1. PRESENTED BY: WILLIAM LAMBERTON, RN NURS 457 PENNSYLVANIA STATE UNIVERSITY FEBRUARY 7, 2010 Electronic Medical Records

2. Objectives Describe electronic medical records (EMRs) List and describe EMR hardware List and describe EMR software Evaluate software used with EMRs Describe and review an EMR information system

3. Objectives—con’t Examine advantages and disadvantages of EMRs Discuss legal and ethical issues associated with EMRs

4. What is an EMR? Electronic database of a individual medical information Information entered by health care providers  From the inpatient setting  From ambulatory care Not interactive Owned by the care provider (HIMSS, 2010)

5. What is an EMR? (con’t) Makes orders easier to manage Provides care prompts to providers Eases administrative tasks  Scheduling  Billing Enables organizations to report to regulatory organizations (OpenClinical, 2009)

6. Hardware Used with an EMR The Server Wireless Tablet Personal Computers (PCs) Work Stations Computer on Wheels (COW) Personal Digital Assistants (PDAs) Photo from www.tabletpc2.com

7. About EMR Hardware Wireless Tablet PCs  Can be taken from room-to-room  Information is entered at the bedside. Work Stations  Wired to the server  Found at the Nurse’s Station  Can be found in or between patient rooms (EMR Experts, 2009)

8. Example of EMR Software Epic Compass Soarian E-Record

9. About E-Record Allows for complete charting  Date Entry by nurses  Data Entry by ancillary staff Viewing of all clinical results Electronic Medication Administration Record (eMAR) (UPMC, 2010)

10. Evaluation of E-Record Usability Improving the human-technology interface Based on Staggers three axioms  Focus on users  Iterative design  Empirical usability measures (Staggers, 2003 and Effken, 2009)

11. Healthcare information system—a description E-Record  End users  Point of service devices  Data storage  Ancillary support (UPMC, 2010 and Hassett, 2002)

12. Information System Review E-Record  Used by all members of the care team  Functions performed  Configuration  Disease Classification  Nursing Practice Standards Classifications  Recommendations (Hardiker, 2009)

13. Advantages of the EMR Information stored securely and viewed later Information can be viewed off site Reduces redundant charting Eliminates the risks of sloppy handwriting Portable, bedside charting (HIMSS, 2010)

14. Disadvantages of EMRs Nurses must be computer savvy Older nurses are resistant to change Security of information on computer screens Downtime (HIMSS, 2010)

15. Ethical and Legal Issues Privacy Security (Hasssett, 2010)

16. Informatics Competencies Ability to enter, view, and manipulate information Ability to navigate sections of the EMR system Ability to transmit information (EMR Experts, 2009)

17. Functions of the Informatics Nurse Support for new users Continuing support of the system (UPMC, 2010)

18. In summary… EMRs as a healthcare technology trend

19. References Effken, J.A. (2009). Improving the human-technology interface. In D. McGonigle and K. Mastrian (Ed.), Nursing informatics and the foundation of knowledge (pp. 61-76). Sudbury, Massachusetts: Jones and Bartlett. EMR Experts (2009). Selecting the right hardware configuration for your EMR Software. Retrieved February 24, 2010, from http://www.emrexperts.com/articles/emr- hardware-buying.php Hardiker, N. (2009). Developing standardized terminologies in nursing infomatics. In D. McGonigle and K. Mastrian (Ed.), Nursing informatics and the foundation of knowledge (pp. 97-106). Sudbury, Massachusetts: Jones and Bartlett.

20. References—con’t Hassett, M. (2002). Applications for health care information systems [Health care informatics: an interdisciplinary approach. Englebardt, Sheila P. and Ramona Nelson, eds. St. Louis. Mosby. 2002. pp. 148-157.]. Retrieved March 20, 2010 from http://reserve.libraries.psu.edu.ezaccess.libraries.psu.edu/ nurs HIMSS (2010). Electronic Medical Records versus Electronic Health Records. Retrieved February 2, 2010, from www.himssanalytics.org/docs/wp_emr_ehr.pdf OpenClinical (2009). Electronic Medical Records. Retrieved February 2, 2010, from http://www.openclinical.org/emr.html

21. References-con’t Staggers, N. (2003). Human factors: imperative concepts for information systems in critical care. AACN Clinical issues, 14(3), Retrieved February 22, 2010 from http://reserve.libraries.psu.edu.ezaccess.libraries.psu.edu/ nurs/457/45721.pdf UPMC (2010). UPMC Creates Electronic Health Record. Retrieved February 25, 2010, from http://www.upmc.com/aboutupmc/QualityInnovation/Exc ellenceInPatientCare/Pages/eRecord.aspx