Electronic Medical Record (EMR) is a computerized medical record that is created in an organization of care delivery for example, a hospital, or a doctor's surgery. These records tend to be part of the local health information system that allows the storage and retrieval of records as well as their modification. All the patients' data can be kept in digital form, which can then be stored in the computer or the Internet.
They demonstrate a clinical need and a reasonable minimum time within the year. Implementation includes the EMR software and hardware such as computers printers and scanners as well as other start up costs such as the custom interface and the costs of transferring the existing data well as the cost of setting up of the local networks. Costs of implementation vary depending on the size of the office and the choice of the EMR system.
The EMR pricing includes onetime cost of licensing, training and the costs of configuration as well as the ongoing costs of professional hosting such as server, 24x7 monitoring devises, cost of maintenance and backups, upgrades needed at an absolute EMR availability. There are no additional costs that are needed for servers, the backup systems, installation or upgrading that will be needed if the server is maintained in the owner's office.
Advantages of EMR
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One of the major advantages of the Electronic Medical records is that it helps in the centralization of the information and data regarding patients. In the past when a receptionist fails to turn up for work due to an emergency it was hard to retrieve the information of the next day's appointment of patients as he would be the only person who is aware of how he or she organizes the papers.
EMR also offers the opportunity to run a paperless clinic. There are two options for the provision of these two software's such as the standalone software, which could be installed in the hospital computer and all the patient data, will be stored in an electronic form, in the hospital. Online software could also be used; this system the patients' data will be stored in the Internet. The information will be stored in the information technology companies that are providing the online services and their experts, who will take care of the information.
Comprehensiveness of the patients' data is achieved with the electronic medical data. Electronic medical data contain the private medical records and other information related to the patient. For instance, it may contain information such as their past medical records, drugs that they are allergic to and the previous medications and that they have undergone in the past.
It only takes a very short time to retrieve the record of patients when using the electronic medical record. All that is required is to type the name of the patient in the form that the EMR soft ware presents and he will be able to access all the information about the patient in details. The most important thing is that it avoids the struggling to decipher someone else handwritings as some handwritings are hard to read. EMR software gives an opportunity to not only access the patients' information while seated in an office but from anywhere in the world though the use of Internet sources (Buzzel.com).
The data format that is presented by the use of the EMR system of data storage is not fixed as compared to the use of paper to record the patients' data, which is fixed. It can only be recorded following the format printed on paper. EMR software gives the chance to key in the data, in one format, and retrieve it in another format that is more suitable. With the use of a proper backup system and the latest antivirus, the reliability of the electronic medical records can be confirmed in that it gives the patient's record the safety and the security required.
The electronic data generated by the EMR soft ware can be monitored and analyzed for any errors. It can be abler to sound an alert for the events that need immediate attention or medical interventions. It can be also in a position to transmit relevant information in the form of an email. In addition, instructions can be sent to the external computer controlled devices such as automatic pills dispensers and infusion pumps, which can then carry the clinical intended action. Multiple, single planed images, can be transformed into a three-dimensional- pictures which can then be used by the surgeons field of view. It can also be able to integrate data from the hospital laboratory in an electronic form and thus ruling out the chances of feeding information with errors into the computer.
Electronic data management helps the staff to be more efficient as it saves time that is needed to do the paper work review. The patients' data will always be at the fingertips and, it will not depend on the mindless activity to search for it. As a management tool, the EMR provides information about the risk management and it offers the assessment of all the outcomes. The reimbursement that exists today strictly depends on the outcomes of all the health organizations and therefore, these institutions should provide a means of innovating ways of improving the quality (Wager, Lee & Glaser, 2009).
Tailored paper output can be obtained using the electronic data, and the data can be printed in a variety of font's colors and different sizes. This will help in the focus of the clinical attention on the most important data. To add on this, images can be combined with textual data, which gives a, more complete picture of the patient.
EMR represents a huge potential for cost saving and, it also decreases the work place inefficiencies. Paper record represents a massive fragmentation of the clinical information, which results in an increase in the cost of managing the patients' information, and it may result in an adverse effect on the future care of the medical records. Research finding support the digital system in that it can link with the clinicians protocols, care plans, literature databases, critical paths, and other pharmaceutical information as well as other databases that are linked to the healthcare knowledge.
On a financial basis, electronic medical recording will provide a more precise way of billing information and thus allows providers to submit their claims in an electronic way. This makes the payment reception quicker, and makes the patient happier as the previous information is available so, there is no need to provide the same information all the time.
Disadvantages of the EMR
Some disadvantages include factors such as the start up cost that can be excessive. Startup capital still offers a challenge for the installation and management of the system. Even though the use of the EMR system offers quality and a more reliable way of information management it is not easy to for most o the institutions to use this service as it is more expensive to maintain and also to install.
Another disadvantage of EMR is that there is a learning curve and training that is required to manage the system hence it can be useful to only to those users who have some type of technical knowledge. In the present, the clinical users are the ones who are the primary users of the EMR as opposed to the past, which were the clerks. The major challenge that is posed is the fact that the clinical officers are the ones who are supposed to use this digital method so, they should be well informed. There must be tools to allow the clinicians to understand and retrieve the data.
Confidentiality and the safety issues are the major concerns that are poses in relation to the use of the EMR system. Major threats are associated with the crushing of the computer system as well as the virus attack that can lead to the loss of information. A powerful up to date antivirus has to be installed to help in this problem. There are several security technologies that are available that will prevent the access of the health information. This security technology can be able to detect and deny access to the information by an unauthorized person.
Placement of a harddisk can be an issue in regards to the portability of the equipment. Workflow will change because of the implementation of the EMR therefore, decisions have to be made in order to determine who enters the data, and the documentation forms have to be revised to accommodate the changes. Another huge problem in the implementation is the lack of a standardized system of terminology system architecture and indexing. By adding standard EMR, plat form clinicians will be in a position to use a range of the best breed clinical applications, which all share a common standard EMR architecture (Scott & Rundall, 2007).
Physician Information Technology Office (PITO)
The Physical Information Technology Office (PITO) helps in the transition to the EMR system and in the realization of the value of the EMR system. It was formed in 2006 as a part of the Physician, master agreement that was formed between the provincial ministry of health services and British Columbia Medical Association. (BCMA). PITO has both professional and funding support that is available to assist those who are in the health sector.
Its support team assists in the early planning and all through to the transition as well as the follow-up that is needed for the EMR to be implemented. PITO provides a 70 per cent financial support and contribution towards meeting the costs needed. It also provides a listing of the qualified PITO solutions, which are conformances extensively and tested as well as the provision of the support of the physician and the medical office assistants who are peer mentors or those who provide local expertise. It also assists in the connection of practices to the ministry of health services private physician network, which gives an opportunity for the secure health system network. This health system network connects to the health authorities and to the provincial electronic health system. The provincial physician network acts as an Internet connection as it gives access to the Internet and it ensures sensitive confidential patients data such as the prescriptions from the laboratory, stays within the segregated private network rather than allowing it to circulate over the open Internet (Bodenheimer & Grumbach, 2006).
PITO's goal is to ensure that the transition to the EMR system is as easy as possible. It recognizes the variability of the practices of various private health centers' and the challenges that arise because of changing the office functions and procedures. PITO has technical expertise and a peer support that helps those who want to implement the EMR system to be in a position to choose the EMR system that fits the organization. It also implements a transitional support program that is designed to be more flexible and responsive to particular needs of an organization. These support programs are provided free of charge.
It also connects to the relation manager who gets to know the goals of the institution and provides information as well as the advices that help in choosing the EMR options that can work well for the office. Afterwards, he is able to guide through the implementation and planning in details, which includes the readiness in assessment, organization of the action plan and the budget template, as well as the procurement and checklist support. An important part of the PITO is to support the physicians in adopting the aspects of management through the provision of tools that are necessary for the analysis and identification of patients in need of special attention, through the association of the chronic disease management and complex care initiative funds (A Buyer's Guide to Medical Software).
Vendors approved to deliver software
EMR software is software that provides complete electronic medical records of a patient's health history. The information that is commonly found this software includes the progress of the patient, past history, vital signs, laboratory data, and others such as the radiology results. These systems are integrated with the medical billing software and practice management software. The market offers a wide range of the web based EMR systems as well as the systems installed on the premises. Many software vendors provide sections that have different features, which a software vendor can implement after the initial software implementation. The most important situation is to evaluate the needs of the office and the future implementation of the process. The choice of the vendors should ensure that the vendor chosen generates enough income from operations to ensure continued investment and enough working capital and if the vendor focuses in the required area of development. There are different vendors that are out there in the market and are the ones who offer these services. The prices of the vendors vary depending on the kind of the service system that they offer. Examples of these vendors include Emis, Med access, med fusion, and the Osler systems management.
Osler Systems offers medical and practice management software to physicians in the BC since 1983. It is the largest medical software vendor and has approximately 3000 practitioners in 1200 sites. Osler's featured products include EMR, Clinical Decision support and order management among others. They sell their products to the general practitioners, specialists, physiotherapists, and chiropractors in small offices, hospitals, and clinics.
Med access provides personal attention during the implementation and it starts with immediate accession of the software, in order to review clinical workflow. They give training and other ongoing support services such as support with online help and video tutorials, and management of back up information. They charge different depending on the module that is required. They recommend a PC (win xp pro or Vista) in each office and the devices must be able to run Internet explorer (Kokwet, 2009).
Emis also offers training and other support services on the workflow analysis as well as the field operation and technical operations. They offer support services and ECR tracker, which allows users to access the user's guide. Minimum hardware specifications more advance as compared to those of the Med access though they offer these software installations at a cheaper price.
My choice of vendor is Osler Systems as they offer all the variety of EMR software at a cheaper price. They are also well developed in terms of working capital and their network development. They sell their products to the practitioners, specialists, physiotherapists, and chiropractors who work in small offices, hospitals, and clinics, which give a chance of all the physicians in all the fields to be represented well.
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