A Researcher S Guide To Using Electronic Health Records

In an age when electronic health records (EHRs) are an increasingly important source of data, this essential textbook provides both practical and theoretical guidance to researchers conducting epidemiological or clinical analysis through EHRs. Split into three parts, the book covers the research journey from start to finish. Part 1 focuses on the challenges inherent when working with EHRs, from access to data management, and raising issues such as completeness and accuracy which impact the validity of any research project. Part 2 examines the core research process itself, with chapters on research design, sampling, and analysis, as well as emerging methodological techniques. Part 3 demonstrates how EHR research can be made meaningful, from presentation to publication, and includes how findings can be applied to real-world issues of public health. Supported by case studies throughout, and applicable across a range of research software programs (including R, SPSS, and SAS), this is the ideal text for students and researchers engaging with EHRs across epidemiological and clinical research.

Electronic health records (EHRs) have become commonplace in the medical profession. Health data are readily captured and permanently stored in a digital fashion, and consequently, are increasingly being utilized in health research. The quality of this research depends upon the investigator’s ability to obtain the correct data to answer the correct question. It is easy to churn out poor quality research from the EHR; it is much harder to produce meaningful results that influence the population’s health. Improving Population Health Using Electronic Health Records takes the reader through the process of conducting meaningful research from data in the EHR. It de-mystifies the entire research process, from how to ask the right kind of research questions, to obtaining data with particular emphasis on data management and manipulation, to performing a valid statistical analyses, and interpreting and presenting the results in a clear, concise fashion that has the potential to improve population health. This book can be used as a hands-on how-to guide of performing research from EHR data in either a piece-meal fashion, selecting only the topics of greatest interest, or a complete guide to the entire research process. Readers will benefit from the intuitive presentation of complex methods with a multitude of examples. It is invaluable reading for researchers and clinicians who are not otherwise familiar with the complexities of working with large data sets.

Commissioned by the Department of Health and Human Services, Key Capabilities of an Electronic Health Record System provides guidance on the most significant care delivery-related capabilities of electronic health record (EHR) systems. There is a great deal of interest in both the public and private sectors in encouraging all health care providers to migrate from paper-based health records to a system that stores health information electronically and employs computer-aided decision support systems. In part, this interest is due to a growing recognition that a stronger information technology infrastructure is integral to addressing national concerns such as the need to improve the safety and the quality of health care, rising health care costs, and matters of homeland security related to the health sector. Key Capabilities of an Electronic Health Record System provides a set of basic functionalities that an EHR system must employ to promote patient safety, including detailed patient data (e.g., diagnoses, allergies, laboratory results), as well as decision-support capabilities (e.g., the ability to alert providers to potential drug-drug interactions). The book examines care delivery functions, such as database management and the use of health care data standards to better advance the safety, quality, and efficiency of health care in the United States.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Revised and updated to include the latest trends and applications in electronic health records, this fifth edition of Electronic Health Records: A Practical Guide for Professionals and Organizations offers step-by-step guidelines for developing and implementing EHR strategies for healthcare organizations. New to This Edition: 2013 Update Addresses the expanded interaction among HIM professionals and system users, IT professionals, vendors, patients and their family, and others. Additions and updates include: Meaningful use (MU) definitions, objectives, standards, and measures Digital appendix on meaningful use stages ONC EHR certification programs Vision for health reform and enhanced HIPAA administrative simplification requirements under ACA Workflow, thoughtflow, and process management Strategies for managing e-discovery and the legal health record in an EHR environment Tools for cost-benefit analysis and benefits realization for EHR Update on hospital resources for core EHR components, medical device integration, and beyond Update on physician practice resources Final Rule update on ARRA/HITECH privacy and security guidelines Update on risk analysis and medical identity theft Practical uses of SNOMED-encoded data Expanded coverage on HIE, PHRs, and consumer empowerment New chapter on specialty-specific EHRs New and expanded downloadable resources Instructor access to online EHR simulation modules

When you visit the doctor, information about you may be recorded in an office computer. Your tests may be sent to a laboratory or consulting physician. Relevant information may be transmitted to your health insurer or pharmacy. Your data may be collected by the state government or by an organization that accredits health care or studies medical costs. By making information more readily available to those who need it, greater use of computerized health information can help improve the quality of health care and reduce its costs. Yet health care organizations must find ways to ensure that electronic health information is not improperly divulged. Patient privacy has been an issue since the oath of Hippocrates first called on physicians to "keep silence" on patient matters, and with highly sensitive dataâ€"genetic information, HIV test results, psychiatric recordsâ€"entering patient records, concerns over privacy and security are growing. For the Record responds to the health care industry's need for greater guidance in protecting health information that increasingly flows through the national information infrastructureâ€"from patient to provider, payer, analyst, employer, government agency, medical product manufacturer, and beyond. This book makes practical detailed recommendations for technical and organizational solutions and national-level initiatives. For the Record describes two major types of privacy and security concerns that stem from the availability of health information in electronic form: the increased potential for inappropriate release of information held by individual organizations (whether by those with access to computerized records or those who break into them) and systemic concerns derived from open and widespread sharing of data among various parties. The committee reports on the technological and organizational aspects of security management, including basic principles of security; the effectiveness of technologies for user authentication, access control, and encryption; obstacles and incentives in the adoption of new technologies; and mechanisms for training, monitoring, and enforcement. For the Record reviews the growing interest in electronic medical records; the increasing value of health information to providers, payers, researchers, and administrators; and the current legal and regulatory environment for protecting health data. This information is of immediate interest to policymakers, health policy researchers, patient advocates, professionals in health data management, and other stakeholders.

This book trains the next generation of scientists representing different disciplines to leverage the data generated during routine patient care. It formulates a more complete lexicon of evidence-based recommendations and support shared, ethical decision making by doctors with their patients. Diagnostic and therapeutic technologies continue to evolve rapidly, and both individual practitioners and clinical teams face increasingly complex ethical decisions. Unfortunately, the current state of medical knowledge does not provide the guidance to make the majority of clinical decisions on the basis of evidence. The present research infrastructure is inefficient and frequently produces unreliable results that cannot be replicated. Even randomized controlled trials (RCTs), the traditional gold standards of the research reliability hierarchy, are not without limitations. They can be costly, labor intensive, and slow, and can return results that are seldom generalizable to every patient population. Furthermore, many pertinent but unresolved clinical and medical systems issues do not seem to have attracted the interest of the research enterprise, which has come to focus instead on cellular and molecular investigations and single-agent (e.g., a drug or device) effects. For clinicians, the end result is a bit of a “data desert” when it comes to making decisions. The new research infrastructure proposed in this book will help the medical profession to make ethically sound and well informed decisions for their patients.

The straight scoop on choosing and implementing an electronic health records (EHR) system Doctors, nurses, and hospital and clinic administrators are interested in learning the best ways to implement and use an electronic health records system so that they can be shared across different health care settings via a network-connected information system. This helpful, plain-English guide provides need-to-know information on how to choose the right system, assure patients of the security of their records, and implement an EHR in such a way that it causes minimal disruption to the daily demands of a hospital or clinic. Offers a plain-English guide to the many electronic health records (EHR) systems from which to choose Authors are a duo of EHR experts who provide clear, easy-to-understand information on how to choose the right EHR system an implement it effectively Addresses the benefits of implementing an EHR system so that critical information (such as medication, allergies, medical history, lab results, radiology images, etc.) can be shared across different health care settings Discusses ways to talk to patients about the security of their electronic health records Electronic Health Records For Dummies walks you through all the necessary steps to successfully choose the right EHR system, keep it current, and use it effectively.