Medical information development ten challenges faced in the early years (1)

In the Church by the Falls, Va-published ten challenges based on CSC's report, pointed out that the medical information widely.

The author thinks that there are two major positive impact factors will continue to occur: the first is the incentive mechanism, they think this will ultimately promote EHRs (electronic case) in the United States of widely used; the second is the next five years, this will lead to continuous development to meet the future requirements of each stage.

"For professionals, this message means that the complete information of the initial challenges must look to the future, not only see the immediate solution.

"The authors say.

CSC Fellows emerging activities mainly two authors Jane Metzger and Walt Zywiak, with CSC's medical group it strategy leader Michelle Mann together presented information at an early stage in the supplier must meet the challenge of the top ten, as follows:

1 acquisition data

Almost all medical information of initial data, all in the element in the form of unstructured data or using a specific encoding system for recording or vocabulary.

In order to meet the medical standards at the beginning of the information, data collection must be put at the beginning of the medical information relevant to the specific data elements as a focus, including vendor-specific items, such as CDS field rule parameters and professional performance measurement indicators. This will require a suitable for all standard structured field gets and load the content database, configuration data entry template to assist and advise the user to enter the correct data, design/development method to download, test results and data from other systems. This also needs to accurately enter patient information to physicians or other user training.

2 the establishment of effective work processes to enhance data entry

Many workflow redesign a success lies in the development team and assign roles.

By Assistant doctors or nurses entry of data, it should be confirmed by a supplier and as a result of its input case entries and sign-off. Ask the patient medication and patient records, notification of transitional arrangements related medication information, Assistant doctors and nurses are also drugs combined with aspects play an important role. The entire work process, the supplier shall provide the cases entries — workflow last results assume ultimate responsibility. In some cases also require separate management workflow.

3 promote the application of the EHR vendor's participation in the

The supplier is aware of the usefulness of EHR, you first must enable suppliers become EHR loyal users.

In order to guarantee a durable and comprehensive EHR data, each supplier must often use this system. This also applies to successfully maintain such as CPOE, CDS and health features and functions. Ensure that providers of loyalty requires at least some of the suppliers of training to be a regulatory constraints (such as the pressure from competitors or upper management Act). If the vendor to be prepared and found application system function value, and as soon as possible to involve system planning and deployment (of course as soon as possible), HER efficiency will reach a new level.

4 computer-based order entry

Rules on CPOE applications, the following two facts would be fully aware of the need for professionals:

First, all the stages of check apply to all orders, including laboratory, radiology, physical therapy, medication, and other means of service checks.

Second, in order to catch the early medical information (and the next second/third stage), each order must be made by the authorized vendor direct sign.

This does not mean that each order of 80% must be entered as CPOE, which means that 80% of the total order must here.

This challenge is to convince the authorized vendor used CPOE, its work processes can provide some help. Nurses or other user can sort the orders to mitigate vendor too much pressure on the "instruments", without their actual placed orders. Standardized command and command set and the specific problems and is closely related to the type of access to, use of CPOE also become easier. Each ordering providers should know how CPOE and how to use and really be put into use.

In practice, practice on CPOE also orders shipping and tracking work closely together.

This requirement is not just for medical information, but rather as a supplier of convenience (to track order status and link to results) on CPOE applications up to long.

5 start the electronic prescription as soon as possible

Medical information in the initial e-prescribing standards require suppliers to provide conventional prescription of 75 per cent of e-prescribing.

In order to achieve this target, may wish to turn to the following professional: configure for electronic medical records; electronic prescriptions module, convenient delivery subscription network; training and force users to use electronic medical records system. There are some difficulties, in fact beyond the supplier's disposal, the need for additional stakeholders to tackle: a), the pharmacy is not equipped with related facilities, and, of course, will not be able to receive and handle electronic prescriptions (40% of pharmacies are independent operations), b) drug enforcement agencies currently prohibit the opening in the electronic prescription drugs.

6 development of a set for clinical decision support management program

Based on clinical decision support criteria, medical information of five CDS in early rules must be all professionals of the demonstration may only be put into use.

In many professional, multi-vendor operation mode, this may mean that you must perform a separate for each profession or vendors refine rules, because these five rules must also be closely associated with professional or clinical focus. To meet the medical information requested, the early CDS each action can have the bestEnough to design and use a set design, development and implementation of the rules of procedure of the powerful. This program should include the review and approval, specification documents, development and testing, and eventually officially announced each rule, including copyright and copyright control. The program makes the operation behavior from the outset in the rules or its refinement rules, these rules are for professionals and suppliers are shared, while allowing them to authorize more vendors that can extend existing types and number of rules. As the second stage, the third stage, as well as health services required.