Ambulatory Care
Robert Rowley, EHR Bloggers
“The idea has been that these HIEs would knit different ambulatory practices together, giving physicians using disparate Electronic Health Records systems a common place to exchange clinical data with each other – at first, it would simply be the summary data (problem lists, medication lists, allergies, immunizations, and lab results) that could be encoded in standard-format transport files (CCDs or CCRs). More robust full-document exchange of complete chart notes, imaging files, etc., would come later.
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27 January 2012 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Health Information Exchange, Hospitals
Johnson KB et al, J Am Med Inform Assoc, 18(5)
OBJECTIVE
Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE.
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23 January 2012 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, emergency, Health Information Exchange
Robert Rowley, EHR Bloggers
“As we head into 2012, the “hot topic” in EHR / Health IT circles is connectivity. A doctor’s EHR in the office is supposed to be able to connect with outside sources of patient data – reference laboratories, other clinicians using the same or different EHRs, immunization and public health registries, and the like.
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3 January 2012 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Hospitals, integration
Davis Giardina T, Singh H. JAMA. 2011
In the outpatient setting, between 8% and 26% of abnormal test results, including those suspicious for malignancy, are not followed up in a timely manner. Despite the use of electronic health records (EHRs) to facilitate communication of test results, follow-up remains a significant safety challenge.
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29 November 2011 | No Comments »
Categories: Science | Country: United States | Tag(s): Ambulatory Care, Communication, Decision Making, diagnose, lab results
Pamela Lewis Dolan, amednews
“The U.S. market for electronic medical records is expected to exceed $8 billion by 2016, up from $4.6 billion today, with the fastest-growing segment occurring in the small practice market, according to an industry report by Millennium Research Group.
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23 November 2011 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Adoption, Ambulatory Care
Holanda AA et al, Journal of Medical Systems, 2011
It is believed that Electronic Health Records (EHR) improve not only quality of care but also patient safety and health care savings. This seems to be true for developed countries but not necessarily in emerging economies. This paper examined the primary care physicians’ satisfaction with a specific EHR in a health district of a major city in Brazil and describes how they are using it as well as its specific functions. A cross-sectional questionnaire survey with all physicians from all Community Health Centers of the 6th health district of the City of Fortaleza that were using HER was conducted. From the 111 subjects (100%), a total of 99 physicians answered the survey (89% response rate). For overall satisfaction with the EHR, 2 (2%) were satisfied, 50 (50.5%) were satisfied in part and 47 (47.5%) were not satisfied.
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12 November 2011 | No Comments »
Categories: Science | Country: Brazil | EHR: EHR, EHR Brazil | Tag(s): Ambulatory Care, Developing Countries, Primary Care, Satisfaction
Abramson EL et al, Joint Commission Journal on Quality and Patient Safety, 37(10)
BACKGROUND
Health policy forces are promoting the adoption of interoperable electronic health records (EHRs) with electronic prescribing (e-prescribing). Despite the promise of EHRs with e-prescribing to improve medication safety in ambulatory care settings–where most prescribing occurs and where errors are common–few studies have demonstrated its effectiveness. A study was conducted to assess the effect of an e-prescribing system with clinical decision support, including checks for drug allergies and drug-drug interactions, that was integrated within an EHR on rates of ambulatory prescribing errors.
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23 October 2011 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, e-prescribing, Medication Errors, Safety
Mike Miliard, Healthcare IT News
“Fewer than half of physician practices have made the switch to EHRs – but that should change very soon.
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1 October 2011 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Adoption, Ambulatory Care, SaaS
Schnipper JL et al, J Am Med Inform Assoc, 18(3)
Serious medication errors occur commonly in the period after hospital discharge. Medication reconciliation in the postdischarge ambulatory setting may be one way to reduce the frequency of these errors. The authors describe the design and implementation of a novel tool built into an ambulatory electronic medical record (EMR) to facilitate postdischarge medication reconciliation. The tool compares the preadmission medication list within the ambulatory EMR to the hospital discharge medication list, highlights all changes, and allows the EMR medication list to be easily updated.
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30 September 2011 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Medication, Primary Care
Jean-Jacques M et al, Journal of General Internal Medicine, 2011
BACKGROUND
Health information technology (HIT)-supported quality improvement initiatives have been shown to increase ambulatory care quality for several chronic conditions and preventive services, but it is not known whether these types of initiatives reduce disparities.
OBJECTIVES
To examine the effects of a multifaceted, HIT-supported quality improvement initiative on disparities in ambulatory care.
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9 September 2011 | No Comments »
Categories: Science | Country: United States | Tag(s): Ambulatory Care, Disparities, Health Information Technology, Quality
Zandieh SO et al, J Am Med Inform Assoc, 2011
Objective
To evaluate practitioners’ expectations of, and satisfaction with, older and newer electronic health records (EHRs) after a transition.
Material and methods
Pre- and post-transition survey administered at six academic-affiliated ambulatory care practices from 2006 to 2008. Four practices transitioned to one commercial EHR and two practices to another. We compared respondents’ expectations of, and satisfaction with, the newer EHR.
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29 August 2011 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Physicians, Satisfaction
Jordan Lanham H et al, J Am Med Inform Assoc, 2011
Objective
Despite efforts made by ambulatory care organizations to standardize the use of electronic health records (EHRs), practices often incorporate these systems into their work differently from each other. One potential factor contributing to these differences is within-practice communication patterns. The authors explore the linkage between within-practice communication patterns and practice-level EHR use patterns.
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16 August 2011 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Communication
Robert Rowley, EHR Bloggers
“Ambulatory practices are “service nodes” in a larger ecosystem. Much of the work is done in concert with other pieces of the delivery system – referring physicians, consultants, pharmacies, outside laboratories, outside x-ray and imaging centers, etc. Thus, the future of EHRs for these kinds of settings really does focus on connectivity.
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22 July 2011 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Connectivity, Hospitals, Workflow
Robert Rowley, KevinMD
“An EHR system built to be an ambulatory solution won’t work well for an inpatient setting. Similarly, an inpatient EHR pushed out onto ambulatory practices won’t work well either. The issues, workflows, and certification criteria are different.
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20 June 2011 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Certification, CPOE, e-prescribing, Hospitals, Workflow
Price M et al, ElectronicHealthcare, 10(1)
Use of electronic medical records (EMRs) is being promoted and funded across Canada. There is a need to consistently assess the use of those EMRs. This paper outlines an EMR adoption framework developed by the University of Victoria’s eHealth Observatory. It assesses provider adoption of an EMR in office-based practices across 10 functional categories.
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30 May 2011 | No Comments »
Categories: Science | Country: Canada | EHR: EHR, EHR Canada | Tag(s): Adoption, Ambulatory Care, e-Health, emr
Abramson EL et al, Journal of General Internal Medicine, 2011
BACKGROUND:
Healthcare providers previously using older electronic health records (EHRs) with electronic prescribing (e-prescribing) are transitioning to newer systems to be eligible for federal meaningful use incentives. Little is known about the safety effects of transitioning between systems.
OBJECTIVE:
To assess the effect of transitioning between EHR systems on rates and types of prescribing errors, as well as provider perceptions about the effect on prescribing safety.
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26 May 2011 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, e-prescribing
Jaimie Oh, ASCReview
“Based on findings from a recent study, researchers suggest electronic health records and clinical decision support systems may not significantly improve quality in ambulatory care settings, according to research published in the Archives of Internal Medicine.
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26 May 2011 | No Comments »
Categories: News | Country: United States | Tag(s): Ambulatory Care, Decision Support, Quality
Ken Terry, FierceHealthIT
“Many leading electronic health record vendors claim their ambulatory-care and hospital systems are integrated, but most are actually interfaced “under the covers,” health IT consultant Vince Ciotti (pictured), a principal of H.I.S. Professionals, LLC, based in Santa Fe, N.M., tells FierceHealthIT in an interview. This applies to almost every vendor that developed either a hospital EHR or an ambulatory-care EHR and then acquired an EHR in the other sphere.
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16 April 2011 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Hospitals, integration
Robert Rowley, KevinMD
“Adoption of electronic health records (EHR) systems remains a challenge, both for hospitals as well as for physicians in ambulatory practice. The process of adoption, implementation, and meaningful use of EHRs (let us keep in mind) is actually quite different between those two setting.
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27 January 2011 | No Comments »
Categories: News | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Hospitals, Implementation
Grieger DL et al, Journal of the American College of Surgeons, 205(1)
BACKGROUND:
Adoption rates for electronic health records (EHRs) have been slow, despite growing enthusiasm. Cost is a frequently cited obstacle to implementing an EHR. The body of literature citing a positive return on investment is largely anecdotal and infrequently published in peer-reviewed journals.
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26 January 2011 | No Comments »
Categories: Science | Country: United States | EHR: EHR, EHR USA | Tag(s): Ambulatory Care, Costs, Implementation
