Electronic Health Electronic Health RecordsRecords

Based on Alliance for Health Reform Toolkit Based on Alliance for Health Reform Toolkit on Health Information Technologyon Health Information Technology

Narrated by Leonel V. BalitonNarrated by Leonel V. Baliton

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CreditCredit

For the source see http://www.allhealth.org/Publications/Health_information_technology/health_information_technology_toolkit.asp#keyfacts

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Health Information Health Information Technology (HIT)Technology (HIT) Information processing Information processing Hardware and softwareHardware and software ForFor

EntryEntry StorageStorage RetrievalRetrieval SharingSharing UseUse

Components:Components: Electronic Medical RecordsElectronic Medical Records Computerized Physician Order Entry Computerized Physician Order Entry

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Electronic Medical Record Electronic Medical Record (EMR)(EMR)

Patient's legal medical recordPatient's legal medical record Stored in digital formatStored in digital format

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Fully Operational Electronic Fully Operational Electronic Health RecordHealth Record Core functionalityCore functionality

Storage & retrievalStorage & retrieval Result managementResult management Order entry & supportOrder entry & support Decision supportDecision support

Other functionalityOther functionality Electronic communicationElectronic communication Patient accessPatient access Administrative supportAdministrative support Population reportingPopulation reporting

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Personal Health Record Personal Health Record (PHR)(PHR)

Owned by a patientOwned by a patient Maintained by a patientMaintained by a patient

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Health Information Exchange Health Information Exchange (HIE)(HIE)

Move clinical information across Move clinical information across organizationsorganizations

Maintain the meaning of the Maintain the meaning of the informationinformation

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Regional Health Information Regional Health Information Network (RHIO)Network (RHIO)

Multi-stakeholder organizationMulti-stakeholder organization Operating in a specific Operating in a specific

geographical areageographical area Enables the exchange of health Enables the exchange of health

informationinformation

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National Health Information National Health Information Network (NHIN)Network (NHIN)

TechnologiesTechnologies StandardsStandards LawsLaws PoliciesPolicies ProgramsPrograms PracticesPractices

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Computerized Physician Computerized Physician Order Entry (CPOE)Order Entry (CPOE)

Computerized system Computerized system Physicians to enter their own Physicians to enter their own

ordersorders

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Consumers can

maintain a personal

health record

From Blumenthal and Glaser, New England Journal of Medicine Vol. 356: 24, June 2007

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Clinicians maintain

an Electronic

Health Record

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Health Information

Exchanges

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This creates a

Regional Health

Information network

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Several RHIOs make up elements

of the National Health Information

Network

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Why Adoption Has Been Why Adoption Has Been Slow?Slow?

InteroperableInteroperable CostCost PrivacyPrivacy

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Why Adoption Has Been Why Adoption Has Been Slow?Slow?

InteroperableInteroperable CostCost PrivacyPrivacy

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Why Adoption Has Been Why Adoption Has Been Slow?Slow?

InteroperableInteroperable CostCost PrivacyPrivacy

$44,000 per full-time provider

$8,500 annual maintenance

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Why Adoption Has Been Why Adoption Has Been Slow?Slow?

InteroperableInteroperable CostCost PrivacyPrivacy

Who Should Pay?

Lack of a business case for HIT

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Why Adoption Has Been Why Adoption Has Been Slow?Slow?

InteroperableInteroperable CostCost PrivacyPrivacy

$150 Billion

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Why Adoption Has Been Why Adoption Has Been Slow?Slow?

InteroperableInteroperable CostCost PrivacyPrivacy

Stark Law Privacy and security obligationsLiability exposure

Lack of trained IT Lack of trained IT personnelpersonnel

People who understand both the People who understand both the technology and the businesstechnology and the business

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Jury is Still Out Jury is Still Out Examples of Success ExistExamples of Success Exist

Department of Veterans Affairs Department of Veterans Affairs Improved quality of careImproved quality of care Easy recoveryEasy recovery

Take Home LessonTake Home Lesson

Adoption of Electronic Health Adoption of Electronic Health Records has been slowRecords has been slow