Research Analysis Paper

1543 words - 7 pages

Since the implementation of Health Information Technology for Economic and Clinical Health Act (HITECH) in 2009, health care industry has seen a dramatic push for adopting electronic medical records (EMRs) and computerized physician order entry (CPOE) (Wikipedia). This mandate falls under the American Recovery and Reinvestment Act (ARRA) of 2009, which includes many other components. HITECH promotes enhanced care for patients by preventing medical errors, reducing health care costs, increasing efficiencies, and decreasing paperwork. To encourage participation, the federal government has offered various financial incentives to the hospitals and private practices if they adopted EHR systems ( ...view middle of the document...

In order to elicit responses, authors organized a 17-question survey to cover many areas of clinical knowledge management including quality of the technologies used. They compared nine commercial vendors with four institutions using their own internally developed systems. The 17-question survey was utilized in obtaining answers to assess viability of various clinical knowledge management features, functions, techniques, and et al. The survey was performed in various sites such as outpatient and inpatient. Largely, the survey is divided into three parts. The first part asked general questions about EHR products such as names of EHRs and a number of users. In the second part, specific questions were targeted to draw out feedback from each vendor about specific tools and capabilities used for the clinical decision support. Some of the questions asked ‘does your system allow the collection of structured data within clinician notes?’, ‘does your system support ad-hoc queries’, ‘do you have a reporting capability to track the effect and/or usage of the CDS content?’ and et al. Lastly, the final section of the survey dealt with questions about clinical content. The survey in the last part included questions about drug data supplier, on-line collaborative knowledge development environment and others. As stated previously, nine commercially available EHR were chosen based on their size, willingness to participate in the survey, and market position from the 2008 list of Certification Commission on Health Information Technology (CCHIT) approved EHR vendors. And four institutions with their own internally developed systems (both from inpatient and outpatient) were selected to compare the results with the nine vendors’ systems.
Results
First part of the survey consisted of two basic questions about their system model and the names and the number of end users utilizing the programs. Of the nine vendors, Allscripts (Chicago, IL) has 60,000 users and Epic Systems (Verona, WI) has ‘thousands’ of employees. The number of 172, 000 at the Washington VA indicates a highly frequent usage of their system. Second part of the survey concentrates on specific features of the clinical decision support-related system tools used by the nine vendors and the four institutions. There were some commonalities between the nine vendors and the four institutions. Most of the vendors and all of the four institutions allow control of the CDS updating by their clients. In terms of use of variety of controlled clinical terminologies (LOINC, SNOMED, ICD-9, etc.), all surveyed sites support recording structured clinical findings. All the vendors and the four internally developed systems had a function for their clients to perform ad hoc queries. In terms of the HL-7 InfoButton function, not every system had a function to bring up a hyperlink, which can bring an online information database such as Micromedex or CliniGuide. Only 3 out of 9 vendors and 1 out of 4 internally-developed...

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