Electronic Medical Records

PRESENTED BY:

WILLIAM LAMBERTON, RN

NURS 457
PENNSYLVANIA STATE UNIVERSITY
FEBRUARY 7, 2010
 Objectives

 Describe electronic medical

records (EMRs)
 List and describe EMR hardware
 List and describe EMR software
 Evaluate software used with EMRs
 Describe and review an EMR
information system
 Objectives—con’t

Examine advantages and disadvantages of

EMRs
Discuss legal and ethical issues associated
with EMRs
 What is an EMR?

Electronic database of a individual medical

information
Information entered by health care
providers
 From the inpatient setting

 From ambulatory care

Not interactive
Owned by the care provider
(HIMSS, 2010)
 What is an EMR? (con’t)

Makes orders easier to manage

Provides care prompts to providers
Eases administrative tasks
 Scheduling
 Billing

Enables organizations to report to

regulatory organizations
(OpenClinical, 2009)
 Hardware Used with an EMR

The Server
Wireless Tablet Personal
Computers (PCs) Photo from
www.tabletpc2.com
Work Stations
Computer on Wheels (COW)
Personal Digital Assistants (PDAs)
 About EMR Hardware

Wireless Tablet PCs

 Can be taken from room-to-room
 Information is entered at the bedside.

Work Stations
 Wired to the server
 Found at the Nurse’s Station

 Can be found in or between patient rooms

(EMR Experts, 2009)

 Example of EMR Software

Epic
Compass
Soarian
E-Record
 About E-Record

Allows for complete charting

 Date Entry by nurses
 Data Entry by ancillary staff

Viewing of all clinical results

Electronic Medication Administration
Record (eMAR)

(UPMC, 2010)
 Evaluation of E-Record Usability

Improving the human-technology

interface
Based on Staggers three axioms
 Focus on users
 Iterative design

 Empirical usability measures

(Staggers, 2003 and
Effken, 2009)
Healthcare information system—a description

E-Record
End users
Point of service devices

Data storage

Ancillary support

(UPMC, 2010 and

Hassett, 2002)
 Information System Review

E-Record
 Used by all members of the care team
 Functions performed

 Configuration

 Disease Classification

 Nursing Practice Standards Classifications

 Recommendations

(Hardiker, 2009)
 Advantages of the EMR

Information stored securely and

viewed later
Information can be viewed off site
Reduces redundant charting
Eliminates the risks of sloppy
handwriting
Portable, bedside charting
(HIMSS, 2010)
 Disadvantages of EMRs

Nurses must be computer savvy

Older nurses are resistant to change
Security of information on computer
screens
Downtime

(HIMSS, 2010)
 Ethical and Legal Issues

Privacy
Security

(Hasssett, 2010)
 Informatics Competencies

Ability to enter, view, and

manipulate information
Ability to navigate sections of
the EMR system
Ability to transmit information

(EMR Experts, 2009)

 Functions of the Informatics Nurse

Support for new users

Continuing support of the system

(UPMC, 2010)
 In summary…

EMRs as a healthcare
technology trend
 References

 Effken, J.A. (2009). Improving the human-technology

interface. In D. McGonigle and K. Mastrian (Ed.), Nursing
informatics and the foundation of knowledge (pp. 61-76).
Sudbury, Massachusetts: Jones and Bartlett.
 EMR Experts (2009). Selecting the right hardware
configuration for your EMR Software. Retrieved February
24, 2010, from http://www.emrexperts.com/articles/emr-
hardware-buying.php
 Hardiker, N. (2009). Developing standardized
terminologies in nursing infomatics. In D. McGonigle and
K. Mastrian (Ed.), Nursing informatics and the foundation
of knowledge (pp. 97-106). Sudbury, Massachusetts: Jones
and Bartlett.
 References—con’t

 Hassett, M. (2002). Applications for health care

information systems [Health care informatics: an
interdisciplinary approach. Englebardt, Sheila P. and
Ramona Nelson, eds. St. Louis. Mosby. 2002. pp. 148-157.].
Retrieved March 20, 2010 from
http://reserve.libraries.psu.edu.ezaccess.libraries.psu.edu/
nurs
 HIMSS (2010). Electronic Medical Records versus
Electronic Health Records. Retrieved February 2, 2010,
from www.himssanalytics.org/docs/wp_emr_ehr.pdf
 OpenClinical (2009). Electronic Medical Records.
Retrieved February 2, 2010, from
http://www.openclinical.org/emr.html
 References-con’t

 Staggers, N. (2003). Human factors: imperative concepts

for information systems in critical care. AACN Clinical
issues, 14(3), Retrieved February 22, 2010 from
http://reserve.libraries.psu.edu.ezaccess.libraries.psu.edu/
nurs/457/45721.pdf
 UPMC (2010). UPMC Creates Electronic Health Record.
Retrieved February 25, 2010, from
http://www.upmc.com/aboutupmc/QualityInnovation/Exc
ellenceInPatientCare/Pages/eRecord.aspx