Hierarchy of Electronic Medical Record (EMR) Functional Components And the Implementation

if you want to add knowledge about E-Healt is to understand the function of the Electronic Medical Record (EMR). Below are the functional components and their explanations:

  1. Integrated patient data
    Repository that concentrates data from various other components or other ways to integrate data.
  1. clinical decision support
    Rules engine, which provides logic programs that can be used to support decisions such as: alertness and statements, order sets and clinical protocols.
  1. The Intake clinician command
    Human interface, obtaining data in a timely manner for service (at the point of care) and the ability to access data, rules and process data (mined data) through aggregate data and data analysis.
  1. Access to sources of knowledge
    The sources of knowledge, namely making information that is always available for the benefit of external sources.
  1. Integrated communication support
    Specific data warehouse that can be processed that produces very useful information. Decision making to support health services. This can be done in any way including entering and removing data through: computer terminals, personal computers, PCs, notebooks, PDAs, voice recognition systems, signatures etc.

EMR implementation in health care facilities

   One of the most difficult aspects of implementing EMR is at the implementation stage. There are several alternative implementations, namely:

  1. Implementation of all functions in all units (installations) at the same time as a whole in the hospital.
  2. Implementation of all functions in one unit (installation). If the location is stable, then proceed to all other locations at the same time.
  3. Implementation of limited functions in all units (installations), for example electronic laboratory test requests. If this function has become part of routine clinical activities, then apply more functions.
  4. Combination of the above approaches, for example applying functions limited to one location. If the function is stable, then expand the various functions at that location and then expand to various units throughout the hospital.

The benefits that can be obtained with EMR are preventing medical error occurrences through three mechanisms, namely:

  1. Adverse event prevention.
  2. Provide a quick response immediately after the occurrence of adverse events.
  3. Track and provide feedback regarding adverse events.

The Weaknesses of EMR in Health Care Facilities:

  1. Requires a larger initial investment than paper medical records, for hardware, software and supporting costs.
  2. The time needed by the key person and doctor to study the system and redesign the workflow.
  3. Conversion of paper medical records to Electronic Medical Record (EMR) requires time, resources, determination and leadership.
  4. Risk of computer system failure.
  5. Problems with data entry by doctors.
  6. Analysis of aggregate data

Some problems that will arise in the EMR system, namely:

  1.  Data entry, including: data capture, data input, error prevention, data entry by doctors.
  2. Display data , including: patient data flowsheet, summary and abstract, turnaround documents, dynamic display.
  3. Query system and surveillance, including clinical services, clinical research, retrospective and administrative studies.

The main issue that must be addressed according to Johan Harlan, namely:

  1. Need for standards in clinical terminology,
  2. Concern for privacy, confidentiality, and data security,
  3. Opposition to data entry by doctors
  4. Difficulties relating to the integration of the medical record system with other sources of information in health services.

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