Electronic Health Record Patient Portals and the Blockchain Technology

The electronic health records (EHR) patient portals are an integrated eHealth technology that combines an EHR system and a patient portal, giving patients access to their medical records, exam results, and services, such as appointment scheduling, notification systems, and e-mail access to their physician. EHR patient portals empower patients to carry out self-management activities and facilitate communication with healthcare providers, enabling the patient and healthcare provider to access the medical information quickly. Worldwide governmental initiatives have aimed to promote the use of EHR patient portals. The implementation of EHR patient portals encompasses several challenges, including security, confidentiality concerns, and interoperability between systems. New technological approaches like blockchain could address these issues and enable a successful worldwide implementation of EHR patient portals.

Tools Used by Hospital Management to Reinforce Change and Sustain Results in the Implementation of EHR System in Public and Private Hospitals

Hospitals are complex to operate, particularly in the implementation of electronic health records systems. The implementation and use of electronic health records (EHR) management in hospitals requires management to reinforce change and sustain results for good end results. The purpose of this chapter is to unveil tools used by public and private hospital management to reinforce change and sustain results in the implementation of electronic health records systems. Both public and private hospital are based in the eThekwini Municipality. The conceptual framework based on Kotter Leading Change Model was comprehensively discussed. The findings of the study revealed that there are no standard guidelines for both public and private hospitals in the implementation of EHR system in hospitals. Clarity regarding change management policies and procedures in the implementation of EHR system in both public and private hospitals is required. The study recommends that both public and private hospitals tools to reinforce change and sustain results in the implementation of electronic health records management need to be developed and officially documented.

Electronic health record–based disease surveillance systems: A systematic literature review on challenges and solutions

Objective Disease surveillance systems are expanding using electronic health records (EHRs). However, there are many challenges in this regard. In the present study, the solutions and challenges of implementing EHR-based disease surveillance systems (EHR-DS) have been reviewed. Materials and Methods We searched the related keywords in ProQuest, PubMed, Web of Science, Cochrane Library, Embase, and Scopus. Then, we assessed and selected articles using the inclusion and exclusion criteria and, finally, classified the identified solutions and challenges. Results Finally, 50 studies were included, and 52 unique solutions and 47 challenges were organized into 6 main themes (policy and regulatory, technical, management, standardization, financial, and data quality). The results indicate that due to the multifaceted nature of the challenges, the implementation of EHR-DS is not low cost and easy to implement and requires a variety of interventions. On the one hand, the most common challenges include the need to invest significant time and resources; the poor data quality in EHRs; difficulty in analyzing, cleaning, and accessing unstructured data; data privacy and security; and the lack of interoperability standards. On the other hand, the most common solutions are the use of natural language processing and machine learning algorithms for unstructured data; the use of appropriate technical solutions for data retrieval, extraction, identification, and visualization; the collaboration of health and clinical departments to access data; standardizing EHR content for public health; and using a unique health identifier for individuals. Conclusions EHR systems have an important role in modernizing disease surveillance systems. However, there are many problems and challenges facing the development and implementation of EHR-DS that need to be appropriately addressed.

Identification of Fundamental Issues Relevant to Implementing Electronic Health Record Medication Reconciliation: Case of Noor Hospital in Iran

By reviewing in the extant literature, it is inferable that implementation of Electronic Health Record (EHR) is practical for providing salutary effects in the healthcare industries during the procedure of medication reconciliation (Med Rec). This research aims to identify issues or latent concepts relevant to implementing EHR system in the Noor Hospital located in Alborz province, Iran. According to the recent study by scholars, nine latent concepts are related to the implementation of EHR, which are: care coordination issues (CCI); patient education issues (PEI); ownership and accountability issues (OAI); process-of-care issues (PCI); IT-related issues (ITRI); workforce training issues (WTI); workflow issues (WI); resources issues (RI); and documentation issues (DI). The author takes a quantitative method that involves questionnaires distribution among one hundred and thirty-eight practitioners. One hundred and thirty-two valid questionnaires were returned, and collected data were analyzed through the Statistical Package for Social Sciences (SPSS). Findings supported the notion that all issues have a positive relationship with the implementation of EHR Med Rec in the Noor hospital. Among them, DI and PEI had the highest association. The current study implies arresting messages and ramifications for the managers in the healthcare industries in Iran, especially Noor Hospital, and it has its academic benefits in this research era.

Impact of EHR Technology Implementation on Physicians' Job Satisfaction

The concept of an electronic health record (EHR) has been the solicitous subject of researchers’ discussion in recent times. The impact that a successful implementation of EHRs can have on physicians cannot be overstated. Factors which are critical to successful implementation of EHR systems are commonly known as crucial technology implementation factors (CTIFs). The present study investigates the CTIFs of EHR systems and also their impact on physicians’ job satisfaction and characteristics in North Indian multispecialty hospitals. The questionnaire has been distributed to physicians of 12 hospitals that have been using EHR technology. It has been concluded that five CTIFs—organizational support, training, software attributes, acceptance to change, and computer knowledge—play a more important role than that played by other factors. The factors have not been considered separately on the basis of preimplementation scenario and postimplementation phase. The study attempts to analyze the impact of EHR systems on job operational performance of physicians.

Increase in the patient wait-time and delays in the clinic workflow post-implementation of the electronic health record.

194 Background: Growth in patient (pt) volume and limited clinic capacity can lead to long wait-times and pt/provider dissatisfaction. We have previously shown that the room pooling model, can reduce pt wait-time in the exam room, improve room utilization, and pt/providers satisfaction (ASCO 2016, Abstract 6595). One of the important goals of adopting electronic health records (EHR) is also to increase the clinical efficiencies, productivity and quality of care. The purpose of this study was to evaluate the impact of implementation of EHR on pt wait-time in the exam room and satisfaction in the Sarcoma Center. Methods: The time studies and pt and provider wait-time satisfaction surveys were carried out over 2 weeks prior to (baseline) and 6 months after the implementation of EHR. All times of when pts, mid-level providers, and doctors (MD) entered and exited the exam rooms were collected for a total sample size of 578 pts (300 before, 278 after) seen during the clinic hours and analyzed using JMP and SAS. Results: The proportion of pts seen within 30 minutes (Min) by MDs from the time pts roomed into exam room decreased by about 32% [from 53% (148/280) to 36% (94/259), p = 0.0001] post implementation of EHR. The median time for pts in the exam room waiting for MD increased (p = 0.0001) from 30 min (range: 0-126 min) to 40 min (range: 0-121 min). Although, the pt satisfaction did not significantly change [increase from 8% (23/278) to 12% (31/267) in the number of pts that were not satisfied to little-satisfied, and decrease from 92% (255/278) to 88% (236/267) in pts that were moderately to very-satisfied], the number of times MD had to wait for an open exam room increased from 8% (5/65) to 24% (14/59, p = 0.01). The delays to see MDs were associated with longer time spent with the nurse (from median 4 to 7 min), followed by delays in seeing Mid-level provider (from 11 to 18 min). Conclusions: These findings indicate that in the initial stages of implementation of EHR, the increase in pt wait-time and reduced clinical efficiencies can be related to the learning of and adapting to the new system. Attempts targeted to the areas of delays (such as training and redesigning workflow) may reduce the pt wait-time and improve the clinical efficiency.

The Effect of Adoption of an Electronic Health Record on Duplicate Testing

Background. The electronic health record (EHR) has been promoted as a tool to improve quality of patient care, reduce costs, and improve efficiency. There is little data to confirm that the use of EHR has reduced duplicate testing. We sought to evaluate the rate of performance of repeat transthoracic echocardiograms before and after the adoption of EHR.Methods. We retrospectively examined the rates of repeat echocardiograms performed before and after the implementation of an EHR system.Results. The baseline rate of repeat testing before EHR was 4.6% at six months and 7.6% at twelve months. In the first year following implementation of EHR, 6.6% of patients underwent a repeat study within 6 months, and 12.9% within twelve months. In the most recent year of EHR usage, 5.7% of patients underwent repeat echocardiography at six months and 11.9% within twelve months. All rates of duplicate testing were significantly higher than their respective pre-EHR rates (p<0.01for all).Conclusion. Our study failed to demonstrate a reduction in the rate of duplicate echocardiography testing after the implementation of an EHR system. We feel that this data, combined with other recent analyses, should promote a more rigorous assessment of the initial claims of the benefits associated with EHR implementation.

Research on Software Key Technology of Implement EHR at Small Medium Enterprises

Solving the key technology of software system is the foundation of the enterprise implementation of EHR. For small medium enterprise data quantity is little, and lack of a large amount of money to support, carry on the key techniques of EHR software studies. First, research software framework technology, compare the characteristics of the J2EE framework and the.Net framework, recommend the latter, and give the frame structure; Study on performance evaluation index system, illustrate the basic idea of target management, design implementation procedures of target management; Finally, research system security, design three-dimensional framework based on OSI model network security system structure, make use of the SSL protocol to improve data security between application factors. The results of the study show that, software key technology for small medium enterprises implementation of EHR has the important practical significance.