scholarly journals Measuring the Delivery of Complex Interventions through Electronic Medical Records: Challenges and Lessons Learned

2018 ◽  
Vol 6 (1) ◽  
pp. 10 ◽  
Author(s):  
Beth Prusaczyk ◽  
Vanessa Fabbre ◽  
Christopher R. Carpenter ◽  
Enola Proctor
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Complex Interventions ◽  
Lessons Learned

scholarly journals Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1477
Author(s):  
Kiran Jobanputra ◽  
Jane Greig ◽  
Ganesh Shankar ◽  
Eric Perakslis ◽  
Ronald Kremer ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Social Impact ◽  
Clinical Information ◽  
Shared Vision ◽  
Lessons Learned ◽  
Software Developers ◽  
Humanitarian Emergencies ◽  
Individual Variables ◽  
Clinical Interactions

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record “pairs” on paper and tablet. 85 record pairs for 32 patients with 26 data items (temperature and symptoms) per pair were analysed. The average agreement between sources was 85%, ranging from 69% to 95% for individual variables. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

scholarly journals Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

F1000Research ◽  
2017 ◽  
Vol 5 ◽  
pp. 1477 ◽  
Author(s):  
Kiran Jobanputra ◽  
Jane Greig ◽  
Ganesh Shankar ◽  
Eric Perakslis ◽  
Ronald Kremer ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Social Impact ◽  
Clinical Information ◽  
Shared Vision ◽  
Lessons Learned ◽  
Software Developers ◽  
Humanitarian Emergencies ◽  
Clinical Interactions ◽  
Good Agreement

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record “pairs” on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

scholarly journals Electronic Medical Records in the American Health System: challenges and lessons learned

2020 ◽  
Vol 25 (4) ◽  
pp. 1293-1304 ◽  
Author(s):  
Robert S. Janett ◽  
Peter Pano Yeracaris
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Information Exchange ◽  
Improve Patient Care ◽  
Lessons Learned ◽  
Disruptive Technology ◽  
The Impact ◽  
Improve Patient

Abstract Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care. Considerable problems have been noted to result from a lack of interoperability and standardization of interfaces among these systems, impairing the effective collaboration and information exchange in the care of complex patients. It is extremely important that regional and national health policies be established to assure standardization and interoperability of systems. Lack of interoperability contributes to the fragmentation of the information environment. The electronic medical record (EMR) is a disruptive technology that can revolutionize the way we care for patients. The EMR has been shown to improve quality and reliability in the delivery of healthcare services when appropriately implemented. Careful attention to the impact of the EMR on clinical workflows, in order to take full advantage of the potential of the EMR to improve patient care, is the key lesson from our experience in the deployment and use of these systems.

scholarly journals Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1477 ◽  
Author(s):  
Kiran Jobanputra ◽  
Jane Greig ◽  
Ganesh Shankar ◽  
Eric Perakslis ◽  
Ronald Kremer ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Social Impact ◽  
Clinical Information ◽  
Shared Vision ◽  
Lessons Learned ◽  
Software Developers ◽  
Humanitarian Emergencies ◽  
Individual Variables ◽  
Clinical Interactions

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. 85 record “pairs” for 32 patients with 26 data items (temperature and symptoms) per pair were analysed. The average agreement between sources was 85%, ranging from 69% to 95% for individual variables. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.

Identification of EMR Hardware and Space Design Requirements using Human Factors Analyses

2014 ◽  
Vol 3 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Catherine Campbell ◽  
Chelsea Kramer ◽  
Shelley Kelsey ◽  
W. James King
Keyword(s):  
Human Factors ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Gap Analysis ◽  
Lessons Learned ◽  
Outpatient Clinics ◽  
Sociotechnical System ◽  
Space Design ◽  
Design Requirements ◽  
Improving Patient Care

Electronic Medical Records (EMR) are being implemented globally in the hope of improving patient care, provider coordination, documentation accuracy, and information availability. Numerous factors impact successful EMR implementation including usability, accessibility and unique characteristics of the sociotechnical system within which it will be used. This paper describes the application of human factors methods to support effective EMR implementation at one pediatric hospital. The focus is on the problem of hardware selection and placement – a topic that has not received much attention in the literature to date. The requirements gathering process for two outpatient clinics included a task and gap analysis of current clinic workflows that led to the identification of specific hardware and design recommendations supporting future EMR workflows. Lessons learned post-implementation and requirements associated with hospital wide practices were extrapolated to generate guiding principles that apply to EMR implementation in other outpatient clinics.

Sign in / Sign up

Export Citation Format

Share Document