Increasing Accuracy in Medical Records Through EHR

Business Posts

(1) Finance

Balance Sheet

ASSETS

Non-current assets

$30,000

Equipment

$30,000

Current assets

$170,000

Inventory

$20,000

Accounts receivable

$100,000

Cash

$50,000

TOTAL ASSETS

$200,000

LIABILITIES

Accounts payable

$12,000

Payroll

$10,000

Rent

$5,000

Utilities

$2,500

$29,500

Owner's equity

$170,500

$170,500

TOTAL EQUITY AND LIABIULITIES

$200,000

(2) Discussion topic: Technology and Tools

Strengths

Weaknesses

Lower start-up costs. Fewer issues with maintenance of hardware. More resources including personnel and sophisticated procedures for security and backup of the patient information.

More ongoing expense over the long-term.

Subject to interruptions to the Internet, which restricts access to the EMR data.

The clinical information may be stored along with data from other practices.

Opportunities

Threats

Enhanced patient safety with respect to drug allergies or interactions and proper dosage. Enhanced documentation with access to digital imaging and special testing. Better integration between the clinic and the business department.

Although somewhat remote, a vendor providing web-based EMR services could go out of business, making back-up systems and disaster planning imperative. The costs attributable to the EMR systems vary depending on whether the systems are in-house or web-based off-site.

Planning of the EMR implementation will focus on intelligence-based system rather than simply a transaction-based system. From the outset, the EMR system needs to be able to leverage big data, support smart processes, and make recommendations based on the care contexts. John Glaser, PhD., is currently the CEO of the Health Services Business for Siemens Healthcare, and prior to that, he served as Vice President and Chief Information Officer for Partners HealthCare. What this means is that Glaser has the perspective of both a vendor and a care provider. Dr. Glasser recently published an article in Hospitals & Health Networks about the transaction-focused rigidity of EMRs. Glaser argues that this is to be expected since the basis for EMR coding is activities such as writing a prescription for medications or documenting an office visit. Research is needed to develop templates, order sets, and guidelines that reflect evidence-based practice and best practices. The research and development processes will need to build an infrastructure that manages processes with supports such as transaction checks for drug-drug interactions, basic process monitoring and guidance, and even asynchronous alert systems such as panic lab reporting. Evaluation needs to occur on a 360 degree basis with feedback loops that ensure physicians can communicate the quality of guidance they have received about orders and documentation. Testing will include the use of predictive modeling, and can be sufficiently sophisticated to indicate patient fragility that could indicate readmission or impoverishment with the potential to negatively impact post-hospitalization healing. Testing would further be facilitated by intelligent data displays that enable data identification and intelligent correction processes.