventive Care Record (IPHR): A Handbook for Using Patient-Centered Personal Health Records to Promote Prevention – AHRQ – June 2012

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services

Krist A, Rothemich S, Kashiri P, et al. An Interactive Preventive Care Record: A Handbook for Using Patient-Centered Personal Health Records To Promote Prevention. (Prepared by Virginia Commonwealth University, Department of Family Medicine, Virginia Ambulatory Care Outcomes Research Network (ACORN), under Grant No. R18 HS 017046.) AHRQ Publication No. 12-0051-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2012.

Extract from the introduction:

“Purpose of This Handbook

This step-by-step guide introduces you to—
●● Using personal health records (PHRs) to promote prevention.
●● Preparing your practice to use a PHR for promoting prevention.
●● Implementing and sustaining the use of a PHR for prevention.

The intended audience for this guide includes primary care practice personnel (e.g., office managers, clinicians, and nurses), practice leaders responsible for selecting informatics systems and ensuring that they are implemented well, and practice informatics staff.

Although the content of this guide can apply to using any PHR to promote prevention, we have focused on a specific type of PHR called an Interactive Preventive Health Record (IPHR). An IPHR is a highly advanced, patient-centered, evidence-based, patient portal focused on prevention. As information systems continue to advance, we believe that more PHRs will have interactivity functionality in the future.

Given the similarities between preventive and chronic care, the steps in this guide can also apply to using an IPHR to promote chronic disease management.

We have used organizational change theory to help determine the steps in this guide. While some steps may be specific to large practices and health systems, the concepts apply equally well to smaller primary care practices.”

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Patient Information Forum (PiF) has released a guide to Personal Health Records (PHRs) – 13 July 2012

Posted on July 18, 2012. Filed under: Health Informatics, Medical Records, Patient Participation |

Patient Information Forum (PiF) has released a guide to Personal Health Records (PHRs) – 13 July 2012

“The Patient Information Forum (PiF) has released a guide to Personal Health Records (PHRs) which highlights their benefits and sets out the challenges practitioners, managers, and patient organisations will face if they are to meet the government’s target of giving every patient access to their GP records by 2015.

A PHR is a patient-controlled copy of all the health information stored about them by health and social care organisations, to which they can add their own data. Paper examples such as women’s maternity notes and children’s Red Books already exist but the NHS Information Strategy has accelerated the drive towards online access.”

… continues

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Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals – The Commonwealth Fund – 2 July 2012

Posted on July 3, 2012. Filed under: Health Informatics, Medical Records | Tags: , , |

Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals – The Commonwealth Fund – 2 July 2012

Authors: Sharon Silow-Carroll et al

“Overview

An examination of nine hospitals that recently implemented a comprehensive electronic health record (EHR) system finds that clinical and administrative leaders built EHR adoption into their strategic plans to integrate inpatient and outpatient care and provide a continuum of coordinated services. Successful implementation depended on: strong leadership, full involvement of clinical staff in design and implementation, mandatory staff training, and strict adherence to timeline and budget. The EHR systems facilitate patient safety and quality improvement through: use of checklists, alerts, and predictive tools; embedded clinical guidelines that promote standardized, evidence-based practices; electronic prescribing and test-ordering that reduces errors and redundancy; and discrete data fields that foster use of performance dashboards and compliance reports. Faster, more accurate communication and streamlined processes have led to improved patient flow, fewer duplicative tests, faster responses to patient inquiries, redeployment of transcription and claims staff, more complete capture of charges, and federal incentive payments.”

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Clear and Present Data: how access to our medical records can help life-saving science – British Heart Foundation – 25 June 2012

Posted on June 26, 2012. Filed under: Medical Records, Research | Tags: |

Clear and Present Data: how access to our medical records can help life-saving science – British Heart Foundation – 25 June 2012

“… shows how the information contained in our medical records has helped us better understand the factors that lead to heart and circulatory disease – and sets out what needs to happen to make sure we can all benefit from this information.”

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Guide to Privacy and Security of Health Information – Office of the National Coordinator for Health Information Technology [US] – May 2012

Posted on May 9, 2012. Filed under: Health Informatics, Medical Records | Tags: , |

Guide to Privacy and Security of Health Information – Office of the National Coordinator for Health Information Technology [US] – May 2012

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Tools for auditing patient record keeping standards launched by Royal College of Physicians – 11 April 2012

Posted on April 16, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Medical Records | Tags: , |

Tools for auditing patient record keeping standards launched by Royal College of Physicians – 11 April 2012

“In a project funded by the Healthcare Quality Partnership (HQIP), the Royal College of Physicians Health Informatics Unit (HIU) has developed three tools for auditing patient records against the HIU standards covering generic record-keeping standards, standards for admission clerking  and discharge summaries.

Find out more about the tools: http://www.hqip.org.uk/record-keeping-audit-tools/

Three audit tools are available for download and for auditing against the:

Generic Multi-Disciplinary Clinical Record Keeping Standards
Hospital Admission Clerking Standards
Hospital Discharge Document Standards”

… continues on the site

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Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win – Canada Health Infoway – 2 March 2012

Posted on March 6, 2012. Filed under: Health Informatics, Medical Records | Tags: , , |

Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win – Canada Health Infoway – 2 March 2012

full text

Co-authored by Dr. Ann Cavoukian, and Richard C. Alvarez, President & CEO, Canada Health Infoway

“Embedding and implementing Privacy by Design (PbD) into electronic health record (EHR) systems being built across Canada will enable us to benefit from the wealth of health information stored on these systems, while protecting patient privacy, according to a new paper released today at the Toronto Board of Trade.

“By incorporating the principles of Privacy by Design into the EHR environment, you can accommodate both individual privacy and access to health information for purposes that benefit society as a whole, such as research purposes – a win-win scenario,” said Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario.”

… continues on the site

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What’s Ahead for EHRs: Experts Weigh In – Booz Allen Hamilton – February 2012

Posted on February 29, 2012. Filed under: Health Informatics, Medical Records |

What’s Ahead for EHRs: Experts Weigh In – Booz Allen Hamilton – February 2012

“Industry experts from health care and informatics ponder the future of electronic health records during the implementation of “meaningful use” and beyond.”

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BCS and DHID to develop patient guidance on safe record keeping – 1 February 2012

Posted on February 2, 2012. Filed under: Health Informatics, Medical Records |

BCS and DHID to develop patient guidance on safe record keeping – 1 February 2012

“The British Computer Society (BCS), The Chartered Institute for IT and the Department of Health Informatics Directorate have launched a project to develop clear and easy-to-follow guidance for patients and the public on the subject of health and social care records

The BCS is inviting individuals or organisations to tender for the contract to carry out this work.

The project will provide patients with advice on how to look after the health and social care records and other sensitive personal data that they are creating, or health and social care providers are sharing with them.

The guidance is intended to support the increasing number of patients accessing their records online and those making use of the growing number of online services to store and share personal health and care data.”

… continues on the site

 

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Guide to Reducing Unintended Consequences of Electronic Health Records – AHRQ – 14 December 2011

Posted on December 16, 2011. Filed under: Health Informatics, Medical Records | Tags: , |

Guide to Reducing Unintended Consequences of Electronic Health Records – AHRQ – 14 December 2011

“The Guide to Reducing Unintended Consequences of Electronic Health Records is an online resource designed to help you and your organization anticipate, avoid, and address problems that can occur when implementing and using an electronic health record (EHR). Our purpose in developing the Guide was to provide practical, troubleshooting knowledge and resources.

The Guide was developed with all types of health care organizations in mind — from large hospital systems to solo physician practices. We anticipate that the primary users will be EHR implementers such as Regional Extension Centers, chief information officers, directors of clinical informatics, EHR champions or “super users,” administrators, information technology specialists, and clinicians involved in the implementation of an EHR. Frontline EHR users (such as physicians and nurses) may also find the Guide useful.

The Guide is based on the research literature, other practice-oriented guides for EHR implementation and use, research by its authors, and interviews with organizations that have recently implemented EHR. The Guide represents a compilation of the known best practices for anticipating, avoiding, and addressing EHR-related unintended consequences. However, this area of research is still in its infancy. Therefore, the Guide is a work in progress. We invite you to revise its tools and recommendations in keeping with your own experience and in response to emerging research findings.”

The RAND Corporation prepared the Guide for the Agency for Healthcare Research and Quality

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Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records [draft] – National Institute of Standards and Technology [US] – October 2011

Posted on November 3, 2011. Filed under: Health Informatics, Medical Records | Tags: , |

Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records [draft] – National Institute of Standards and Technology [US] – October 2011

“Executive Summary

This document summarizes the rationale for an Electronic Health Record (EHR) Usability Protocol (EUP) that encompasses procedures for (1) expert evaluation of an EHR user interface from a clinical perspective and a human factors best practices perspective, and (2) validation studies of EHR user interfaces with representative user groups on realistic EHR tasks.

This document begins with a brief overview of the problem at hand: Why is EHR usability critical? There is a sentiment among clinical users that EHRs are harder to use than they need to be and can introduce “use error” that could have potential negative implications on patient care. This document centers on improving user performance of EHRs through system developer demonstration of application of human factors best practices and user-centered design principles.

Within this document there is a detailed description of research findings relating to the usability issues and their potential impact on patient care. These findings resulted in the development of a model for understanding usability and patient safety outcomes. As a backdrop, these findings motivate and guide the clinical aspects of the expert evaluation procedure.

Another intent of the EUP is to provide detailed systematic steps for conducting validation studies (that is, summative usability tests). The validation study procedure guides the reader to help insure that the application’s user interface is free from critical usability issues and supports error-free user interaction with the EHR. The sample forms for data collection and test scenarios provided in the appendices are guidance only; the development teams can choose other scenarios or modify these examples as necessary for their medical context.

This document presents a three-step process — that incorporates both the evaluation and validation procedures — for design evaluation and human user performance testing for an EHR, see Figure 1. This process is focused on increasing safe use of the EHR and increasing ease of use of the EHR by users. The steps are as follows:

1. Usability/Human Factors Analysis of the application during EHR user interface development,
2. Expert Review/Analysis of the EHR user interface after it is designed/developed, and
3. Testing of the EHR user interface with users.”

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The Correlation of Training Duration With EHR Usability and Satisfaction: Implications For Meaningful Use – AmericanEHR Partners – 20 October 2011

Posted on October 25, 2011. Filed under: Educ for Hlth Professions, Health Informatics, Medical Records | Tags: |

The Correlation of Training Duration With EHR Usability and Satisfaction: Implications For Meaningful Use – AmericanEHR Partners – 20 October 2011

“New Report Highlights Relationship Between EHR Training and Satisfaction As well as the Usability of Features Important for Achieving Meaningful Use

Washington –  A report released today by AmericanEHR Partners highlights physicians’ experiences with the usability of EHRs to achieve some Meaningful Use requirements. The survey data, from more than 2,300 physicians, was collected from April 2010 to July 2011 on satisfaction with their use of EHR systems.  It also provides strong evidence that clinicians do not receive adequate training to effectively use their EHRs. 

The survey was conducted collaboratively with the American Academy of Allergy Asthma & Immunology, the American College of Physicians, the American Osteopathic Association of Medical Informatics, the Infectious Disease Society of America, and the Renal Physicians Association. Key findings from the report include:”

… continues on the site

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Incorporating Occupational Information in Electronic Health Records: Letter Report – Institute of Medicine – 30 September 2011

Posted on October 3, 2011. Filed under: Health Informatics, Medical Records, Occupational Hlth Safety | Tags: , |

Incorporating Occupational Information in Electronic Health Records: Letter Report – Institute of Medicine – 30 September 2011

“Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. The use of electronic health records (EHRs) has increased rapidly since the passage of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. Incorporating patients’ occupational information into EHRs could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population.

At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients’ EHRs. The committee focused on the potential benefits of the inclusion of occupational information to individual and public health, current systems that use this information, and technical barriers to incorporating occupational information into the EHR. The IOM concluded that three data elements – occupation, industry, and work-relatedness – were ready for immediate focus. To incorporate these data into EHRs, recommendations were made that include assessment of data collection and incorporation, requirements for storing and communicating occupational information, development of metrics and performance measures, and assessment of privacy concerns, among others.”

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Old data learns new tricks: Managing patient security and privacy on a new data-sharing playground – pwc – September 2011

Posted on September 23, 2011. Filed under: Health Informatics, Medical Records | Tags: |

Old data learns new tricks: Managing patient security and privacy on a new data-sharing playground – pwc – September 2011

“Data is quickly becoming one of the health industry’s most treasured commodities. Yet, health organizations are acutely aware that sensitive data can be easily compromised. In just the last year and a half, a breach of personal health information occurred, on average, every other day. Breaches erode productivity and patient trust. They’re costly, unpredictable, and unfortunately quite common. More than half of healthcare organizations surveyed by PwC have had at least one privacy/security-related issue in the last two years.”

commentary in Healthcare IT News

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Improving coding, costing and commissioning [NHS] – Audit Commission – 22 September 2011

Posted on September 22, 2011. Filed under: Health Economics, Medical Records | Tags: , |

Improving coding, costing and commissioning [NHS] – Audit Commission – 22 September 2011

Annual report on the Payment by Results data assurance programme 2010/11Released  22 September 2011

“Summary
 
In our annual report looking at the Payment by Results (PbR) data assurance programme, ‘Improving coding, costing and commissioning: Annual report on the Payment by Results data assurance programme 2010/11’, we say that the data used to inform the current PbR tariff in the last financial year was generally good, but the NHS needs to improve the quality of its data if the government is to expand its PbR system.

The data for ‘non-tariff’ areas such as community services and chemotherapy was often of poor quality, and it is these areas that will be brought under the PbR umbrella under the government’s plans. This data is also currently used to inform local contracts.

Extending the PbR tariff system is a key government policy. Under their plans, most or all of the £51 billion spent on acute hospital activity, as well as wider community and health services, will be subject to a PbR tariff. Currently it covers £26 billion of acute services. The report summarises the findings of the Commission’s annual audit of data used to underpin PbR payments. This year the Commission looked at reference costs that are used to set the tariff, and also conducted the first major review of independent sector hospitals as part of its clinical coding programme.

An important finding from our research is that there are simple solutions available to trusts wanting to improve their data. Greater use of basic checks by trusts would lead to improved data quality. These include checking submissions against other data sources, and benchmarking unit costs against those of other providers. Better senior leadership within organisations and greater clinical involvement are also needed.

Our report finds trusts that followed recommendations from their auditors saw the quality of their data improve substantially. A checklist covering ten key areas that senior hospital managers can use to improve reference cost data quality is included in the report. The Commission’s award-winning National Benchmarker can also be used to check for discrepancies in data.”

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Guide to Reducing Unintended Consequences of Electronic Health Records – Agency for Healthcare Research and Quality [US] – August 2011

Posted on September 21, 2011. Filed under: Health Informatics, Medical Records | Tags: , |

Guide to Reducing Unintended Consequences of Electronic Health Records – Agency for Healthcare Research and Quality [US] – August 2011

S.S. Jones, R. Koppel, M.S. Ridgely, T.E. Palen, S. Wu, and M.I. Harrison. Guide to Reducing Unintended Consequences of Electronic Health Records Prepared by RAND Corporation under Contract No. HHSA290200600017I, Task Order #5. Agency for Healthcare Research and Quality (AHRQ). Rockville, MD. August, 2011.
 
“The Guide to Reducing Unintended Consequences of Electronic Health Records is an online resource designed to help you and your organization anticipate, avoid, and address problems that can occur when implementing and using an electronic health record (EHR). Our purpose in developing the Guide was to provide practical, troubleshooting knowledge and resources.

The Guide was developed with all types of health care organizations in mind — from large hospital systems to solo physician practices. We anticipate that the primary users will be EHR implementers such as Regional Extension Centers, chief information officers, directors of clinical informatics, EHR champions or “super users,” administrators, information technology specialists, and clinicians involved in the implementation of an EHR. Frontline EHR users (such as physicians and nurses) may also find the Guide useful.

The Guide is based on the research literature, other practice-oriented guides for EHR implementation and use, research by its authors, and interviews with organizations that have recently implemented EHR. The Guide represents a compilation of the known best practices for anticipating, avoiding, and addressing EHR-related unintended consequences. However, this area of research is still in its infancy. Therefore, the Guide is a work in progress. We invite you to revise its tools and recommendations in keeping with your own experience and in response to emerging research findings.”

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Hospital Episode Statistics (HES): Improving the quality and value of hospital data – NHS Information Centre – May 2011

Posted on May 23, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Informatics, Medical Records |

Hospital Episode Statistics (HES): Improving the quality and value of hospital data – NHS Information Centre – May 2011

“This discussion document, produced by The NHS Information Centre and endorsed by the Academy of Royal Medical Colleges, highlights how improvements to the collection and use of hospital data by clinicians can be made to secure good quality outcomes and inform patient choice.

It stresses the need for more discussion within Trusts and colleges over the importance of:”

… continues on the site

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PCEHR Concept of Operations Consultation – 12 April 2011

Posted on April 13, 2011. Filed under: Health Informatics, Medical Records |

PCEHR Concept of Operations Consultation – 12 April 2011

“The Draft Concept of Operations – Relating to the introduction of a PCEHR system provides details on how the personally controlled electronic health record (PCEHR) system may look, what information it might contain, and how it will function and connect with existing clinical systems.

It also covers participation issues, information management, privacy and security, and matters of implementation, evaluation and consultation.

The content has been shaped by the wide range of consultations which the Department and NEHTA have held with stakeholders-consumer groups, health professionals, the ICT industry and state and territory governments.”  …continues on the site

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Improving data quality in the NHS – Audit Commission – Released 26 August 2010

Posted on August 26, 2010. Filed under: Health Economics, Medical Records | Tags: , |

Improving data quality in the NHS – Audit Commission – Released  26 August 2010

“Annual report on the PbR assurance programme 2010
 
This report summarises the results of the PbR data assurance programme since it began in 2007. For the last three years, the Audit Commission has looked at over £200 million worth of payments for inpatient treatments.

The report finds that the accuracy of clinical coding has improved since 2007. The coding error rate has dropped from 16 per cent to 11 per cent in three years, which shows that NHS organisations have made real progress in tackling the quality of their data.

But there remains wide variation between the best and worst performing trusts, even if the gap is narrowing.

Errors are continuing to affect payments. We estimate that of the £21 billion spent on the four specialties we’ve audited for three years, £1 billion (5 per cent) was paid wrongly.

To continue to improve data quality, the report makes a series of recommendations for primary care trusts and NHS trusts to consider.

A summary of the report is available to download and examples of good practice have been published to assist trusts.

By including reviews of all 2009/10 reference cost data in the PbR assurance programme for 2010/11, we intend to work with the NHS to further improve the accuracy of costing information. More information on the future programme is available.”

Download the report and executive summary 

Improving data quality in the NHS report ( PDF, 2mb ) 

Improving data quality in the NHS executive summary ( PDF, 561kb )

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HHS advisory panel considers patient consent framework – US – 23 April 2010

Posted on April 28, 2010. Filed under: Health Informatics, Medical Records | Tags: |

HHS advisory panel considers patient consent framework   By Alice Lipowicz Apr 23, 2010  Extract copied from Federal Computer Week

“An advisory group to the Health and Human Services Department today began considering a draft Basic Patient Privacy Consent technical framework that describes how health organizations should incorporate patients’ consents and consent policies into their enterprises.

The Health IT Policy Committee’s privacy and security workgroup gave its members a draft patient consent framework. The draft was created with input from Integrating the Health Enterprise, an organization that promotes the coordinated use of technical standards.

The patient consents are needed for collecting and sharing patient health care data in electronic health record (EHR) systems to improve quality of care and public health. In many cases, data is de-identified to avoid identifying the patient. HHS currently is distributing $17 billion in incentives under the economic stimulus law to doctors and hospitals that adopt the electronic systems.”

…continue on Federal Computer Week site

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Evaluating the Value and Impact of an Electronic Health Record in a Complex Health System – article – 2010

Posted on April 13, 2010. Filed under: Health Informatics, Medical Records | Tags: |

ElectronicHealthcare, 8(4) 2010: e3-e14
Evaluating the Value and Impact of an Electronic Health Record in a Complex Health System
Damon C. Mayes and David R. Mador
pdf

 “Abstract:
NetCARE is Canada’s first region-wide electronic health record (EHR) (Hospital News 2004). It is a clinical, web-based, view-only record of an individual’s key health information drawn from multiple sources. NetCARE is available in both hospital and community settings and is accessed by a variety of clinical users. A systematic evaluation showed that an average of 88% of respondents agreed or strongly agreed that netCARE provided valuable lab test results, event history, diagnostic imaging and transcribed reports. Seventy-six per cent indicated that it helped provide quality patient care, and 82% felt it integrated easily into their clinical workflow. A 15-fold increase in EHR use over two and a half years was accompanied by a 56% decrease in physician use of a major legacy system (p=.004) and an average decrease of 24% in requests for paper-based records (p=.03). The average time for netCARE to decrease both legacy system use and patient-chart requests to desired levels was two years.”

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Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less? – Center for Studying Health System Change – 7 April 2010

Posted on April 9, 2010. Filed under: Health Informatics, Medical Records |

Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less? – Center for Studying Health System Change – 7 April 2010
Issue Brief No. 131
Ann S. O’Malley, Genna R. Cohen, Joy M. Grossman

Media Release

“Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication—real-time, face-to-face or phone conversations—with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-workflow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.”

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Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method – article – 2009

Posted on December 15, 2009. Filed under: Health Informatics, Medical Records | Tags: , |

Tensions and Paradoxes in Electronic Patient Record Research: A Systematic Literature Review Using the Meta-narrative Method
Trisha Greenhalgh, Henry W.W. Potts, Geoff Wong, Pippa Bark, and Deborah Swinglehurst
University College London
The Milbank Quarterly, Vol. 87, No. 4, 2009 (pp. 729–788)

Context: The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches.

Methods: Using the meta-narrative method and searching beyond the Medline-indexed literature, this review used “conflicting” findings to address higher-order questions about how researchers had differently conceptualized and studied the EPR and its implementation.

Findings: Twenty-four previous systematic reviews and ninety-four further primary studies were considered. Key tensions in the literature centered on (1) the EPR (“container” or “itinerary”); (2) the EPR user (“information-processer” or “member of socio-technical network”); (3) organizational context (“the setting within which the EPR is implemented” or “the EPR-in-use”); (4) clinical work (“decision making” or “situated practice”); (5) the process of change (“the logic of determinism” or “the logic of opposition”); (6) implementation success (“objectively defined” or “socially negotiated”); and (7) complexity and scale (“the bigger the better” or “small is beautiful”).

Conclusions: The findings suggest that EPR use will always require human input to recontextualize knowledge; that even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper may offer a unique degree of ecological flexibility; and that smaller EPR systems may sometimes be more efficient and effective than larger ones. We suggest an agenda for further research.

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Hospital Computing and the Costs and Quality of Care: A National Study – American Journal of Medicine – Nov 2009

Posted on November 23, 2009. Filed under: Health Informatics, Medical Records |

Hospital Computing and the Costs and Quality of Care: A National Study – American Journal of Medicine – Nov 2009
doi:10.1016/j.amjmed.2009.09.004
OR
http://dx.doi.org/10.1016/j.amjmed.2009.09.004

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Positive report from AG on Canada Health Infoway – from Health Edition – Nov 2009

Posted on November 6, 2009. Filed under: Health Informatics, Medical Records |

Positive report from AG on Canada Health Infoway
November 6, 2009

Info copied from Health Edition

“Canada’s efforts to create an electronic health record system have received a vote of confidence from the country’s auditor general. In a report this week, Sheila Fraser said the agency guiding the national electronic health record agenda, Canada Health Infoway, has “accomplished much in the eight years since its creation.”

This stands in marked contrast to a damning report last month by Ontario’s auditor general into eHealth Ontario which concluded that taxpayers had not received value-for-money from the more than $1 billion spent since 2002 to create an electronic health record or EHR system in that province.

Canada Health Infoway sees itself as a “strategic investor” in provincial and territorial EHR projects, paying up to 75 per cent of the costs if they meet certain deliverables, and Ms. Fraser found it had put the necessary controls in place to make sure it got its money’s worth.”  … continues on the website

The auditor general’s report.

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Ontario’s EHR problems revealed in audit report – 9 October 2009

Posted on October 27, 2009. Filed under: Health Informatics, Medical Records | Tags: |

Ontario’s EHR problems revealed in audit report
October 9, 2009
 
Info below  copied from Health Edition.

There is other coverage on it in Health Edition,   and on Alberta’s EHR program.

“Ontario taxpayers have not received value-for-money from the more than $1 billion spent since 2002 on activities related to the development of electronic health records, the province’s auditor general says in a blockbuster report delivered Wednesday.
 
The report by Auditor General Jim McCarter was based on an audit of eHealth Ontario and its predecessor organization that got underway in February. Its release was scheduled for December, but was fast-tracked at the request of the government amidst a blaze of publicity about millions of dollars of untendered contracts being awarded to contractors with close ties to eHealth management.   … continues on the Health Edition website.

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Shared Record Professional Guidance – NHS Connecting for Health and Royal College of General Practitioners – 18 August 2009

Posted on August 19, 2009. Filed under: General Practice, Health Informatics, Medical Records |

Shared Record Professional Guidance (SRPG)

“NHS Connecting for Health has been pleased to commission the Royal College of General Practitioners to produce the Shared Record Professional Guidance report, published today (18 August 2009).

We thank the Royal College of General Practitioners for co-ordinating the involvement of other professional and patient stakeholder groups in order to achieve a wide agreement on principles.

This report, ‘Informing Shared Clinical Care’, will provide key principles for professional bodies as the first step towards creating guidelines for Shared Electronic patient records.

The report was written by the Royal College of General Practitioners (RCGP) Informatics Group who consulted over 30 different professional and patient stakeholder groups in order to achieve agreement and endorsement of the 16 principles.”

…continues on the website

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The New Sentinel Network — Improving the Evidence of Medical-Product Safety – NEJM – 27 July 2009

Posted on July 30, 2009. Filed under: Health Informatics, Health Technology Assessment, Medical Records, Patient Safety | Tags: , |

The New Sentinel Network — Improving the Evidence of Medical-Product Safety
Posted by NEJM • July 27th, 2009
Richard Platt, M.D., M.Sc., Marcus Wilson, Pharm.D., K. Arnold Chan, M.D., Sc.D., Joshua S. Benner, Pharm.D., Sc.D., Janet Marchibroda, M.B.A., and Mark McClellan, M.D., Ph.D.

“In 2007, Congress directed the Food and Drug Administration (FDA) to create a new postmarketing surveillance system that will, by 2012, be using electronic health data from 100 million people to prospectively monitor the safety of marketed medical products.1 This new system is intended to complement existing systems of “spontaneous” adverse-event reporting. In May 2008, the FDA announced the Sentinel Initiative, which would “access the capabilities of multiple, existing data systems (i.e., electronic health record systems, medical claims databases).”2 The network of data systems is intended both to detect signals (i.e., higher-than-expected rates of adverse outcomes) and to confirm signals, including those suggested by other sources, and to do so rapidly and quantitatively. At a recent Senate hearing before her confirmation, FDA Commissioner Margaret Hamburg stated that close postmarketing monitoring of medical-product safety would remain a high priority during her tenure.3

Achieving these goals requires the first large-scale, truly integrated use of the electronic data that are increasingly available in our pluralistic health care system. The first hurdles are determining how best to organize the Sentinel Network, how it should operate, and what steps are needed for its implementation.”

…continues on the website

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Long live the database state – 24 July 2009 – from Dr Foster intelligence

Posted on July 29, 2009. Filed under: Health Informatics, Medical Records | Tags: , , |

Long live the database state 24 July 2009 – from Dr Foster intelligence

“Smarter use of public service statistics can save lives as well as money. But anxious civil libertarians want to stop the state sharing our personal records. They must not succeed.

Tim Kelsey has written a striking article for Prospect magazine on the ongoing struggle of using personal records to improve public service performance. Tim recounts the battle to get HSMRs published and recognised by Government. He also addresses the need to translate records collected by public services into knowledge that leads to the improved performance and connectivity of essential services such as teaching, social services and healthcare.

Read the full article courtesy of Prospect Magazine.”

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It’s ours: Why we, not government, must own our data – UK – June 2009

Posted on July 28, 2009. Filed under: Health Informatics, Medical Records | Tags: |

It’s ours: Why we, not government, must own our data / Liam Maxwell  Centre for Policy Studies, June 2009
ISBN 978-1-906996-00-0

Related article:

From The Times July 27, 2009  I wouldn’t trust Google with my personal info: My party would be mad to give control of sensitive records to an internet giant notorious for ignoring privacy concerns / David Davis

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Electronic Health Records in Hospitals – NEJM letter to the editor – 23 July 2009

Posted on July 23, 2009. Filed under: Health Informatics, Medical Records | Tags: , , |

Electronic Health Records in Hospitals

Recommends using the VHA’s Computerized Patient Record System

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MedforYou – Quebec personal electronic health record system announced

Posted on July 10, 2009. Filed under: Health Informatics, Medical Records | Tags: |

MedforYou

Information found from Health Edition Online – July 10 edition

“Quebec personal electronic health record system announced

McGill University Health Centre is partnering with Quebec-based Medical.MD to launch a personal electronic health record called MedForYou. It will allow people to post and track their medical information online. Medical.MD is also in discussions to include its new offering in Telus Health Space, powered by Microsoft HealthVault. Medical.MD is looking for 300 subscribers to test its system which it hopes to make available to the Quebec market in October, and eventually to the rest of Canada. More information at http://www.medforyou.com”

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Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating – June 2009

Posted on July 3, 2009. Filed under: Health Informatics, Medical Records |

Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating
HIMSS EHR Usability Task Force June 2009

EXECUTIVE SUMMARY

“Electronic medical record (EMR) adoption rates have been slower than expected in the United States, especially in comparison to other industry sectors and other developed countries. A key reason, aside from initial costs and lost productivity during EMR implementation, is lack of efficiency and usability of EMRs currently available. Achieving the healthcare reform goals of broad EMR adoption and “meaningful use” will require that efficiency and usability be effectively addressed at a fundamental level.

We conducted a literature review of usability principles, especially those applicable to EMRs. The key principles identified were simplicity, naturalness, consistency, minimizing cognitive load, efficient interactions, forgiveness and feedback, effective use of language, effective information presentation, and preservation of context.

Usability is often mistakenly equated with user satisfaction, which is an oversimplification. We describe methods of usability evaluation, offering several alternative methods for measuring efficiency and effectiveness, including patient safety. We provide samples of objective, repeatable and cost‐efficient test scenarios applicable to evaluating EMR usability as an adjunct to  certification, and we discuss rating schema for scoring the results.”

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Quebec Auditor General’s report on the implementation of electronic medical records – May 2009

Posted on May 29, 2009. Filed under: Health Informatics, Medical Records |

The Auditor General of Québec presents the conclusions of his watch over the project Dossier de santé du Québec, Thursday, May 21, 2009 – Mr. Renaud Lachance today made public Volume I of the Report of the Auditor General of Québec to the National Assembly for 2009-2010.

Highlights – press release (pdf)

“Chapter 6 presents, for a second year, the results of our watch dealing with the DSQ. The purpose of this project is to make accessible electronically, to authorized health care professionals, certain relevant clinical information to do a follow-up on and offer care to patients, wherever a person may receive health care services in Québec. Initially, the planned investment in this respect was $563 million, of which $260 million will be funded by the Government of Québec and $303 million funded by the Canada Health Infoway (CHI). The implementation was planned for completion in four years, namely from 2006 to 2010, with a potential number of users evaluated at 95,000.

We first found unsatisfactory progress in relation to 7 of the 12 recommendations that we had made in March 2008.”

It appears at chapter 6 in the fulhttp://www.vgq.qc.ca/en/publications/rapport-annuel/fichiers/Highlights2009-2010-T1.pdf?bcsi_scan_276FAA45874D151E=0&bcsi_scan_filename=Highlights2009-2010-T1.pdfl report.

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US plans for a Health Record Bank Model for patient medical records – May 2009

Posted on May 25, 2009. Filed under: Health Informatics, Medical Records | Tags: |

GOP Health Reform Proposal Includes Health Record Banks Friday, May 22, 2009

“On Wednesday, Republicans in the House and Senate proposed health care reform legislation (HR 2520, S 1099) that would create health record banks to collect and maintain patients’ health records, Health Data Management reports.

Health Record Bank Model

Under a health record bank model, a trusted entity collects patients’ paper and electronic health records from physicians, laboratories, pharmacies and other sources.

Each bank account contains an electronic copy of a patient’s health record, and patients control who can access their data and what information to make available.

Typically, a health record bank is financed through account fees charged to individuals or sponsors, such as health care provider organizations or health plans.

Legislation Details

The legislation, called the Patients’ Choice Act of 2009, states, “This act proposes adopting the same model used by the financial services industry in promoting the use of automated teller machines.”

It adds, “Individuals could get a card — just like their ATM card — that would maintain their insurance and medical history information from an independent health record bank. Every time you visit your doctor, you would swipe the card for instant access to your medical history and insurance payment information.””

+++++++++++++++++++++++++++++++++++++

GOP Reform Plan Includes Records Banks May 21, 2009

“A comprehensive health reform plan from conservatives in the House and Senate would authorize health records banks that collect and maintain individuals’ medical records.

Under the health records bank model, a trusted entity collects a patient’s paper and electronic medical records from physicians, hospitals, laboratories, pharmacies and other sources. Each bank account contains an electronic copy of an individual’s health record. Individuals control who accesses their data and what data can be accessed. A health records bank generally would be funded through account fees charged to individuals or sponsors, such as provider organizations or health plans.

“This act proposes adopting the same model used by the financial services industry in promoting the use of automated teller machines,” according to a summary of the Patients’ Choice Act of 2009, introduced on May 20. “Individuals could get a card–just like their ATM card–that would maintain their insurance and medical history information from an independent health record bank. Every time you visit your doctor, you would swipe the card for instant access to your medical history and insurance payment information.”

Bill sponsors include Sens. Tom Coburn, M.D. (R-Okla.) and Richard Burr (R-N.C.), and Reps. Paul Ryan (R-Wis.) and Devin Nunes (R-Calif.). The bills, S. 1099 and H.R. 2520, soon will be available on the congressional Web site at congress.gov.  http://thomas.loc.gov/

–Joseph Goedert”

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NSW Health – Patient care and safety enters the digital age 2 May 2009

Posted on May 4, 2009. Filed under: Health Informatics, Medical Records, Nat Hlth & Hosps Reform Comm |

02 May 2009

Patient care and safety enters the digital age Information from this NSW Health site:

“NSW Minister for Health, John Della Bosca, announced today that the State Government had started rolling out new electronic medical records (eMR)s technology into public hospitals across the State to help improve patient care and safety.” …. continues on the website

See also the National Health and Hospitals Reform Commission (NHHRC)  supplementary paper to its Interim Report, which outlines the Commission’s support for person-controlled electronic health records for every Australian. 30 April 2009

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Healthspace – NHS Connecting for Health – weblink

Posted on April 17, 2009. Filed under: Health Informatics, Medical Records, Patient Participation |

Healthspace is a free, secure online personal health organiser.

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Critical issues for electronic health records: considerations from an expert workshop – UK

Posted on April 17, 2009. Filed under: Health Informatics, Medical Records | Tags: |

Critical issues for electronic health records: considerations from an expert workshop – UK

This report is based on the Electronic Health Records Symposium – an expert seminar hosted by the Nuffield Trust and Wellcome Trust. This seminar brought together health leaders, policy-makers and academics to identify the key priorities involved in research, strategy and implementation of electronic health record systems (EHR). The report augments the workshop findings with further comment from the authors and identifies the key requirements for successful EHR systems implementation, integration and maintenance worldwide

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Australian Centre for Clinical Terminology and Information established 9 February 2009

Posted on April 8, 2009. Filed under: Health Informatics, Medical Records |

The newly-formed Australian Centre for Clinical Terminology and Information (ACCTI) commenced operations on Monday 9 February as part of the Centre for Health Service Development (CHSD) and the Sydney Business School, University of Wollongong.

The establishment of ACCTI will bring a range of specialist skills to the CHSD and complement our other centres:

·   The Australian Health Outcome Centre (AHOC)

·   The Australasian Rehabilitation Outcome Centre (AROC)

·   The Palliative Care Outcomes Collaboration (PCOC)

·   The Australian Occupational Science Centre (AOSC)

ACCTI will be led by Kerry Innes, Senior Research Fellow. Until recently Kerry was the Associate Director of the National Centre for Classification in Health, University of Sydney.  Kerry will be joined by three Research Fellows, who also previously worked at the NCCH: Patricia Saad; Donna Truran; and Ming Zhang.

ACCTI will focus on the development and use of clinical terminologies and data information strategies. The team has nationally and internationally recognised expertise in ICD and SNOMED CT and intends to build on and extend this expertise into new areas.  The CHSD expects that this new Centre will support and progress the nation’s eHealth agenda.

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Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research – US Institute of Medicine

Posted on April 8, 2009. Filed under: Health Informatics, Medical Records, Research | Tags: |

US IOM Report published 4 February 2009

“Our modern electronic world has many benefits and conveniences, but the free flow of information also creates privacy concerns. In the realm of health care, privacy protections are needed to preserve patients’ dignity and prevent harms such as discrimination. But such protections can also have unintended consequences for health care, and the health research that is vital for making medical advances. More than 10 years ago Congress called for a set of federal standards, now known as the HIPAA Privacy Rule, to protect the privacy of personally identifiable health information while still allowing the flow of information needed to promote high-quality health care.

In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine’s Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that, as currently implemented, it impedes important health research. The committee recommends an entirely new approach to protecting privacy in health research. However, if national policy makers choose to continue to rely on the HIPAA Privacy Rule rather than adopt the new approach, the committee recommends a series of changes to improve the rule and the guidance that the HHS provides on how to comply with it. More specific recommendations related to these approaches are available in the report brief.

Privacy protec­tions and ethically-conducted health research provide valuable, interrelated benefits to society, and society should strive to support both to the extent possible. In order to preserve patients’ dignity and ensure continued progress in improving our nation’s health and health care, Congress and HHS must implement more effective privacy protections in health research. “

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Records management: NHS code of practice – update to part 2

Posted on April 8, 2009. Filed under: Medical Records, Records Management |

Published 8 January 2009

This is a guide to the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England. It is based on current legal requirements and professional best practice. As a result of a review, part 2 of the code has been updated in light of guidance and advice given from the NHS and professional best practice. (Department of Health – publications)

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