Overview of Electronic Medical RecordsDr Sanjoy Sanyal

MBBS, MS, MSc, ADPHA, ADHRD

Staff seminar in Seychelles medical college in February 2008

Table of contents

• EMR – General considerations

• EMR – Screenshots from companies

• EMR – Specialty-specific examples

• EPM / PMS – Automated clinical workflow integration

• Conclusion – Relevance to us

• References

Definition

• ISO TC 215 defines an EHR as “a healthcare record in computer processable format.”

Electronic medical record

• Should document history, examination, diagnoses intuitively, rapidly, efficiently

• Should automate tests, medication, submission of diagnostic / procedure codes

• Should include error checking rules to avert allergies / cross reactions

Electronic medical record

• Evaluation and Management (E & M) electronic guidelines should be built into the code system

• Should be compliant with HIPAA policies– [HIPAA: Health Insurance Portability and

Accountability Act]

EMR Inter-relationships

Framework of EMR solutions

Stages of EMR complexity

1

2

3

0

eMAR

CDR is the central pivot

EMR – Nuesoft Xpress

ChiroChart EMR – MediPro

EMR frontscreen – MediNotes

EMR – Veterans Affairs

VA – DoD

EMR – MS Office OneNote

EMR – FileMed

EMR – Data Center

EMR – NextGen

EMR face sheet – AMBAS

EMR progress notes – AMBAS

EMR configuration – AMBAS

MedicsRIS – ADS

MedicsDocAsst EMR – ADS

MedicsDocAsst EMR – ADS

EMR – Medinformatix

RTS EMR – Customized page

RTS EMR – Tabbed menus

RTS EMR – Access rights

RTS EMR – Time savers

RTS EMR – Governance

RTS EMR – Electronic sign

Automated patient q’aire – ADS

MDA allergy EMR – ADS

MDA Int Medicine EMR – ADS

MDA pain Mx EMR – ADS

MDA pain Mx EMR – ADS

MDA pain Mx EMR – ADS

Cardiology EMR – MDS

Cardiology EMR – MDS

Chiropractic EMR – MDS

Dermatology EMR – MDS

Dermatology EMR – MDS

Pediatric EMR – MDS Medical

Pediatric EMR – MDS Medical

Pediatric EMR – MDS Medical

Oncology EMR – Synergy

Oncology EMR (Patient chart)

Oncology EMR (Complaints)

Oncology EMR (Diagnosis)

Oncology EMR (Staging)

3-D EMR Mapping Engine

‘Bugle’ patient database – ARG

PMS – Nuesoft Xpress

PMS patient info – AMBAS

PMS scheduler – AMBAS

PMS online charge slip – AMBAS

PMS + EMR – MedInformatix

EPM appointment scheduling

Automated docu distribution

Accounts – Medinformatix

Collections – Medinformatix

Automated remittance module

Real time claim status

PMS – Scheduling screen

ADS MedicsElite – Patient Demog

ADS MedicsElite – Finance

ADS MedicsElite – Scheduler

ADS MedicsElite – PDA access

EMR data entry in PDA

Summary

• EMR is ultimately geared towards reducing errors, improving safety and care and cutting costs of healthcare

• EMR is not about just installing a few computers and storing patient data

• EMR has to be integrated with PMS / EPM

• EMR is all about automating WORKFLOW process

Automated clinical workflow

Automated clinical workflow

Automated clinical workflow

Governmental mandate• April 2004 Bush issued an executive order to

computerize USA medical health records by 2014.

• “By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care”;

– President George W. Bush; 2004 State of the Union address.

Our ability to meet the 2014 deadline is highly doubtful

Conclusion

• A parallel can be envisaged in every organizational setup

• Every organization (hospitals, educational institutions etc) should aim for automated workflow integration

• It requires an attitudinal shift

• We are still quite a way off

References

• HemiData: www.hemidata.com/emr.html

• The Aesculapius Research Group: http://www.aesculapiustech.com/articles/ElectronicMedicalRecords.htm

• HIMSS Analytics: http://www.himssanalytics.org/PDFFiles/

• Nuesoft Xpress: http://www.nuesoftxpress.com/products/

• MediPro: http://www.medipro.com

References

• Veterans Affairs (VA): http://www.va.gov

• Advanced Medical Billing and Accounting Solutions (AMBAS): http://ambas.net

• Advanced Data Systems (ADS): http://www.adsc.com/ris.asp

• Medinformatix: http://www.medinformatix.com/Products/

References

• Residential Treatment Solutions (RTS): therts.com/EMR4RTC.php

• MDS Medical Software: www.mdsmedicalsoftware.com/

• Synergy EMR: www.synergyemr.com/product_overview.htm

• Charette RN: Visualizing Electronic Health Records With "Google-Earth for the Body" http://spectrum.ieee.org/jan08/5854