Introduction to Electronic Health Records

Transcription

1 Introduction to Electronic Health Records Alvin B. Marcelo, MD Associate Professor of Surgery, University of the Philippines Manila and Philippine General Hospital Program Manager, International Open Source Network ASEAN+3

2 About us Definition of terms A look at current health management information systems Why do we need HMIS in the hospital? What is an EHR? Benefits of EHRs Problems with EHRs Best practice and lessons learned

3 National Telehealth Center Created in 1998 by the UP Board of Regents An office directly under the UPM chancellor Mandate: improve the health of Filipinos (especially the under-served) using information and communications technology Centre of Excellence in Free and/or Open Source Software in ASEAN+3 (IOSN ASEAN+3)

4 2003: UNDP creates the International Open Source Network 2006: IOSN starts devolving the program to three centres of excellence: South Asia (Chennai, India), Pacific Island Countries (Suva, Fiji), ASEAN+3 (Manila, Philippines) 2008: Transfer completed 2009: November 6-13 Asia Source 3 (one of the largest source camps in Asia)

5 Created in 1997 by the Dean of the UP College of Medicine Precursor to the National Telehealth Center Medical informatics - the organization and management of information in support of patient care, education, research and administration

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7 answers.com

8 An information system for health Clinical information system Pharmacy information system Laboratory information system Health management information system

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10 Integrated collection of hardware, software, network, policies, people, and data to support the business processes of health care Provides the vital communication link between purchasers and providers through which business transactions can flow

11 Current HMIS in the Philippines is paper- based Error-prone Difficult to consolidate Hard to analyze Not useful for research

12 PhilHealth, the largest payor, will be implementing contracting between PHIC and hospitals. The contract has a section on HMIS.

13 Providers and PhilHealth share the same values and have similar goals HMIS serves as the vital link between hospitals and PhilHealth to achieve these goals

14 Focal point is patient safety. Healthcare that is: Effective Patient-centric Timely Efficient Equitable

15 Improved availability of appropriate information for decision making Improved accessibility for all people Improved productivity of all health workers Improved cost-efficiency Improved appropriate utilization of health care resources Improved quality of care

16 Implementing appropriate provider systems Implementing appropriate purchaser systems Implementing an appropriate link between purchaser and provider systems Provider HMIS Link PhilHealth HMIS

17 At the core will be electronic health records. Subsequent modules will be medication administration, results review, etc

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19 1. Enrolment request (new family member...etc.) 2. Eligibility check (provider to payer, response payer to provider) 3. Pre-authorization request (provider to payer, response payer to provider) 4. Claim submission (provider to payer, acknowledgement payer to provider) 5. Claim status and tracking inquiry (provider to payer, response payer to provider) 6. Claim rejection (payer to provider) 7. Claim resubmission (provider to payer) 8. Claims payment (payer to provider) 9. Claims payment to Bank (via EDI)

20 Wide variations (simple listing to complex billing) Preliminary studies in PhRO I showed that more than 50% of hospitals submitted MMHRs via computer printout (all level 3 hospitals were computerized) Only one was still handwritten

21 Internet connection or cellphone signal Any computer (DOS will work) Security USB (around P4000 one-time purchase)

22 Hospitals Faster processing Easily retrievable data Claims tracking PhilHealth Easier posting Computer-assisted medical evaluation Computer-assisted adjudication Minimal touch claims processing

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24 Integrated Surgical Information System University of the Philippines Manila Philippine General Hospital Contact:

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26 Linux server operating system Apache webserver MySQL database PHP programming language Most of expenses went to programmers and equipment purchases.

27 Community Health Information Tracking System (CHITS) National Telehealth Center UP Manila

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30 EMR for village health centers in the Philippines seed funding by International Development Research Centre of Canada running for three years now with minimal technical support Linux desktops Apache, MySQL, PHP

31 Care2X

32 developed in Europe multiple, international set of developers Multi-facility hospital information system practice management central data server Health Data Xchange Protocol

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34 WorldVista

35 based on the Department of Veteran Affairs EMR called Vista uses the original MUMPS programming and database language unlike the Vista which is public domain, WorldVista is released on a general public license (open source)

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37 Available online at Or can be downloaded at

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41 OpenVista

42 based on Vista uses the Java programming language as platform

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44 An EHR/EMR is an important tool for improving quality of health care EHRs form the core HMIS for hospitals a prerequisite to contracting with PHIC Free and/or open source EMR like OpenMRS are cost-effective HMIS activities for hospitals The key component for any EMR is the concept dictionary