Implementation Of Electronic Medical Record Research Articles

Adoption of Electronic Medical Records in Healthcare Facilities in the Emirate of Dubai

Objectives: This paper aimed to assess the adoption of electronic medical records (EMRs) in healthcare facilities in Dubai, the largest city in the United Arab Emirates (UAE) and a location where extensive healthcare services are provided. It explored the challenges, milestones, and accomplishments associated with this process.Methods: A situation analysis was conducted by contacting 2,089 healthcare facilities in Dubai to determine whether they had implemented EMR in their medical practices and to identify the challenges they faced during this process. Additionally, the Electronic Medical Record Adoption Model (EMRAM) was utilized to measure the maturity level of hospitals in terms of EMR adoption. The EMRAM stages were rated on a scale from 0 to 7, with 0 representing the least mature stage and 7 the most mature.Results: By September 2023, all hospitals (100%, n = 54) and 75% of private clinics (n = 1,460) in Dubai had implemented EMRs. Several challenges were identified, including the absence of EMRs within the healthcare facility, having an EMR with a low EMRAM score, or the lack of a unified interoperability standard. Additionally, the absence of a clear licensing program for EMR vendors, whether standalone or cloud-based, was among the other challenges noted.Conclusions: EMR implementation in healthcare facilities in Dubai is at a mature stage. However, further efforts are required at both the decision-making and technical levels. We believe that our experience can benefit other countries in the region in implementing EMRs and using EMRAM to assess their health information systems.

Organizational Culture with Individual Readiness as a Mediator for Championing Behavior Electronic Medical Record Implementation

The dynamism of the application information technology in the health sector, especially in hospitals, which is currently being developed is the electronic medical record (EMR). Global competition in the era of industrial revolution 4.0 makes all hospitals have to be ready for the changes that will occur in the management of medical record management. This study aims to analyze the influence of organizational culture with individual readiness as a mediator on championing behavior in the implementation of electronic medical records (EMR) at Muhammadiyah Hospital. Respondents amounted to 133 people consisting of professional health workers who will later be involved implementation of EMR. The research instrument was in the form of a questionnaire via a google form link. Analysis using SEM (structural equation model) with Lisrel. The results showed that organizational culture significantly affected individual readiness (?=0.67, t-value=7.40). Organizational culture has a significant effect on championing behavior (?=0.42, t-value=4.10). Individual readiness significantly affects championing behavior (?=0.48 , t-value = 4.56). Individual readiness is also a significant mediator of the relationship between organizational culture and championing behavior (complementary mediation type). A strong organizational culture will support the readiness of the organization's planned changes. A strong organizational culture also influences behavior to fight for the success of the change plan. Through individual readiness, organizational culture influences behavior to fight for the successful implementation of EMR. So, organizations need to prepare individuals well for the success of the change plan.   Keywords : Championing Behavior, EMR, Organizational Culture, Readiness for Change

The effect of electronic medical records on medication errors, workload, and medical information availability among qualified nurses in Israel– a cross sectional study

BackgroundErrors in medication administration by qualified nursing staff in hospitals are a significant risk factor for patient safety. In recent decades, electronic medical records (EMR) systems have been implemented in hospitals, and it has been claimed that they contribute to reducing such errors. However, systematic research on the subject in Israel is scarce. This study examines the position of the qualified nursing staff regarding the impact of electronic medical records systems on factors related to patient safety, including errors in medication administration, workload, and availability of medical information.MethodsThis cross-sectional study examines three main variables: Medication errors, workload, and medical information availability, comparing two periods– before and after EMR implementation based on self-reports. A final sample of 591 Israeli nurses was recruited using online private social media groups to complete an online structured questionnaire. The questionnaires included items assessing workload (using the Expanding Nursing Stress Scale), medical information availability (the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire), and medical errors (the Medical Error Checklists). Items were assessed twice, once for the period before the introduction of electronic records and once after. In addition, participants answered open-ended questions that were qualitatively analyzed.ResultsNurses perceive the EMR as reducing the extent of errors in drug administration (mean difference = -0.92 ± 0.90SD, p < 0.001), as well as the workload (mean difference = -0.83 ± 1.03SD, p < 0.001) by ∼ 30% on average, each. Concurrently, the systems are perceived to require a longer documentation time at the expense of patients’ treatment time, and they may impair the availability of medical information by about 10% on average.ConclusionThe results point to nurses’ perceived importance of EMR systems in reducing medication errors and relieving the workload. Despite the overall positive attitudes toward EMR systems, nurses also report that they reduce information availability compared to the previous pen-and-paper approach. A need arises to improve the systems in terms of planning and adaptation to the field and provide appropriate technical and educational support to nurses using them.

Improving Identification of Firearm Access in Children With Mental Health Complaints.

To determine if electronic medical record (EMR) changes and implementation of a study on firearm storage practices changed identification of firearm exposure in children presenting to a pediatric emergency department (PED) with mental health complaints. We also sought to determine the accuracy of information collected on firearm storage practices. Retrospective study of EMR documentation of firearm exposure in PED patients with mental health complaints from January 20, 2015 until November 20, 2017. EMR changes occurred on January 20, 2016 and the firearms study began on February 13, 2016. The primary outcome was documentation of firearm exposure. Secondary outcomes were documentation of unsafe firearm storage practices. We also examined differences between clinical and research documentation of unsafe firearm storage practices post-intervention. We compared groups using descriptive statistics and chi-squared tests. We used statistical process control to examine the relationship between interventions and changes in outcomes. 5582 encounters were examined. Identification of firearm exposure increased from 11 to 17% postintervention. Identification of unsafe storage practices increased from 1.9% to 4.4% across all encounters. Special cause variation in both metrics occurred concurrently with the interventions. Postintervention, unsafe firearms storage practices in firearm owning families were under-identified (39% identified as not triple-safe in clinical data vs 75% in research data). EMR changes and implementation of a firearms study improved identification of firearm exposure and unsafe storage practices in families of PED patients being evaluated for mental health complaints. However, unsafe storage practices continued to be under-identified in firearm-owning families.

Factors inhibiting readiness to implement Electronic Medical Records (RME) in management information systems in hospitals: Literature review

Advances in communication and information technology have occurred in the health sector, especially in health services such as hospitals, one of which is Electronic Medical Records (RME). RME is the application of information technology used in collecting, storing data, processing data and accessing data as patient track records. The Ministry of Health is also targeting all health facilities to have implemented RME no later than December 2023. The challenges for implementing RME are so complex, it is necessary to identify factors inhibiting RME implementation and evaluate them. Research Objective: to identify factors inhibiting the implementation of Electronic Medical Records in hospitals. Method: Data collection was carried out through 4 data sources, namely, Google Scholar, ScienceDirect, PubMed, and Digital Referral Garba (Garuda) using the keywords " Barriers of Electronic Medical Record" OR "Readiness of Electronic Medical Record" AND "Electronic Medical Record Implementation" OR “Hospital Management Information System”. Results: Based on the screening , 4 Google Scholar articles were obtained , 2 ScienceDirect articles , 2 PubMed articles, 2 Digital Reference Garba (Garuda) articles. The results of a review of 10 journals on factors inhibiting the implementation of RME in hospitals are caused by individual readiness factors and organizational readiness factors. From all journals, the most frequently found results were individual unpreparedness to face changes and technological advances , lack of training. Conclusion: Barriers to implementing electronic medical records are influenced by two factors, namely individual readiness factors and organizational readiness factors which are divided into psychological factors and also structural factors.

The Effect of Interprofessional Collaboration and Total Quality Management on the Implementation of Electronic Medical Records In Outpatient Units Mediated By Work Culture

The enactment of government regulations requires every health service facility to maintain electronic medical records as an effort to improve the quality of health services in Indonesia. There are 13,372 healthcare facilities in Indonesia and only 40% have run EMR. Influencing aspects: human data sources, policies, regulations, infrastructure and costs. There are still differences in aspects and responses of doctors and nurses to the implementation of electronic medical records. The importance of interprofessional collaboration through communication, joint decision making, coordination and cooperation, as well as continuous quality improvement through total quality management strategies and work culture of health workers as an effort to improve the quality of health services. The purpose of the study was to analyze the effect of interprofessional collaboration, total quality management on the implementation of electronic medical records in the mediation of work culture simultaneously and partially. The method uses descriptive statistics, quantitative associative correlations and questionnaires. Sampling using systematic random sampling from respondents of 109 health workers in the outpatient installation of RSUD Kabupaten Tangerang. The results showed that there is an influence of interprofessional collaboration and total quality management on the implementation of electronic medical records mediated by work culture.  The coefficient value of the determination of influence on work culture variables and the implementation of electronic medical records of more than 0.75 is included in the medium category. Workshops related to the implementation of electronic edis records and effective communication among interprofessionals need to be conducted and further research can be carried out on the impact and benefits.

Implementation of Electronic Medical Record System in Indonesia Viewed from the Perspective of Legal Certainty

Indonesia's Health Transformation is rapidly advancing, marked by the launch of six Pillars of Health Transformation, including the Health Technology Transformation Pillar. The implementation of Electronic Medical Records (EMR) is a key component of this transformation, aiming to transition health records from paper to electronic form, with the government emphasizing the need for secure data management, as outlined in the Regulation of the Minister of Health of the Republic of Indonesia number 24 of 2022. The purpose of this study is to analyze the implementation of the Electronic Medical Record System in Indonesia which has one important and strategic aspect, namely in relation to existence as one of the pillars of health technology transformation in realizing national health and as a condition for indicators of realizing people's welfare mandated in the Preamble of the 1945 Constitution as a national goal. Its implementation is regulated according to the applicable laws and regulations in Law No. 17 of 2023 concerning Health, as well as specifically in Minister of Health Regulation No. 24 of 2022 concerning Medical Records. The method used is Normative Juridic. As part of the health service system, the role of the Electronic Medical Record System is very strategic in the quality of health services. The quality of health services is greatly influenced by the successful implementation of the Electronic Medical Record System. This will boil down to the regulation regarding the Electronic Medical Record in question. Currently, the laws governing RME are Law Number 17 of 2023 concerning Health and Minister of Health Regulation Number 24 of 2022 concerning Medical Records. In both regulations, it is regulated on the Implementation of Medical Records, it is formulated that Medical Records are one of the implementation of the pillars of health transformation in the realization of state goals mandated in the 1945 Constitution, especially to improve the nation's health through a sustainable Electronic Medical Record system. Although various obstacles were found in the implementation of the RME, one of them was related to the Electronic Medical Record System used, one of which was related to the security and confidentiality of patient health data. The conclusion in this study will be further examined the implementation of the Electronic Medical Record System which is still experiencing problems in terms of security and confidentiality of Electronic Medical Record data in Indonesia.

Analysis Of Inhibiting Factors Implementation Of Electronic Medical Records In East Pamulang Community Health Center

Patient medical records in Indonesia are starting to transform into electronic-based medical records. Electronic Medical Records (EMR) are medical records created using an electronic system. It is an electronic repository of information about a patient's health status and health services throughout patient life. The impact if health services have not implemented EMR is that it could hamper patient health services. This research aims to identify factors inhibiting the implementation of EMR at the East Pamulang Community Health Center (Puskesmas). The research method used is descriptive with a qualitative approach. The research subject population was medical records officer and chief administrative officer, while the object population was the medical records, registration, clinics, laboratory, and pharmacy room. The results of the research identified several factors inhibiting the implementation of EMR, such as inadequate infrastructure, no officers with a background in medical records, and still using paper-based manual medical records. The conclusion of this research is the discovery of several factors inhibiting the implementation of EMR, human resource factors where it doesn’t yet have an officer with an educational background in medical records, the number of computers is still limited which supporting EMR in each service unit, and the electronic-based medical record applications are still not used comprehensively in the service units of the Puskesmas. Suggestions from the results of this research are that Puskesmas immediately recruits officers who have an educational background in Medical Records, increases the number of computer devices that support the implementation of EMR, and immediately implements electronic-based medical records.

Electronic medical record implementation in the emergency department in a low-resource country: Lessons learned.

There is paucity of information regarding electronic medical record (EMR) implementation in emergency departments in countries outside the United States especially in low-resource settings. The objective of this study is to describe strategies for a successful implementation of an EMR in the emergency department and to examine the impact of this implementation on the department's operations and patient-related metrics. We performed an observational retrospective study at the emergency department of a tertiary care center in Beirut, Lebanon. We assessed the effect of EMR implementation by tracking emergency departments' quality metrics during a one-year baseline period and one year after implementation. End-user satisfaction and patient satisfaction were also assessed. Our evaluation of the implementation of EMR in a low resource setting showed a transient increase in LOS and visit-to-admission decision, however this returned to baseline after around 6 months. The bounce-back rate also increased. End-users were satisfied with the new EMR and patient satisfaction did not show a significant change. Lessons learned from this successful EMR implementation include a mix of strategies recommended by the EMR vendor as well as specific strategies used at our institution. These can be used in future implementation projects in low-resource settings to avoid disruption of workflows.

Qualitative study of challenges with recruitment of hospitals into a cluster controlled trial of clinical decision support in Australia

ObjectiveTo identify barriers to hospital participation in controlled cluster trials of clinical decision support (CDS) and potential strategies for addressing barriers.DesignQualitative descriptive design comprising semistructured interviews.SettingFive hospitals in New South...

Implementation of Sanctions for Health Facilities that Have Not Implemented Electronic Medical Records (EMR)

Hospitals are health care institutions that provide inpatient, outpatient, and emergency services. One of the services in the hospital is medical record services. This medical record stores various records regarding the identity, examination, treatment, actions, and other services performed on the patient. Along with the development of technology, medical records are present in digital form or called Electronic Medical Records (RME). The purpose of this study is to analyze sanctions for health facilities that have not implemented Electronic Medical Records (RME). The research method used is a literature review with a qualitative approach. The results show that with the regulatory provisions and sanctions, the implementation of RME is expected to improve the overall standard of health services. In accordance with circular number HK.02.01/MENKES/1030/2023, health facilities that do not comply with the RME implementation deadline may face administrative sanctions, including recommendations for revocation of accreditation status. These sanctions also apply to health facilities that have not integrated with the SATUSEHAT Platform by March 2024 or have not submitted patient visit data as required. This regulation is not only a guide, but also an encouragement for health service delivery to become more sophisticated, efficient, and safe through the implementation of RME.

Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis of Hemodialysis Electronic Health Record Implementation.

The Nephrology Department of Hassan II Hospital in Fez, Morocco, has implemented an Electronic Medical Record (EMR) system for managing patients undergoing acute hemodialysis. This initiative aims to digitize patient monitoring and enhance the management of acute dialysis within the department. Conducting strengths, weaknesses, opportunities, and threats (SWOT) analysis - assessing strengths, weaknesses, opportunities, and threats - was crucial to identifying and understanding the internal strengths and weaknesses, as well as the external opportunities and threats. This article outlines the SWOT analysis findings that may impact the project's success and shape decision-making. It also discusses strategies that could be implemented to allocate resources, mitigate risks, and capitalize on potential advantages. This study involved a multidisciplinary team, including professors, nephrologists, nephrology residents, and a healthcare information system engineer. Brainstorming sessions were held during the specification drafting phase to pinpoint both internal and external factors affecting the project. User feedback during testing further refined these factors, ensuring the project's alignment with real-world needs and challenges. The study identifies the project's strengths as providing safe and immediate access to information, along with strong communication between the department (application users) and the project manager. The significant EMR weakness is the lack of logistical resources and the absence of a long-term maintenance plan for the application. The opportunity presented by this EMR implementation is its functionality's potential to evolve, enabling the solution to be deployed in other dialysis centers across the region. The project's threat is the potential abandonment of EMR use by future practitioners. These SWOT analysis findings enable the development and implementation of strategies to reduce the current deployment's vulnerabilities and ensure the success of future HIS implementations in the nephrology network of the Fez-Meknes region, Morocco.

THE INCREASE OF BPJS CLAIMS AT HOSPITAL AFTER CHANGING TO E-MEDICAL RECORDS: CASE ANALYSIS AND MITIGATION STRATEGY

With the advancement of digital transformation, EMR has become an important step towards operational efficiency and better care. Through Permenkes No.24 of 2022, all health facilities in Indonesia are expected to have implemented the EMR system by the end of 2023. This is a mixed-methods study that combines primary data from interviews with 5 respondents and secondary data regarding BPJS claims during the period before and after EMR implementation, from January to August 2023. Secondary data analysis will be conducted using tables, graphs, and descriptive statistics such as mean, median, and standard deviation to detail and explain changes in BPJS claims patterns before and after EMR implementation. Qualitative data will be analysed. The results showed that EMR implementation increased the number of cases (11.27%) and the nominal amount of BPJS claims (15.04%). In addition, this study identified several factors that became challenges after the change to EMR. These factors include data errors, lack of staff training, technical constraints, and changes in operational processes that have not been fully integrated with the EMR system. Mitigation strategies include staff training, periodic monitoring and evaluation, internal claim audits, improvement of claim business processes, and monitoring and evaluation from management. Based on the results of the study, it can be concluded that the change to electronic medical records (EMR) at Sultan Agung Islamic Hospital has increased starting from the number of patients, the number of cases and the nominal amount of BPJS claims. Despite the increase in the nominal amount of BPJS claims, there are still challenges and problems that need to be overcome after the implementation of EMR.

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.

Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units

Patient safety research has focused mostly on the hospital and acute care setting whereas assessments of patient safety climate in primary health care settings are warranted. Valid questionnaires as e.g., the Safety Attitudes Questionnaire (SAQ) may capture staff perceptions of patient safety climate but until now, an overview of the use of SAQ in primary care has not been systematically presented. Thus, the aim of this systematic review is to present an overview of SAQ used in primary care.Methods The electronic databases: PubMed, Embase, Cinahl, PsycInfo and Web of Science were used to find studies that used any version of SAQ in primary care. Studies were excluded if only abstract or poster was available, as the information in abstract and posters was deemed insufficient. Commentaries and nonempirical studies (e.g., study protocols) were excluded. Only English manuscripts were included.Results A total of 43 studies were included and 40 of them fell into four categories: 1) validation analysis, 2) descriptive analysis, 3) variance assessment and 4) intervention evaluation and were included in further analyses. Some studies fell into more than one of the four categories. Seventeen studies aimed to validate different versions of SAQ in a variety of settings and providers. Twenty-five studies from fourteen different countries reported descriptive findings of different versions of SAQ in a variety of settings. Most studies were conducted in primary health care centres, out-of-hours clinics, nursing homes and general practice focusing on greatly varying populations. One study was conducted in home care. Three studies investigated variance of SAQ scores. Only five studies used SAQ to assess the effects of interventions/events. These studies evaluated the effect of electronic medical record implementation, a comprehensive Unit-based Safety Program or COVID-19.Conclusion The synthesis demonstrated that SAQ is valid for use in primary care, but it is important to adapt and validate the questionnaire to the specific setting and participants under investigation. Moreover, differences in SAQ factor scores were related to a variety of descriptive factors, that should be considered in future studies More studies, especially variance and intervention studies, are warranted in primary care.Trial registration This systematic review was not registered in any register.

Optimizing Nutrition Care Management at Nutrition Care Center (NCC)

In nutrition care services, the creation and storage of medical records at the Nutrition Care Center (NCC) are still relatively simple and paper-based or manual. Additionally, management challenges, in the form of system constraints, are one of the obstacles to healthcare management at NCC. Therefore, there is a need for optimizing healthcare management at NCC. The aim of this study is to optimize nutrition care management at the NCC clinic through the use of EMR (Electronic Medical Records) facilitated by QR Codes and the implementation of a Whatsapp Bot. The results indicate that optimizing Nutrition Care Management through the Implementation of EMR with QR Codes and Whatsapp Bot simplifies nutritionists' access to previous client allergy and therapy history in one view and facilitates clients in accessing their medical record number without a physical card. This research has also designed a system that can be used both through web and mobile platforms

Benefits, facilitators, and barriers of electronic medical records implementation in outpatient settings: A scoping review.

This scoping review examined the breadth and depth of evidence on Electronic Medical Record (EMR) implementation benefits in outpatient settings. Following PRISMA guidelines for scoping reviews, five databases were searched, and 24 studies were retained and reviewed. Benefits, facilitators, and barriers to EMR implementation were extracted. Direct benefits included improved communication/reporting, work efficiency, care process, healthcare outcomes, safety, and patient-centredness of care. Indirect benefits were improved financial performance and increased data accessibility, staff satisfaction, and decision-support usage. Barriers included time and financial constraints; design/technical issues; limited information technology resources, skills, and infrastructure capacity; increased workload and reduced efficiency during implementation; incompatibility of existing systems and local regulations; and resistance from healthcare professionals. Facilitators included training, change management, user-friendliness and alignment with workflow, user experience with EMRs, top management support, and sufficient resources. More rigorous, systematic research is needed, using relevant frameworks to inform healthcare policies and guide EMR projects in outpatient areas.

A Cross-Sectional Study of Investigating the Errors in Prescription and Drug Prescribing Pattern among General Community

The main purpose of this study is to access the awareness and knowledge of finding out errors in prescription among general public which include determination of the quality of prescription in hospital pharmacy and to address the errors identified in prescriptions. Implementation of teaching electronic medical record within didactic using drug info assignment. This survey emphasised the need for monitoring and evaluating the prescription handling conducted through google form. Therefore, the present study will help to understand the prescribing patterns and errors to the general community which will, in turn, improve the quality of the use of medicine and healthcare facilities. This following report has comprehensive studies that public have developed knowledge about prescription parts, drug information, self-evaluation, health care factors when compared to previous studies

S66 High Rates of Patient-Reported Outcome Measurements in Patients With Inflammatory Bowel Disease With Electronic Medical Record Implementation

S66 High Rates of Patient-Reported Outcome Measurements in Patients With Inflammatory Bowel Disease With Electronic Medical Record Implementation

Patient privacy protection: Generating available medical treatment plans based on federated learning and CBR

Although the favorable impact of sharing electronic medical records (EMRs) with other hospitals on improving clinical decision-making efficiency is widely acknowledged, the actual implementation of EMR sharing has been limited to some extent because of patient privacy protections. This study proposes a three-stage framework to retrieve medical treatment plans from multiple hospitals based on federated learning and case-based reasoning (CBR). We demonstrate that the proposed framework compensates for the privacy protection weaknesses of CBR and solves the problem of data islands among hospitals.