the international council on medical & care compunetics

science pages

December, 2014

electronic medical records

Separate may not be equal: A preliminary investigation of clinical correlates of electronic psychiatric record accessibility in academic medical centers

Kozubal DE et al, International Journal of Medical Informatics, 2012

Electronic Medical Records (EMR) have the potential to improve the coordination of healthcare in this country, yet the field of psychiatry has lagged behind other medical disciplines in its adoption of EMR.

Psychiatrists at 18 of the top US hospitals completed an electronic survey detailing whether their psychiatric records were stored electronically and accessible to non-psychiatric physicians. Electronic hospital records and accessibility statuses were correlated with patient care outcomes obtained from the University Health System Consortium Clinical Database available for 13 of the 18 top US hospitals.
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Published: 20 December 2012 |
Keyword(s): Accesibility, Adoption, e-Health, Electronic Health Records, Electronic Medical Records, Psychiatry, United States

Biomedical data privacy: problems, perspectives, and recent advances

Malin BA et al, J Am Med Inform Assoc, 2012

The notion of privacy in the healthcare domain is at least as old as the ancient Greeks. Several decades ago, as electronic medical record (EMR) systems began to take hold, the necessity of patient privacy was recognized as a core principle, or even a right, that must be upheld. This belief was re-enforced as computers and EMRs became more common in clinical environments. However, the arrival of ultra-cheap data collection and processing technologies is fundamentally changing the face of healthcare. The traditional boundaries of primary and tertiary care environments are breaking down and health information is increasingly collected through mobile devices, in personal domains (eg, in one’s home), and from sensors attached on or in the human body (eg, body area networks).
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Published: 6 December 2012 |
Keyword(s): Biomedical Data, De-identification, Electronic Medical Records, Privacy, Review

Defining and Evaluating Electronic Medical Record Data Quality within the Canadian Context

Bowen M, Lau F. ElectronicHealthcare, 11(1)

Data collected by primary care providers in electronic medical record (EMR) systems can be used to support a variety of actions including provision of day-to-day care, decision support, practice reflection, research and public health surveillance. The extent to which EMR data can be relied on to support such actions is dependent on the quality of the held data. While a body of literature describing data quality assessment techniques exists, few studies speak to the challenges of evaluating data quality in the Canadian primary care setting. In response, researchers at the University of Victoria’s eHealth Observatory are refining data quality definitions and developing techniques for the evaluation of EMR data quality within the Canadian primary care context.
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Published: 25 June 2012 |
Keyword(s): Canada, Electronic Health Records, Electronic Medical Records, Evaluation, Primary Care, Quality

The electronic medical record and patient-centered care

Nusbaum NJ. Online Journal of Public Health Informatics, 3(11)

One goal in EMR development should be to facilitate a patient-centered clinical encounter.

Qualitative analysis and suggestions are offered for how the EMR can individualize patient care, in support of a patient-centered approach.
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Published: 2011 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Health Information Technology, health-literacy, Prevention, United States, Usability

Comparing virtual consults to traditional consults using an electronic health record: an observational case¿control study

Palen TE et al, BMC Medical Informatics and Decision Making, 12(1)

Patients have typically received health care through face-to-face encounters. However, expansion of electronic communication and electronic health records (EHRs) provide alternative means for patient and physicians to interact. Electronic consultations may complement regular healthcare by providing “better, faster, cheaper” processes for diagnosing, treating, and monitoring health conditions. Virtual consultation between physicians may provide a method of streamlining care, potentially saving patients the time and expense of added visits. The purpose of this study was to compare physician usage and patient satisfaction with virtual consultations (VCs) with traditional consultations (TCs) facilitated within an EHR.
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Published: 8 July 2012 |
Keyword(s): e-Consultation, Electronic Health Records, Electronic Medical Records, Referral, Satisfaction, United States

An Electronic Medical Record (EMR) Implementation Framework for HIV Care and Treatment Facilities in Ethiopia

Gebre-Mariam M et al, ElectronicHealthcare, 11(1)

Implementing electronic medical record (EMR) systems is a complex process that is receiving more focus in developing countries to help understaffed and overcrowded health facilities deal with the HIV/AIDS epidemic. Despite growing evidence of EMR systems implementation in various developing countries to support acute and chronic disease management, use of these systems by clinicians for patient monitoring and management is limited in many sub-Saharan African countries.
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Published: 25 June 2012 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Ethiopia, HIV, Implementation

Integrating Clinical Practice and Public Health Surveillance Using Electronic Medical Record Systems

Klompas M et al, American Journal of Preventive Medicine, 42(6, Supplement 2)

Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of public health interest, and automatically communicate results to health departments.
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Published: 12 June 2012 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Primary Care, Public Health, United States

The Use of Patient Pictures and Verification Screens to Reduce Computerized Provider Order Entry Errors

Hyman D et al, Pediatrics, 2012

To determine whether an order verification screen, including a patient photograph, is an effective strategy for reducing the risk that providers will place orders in an unintended patient’s electronic medical record (EMR).
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Published: 4 June 2012 |
Keyword(s): Adverse Events, CPOE, Electronic Health Records, Electronic Medical Records, Identification, Patient Safety, United States

Typical Electronic Health Record Use in Primary Care Practices and the Quality of Diabetes Care

Crosson JC et al, The Annals of Family Medicine, 10(3)

Recent efforts to encourage meaningful use of electronic health records (EHRs) assume that widespread adoption will improve the quality of ambulatory care, especially for complex clinical conditions such as diabetes. Cross-sectional studies of typical uses of commercially available ambulatory EHRs provide conflicting evidence for an association between EHR use and improved care, and effects of longer-term EHR use in community-based primary care settings on the quality of care are not well understood.
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Published: 1 May 2012 |
Keyword(s): Diabetes Mellitus, Electronic Health Records, Electronic Medical Records, Medical Record Systems, Primary Care, Quality, United States

Genetic testing behavior and reporting patterns in electronic medical records for physicians trained in a primary care specialty or subspecialty

Ronquillo JG et al, J Am Med Inform Assoc, 2012

To characterize important patterns of genetic testing behavior and reporting in modern electronic medical records (EMRs) at the institutional level.

Materials and methods
Retrospective observational study using EMR data of all 10 715 patients who received genetic testing by physicians trained in a primary care specialty or subspecialty at an academic medical center between January 1, 2008 and December 31, 2010.
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Published: 17 April 2012 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Genetic Tests, Physician, Primary Care, United States

Impact of electronic medical record on physician practice in office settings: a systematic review

Lau F et al, BMC Medical Informatics and Decision Making, 12(1)

Increased investments are being made for electronic medical records (EMRs) in Canada. There is a need to learn from earlier EMR studies on their impact on physician practice in office settings. To address this need, we conducted a systematic review to examine the impact of EMRs in the physician office, factors that influenced their success, and the lessons learned.
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Published: 24 February 2012 |
Keyword(s): Canada, Electronic Health Records, Electronic Medical Records, Impact, Systematic Review

Electronic medical record quality and its impact on user satisfaction — Healthcare providers’ point of view

Chang I-C et al, Government Information Quarterly, 2011

With the increasing mobility of the population, Electronic Medical Records (EMRs) become a promising opportunity for governmental investment to many countries. An EMR project usually involves a huge grant and needs tight control of the output. However, most measuring tools for the quality of paper-based medical records placed a focus on data format and compliance with law which may not be sufficient and adequate enough in measuring the EMR’s quality.
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Published: 18 February 2012 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Quality, User Satisfaction

INVITED COMMENTARY–Electronic Medical Records and Preserving Primary Care Physicians’ Time

McDonald CJ, McDonald MH. Archives of Internal Medicine, 172(3)

We both hear strong complaints from primary care physicians (PCPs) about electronic medical records (EMRs) cutting their time efficiency. A long and detailed venting occurred 4 years ago when we were together at a social gathering and M.H.M. was bragging about his brother’s (C.J.M.’s) involvement in the genesis of EMRs. Two general internists—both women—did not agree that such involvement was praiseworthy.
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Published: 13 February 2012 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Primary Care, United States

Access to the Medical Record for Patients and Involved Providers: Transparency Through Electronic Tools

Feeley TW et al, Annals of Internal Medicine, 155(12)

Physicians’ notes are one of the oldest tools in medicine and have evolved into today’s electronic medical record. As we move toward greater transparency in health care, one emerging concept is that sharing information among patients, caregivers, and involved clinicians can improve efficiency, decrease redundancy, and decrease cost. The concept of improving health care delivery by sharing the medical record with the patient is not new.
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Published: 20 December 2011 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Patient, Patient Record Access, Physician notes, Provider, Transparency, United States

You and your EMR: the research perspective: Part 2. How structure matters

Ryan BL et al, Canadian Family Physician, 57(12)

Inputting information into your EMR requires a balance between being efficient and being complete and accurate. Both goals are critical for patient care. When you intend to conduct research using data from your EMR, there is an additional goal of being able to retrieve the data in a reliable and consistent manner.
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Published: December 2011 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Narrative, Structured data entry

You and your EMR: the research perspective: Part 1. Selecting and implementing an EMR

Ryan BL et al, Canadian Family Physician, 57(9)

The pace of EMR adoption among family physicians in Canada is accelerating and the potential of EMR research is tantalizing for physicians, researchers, and policy makers. This 4-part series, written by a team of clinicians and researchers who have expertise in EMR implementation and research, addresses considerations for EMR adoption when the goal is not only individual patient care but also research.
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Published: September 2011 |
Keyword(s): Canada, Electronic Health Records, Electronic Medical Records, Implementation

The adoption of electronic medical records and decision support systems in Korea

Chae YM et al, Healthcare Informatics Research, 17(3)

To examine the current status of hospital information systems (HIS), analyze the effects of Electronic Medical Records (EMR) and Clinical Decision Support Systems (CDSS) have upon hospital performance, and examine how management issues change over time according to various growth stages.
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Published: September 2011 |
Keyword(s): Decision Support Systems, Electronic Health Records, Electronic Medical Records, Hospital Information Systems, Information Management, Knowledge Management, Korea

[Electronic medical records and diabetes in Spain]

Navarro-Pérez J et al, Avances en Diabetología, 2011

Optimising care for people with diabetes goes through the incorporation of information and communication technology to a chronic care model.

To determine the development of electronic medical records related to diabetes in different regions of Spain.
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Published: 17 November 2011 |
Keyword(s): Chronic Diseases, Diabetes, Electronic Health Records, Electronic Medical Records, Primary Care, Quality, Spain

Evidence-Based Medicine in the EMR Era

Frankovich J et al, N Engl J Med, 2011

Many physicians take great pride in the practice of evidence-based medicine. Modern medical education emphasizes the value of the randomized, controlled trial, and we learn early on not to rely on anecdotal evidence. But the application of such superior evidence, however admirable the ambition, can be constrained by trials’ strict inclusion and exclusion criteria — or the complete absence of a relevant trial.
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Published: 2 November 2011 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Evidence-Based Medicine, United States

Electronic Medical Record Reminders and Panel Management to Improve Primary Care of Elderly Patients

Loo TS et al, Arch Intern Med, 171(17)

Most elderly patients do not receive recommended preventive care, acute care, and care for chronic conditions.

We conducted a controlled trial to assess the effectiveness of electronic medical record (EMR) reminders, with or without panel management, on health care proxy designation, osteoporosis screening, and influenza and pneumococcal vaccinations in patients older than 65 years. Physicians were assigned to 1 of the following 3 arms: EMR reminder, EMR reminder plus panel manager, or control. We assessed completion of recommended practices during a 1-year period.
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Published: 27 September 2011 |
Keyword(s): Alerts and Reminders, Elderly, Electronic Health Records, Electronic Medical Records, Primary Care, United States

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