A structure for the planning, management and continuous enhancement of electronic medical records systems.

1. Anatomy and Issues of Electronic Medical Records Systems Lyon, Popanz  Forester May 26, 2009

4. Focus of $19.2 billion for health information technology http://content.nejm.org/cgi/content/full/NEJMp0900665?query=TOC Part of $787 billion economic stimulus package American Recovery and Reinvestment Act of 2009 The Health Information Technology for Economic and Clinical Health Act or HITECH Why electronic medical records?

7. Scope: EMR & PHR EMR – electronic medical records managed by source of the data, e.g., hospital, doctor, etc. PHR – personal health records managed by the patient/consumer using Google, Microsoft, etc. Other systems: Billing and payments; HR; Hospital operations: dietary; etc. HITECH EMR Hospitals Doctors’ Offices Public Health Support Services, e.g., Labs, Pharmacies Google/Microsoft PHR Pharmacy e.g., refills Medical Devices e.g., monitors Support Services e.g., Labs Family authorized access

8. Status of Implementation The Wall Street Journal identified 10 types of EMR systems and assessed their implementation in hospitals: Highest: Laboratory Results 75% Lowest: Physician’s Notes & Clinical Guidelines:15% All others: 27% to 52% Full EMR: 1.5% of US hospitals * The survey did not address the question of whether or not these systems can be integrated into a nationwide health information infrastructure without significant modification or replacement http://online.wsj.com/article_email/SB124104350516570503-lMyQjAxMDI5NDAxMTAwNDEzWj.html April 30, 2009 * There are about 5,000 hospitals of which about 3,000 have 100 beds or more

9. Basic Anatomy of an EMR

10. EMR Systems & Context Systems: Context: All of these elements are in the process of evolution

11. Participants Sponsors of a system

14. Data Retain Receive Send Exchange

17. Technology

22. Additional resources: Internet research on ERM: http://www.delicious.com/hal9007/emr Twitter links to EMR: http://www.twitter.com/hal9007 Google Health (PHR+) http://www.google.com/health Microsoft Vault (PHR+) http://healthvault.com Microsoft A malga http://microsoft.com/amalga