EHR Evaluation Report - University Healthcare Analysis

This report, authored by a student, examines the evaluation of Electronic Health Records (EHRs) in healthcare settings, specifically focusing on two oncology programs in Arizona. It highlights the importance of EHRs in storing patient data and administrative information, while also exploring the core functions and evaluation methods associated with EHR systems. The report identifies significant gaps and workflow issues in the EHR system of one of the programs, and discusses the use of electronic forms, principles of human factor engineering, and various evaluation techniques. It emphasizes the need for a standardized workflow and post-implementation evaluations to improve processes and achieve the benefits of EHRs. The study also touches on the evaluation processes using ICD10/ICD9 and IMO codes to understand the impact of EHR on patient data preservation and overall healthcare outcomes. The report concludes by emphasizing the importance of EHR in healthcare and the need for continuous improvement and evaluation.

MEASURE EVALUATION OF
ELECTRONIC HEALTH RECORDS
Name of the Student
Name of the University
Author’s Note

ABOUT EHR
 EHR is abbreviated as electronic health record which stores all the records of the patient including their medical histories.
 This is a very effective technique to include all the administrative and relevant clinical data for a long period of time.
 EHR includes a software system which allows the medical professionals to enter and store new patient information.
 Practices has been found to control the access to patient data in a more secure way.
 There are eight significant core functions associated with EHR, from which health information and data followed by patient
support are the most important ones.

SUMMARY OF THE TOPIC
There are two oncology programs in Arizona- One is affiliated with Academic Hospital and the other is a large national
oncology programs.
Significant variations has been found to exist in between the operation processes of the two organizations.
Oncology North became the model program for Oncology South program since the former one was a part of universal
health for 8 years.
Oncology North has been stated to have various issues with the recent build and various gaps has been spotted in their
HER system.
This gap analysis was performed by Chrystal found that Oncology build for Universal Health did not align with the
recommendations for oncology specialties in various areas inside the EHR.
Oncology population services has been identified as an important patient demographics part associated with large
healthcare organizations.

 Cancer treatment has been found to be costly in dealing with the authorization of insurance companies.
 The operation differences can be tabularized as given below:
Operations Differences Oncology South Oncology North
Initial Contact With
Patient
Phone interview within 3
days
Initial physician clinic visit
Patient Oversight
All oncology patients Only oncology patients that
have identified needs
Documentation
Paper form: See document:
Nav Assessment 2018
Paper form: See document:
Oncology North
 However some similarities has been found to be associated with the two organizations.
 These similarities has mainly been identified in the tools being used in EHR.
 These similarities has been shown on the top right table.
Operations Similarities Oncology North and Oncology South
Position Navigator/Coordinator RN
Data Request Wanted discrete data for reports
Electronic Documentation
Used same two electronic methods to chart:
1. Electronic forms shared by all types of navigators (e.g.,
ortho, pulmonary)
2. Free-text note also shared by same navigators above
Electronic Documentation
Wanted it to be easier to find specific oncology navigator
documentation

GAP OR NEED IDENTIFIED
 Significant issues with the current build were observed and several gaps related with the functionality of oncology
clinicians were observed.
 Gap analysis was performed by Chrystal alignment specialists.
 The oncology build for Universal Health did not align with the recommendations for EHR oncology specialties.
 The functional workflow associated with the oncology clinicians has been identified as one of the major gaps.
 The oncology navigators has been identified as the significantly underdeveloped inside the Universal EHR to be a major
gap.

ELECTRONIC FORM
 Documentation processes has been found to be performed by the electronic forms (Berndt & Fischer, 2018).
 Electronic forms are shared by all types of navigators.
 Navigators from both orthopedics and pulmonary specialist sectors has been found to store patient data in electronic
health record systems.
 Electronic forms mainly consist of the patient demographic characteristics, medical history, current condition of the
patient and reason of admittance to the hospital.
 All the records are taken and stored by the junior doctors or coordinator RN who is in charge of data request associated
with discrete data collection for reports.
 This is all about the electronic forms used by the healthcare organizations associated with these research studies.

FUTURE STATE WORKFLOW
 Initial focus has been associated with financial
gaps and workflow of all the oncology
clinicians.
 The collected documents from this patients
has been found to vary in pathology reports
and diagnostic results.
 Thus it has been found to be very significant
to have a standard workflow and expectations
in the documentation process of EHR.
 Chrystal IT team has been found to be
responsible for the submission of final
recommendation in the documented
workflow.

PRINCIPLES OF HUMAN FACTOR ENGINEERING AND USER INTERFACE
 Human factors includes the health condition of the patient and the efficiency of the professional who is responsible for
the EHR process (Norros & Savioja, (2017).
 HFE (design thinking) is defined as the process of design oriented thinking.
 This Principle allows the human beings to focus of the use of technology in a safe and efficient manner.
 The principles followed in the case study are interdependent performance and design, human machine analysis system
while recording the information from patient (Herout et al., 2018).
 Tailor design for controlling the capabilities has been found to be associated with the behavior.
 The coordinator RNs are uses these principles of human factor engineering and user interface associations in order to
perform their roles associated with their daily job roles.

EVALUATION METHODS
 Implementation of EHR has been found to be a critical implementation step.
 Conduction of post implementation evaluation will help the evaluator to continue the improvement in workflows and
achieve goals with benefits of EHRs.
 Various EHR evaluation techniques including checklists has been used in order to evaluate the EHR system of an
organization ().
 Evaluation matrix has also been identified as a simple grid which includes the information of every patient data record
storage.
 These are the overall evaluation methods being used for the evaluating the EHR system of an organization.
 This process is also useful in comparing the HER systems of two healthcare originations.

EVALUATION PROCESS
 Healthcare is mainly focused on the collection of data from patients.
 Evaluation of the outcomes plays an important role in understanding the actual effect of EHR on preserving the patient
data.
 ICD10/ICD9 has been used by the coders and providers to evaluate the outcomes of EHR in the selected organizations.
 Clinicians has been found to use IMO codes and SNOMED in the form of flow sheets from discrete data fields.
 These are the overall evaluation processes used in these organizations.

CONCLUSION

REFERENCES
Berndt, M., & Fischer, M. R. (2018). The role of electronic health records in clinical reasoning. Annals of the New York
Academy of Sciences, 1434(1), 109-114.
Herout, J., Saleem, J. J., Weinger, M., Grundmeier, R. W., Patterson, E. S., Anders, S., & Hettinger, A. Z. (2018, September). EHR
to EHR Transitions: Establishing and Growing a Knowledge Base. In Proceedings of the Human Factors and Ergonomics
Society Annual Meeting (Vol. 62, No. 1, pp. 513-517). Sage CA: Los Angeles, CA: SAGE Publications.
Jetelina, K. K., Woodson, T. T., Gunn, R., Muller, B., Clark, K. D., DeVoe, J. E., ... & Cohen, D. J. (2018). Evaluation of an
electronic health record (EHR) tool for integrated behavioral health in primary care. The Journal of the American Board
of Family Medicine, 31(5), 712-723.
Norros, L., & Savioja, P. (2017). Principles of Human Factors Engineering. Handbook of safety principles, 164-195.

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