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At least 703 records · Page 39Linked to original sources
PubMed2006

Electronic patient records and their benefit for patient care. Findings from the Section on Patient Records.

OBJECTIVES: To summarize current excellent research in the field of patient records. METHOD: Synopsis of the articles selected for the IMIA Yearbook 2006. RESULTS: Current research in the field of patient records analyses users' needs and attitudes as well as the potential and limitations of electronic patient record systems. Particular topics are the questions physicians have when assessing patients during ward rounds, the timeliness of results when ordered electronically, the quality of documenting haemophilia home therapy, attitudes towards patient access to health records and adequate strategies for record linkage in dependence on the intended purpose. CONCLUSIONS: The best paper selection of articles on patient records shows examples of excellent research on methods used for the management of patient records and for processing their content as well as assessing the potential, limitations of and user attitudes towards electronic patient record systems. Computerized patient records are mature, so that they can contribute to high quality patient care and efficient patient management.

Awards and Prizes↗
PubMed2006

e-Prescribing, efficiency, quality: lessons from the computerization of UK family practice.

Nearly all general practice physicians (GPs) in the United Kingdom (UK) have electronic health record (EHR) systems in their practices compared with perhaps 15% of primary care physicians in the United States (U.S.). Based on interviews of 13 general GPs and review of current literature, the authors argue that the historical experience of widespread electronic health record uptake in the UK provides insight into features that might motivate broad adoption in the United States. These features include electronic prescribing, improved quality and consistency of care, practice efficiencies that have both timesaving and revenue generating effects, and potential shielding from malpractice claims.

Diffusion of Innovation↗
PubMed2003

Reducing trauma payment denials with computerized collaborative billing.

BACKGROUND: Trauma care demands constant physician availability, resulting in rotational coverage systems. Third-party payors consider separate trauma surgeon bills as originating from the same individual. Trauma surgeons may be unaware of their colleagues' billing history on jointly managed patients. Not all postoperative procedures and evaluation and management services are denied by global surgical package rules. We investigated whether a networked billing program designed to crosscheck for global package coding concerns would reduce payment denials. METHODS: A networked relational database was created for trauma surgeons to enter billable encounters, displaying global periods and operative diagnoses while prompting for postoperative modifiers. Denials were compared for equivalent time periods before and after program initiation. RESULTS: Payment denials fell from 361 to 16 for "bundled" evaluation and management services and from 55 to 13 for bundled postoperative procedures. Time spent on billing decreased and legibility improved. Overall savings totaled $183,404. CONCLUSION: Collaborative billing can improve payments for professional trauma care.

Forms and Records Control↗
PubMed1998

The benefits and challenges of an electronic medical record: much more than a "word-processed" patient chart.

The electronic medical record (EMR) will constitute the core of a computerized health care system in the near future. The electronic storage of clinical information will create the potential for computer-based tools to help clinicians significantly enhance the quality of medical care and increase the efficiency of medical practice. These tools may include reminder systems that identify patients who are due for preventative care interventions, alerting systems that detect contraindications among prescribed medications, and coding systems that facilitate the selection of correct billing codes for patient encounters. Numerous other "decision-support" tools have been developed and may soon facilitate the practice of clinical medicine. The potential of such tools will not be realized, however, if the EMR is just a set of textual documents stored in a computer, i.e. a "word-processed" patient chart. To support intelligent and useful tools, the EMR must have a systematic internal model of the information it contains and must support the efficient capture of clinical information in a manner consistent with this model. Although commercially available EMR systems that have such features are appearing, the builders and the buyers of EMR systems must continue to focus on the proper design of these systems if the benefits of computerization are to be fully realized.

California↗
PubMed1994

Data storage and knowledge representation for clinical workstations.

The representation of patient information for use in clinical workstations is a complex problem. Ideally, it should be addressed in a way that allows multiple uses of the data, including simple manual review, sharing and pooling across institutions, and as input to knowledge-based decision support systems. To a great extent, this means coding information with controlled medical vocabularies, but it does not mean that all information must be codable before workstations are feasible. This paper defines some of the choices, both current and future, that are available to address the needs of controlled medical vocabularies for representing data and knowledge in clinical workstations and explores some of the implications of those choices.

Computer Communication Networks↗
PubMed1994

An architecture for a health care provider's workstation.

This paper presents an architecture for a health care provider's workstation designed to assist health care providers in performing their daily activities. The design is based on the concept of a clinician's associate which acts as an intelligent intermediary between the provider and a diverse collection of clinical, administrative, and educational information sources. The architecture is designed to be hardware platform independent, to work across different I/O capabilities, and to be open, allowing specialized applications to be easily integrated with the system and their functionality delivered through a common user environment.

Computer Communication Networks↗
PubMed2004

Security issues arising in establishing a regional health information infrastructure.

A regional health information infrastructure is being developed in an internally self-governing country which is a dependent territory of the British Crown, is not part of the United Kingdom but is a member of the British Commonwealth. This country of about 70000 inhabitants (and significant numbers of visitors) within the British Isles shares many functions with the United Kingdom-from the perspective of this paper the key shared functions relate to the infrastructure of the departments of social security, social services, central registry, all health care services and national insurance systems. Although it remains independent in various other respects, for the most part it endeavours to achieve an harmonious legislative relationship with the UK, and with the EU. One primary goal of the information infrastructure development project is to provide links between community, primary and secondary healthcare services and thereby to ensure integrity of information as it refers to each individual receiving care services. A second goal has been to integrate this environment with various other government functions including the issuing and checking of NHS ID numbers and of national insurance ID numbers, the payment of social welfare benefits, and perhaps with other functions where access to a common list of names and addresses is a significant factor. This paper outlines some of the issues that have arisen in endeavouring to meet the often conflicting wishes and needs of different groups as regards a health information infrastructure within a general public sector information service.

Computer Security↗
PubMed1977

Immunisation.

Explore the source record for details and available documents.

England↗
PubMed2002

The computer in office medical practice.

There will continue to be change and evolution in the medical office environment. As voice recognition systems continue to improve, instant creation of office notes with the absence of dictation may be commonplace. As medical and computer technology evolves, we must continue to evaluate the many new computer systems that can assist us in our clinical office practice.

Appointments and Schedules↗
PubMed2000

Dermatology practice management assures practice development and efficiency.

This article provides an overview of the disciplines involved in managing a dermatology practice today. Several key management processes, including strategic planning, financial analysis, advertising and public relations, information systems management, and compliance program development and monitoring are addressed. This article explores several possible tactics that can be used to help guide your practice in the right direction without overtaxing your resources. Also offered are possible solutions for creating an organization that is poised for success, and a management team capable of steering the practice through the sea of change ahead.

Advertising↗
PubMedDate not supplied

Considerations for sociotechnical design: experiences with an electronic patient record in a clinical context.

This paper argues that we should understand the process of IT design as the development of sociotechnical configurations. Drawing upon our experiences with an electronic patient record (EPR) on an Intensive Care Unit (ICU), we depict medical work practices as natural systems. Several considerations for design are developed. First, the EPR should not be overly structured with rationalistic and prefixed notions of the organization and content of medical work. Implementing structure is crucial, however, this should be derived from detailed, empirical knowledge of the practice involved. Second, it is crucial to ensure that the usage of the system will yield immediate benefits for primary users: the systems should support work, not generate it. Third, designing IT should include being aware of the socio political nature of seemingly 'neutral' tools as EPRs.

Decision Making, Computer-Assisted↗
PubMed2007

The electronic, 'paperless' medical office; has it arrived?

Modern information technology offers efficiencies in medical practice, with a reduction in secretarial time in maintaining, filing and retrieving the paper medical record. Electronic requesting of investigations allows tracking of outstanding results. Less storage space is required and telephone calls from pharmacies, pathology and medical imaging service providers to clarify the hand-written request are abolished. Voice recognition software reduces secretarial typing time per letter. These combined benefits can lead to significantly reduced costs and improved patient care. The paperless office is possible, but requires commitment and training of all staff; it is preferable but not absolutely essential that at least one member of the practice has an interest and some expertise in computers. More importantly, back-up from information technology providers and back-up of the electronic data are absolutely crucial and a paperless environment should not be considered without them.

Computer Security↗
PubMed2005

Development of a web-based database to manage American College of Emergency Physicians/American Academy of Pediatrics Emergency Information Forms.

Children with special health care needs require special advanced planning for their unique emergencies. A Web site has been developed to allow secure Internet access to a database of Emergency Information Forms developed using the American College of Emergency Physicians/American Academy of Pediatrics format. The content and organization of the Web site, found at http://www.memscis.org, are described. A tour of the site is available. A set of XML data elements has been defined. Additional disaster preparedness elements have been added to the American College of Emergency Physicians/American Academy of Pediatrics Emergency Information Forms. The organization, security, and relationship of the site to electronic health records are described.

Data Collection↗
PubMedDate not supplied

Medical groups' adoption of electronic health records and information systems.

We surveyed a nationally representative sample of medical group practices to assess their current use of information technology (IT). Our results suggest that adoption of electronic health records (EHRs) is progressing slowly, at least in smaller practices, although a number of group practices plan to implement an EHR within the next two years. Moreover, the process of choosing and implementing an EHR appears to be more complex and varied than we expected. This suggests a need for greater support for practices, particularly smaller ones, in this quest if the benefits expected from EHRs are to be realized.

Data Collection↗
PubMed2006

Applied medical informatics for the chest physician: information you can use!--Part 3.

In this third and last part in our series on applied medical informatics (AMI), we will examine the following: (1) a concise wrap-up of the practice steps necessary to achieve the benefits from AMI in your practice; (2) an introduction to the patient health-care record and why it is important to physicians; and (3) a look at some of the latest developments in AMI that are of interest to the chest physician.

Humans↗