Unintended Consequences of Electronic Medical Records
Unintended Consequences of Electronic Medical Records

Author: Barbara Cook Overton

Publisher: Rowman & Littlefield

Published: 2019-12-13

Total Pages: 281

ISBN-13: 1498567460

DOWNLOAD EBOOK

Unintended Consequences of Electronic Medical Records: An Emergency Room Ethnography argues that while electronic medical records (EMRs) were supposed to improve health care delivery, EMRs’ unintended consequences have affected emergency medicine providers and patients in alarming ways. Higher healthcare costs, decreased physician productivity, increased provider burnout, lower levels of patient satisfaction, and more medical mistakes are just a few of the consequences Barbara Cook Overton observes while studying one emergency room’s EMR adoption. With data collected over six years, Overton demonstrates how EMRs harm health care organizations and thrust providers into the midst of incompatible rule systems without appropriate strategies for coping with these challenges, thus robbing them of agency. Using structuration theory and its derivatives to frame her analysis, Overton explores the ways providers communicatively and performatively receive and manage EMRs in emergency rooms. Scholars of communication and medicine will find this book particularly useful.

The Unintended Consequences of the Adoption of Electronic Medical Record Systems on Healthcare Costs
The Unintended Consequences of the Adoption of Electronic Medical Record Systems on Healthcare Costs

Author: Kartik Krishna Ganju

Publisher:

Published: 2016

Total Pages: 127

ISBN-13:

DOWNLOAD EBOOK

In my dissertation, I study unintended consequences of the adoption of EMR systems. In my three essays, I examine how the adoption of EMR systems affects neighboring hospitals (spillover effects), can be used by hospitals to further its objectives in an unconventional manner ("upcoding" of patient case mix data), and how EMR adoption may end in the eventual abandonment of the system along with corresponding negative effects. In my first essay, I examine if the adoption of EMR systems has effects beyond the adopting hospital to neighboring hospitals. I find that the adoption of these systems has "spillover" effects to neighboring hospitals and that although the adoption of EMR systems leads to an increase in the operating cost of the adopting hospital, spillover effects reduce the operational cost of neighboring hospitals. In the second essay of my dissertation, I examine if an unintended consequence of the adoption of EMR systems is that there could be an increase in "upcoding" activities by hospitals. Upcoding deals with patients being diagnosed in such a manner as to increase the reimbursement of hospitals by inappropriately increasing the patient's case mix. Using the roll-out of an auditing program as a natural experiment, I find that there is evidence to suggest upcoding by hospitals, particularly by for-profit hospitals. Finally, in the third essay of my dissertation, I examine the phenomenon of abandonment of EMR systems and find that the abandonment of EMR system leads to an increase in the operational cost of hospitals. I also examine which hospitals are more likely to abandon their EMR systems both outside and during the HITECH Act. I argue that the adoption of EMR systems often has unanticipated and unintended consequences.

SAFER Electronic Health Records
SAFER Electronic Health Records

Author: Dean F. Sittig

Publisher: CRC Press

Published: 2015-04-14

Total Pages: 497

ISBN-13: 1498726380

DOWNLOAD EBOOK

This important volume provide a one-stop resource on the SAFER Guides along with the guides themselves and information on their use, development, and evaluation. The Safety Assurance Factors for EHR Resilience (SAFER) guides, developed by the editors of this book, identify recommended practices to optimize the safety and safe use of electronic heal

Taking Action Against Clinician Burnout
Taking Action Against Clinician Burnout

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-01-02

Total Pages: 335

ISBN-13: 0309495474

DOWNLOAD EBOOK

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

Capturing Social and Behavioral Domains and Measures in Electronic Health Records
Capturing Social and Behavioral Domains and Measures in Electronic Health Records

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-01-08

Total Pages: 287

ISBN-13: 0309312450

DOWNLOAD EBOOK

Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material. Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.

Cognitive Informatics
Cognitive Informatics

Author: Kai Zheng

Publisher: Springer

Published: 2019-07-25

Total Pages: 322

ISBN-13: 3030169162

DOWNLOAD EBOOK

This timely book addresses gaps in the understanding of how health information technology (IT) impacts on clinical workflows and how the effective implementation of these workflows are central to the safe and effective delivery of care to patients. It features clearly structured chapters covering a range of topics, including aspects of clinical workflows relevant to both practitioners and patients, tools for recording clinical workflow data techniques for potentially redesigning health IT enabled care coordination. Cognitive Informatics: Reengineering Clinical Workflow for More Efficient and Safer Care enables readers to develop a deeper understanding of clinical workflows and how these can potentially be modified to facilitate greater efficiency and safety in care provision, providing a valuable resource for both biomedical and health informatics professionals and trainees.

The Computer-Based Patient Record
The Computer-Based Patient Record

Author: Committee on Improving the Patient Record

Publisher: National Academies Press

Published: 1997-10-28

Total Pages: 257

ISBN-13: 030957885X

DOWNLOAD EBOOK

Most industries have plunged into data automation, but health care organizations have lagged in moving patients' medical records from paper to computers. In its first edition, this book presented a blueprint for introducing the computer-based patient record (CPR). The revised edition adds new information to the original book. One section describes recent developments, including the creation of a computer-based patient record institute. An international chapter highlights what is new in this still-emerging technology. An expert committee explores the potential of machine-readable CPRs to improve diagnostic and care decisions, provide a database for policymaking, and much more, addressing these key questions: Who uses patient records? What technology is available and what further research is necessary to meet users' needs? What should government, medical organizations, and others do to make the transition to CPRs? The volume also explores such issues as privacy and confidentiality, costs, the need for training, legal barriers to CPRs, and other key topics.