Week 8 Assignment in #HI201 course in #MSHI

1. ELECTRONIC HEALTH RECORDS
ISSUES & CHALLENGES
IN A GOVERNMENT INSTITUTION
MARY GRACE A. VILLAREAL, RN

2. Photo Credit: http://www.bayhewitt.com
“COMING TOGETHER IS A
BEGINNING. KEEPING TOGETHER
IS PROGRESS. WORKING
TOGETHER IS SUCCESS.” -Henry Ford

3. TIME REQUIRED TO ENTER DATA
VS. MORE TIME WITH PATIENTS
Upon introduction of computerisation to
the clinical area, bulk of work is coursed
through the nursing staff. Encoding of
request (laboratory, prescription, &
charging of procedures and supplies)
Medication Request
Photo Credit: MedlinePlus.gov
Gives
prescription to
Nursing Staff for
Encoding

4. SOLUTION:
• Give physicians access to directly encode prescriptions.
• Pharmacy staff can render medications issued.
• Nursing staff will charge medications given per patient.
Avoidance
of duplicate
task
=
Efficient
workflow;
Quality
patient care
Photo Credit: http://www.dementia.org

5. LACK OF CUSTOMISATION VS.
TIME TO LEARN THE SYSTEM
The system provided by the
institution is geared towards a
paperless clinical area. Since it
was provided pre-built the
users were left to adjust &
adopt to the system, without
taking into consideration the
users’ needs and requirements.
Image Credit: http://macrovations.com

6. SOLUTION:
• Work with the end-user in design and observe their work
flow.
• Provide a system that will meet the users’ special needs or
requirements.
• Give ample time to train staff, provide feedback and support.
• Give periodic follow up regarding system use, and audit
works done.
Customized
System
Training Ease;
System
Adaption
Staff
Participation

7. CLINICAL DATA ENTRY ERRORS
AND MULTIPLE RECORDS
The point and click and
drop-down menu capabilities
of most EMR systems foster
the propagation of erroneous
data. Unless a provider takes
the t ime to audi t the
electronic record on each
visit, inaccurate information
can be placed in a record and
continued forward.
-Kevin R. Campbell, MD

8. SOLUTION:
• Assign a “unique number assigned to each patient within a
hospital that distinguishes the patient and his or her health
record from all others” (Johns, 2002)
• Consolidate duplicate records, and migrate out-patient and
in-patient data.
• Educate and train users in health record documentation and
prepare them for EHR implementation.
• Provide data standards within the institution, if possible,
within the industry.
http://www.shorelinerecordsmanagement.com

9. Image Credit: http://allthingslearning.files.wordpress.com

10. CONCLUSION:
In every system, there will always be room for improvement and
evolution. Resistance will always be met, but by finding
champions who will advance the program change can be shown
as a more tangible process. Involving the users’ and showing
them the possible benefits will provide the long term ideals of
Electronic Health Record use. Data quality is significant,
“garbage in = garbage out”, by training, standard implementation
and audit it can be translated into valuable information. Privacy
and security being the constant guide to building great EHR
systems.