Electronic Medical Record Adoption Research Articles

Electronic Health Record Adoption in Oral and Dental Health Centres in Turkey

The digitalisation studies in public hospitals in Turkey started with the Health Transformation Program in 2003. The Ministry of Health has been measuring the dissemination of meaningful usage and adoption of electronic health record (EHR) using Electronic Medical Record Adoption Model (EMRAM) and Outpatient Electronic Medical Record Adoption Model (O-EMRAM). Using a comprehensive survey, our study intends to measure the stage of EHR adoption in oral and dental health centres (ODHCs) providing primary healthcare services in Turkey. The results obtained were classified by basic and comprehensive EHR functions and benchmarked against the studies addressing EHR adoption in primary healthcare institutions of other countries. In 2021, 167 ODHCs/oral and dental health hospitals (ODHHs) actively operating in Turkey completed the O-EMRAM survey. The data obtained from the survey results were analysed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured. It is observed that 59 (40.7%) of ODHCs/ODHHs have comprehensive EHR functions, while the remaining 86 (59.3%) have basic EHR functions. Under these circumstances, it can be stated that all ODHCs/ODHHs in Turkey use at least basic EHR functions. All ODHCs/ODHHs in Turkey have at least basic EHR functions. The integration of e-prescription, electronic authorisation system and e-Pulse used throughout Turkey and Health Information Management System Society (HIMSS) used in ODHCs/ODHHs can be listed as one of the decisive factors in this result. ODHCs/ODHHs still have a long way to go in adopting EHR, but the current circumstances are also promising. It is considered that this study will serve as a baseline for future measurements and produce a notable result for decision-makers.

Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study.

Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania. A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations. Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts. The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.

Overcoming Electronic Medical Records Adoption Challenges in Saudi Arabia.

In the digital era, the seamless integration of electronic medical records (EMR) stands as a pivotal milestone in transforming healthcare delivery, with Saudi Arabia at the forefront of this revolution in the Middle East. This literature review comprehensively explores the challenges and opportunities associated with adopting EMRin the Kingdom of Saudi Arabia (KSA) in alignment with the nation's Vision 2030 healthcare objectives. The review synthesizes research from various scholarly sources, utilizing databases such as PubMed, Scopus, Google Scholar, and regional databases, and focuses on literature published between 2010 and 2023. Our methodology included a strategic combination of keywords and a stringent selection criterion to ensure a focus on relevant EMR adoption studies within KSA. The review addresses key aspects of EMR adoption, including technical challenges, financial constraints, human factors, cultural and organizational barriers, privacy and security concerns, and policy and regulatory challenges. It also explores the integration of EMR with other digital health initiatives like telehealth, personal health records, and community pharmacy services. The findings reveal a complex interplay of factors influencing EMR adoption, highlighting the need for comprehensive strategies that address technical, financial, cultural, and policy-related barriers. The review concludes that while significant challenges exist, strategic approaches and solutions tailored to the specific context of Saudi Arabia can effectively facilitate EMR integration, thereby enhancing healthcare quality and efficiency in line with the nation's Vision 2030 goals.

The use of Electronic Medical Record (EMR) in hospitals during the COVID-19 pandemic in Indonesia: a systematic literature review

Purpose: Electronic medical records (EMR) are information technology-based systems that store and manage patient medical data. EMR are beneficial for improving healthcare services' efficiency, effectiveness, and security. The COVID-19 pandemic has driven the adoption of EMR, but there are still challenges, such as the surge in patient numbers and problems with EMR filling. This study aimed to investigate the use of EMR in hospitals during the COVID-19 pandemic in Indonesia. &#x0D; Method: This study was a systematic literature review using the PRISMA diagram. Article search was conducted based on the PICO model eligibility criteria. The articles used were retrieved from 3 databases: Google Scholar, ResearchGate, and Cerdika. The researcher limited the publication year of the journals to 2020-2021, when the COVID-19 pandemic was ongoing, and added the keyword "COVID-19" to the journals published in 2022-2023. &#x0D; Results: The results of the study showed that the COVID-19 pandemic has had a significant impact and the need for the implementation of EMR due to its various benefits, such as improving the efficiency and effectiveness of healthcare services, facilitating access to patient health information, increasing collaboration among healthcare workers, accelerating the process of clinical decision-making, and improving the security and accuracy of health data. However, implementing EMR during the COVID-19 pandemic has only sometimes been smooth. Some challenges include suboptimal infrastructure, untrained human resources, and inadequate policies. &#x0D; Conclusion: To overcome these challenges, efforts from various parties, including the government, hospitals, and healthcare workers, are needed.

Technology adoption of electronic medical records in developing economies: A systematic review on physicians' perspective.

Electronic Medical Records (EMRs) are a tool that could potentially improve the outcomes of patient care by providing physicians with access to up-to-date and accurate vital patient information. Despite this potential, EMR adoption in developing economies has been dilatory. This systematic review aims to synthesize the related literature on the adoption of EMRs in developing economies, with a focus on the perspective of physicians. With the aim to discern the key factors that impact EMR adoption as perceived by physicians and to offer guidance for future research on filling any gaps identified in the existing literature, this study utilized a systematic literature review by following the PRISMA guidelines. Out of 1160 initial articles, 21 were selected for analysis after eliminating duplicates and non-qualifying articles. Results show that common enablers of EMR adoption from physicians' perspective were identified to be computer literacy, education, voluntariness, and the system functionality including its features and user interface, implying that the provision of proper interventions focusing on the aspects of the health information system has an impact in maximizing the utilization and capabilities of EMRs among healthcare providers. The most prevalent barriers include the lack of training and IT usage experience along with resistance to changes associated with respondents' age and gender, the lack of time for learning complex EMR systems, and costs of the new technology. This indicates that a thorough planning and proper budget allocation is necessary prior to implementing and integrating EMR systems in healthcare institutions. From this synthesis of the common research conclusions, limitations, and recommendations from physicians' perspective, the result of this systematic review is expected to shed light on the optimal technology adoption of EMRs and its contribution to the health care systems of developing economies.

Exploring Determinants Affecting Technology Adoption of Electronic Medical Records among Health Care Professionals in Mumbai

Exploring Determinants Affecting Technology Adoption of Electronic Medical Records among Health Care Professionals in Mumbai

Understanding Adoption of Electronic Medical Records (EMRs) during a Health Emergency: An Analysis of EMR Usage Logs from Rural Health Facilities in the Philippines

Understanding Adoption of Electronic Medical Records (EMRs) during a Health Emergency: An Analysis of EMR Usage Logs from Rural Health Facilities in the Philippines

Physicians’ Use, Perceptions And Attitude Toward Electronic Medical Record In Iraq

Physician acceptance is critical to the widespread adoption of Electronic Medical Records (EMRs). The main objective of this research is to explore physicians’ perceptions of EMRs' function importance, anticipated usage, and their attitudes and opinions regarding EMRs in the sole organization that implemented EMRs in Kurdistan, Iraq. This cross-sectional study was conducted on 150 specialist physicians randomly selected from Faruk Medical City in Sulaimani City, Kurdistan, Iraq, using a self-administered questionnaire. The main findings of this study indicate that the greatest important functions were the display of lab results, clinical notes, and reports, as well as the display of time-trended clinical data and physician order entry (tests and medication orders) with a percentage of 100%. while the least important functions were the reporting of medical management &amp; disease management, and nuclear medicine with percentages of (89.3%), and (72.7%) respectively. In addition, the results showed that the respondents used six out of 19 EMR functions at least weekly, agreed on the need for an EMR system implementation, and expressed overall support for EMRs. All the respondents (100%) perceived that EMRs would enhance the quality of care and reduce errors, improve the quality of practice (i.e., work-life), and have a positive impact on the cost and security of patients’ information. Most of the respondents (92.7%) also anticipated an increase in practice productivity with EMRs and recognized the necessity of spending time for training (94%). The study concluded that the respondents had a positive attitude toward EMRs. The main recommendation was to conduct a systematic examination of physician perceptions related to EMRs as both vendors and healthcare organizations can facilitate physician acceptance and ultimately the rate of adoption and utilization. This study would help them to design targeted education to demonstrate the advantages of EMRs and further improve physician perceptions toward EMRs. Keywords: Electronic Medical Records; physician acceptance; Use of medical record; Tertiary referral centers; Kurdistan Iraq.

Adoption of Electronic Medical Records for Chronic Disease Care in Kenyan Refugee Camps: Quantitative and Qualitative Prospective Evaluation.

Noncommunicable disease (NCD) prevention and control in humanitarian emergencies is a well-recognized need, but there is little evidence to guide responses, leading to varying care delivery. The Sana.NCD mobile health (mHealth) app, initially developed in Lebanon, is the only known mHealth tool for NCD management designed to increase care quality and coverage for providers in humanitarian settings. We evaluated a specialized mHealth app consisting of an abbreviated medical record for patients with hypertension or diabetes, adapted for a Kenyan refugee camp setting. We tested an adapted version of the Sana.NCD app (diabetes and hypertension medical record) in an 11-month (May 2021 to March 2022) quantitative and qualitative prospective evaluation in Kenya's Hagadera refugee camp. Leveraging the rollout of a general electronic medical record (EMR) system in the Kakuma refugee camp, we compared a specialized NCD management app to a general EMR. We analyzed secondary data collected from the Sana.NCD app for 1539 patients, EMR data for 68 patients with NCD from Kakuma's surgical and outpatient departments, and key informant interviews that focused on Hagadera clinic staff perceptions of the Sana.NCD app. The Hagadera NCD clinic reported 18,801 consultations, 42.1% (n=7918) of which were reported in the NCD app. The Kakuma EMR reported 350,776 visits, of which 9385 (2.7%) were for NCDs (n=4264, 1.2% hypertension; n=2415, 0.7% diabetes). The completeness of reporting was used as a quality-of-care metric. Age, sex, prescribed medicines, random blood sugar, and smoking status were consistently reported in both the NCD app (>98%) and EMR (100%), whereas comorbidities, complications, hemoglobin A1c, and diet were rarely reported in either platform (≤7% NCD app; 0% EMR). The number of visits, BMI, physical activity, and next visit were frequently reported in the NCD app (≥99%) but not in the EMR (≤15%). In the NCD app, the completeness of reporting was high across the implementation period, with little meaningful change. Although not significantly changed during the study, elevated blood sugar (P=.82) and blood pressure (P=.12) were reported for sizable proportions of patients in the first (302/481, 62.8%, and 599/1094, 54.8%, respectively) and last (374/602, 62.1%, and 720/1395, 51.6%, respectively) study quarters. Providers were satisfied with the app, as it standardized patient information and made consultations easier. Providers also indicated that access to historic patient information was easier, benefiting NCD control and follow-up. A specialized record for NCDs outperformed a more general record intended for use in all patients in terms of reporting completeness. This CommCare-based NCD app can easily be rolled out in similar humanitarian settings with minimal adaptation. However, the adaptation of technologies to the local context and use case is critical for uptake and ensuring that workflows and time burden do not outweigh the benefits of EMRs.

Benefits and challenges of adopting Electronic Medical Records in Nigerian Federal Capital Territory Hospitals-lessons learned

Electronic Medical Records (EMR) is a digital version of paper-based medical records designed to enhance patient outcomes. EMR in the healthcare system is fundamental to the continuity of patient care and the improvement of quality services. However, the lack of adequate and sustainable funding for health system utilization remains a significant challenge to the successful adoption of EMR. This study aims to identify the benefits and challenges associated with the adoption of Electronic Medical Records in the Federal Capital Territory (FCT) Hospitals in Abuja, Nigeria. A qualitative research method was employed to examine the benefits and challenges of adopting EMR in FCT hospitals. Questionnaires were administered to 310 participants, and collected data were analyzed using a thematic approach. The implementation of Electronic Medical Records (EMR) in FCT hospitals led to better healthcare services such as prompt tracking of patients’ records, and reduced costs associated with repetitive medical tests arising from the loss of patient files. Despite these benefits, a lack of sustainable funding and inadequate infrastructure technology were identified as major obstacles to the successful adoption of EMR in FCT hospitals. To ensure the continued use of EMR in FCT hospitals, it is essential to maintain efficient governance and regulation alongside upgrading the hospitals’ Information Communication Technology (ICT) infrastructures.

Basic electronic health record (EHR) adoption in **Türkiye is nearly complete but challenges persist

BackgroundThe digitalization studies in public hospitals in Türkiye started with the Health Transformation Program in 2003. As digitalization was accomplished, the policymakers needed to measure hospitals’ electronic health record (EHR) usage and adoptions. The ministry of health has been measuring the dissemination of meaningful usage and adoption of EHR since 2013 using Electronic Medical Record Adoption Model (EMRAM). The first published study about this analysis covered the surveys applied between 2013 and 2017. The results showed that 63.1% of all hospitals in Türkiye had at least basic EHR functions, and 36% had comprehensive EHR functions. Measuring the countrywide EHR adoption level is becoming popular in the world. This study aims to measure adoption levels of EHR in public hospitals in Türkiye, indicate the change to the previous study, and make a benchmark with other countries measuring national EHR adoption levels. The research question of this study is to reveal whether there has been a change in the adoption level of EHR in the three years since 2018 in Türkiye. Also, make a benchmark with other countries such as the US, Japan, and China in country-wide EHR adoption in 2021.MethodsIn 2021, 717 public hospitals actively operating in Türkiye completed the EMRAM survey. The survey results, deals with five topics (General Stage Status, Information Technology Security, Electronic Health Record/Clinical Data Repository, Clinical Documentation, Closed-Loop Management), was reviewed by the authors. Survey data were compared according to hospital type (Specialty Hospitals, General Hospitals, Teaching and Research Hospitals) in terms of general stage status. The data obtained from the survey results were analyzed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured.ResultsWe found that 33.7% of public hospitals in Türkiye have only basic EHR functions, and 66.3% have extensive EHR functions, which yields that all hospitals (100%) have at least basic EHR functions. That means remarkable progress from the previous study covering 2013 and 2017. This level also indicates that Türkiye has slightly better adoption from the US (96%) and much better than China (85.3%) and Korea (58.1%).ConclusionsAlthough there has been outstanding (50%) progress since 2017 in Turkish public hospitals, it seems there is still a long way to disseminate comprehensive EHR functions, such as closed-loop medication administration, clinical decision support systems, patient engagement, etc. Measuring the stage of EHR adoption at regular intervals and on analytical scales is an effective management tool for policymakers. The bottom-up adoption approach established for adopting and managing EHR functions in the US has also yielded successful results in Türkiye.

Exploring maturity of electronic medical record use among allied health professionals.

Electronic medical records (EMRs) have the potential to improve and streamline the quality and safety of patient care. Harnessing the full benefits of EMR implementation depends on the utilisation of advanced features, defined as "mature usage." At present, little is known about the maturity of EMR usage by allied health professionals (AHPs). To examine current maturity of EMR use by AHPs and explore perceived barriers to mature EMR utilisation and optimisation. AHPs were recruited from three health services. Participants completed a 27-question electronic questionnaire based on the EMR Adoption Framework, which measures clinician EMR utilisation (0 = paper chart, 5 = theoretical maximum) across 10 EMR feature categories. Interviews were conducted with both clinicians and managers to explore the nature of current EMR utilisation and perceived facilitators and barriers to mature usage. Questionnaire responses were obtained from 192 AHPs. The majority of questions (74%) showed a mean score of <3, indicating a lack of mature EMR use. Pockets of mature usage were identified in the categories of health information, referrals and administration processes. Interviews with 18 clinicians and managers revealed barriers to optimisation across three themes: (1) limited understanding of EMR opportunities; (2) complexity of the EMR change process and (3) end-user and environmental factors. Mature usage across EMR feature categories of the EMR Adoption Framework was low. However, questionnaire and qualitative interview data suggested pockets of mature utilisation. Achieving mature allied health EMR use will require strategies implemented at the clinician, EMR support, and service levels.

Opportunities and Challenges of Digitalization in Rehabilitation: Results of a Survey of Rehabilitation Facilities

The aim of this study was to measure the status of digitalization and the opportunities and challenges for rehabilitation facilities connected to telematics infrastructure. A partially standardized online survey of all providers of rehabilitation facilities in Bavaria (n=33) was carried out. The questionnaire with 36 questions included a scale based on the Electronic Medical Record Adoption Model (EMRAM). The level of digitization was reported as level 0 in 70% of the rehabilitation facilities (level model to 7). The transmission of patient-related data (incoming and outgoing) is often analogue, whereas the processing within the facility is already predominantly digital in many cases. When connecting to the telematics infrastructure, installation, training of staff and adaptation of work organization required quite a bit of effort. Changes in the legal-financial situation in Germany open up new opportunities for increased digitalization of rehabilitation facilities. Hurdles are related to IT security requirements, staff training, and the low level of digitalization in hospitals, among doctors, and patients, which make digital data transmission difficult.

Health professionals’ readiness to implement electronic medical record system in Gamo zone public hospitals, southern Ethiopia: an institution based cross-sectional study

BackgroundThe adoption of Electronic Medical Records (EMR) by the healthcare sector can improve patient care and safety, facilitate structured research, and effectively plan, monitor, and assess disease. EMR adoptions in low-income countries like Ethiopia were delayed and failing more frequently, despite their critical necessity. The most popular way to solve the issue is to evaluate user preparedness prior to the adoption of EMR. However, little is known regarding the EMR readiness of healthcare professionals in this study setting. Therefore, the objective of this study was to assess the readiness and factors associated with health professional readiness toward EMR in Gamo Zone, Ethiopia.MethodsAn institution-based cross-sectional survey was conducted by using a pretested self-administered questionnaire on 416 study participants at public hospital hospitals in southern Ethiopia. STAT version 14 software was used to conduct the analysis after the data was entered using Epi-data version 3.2. A binary logistic regression model was fitted to identify factors associated with readiness. Finally, the results were interpreted using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p-value less than 0.05.ResultsA total of 400 participants enrolled in the study, with a response rate of 97.1%. A total of 65.25% (n = 261) [95% CI: 0.60, 0.69] participants had overall readiness, 68.75% (n = 275) [95% CI: 0.64, 0.73] had engagement readiness, and (69.75%) (n = 279) [95% CI: 0.65, 0.74] had core EMR readiness. Computer skills (AOR: 3.06; 95% CI: 1.49–6.29), EMR training (AOR: 2.00; 95% CI: 1.06–3.67), good EMR knowledge (AOR: 2.021; 95% CI: 1.19–3.39), and favorable attitude (AOR: 3.00; 95% CI: 1.76–4.97) were factors significantly associated with EMR readiness.ConclusionAlthough it was deemed insufficient, more than half of the respondents indicated a satisfactory level of overall readiness for the adoption of EMR. Moreover, having computer skills, having EMR training, good EMR knowledge, and favorable EMR attitude were all significantly and positively related to EMR readiness.

Allied health professionals’ experiences and lessons learned in response to a big bang electronic medical record implementation: A prospective observational study

IntroductionThere is limited evidence describing the impact of electronic medical record (EMR) implementation on allied health professionals’ acceptance, expectations, and work efficiencies. This study aims to: A) identify clinician expectations and factors that influence EMR acceptance; B) evaluate perceived usability, technology proficiency and satisfaction; and C) assess the impact of EMR big bang implementation on allied health workflows at three Australian tertiary hospitals. MethodsRepeated measures study pre and six-months post EMR implementation. User acceptance was evaluated with online surveys: Unified Theory of Acceptance and Use of Technology (pre), System Usability Scale and open-ended questions (post). A four-hour time-motion study evaluated changes in allied health inpatient workflows. ResultsSurveys were completed by 224 allied health clinicians (47% response rate) pre, and 196 (41%) post-implementation. Pre-implementation, 96% of respondents felt using the EMR was a good idea and they would find it useful. Six-months post-implementation 88% liked interacting with the EMR. 64% found it easy to use and most didn’t require technical support (78%). While 68% of participants felt very confident, 51% believed they were not using the EMR’s full potential.Post-implementation half of participants agreed significant upskilling was required and that EMR workflows were not quick to learn. Live demonstrations were considered the most helpful activity prior to training; hands-on practice in the training environment and superuser support were invaluable preparing for and during go-live. Time-motion data (mean difference (MD) (95% CI)) indicated that following implementation participants spent 2.27% (−3.53, 8.09, p = 0.731) more time in clinical tasks. More time was spent performing clinical documentation (5.39% (1.98, 8.8), p = 0.002). ConclusionsMany factors can impact allied health professional’s adoption of a new EMR. Institution-wide, simultaneous big bang EMR implementation, with strong allied health leadership, can lead to positive benefits, particularly in user experience. Ongoing evaluation will drive future improvements.

Adoption of Electronic Medical Records in Tertiary Health Care Centres: A Survey of Federal Medical Centres in South-South Nigeria

The study investigated the adoption of electronic medical records in Federal Medical Centres in Bayelsa and Delta States of Nigeria. The study adopted descriptive survey research design. One hundred and nineteen staff of Departments of Health Records and Information Management of both medical centres participated in the study. Online questionnaire was used for data collection. One hundred and thirty-four soft copies of the questionnaire were distributed to the respondents via personal whatsapp accounts of the respondents and whatsapp platforms of the Health Information Managers Association of Nigeria and the Association of Health Records and Information Management Practitioners of Nigeria to which the respondents belonged. One hundred and nineteen questionnaires were properly completed, retrieved and found usable for data analysis. This produced a response rate of 88.81 %. The data collected were analyzed using weighted mean and standard deviation. Findings showed that the extent of adoption of electronic medical records in the medical centres was low; benefits derived from adoption, which were not perceived much differently by the sampled staff, were enhanced healthcare service delivery/access to medical information, saving of records storage space/cost of medical care, speeding up of treatment process, improvement of confidentiality/security of medical information/timely communication among medical practitioners, reduction of treatment error risk/ patients’ mortality rate/patients’ waiting time and facilitation of clinical decision making; challenges encountered in adoption, which were seen much differently by the records personnel, were poor internet connectivity or network, high cost of ICT equipment, low technical expertise, lack of funds/training/uniform standards and poor power supply.

Examining the Extension of the Technology Acceptance Model (TAM) in Electronic Medical Records Among Community Pharmacists in Malaysia

Background: Background: Electronic medical records (EMR) have been proven to reduce medical errors in drug distribution. However, EMR adoption is still relatively low among Malaysian community pharmacists. Objective: As a result, this study aims to see how community pharmacists in Malaysia use the EMR system. The factors influencing the community pharmacist's intent in adopting EMR will also be determined. Methods: The Technology Acceptance Model (TAM) and Extended TAM were utilized in this study to determine Malaysian community pharmacists' main intention for using EMR. The information was gathered by surveying 144 community pharmacists nationwide. The data was analyzed using SPSS and Smart PLS software. Results: The study found a positively significant relationship between Perceived Usefulness (PU) and Behavioural Intention to Use (BIU). Conclusion: This study shows critical factors influencing the intention to use EMR among Malaysian community pharmacists. Hopefully, this study will better understand the importance of EMR in the healthcare industry.

A Framework for User-Focused Electronic Health Record System Leveraging Hyperledger Fabric

This research study aims to examine the possibilities of Hyperledger Fabric (HLF) in the healthcare sector. The study addresses the gap in the knowledge base through developing customization techniques to enable the simplicity and efficacy of Electronic Medical Records (EMR) adoption for healthcare industry applications. The focus of this research explores methods of using blockchain technology that prioritise users. The investigation of several concepts used in developing web applications has been determined. The study identified that an open-source project, known as Hyperledger Fabric, can be utilised to construct a novel method of storing EMRs. The framework provides a test network that can be customised to satisfy the need of several projects, including storing medical records. This research additionally outlines the difficulties encountered and problems that need to be resolved before Hyperledger Fabric can be successfully implemented in healthcare systems. Considering all types of blockchains available, the needs are met by Hyperledger Fabric, which offers a distributed and secure environment for healthcare systems. Blockchain has the potential to transform healthcare by putting the patient at the centre of the system and enhancing health data protection and interoperability. Also, by using grant and revoke access mechanisms, patients have complete control over their medical information as well as authorized doctors who are allowed to view records. This functionality is made possible by the chaincode defined in the blockchain platform. The research study has both practitioner and research implications for the development of secure blockchain-based EMRs.

2126. Disorders of Childhood Development in Congenital Cytomegalovirus

Abstract Background The spectrum of disease in congenital cytomegalovirus (cCMV) is broad. The widespread adoption of Electronic Medical Records (EMRs) at large academic centers suggests that high-throughput informatics approaches would be a reasonable means to extract relevant information to describe long term outcomes in cCMV. Database queries were used to extract records directly from EMR which describe progression of developmental and sensory disorders in cCMV. Methods SlicerDicerTM, a reporting tool in our Epic® EMR, was used to identify patients seen in our cCMV Clinic at Texas Children’s Hospital in Houston, Texas, between years 2008 and 2020, with a diagnosis of congenital cytomegalovirus (CMV) infection. ICD-10 diagnoses and encounters were extracted from our EMR with a series of generalizable Structured Query Language (SQL) queries. Using SAS V9.4 (Cary, N.C.), we parsed this information into relational databases and categorized ICD-10 codes by semantic terms associated with sensory and developmental disabilities guided by SNOMED-CT®. Results Data acquisition took seconds to complete and included over 55,000 unique encounters (Figure 1), 11,000 provider encounters, and 48,000 billing diagnoses. Of 152 patients with an ICD-10 diagnosis of cCMV, 112 were born after 1/1/2008 (when records were reliably found in our EMR). 76/112 (68%) had symptomatic cCMV (ScCMV), 36/112 (32%) had asymptomatic cCMV (AcCMV). 60 (79%) of ScCMV had at least one disorder of development noted in EMR compared with 20 (56%) of AcCMV (ChiSq: p&amp;lt; 0.05). The average age of first diagnosis of a disorder of development was 1.9 +/- 1.6 years (median 1.6 years) (Figure 2). Of the 48,000 billing diagnoses recorded for these children, only 3,751 (8%) pertained to disorders of development, of which “Mixed receptive-expressive language disorder: F80.2” (n=713, 19%) was most frequent (Table 1). Unique Encounters Across our Healthcare System by Department Stacked bar plot of all encounters for patients with cCMV within our EMR, colored by the department in which the encounter occurred. For visualization, we have binned data along the x-axis on the basis of the listed age ranges. Abbreviations: Texas Children’s Hospital (TCH), Texas Children’s Pediatric Associates (TCPA) Whisker Plot of Earliest Age that Deficits in Development are First Noted in cCMV A whisker plot of the age (years) at which ICD-10 codes specific to developmental disorders are first noted in the EMR. The age at which a diagnosis was first noted is the difference in the first occurrence of an ICD-10 code in a chart reported and the patient’s date of birth. The horizontal box plots have been sorted by the ascending mean age at which problems were noted. ICD-10 codes occurring less frequently than in 5% of the sample have been suppressed. Table of the Most Frequent Developmental Disorder ICD-10 Codes Billed for Patients with cCMV List of ICD-10 billing diagnoses pertinent to disorders of development, which were associated with all encounters for children with cCMV across our healthcare system. This cohort comprised 771 person-years of follow up, with a mean of 6.9 years of follow-up per patient. Conclusion Both ScCMV and AcCMV are associated with sensory and developmental disabilities, most of which manifest in the first 2 years of life. EMR gives us the potential to study the many facets of cCMV in finer detail (e.g hearing loss) to identify rates of systems-based disease progression throughout time (Figure 3), and provide help with anticipatory guidance and generate cost-models for the true economic impact of cCMV. Whisker Plot of Earliest Age that Hearing Deficits are Noted for Patients with cCMV A whisker plot of the age (years) at which ICD-10 codes specific to hearing problems are first noted in the EMR. The age at which a diagnosis was first noted is the difference in the first occurrence of an ICD-10 code in a chart reported and the patient’s date of birth. Repeated measures across the cohort have been mitigated by keeping only the first time a code was noted in the patient’s chart. The horizontal box plots have been sorted by the ascending mean age at which problems were noted. Disclosures Ryan H. Rochat, MD, PhD, MS, Merck Sharpe &amp; Dohme: Grant/Research Support Gail J. Demmler-Harrison, MD, Elsevier: Book royalties|Merck: Grant/Research Support|Microgen: Advisor/Consultant|Microgen: Grant/Research Support|Moderna: Advisor/Consultant|UpToDate Wolters Kluwer Health: Royalties.

Comparative Analysis of HQS, JCI and HIMSS-EMRAM Quality Assessment Models Widely Used in Turkey

The standards developed for measuring quality ensure the management of the dynamic structure of health services, the reduction of uncertainties, and the prevention of errors since quality relies on measurement, evaluation, and continuous improvement. Additionally, the models used in measuring health service quality are divided into two: case-based and indicator-based. Using the document analysis method, this study compared the Joint Commission International (JCI), Healthcare Quality Standards (HQS) and Healthcare Information and Management Systems Society (HIMSS) – Electronic Medical Record Adoption Model (EMRAM) models, which are included in the indicator-based health quality measurement models, in terms of the concepts, processes, and standards featured in them. Within the scope of the study, a total of 1,141 standards from all three models were examined. Ethical approval was taken from local ethics committee on 10/08/2020. Upon the comparison, it was understood that the HQS and JCI models were more similar in "presence rates" than the HIMSS-EMRAM model in terms of concept (83%), process (66%), and standard (64%). It was concluded that HIMSS EMRAM standards can be used as a very useful tool for making improvements and identifying deficiencies in HQS and JCI processes.