Electronic Health Record (EHR) System

An Electronic Health Record (EHR) System is a clinical Electronic Data Capture system that can support EHR tasks (such as collect patient medical records and stored them as electronic health records).

• AKA: Digitized Medical Record (DMR) System.
• Context:
  • It can range from being an Inpatient EHR System to being an Ambulatory EHR System.
  • It can (typically) be based on an EHR Platform.
  • …
• Example(s):
  • one based on Epic EHR, or Cerner EHR.
  • a Mobile Health Research Application.
  • …
• Counter-Example(s):
  • a Clinical Decision Support (CDS) System,
  • a Computerized Physician Order Entry (CPOE) System,
  • an Electronic Clinical Outcome Assessment (eCOA) System,
  • an Electronic Clinical Case Report Form (eCRF) System,
  • an Electronic Informed Consent (eConsent) System,
  • an Electronic Health Record (eHR) System,
  • an Electronic Patient Diary (eDiary) System,
  • a Health Information Exchange (HIE) System.
• See: OpenEHR, Decentralized Clinical Trial, Direct Data Capture (DDC) System, Clinical Data Acquisition System, Clinical Trial Management System (CTMS), Interactive Voice Response (IVR) System, Software as a Medical Device (SaMD), Optical Character Recognition (OCR) System.

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References

• https://simplepractice.com/resource/ehr-vs-emr/

2021a

• (Were et al., 2021) ⇒ Martin Chieng Were, Simon Savai, Benard Mokaya, Samuel Mbugua, Nyoman Ribeka, Preetam Cholli, and Ada Yeung (2021). "mUzima Mobile Electronic Health Record (EHR) System: Development and Implementation at Scale". In: Journal of Medical Internet Research, 23(12), e26381. DOI:10.2196/26381.
  • QUOTE: mUzima is a robust and adaptable Android-based mHealth platform that can seamlessly interoperate with the OpenMRS EHR system (Figure 1) ,. The OpenMRS EHR system was chosen for the mHealth extension, as it is the most widely endorsed EHR system for national use by Ministries of Health (MoHs) across numerous LMICs. OpenMRS is currently in use in over 40 countries, with national deployments for HIV and tuberculosis care in Kenya, Mozambique, Nigeria, and Uganda, among others . The hardware requirements for mUzima include an Android smartphone device and an OpenMRS EHR system instance. In Africa, over 85% of smartphones use the Android operating system . mUzima was developed to work with Android versions 4.4 and above, as low-end Android smartphones predominate in LMICs. mUzima has robust offline functionality to address limited internet connectivity in many LMICs, allowing for health providers using mUzima to care for patients even when disconnected from the EHR system server. These infrastructure considerations align with the Digital Development Principles of “Understanding the Existing Ecosystem” by recognizing that power and internet connectivity challenges exist in the LMIC settings where mUzima is intended for use and that low-end Android smartphones predominate in these settings.

Figure 1: Interaction between mUzima and the OpenMRS electronic health record (EHR) system.

2021b

• (Wikipedia, 2021) ⇒ https://en.wikipedia.org/wiki/Electronic_data_capture Retrieved:2021-12-5.
  • QUOTE: An electronic data capture (EDC) system is a computerized system designed for the collection of clinical data in electronic format for use mainly in human clinical trials. EDC replaces the traditional paper-based data collection methodology to streamline data collection and expedite the time to market for drugs and medical devices. EDC solutions are widely adopted by pharmaceutical companies and contract research organizations (CRO).

    Typically, EDC systems provide:

    • a graphical user interface component for data entry
    • a validation component to check user data
    • a reporting tool for analysis of the collected data
  • EDC systems are used by life sciences organizations, broadly defined as the pharmaceutical, medical device and biotechnology industries in all aspects of clinical research, but are particularly beneficial for late-phase (phase III-IV) studies and pharmacovigilance and post-market safety surveillance. EDC can increase data accuracy and decrease the time to collect data for studies of drugs and medical devices. The trade-off that many drug developers encounter with deploying an EDC system to support their drug development is that there is a relatively high start-up process, followed by significant benefits over the duration of the trial. As a result, for an EDC to be economical the saving over the life of the trial must be greater than the set-up costs. This is often aggravated by two conditions: #that initial design of the study in EDC does not facilitate the decrease in costs over the life of the study due to poor planning or inexperience with EDC deployment; and #initial set-up costs are higher than anticipated due to initial design of the study in EDC due to poor planning or experience with EDC deployment. The net effect is to increase both the cost and risk to the study with insignificant benefits. However, with the maturation of today's EDC solutions, much of the earlier burdens for study design and set-up have been alleviated through technologies that allow for point-and-click, and drag-and-drop design modules. With little to no programming required, and reusability from global libraries and standardized forms such as CDISC's CDASH, deploying EDC can now rival the paper processes in terms of study start-up time. As a result, even the earlier phase studies have begun to adopt EDC technology.

2021c

• (Wikipedia, 2021) ⇒ https://en.wikipedia.org/wiki/electronic_health_record Retrieved:2021-11-8.
  • An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information. For several decades, electronic health records (EHRs) have been touted as key to increasing of quality care. Electronic health records are used for other reasons than charting for patients, today, providers are using data from patient records to improve quality outcomes through their care management programs. EHR combines all patients demographics into a large pool, and uses this information to assist with the creation of “new treatments or innovation in healthcare delivery” which overall improves the goals in healthcare. Combining multiple types of clinical data from the system's health records has helped clinicians identify and stratify chronically ill patients. EHR can improve quality care by using the data and analytics to prevent hospitalizations among high-risk patients. EHR systems are designed to store data accurately and to capture the state of a patient across time. It eliminates the need to track down a patient's previous paper medical records and assists in ensuring data is up-to-date, accurate and legible. It also allows open communication between the patient and the provider, while providing “privacy and security.” It can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date and decreases risk of lost paperwork and is cost efficient. Due to the digital information being searchable and in a single file, EMRs (electronic medical records) are more effective when extracting medical data for the examination of possible trends and long term changes in a patient. Population-based studies of medical records may also be facilitated by the widespread adoption of EHRs and EMRs.

2017

• (Pennic, 2017) ⇒ Jasmine Pennic (2017). "Medable Integrates with Redox’s EHR Integration Platform to Streamline Mobile Medical Research". In: HIT Consutant.
  • QUOTE: Medable, a Palo Alto-based healthcare app and analytics platform has formed a strategic partnership with Redox, an EHR integration API platform for developers and healthcare organizations. The integration partnership will enable a fully-integrated medical research platform between smart phones and EHRs.

    By using Medable's platform and Redox's API services, clinical trial leaders and health researchers can integrate patient-generated health data into the electronic health record. With the partnership, the two companies are identifying overlapping and potential customers and deploying their technologies to enable fully-integrated mobile clinical trial and clinical research applications.

2011

• (Menachemi & Taleah, 2011) ⇒ Nir Menachemi, and Taleah H. Collum (2011)."Benefits and Drawbacks of Electronic Health Record Systems". In: Risk management and healthcare policy, 4, 47.DOI:10.2147/RMHP.S12985.
  • QUOTE: Electronic health record (EHR) systems have the potential to transform the health care system from a mostly paper-based industry to one that utilizes clinical and other pieces of information to assist providers in delivering higher quality of care to their patients. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which is part of the American Recovery and Reinvestment Act (ARRA) (aka “stimulus package”), was signed into law with an explicit purpose of incentivizing providers (e.g., hospitals and physicians) to adopt EHR systems. However, given that a bare-bone EHR system provides only partial benefits to patients and society, the HITECH Act requires that providers adopt EHRs and utilize them in a “meaningful” way, which includes using certain EHR functionalities associated with error reduction and cost containment(...)

    (...)EHR systems can include many potential capabilities, but three particular functionalities hold great promise in improving the quality of care and reducing costs at the health care system level: clinical decision support (CDS) tools, computerized physician order entry (CPOE) systems, and health information exchange (HIE). These and other EHR capabilities are requirements of the “meaningful use” criteria set forth in the HITECH Act of 2009.

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