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IT & Communication


Clinical research organizations


use HMIS for data collection, process- ing, analytics, data dissemination, management for studies involv-


ing patient clinical data, to monitor and evaluate programs, and carry out research processes. The same holds true for academic institutions that carry out cutting-edge research on disease patterns and new therapeutic modalities. Government Public Health Organizations study the epidemio- logical design of diseases to deter- mine their course in order to predict and prevent sudden outbreaks. HMIS allows for the standardized reporting of key indicators, enables data to be collated across centers throughout the country, and facilitates its analy- sis at a single central station. It would also allow scientists and doctors to work together across state borders and feed data into a central data repository that can be accessed from different places. However, to take HMIS beyond the


basic HIS and use its capabilities to the maximum, as in the above mentioned applications, it is necessary to have interoperability, which is the ability to interlink various disparate systems to enable the sharing of data. This would require the system to conform to vari- ous standard protocols and interna- tional standards. These information exchange standards dictate the type of syntax for electronic data trans- fer. There are two standard formats in which information is exchanged — message-based format, wherein it is sent in a basic message; and document-based format, wherein it is delivered in a structured document form. One of the common standards is the Digital Imaging and Communica- tions in Medicine (DICOM) Protocol, which governs the transfer of medical diagnostic and therapeutic informa- tion in the form of digital images and all other associated data common in medical specialties like Cardiology, Radiology, and Oncology. Health Level


38 INSIGHT ON


HOSPITAL & HEALTHCARE MANAGEMENT Vol. 1 Issue 2 August 2011


It would also allow scientists and doctors to work together across state borders and feed data into a central data repository that can be accessed from different places.


test results, etc. The second is to be easily transferable within the hospi- tal between various physicians and departments, and beyond, to other disparate institutions that may not be connected to the hospital.


Seven is another common standard that governs the exchange in case of clinical patient-related data. It also supports administrative, financial, and logistical processes in hospitals and clinics.


Electronic Health Records Overview Electronic Health Records (EHR) or Electronic Medical Records (EMR) are simply patient records that are stored in a digital format. Although the terms are used interchangeably, there is a difference. EMR is an internal record of patient information created by hospitals and it acts as a data source for EHR, which has wider scope. This is because EHR is a record of data that can be transferred and viewed by external entities like other hospi- tals and research organizations. There are two vital functions for EMR to perform. The first is to act as a single source of reference for the physician by being a digital archive contain- ing all the patient data including the digitally-recorded diagnostic images,


Features and Importance of EHR An EHR record ideally contains all the basic patient demographic infor- mation and all relevant clinical data regarding the signs and symptoms of the disease and other details elicited by the physician during the routine interview and examination, includ- ing medical and drug history. The record also has data sent from the Laboratory Information Management Systems (LIMS) and Radiology Infor- mation Systems (RIS), which includes biochemical and microbiological test results and digital images, with related data like clinical interpreta- tions and diagnosis. Computerized Physician Order Entry (CPOE), which are electronic entries made by the physician to change treatment plans, medication, etc. is also included in the EMR and can be used as a deci- sion-support tool to track the overall progress of the treatment and the reasons for the changes included in the treatment plan. EHR provides a mine of informa-


tion, which has different implications for different players in the healthcare spectrum. In hospitals, these digital records ensure a smooth workflow across departments due to the ease in sharing of data. The records can also be kept safe in case of accidents or natural disasters and reduce the patient waiting time and consultation time. So, this allows more patients to be treated in lesser time, thereby improving the efficiency and revenues of the hospital. For the individual physician, EHR is a boon, because he is able to view all the patient informa- tion instantaneously, including any modifications he might have made to


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