Informatics Jenna Barlow, Pamela Chong, Amy Eichelberger, Denise Gonzalez, Kaitlin Joyce, Jonelle Milfort, Cassidy Parolin, Berekia Irace

Our Question What are the two main issues with Electronic Medical Records (EMR) on this unit? Informatics: Use information and technology (IT) to communicate, manage knowledge, mitigate error, and support decision making.

Importance of Topic and Rationale Importance: EMR are the present and future. Everybody is going to work with electronic charts. Rationale: It is important to know what are some potential issues with EMR so that we can avoid them if possible and take additional precautions to make sure the EMR are safe and secure.

Two Main Issues with Electronic Medical Records Safety of Patient Information is compromised EMRs are often inaccurate and incomplete

Compromise of Patient Information Unencrypted passwords Anyone in the hospital can gain access to patient’s medical records and social security numbers Interventions Cloud storage, password protection, and encryption Nurses should log off their terminals, not share their IDs, and use their own ID to access patient’s records Routine audits should also be done to access the security of medical records

Evidence-Based Articles A group of almost 2000 physicians were interviewed and asked to identify the top 11 barriers that made them hesitant to use an EMR as opposed to original paper charts. One of the main concerns was that the patient’s clinical information would not be as safe and the patient’s privacy would be at risk with an electronic record system.

EBP Continued While computer programmers try to make the EMR as secure as possible, patient records are still open access for all hospital employees and there is always potential risk that the system may be hacked into by an outside engineer. The patient’s privacy may be at risk and there is a chance the record may be exploited for financial gain; VIP (celebrity) snooping; or medical gain, such as receiving prescription drugs or free medical treatment.

EMRs are often inaccurate and incomplete One study found that over 25% of EMRs have inaccurate information present or are incomplete The most common areas that are inaccurate are current patient medications, medical history, allergies, history of present illness and prior surgeries Inaccurate information can be placed in a medical record and continued forward through remaining health care visits and documentation Drop-down menus and copying and pasting functions can lead to erroneous data being placed in the health record

Evidence- Based Articles Medical students use EMR to document on patients. Short cuts such as copy forward, and check boxes may perpetuate the spread of inaccurate information. 86% of 3rd year medical students at a university reported witnessing other students using copy forward when documenting.

EBP Continued Physician adoption of EMR remains low. When asked to consider the barriers to integrating the EMR in practice, technical limitation of systems was an issue that physicians found.

Opportunies/Challenges Improving EMR by implementing different interventions that can improve the security of patient information Challenges “Just clicking boxes” becomes automatic and can result in error

References Heiman, H. L., Rasminsky, S., Bierman, J. A., Evans, D. B., Kinner, K. G., Stamos, J., Martinovich, Z., & McGaghie, W. C. (2014). Medical students' observations, practices, and attitudes regarding electronic health record documentation. Teaching and Learning in Medicine: An International Journal, 26(1), 49- 55. doi: 10.1080/10401334.2013.857337 Krist, A.H. (2015). Electronic health record innovations for healthier patients and happier doctors. Journal of the American Board of Family Medicine, 28(3), 299-302. doi: 10.3122/jabfm.2015.03.150097 Sittig, D. F., & Wright, A. (2015). What makes an ehr "open" or interoperable?. Journal of the American Medical Informatics Association Advance Access, 6, 1-3. doi: 10.1093/jamia/ocv060 Yan, H., Gardner, R., & Baier, R. (2012). Beyond the focus group: understanding physicians' barriers to electronic medical records. The Joint Commission Journal on Quality and Patient Safety, 38(4). Retrived from: https://www-ncbi-nlm -nih-gov.ezproxy.hsc.usf.edu/pubmed/22533131