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History of Health Information Technology in The U.S

The Health IT Workforce Curriculum was developed for U.S. community colleges to enhance workforce training programmes in health information technology. The curriculum consist of 20 courses of 3 credits each. Each course includes instructor manuals, learning objectives, syllabi, video lectures with accompanying transcripts and slides, exercises, and assessments. The materials were authored by Columbia University, Duke University, Johns Hopkins University, Oregon Health & Science University, and University of Alabama at Birmingham. The project was funded by the U.S. Office of the National Coordinator for Health Information Technology. All of the course materials are available under a Creative Commons Attribution Noncommercial ShareAlike (CC BY NC SA) License (http://creativecommons.org/licenses/by-nc-sa/3.0/). The course description, learning objectives, author information, and other details may be found at http://archive.org/details/HealthITWorkforce-Comp05Unit06. The full collection may be browsed at http://knowledge.amia.org/onc-ntdc or at http://www.merlot.org/merlot/viewPortfolio.htm?id=842513.

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Health IT Workforce Curriculum - 2012
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© © All Rights Reserved
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22 views

History of Health Information Technology in The U.S

The Health IT Workforce Curriculum was developed for U.S. community colleges to enhance workforce training programmes in health information technology. The curriculum consist of 20 courses of 3 credits each. Each course includes instructor manuals, learning objectives, syllabi, video lectures with accompanying transcripts and slides, exercises, and assessments. The materials were authored by Columbia University, Duke University, Johns Hopkins University, Oregon Health & Science University, and University of Alabama at Birmingham. The project was funded by the U.S. Office of the National Coordinator for Health Information Technology. All of the course materials are available under a Creative Commons Attribution Noncommercial ShareAlike (CC BY NC SA) License (http://creativecommons.org/licenses/by-nc-sa/3.0/). The course description, learning objectives, author information, and other details may be found at http://archive.org/details/HealthITWorkforce-Comp05Unit06. The full collection may be browsed at http://knowledge.amia.org/onc-ntdc or at http://www.merlot.org/merlot/viewPortfolio.htm?id=842513.

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Health IT Workforce Curriculum - 2012
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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History of Health Information

Technology in the U.S.


History of Electronic Health Records (EHRs)
Lecture b Evolution of Functional
Requirements for EHRs
This material Comp5_Unit 6 was developed by The University of Alabama Birmingham, funded by the Department of Health
and Human Services, Office of the National Coordinator for Health Information Technology under Award Number
1U24OC000023
History of Electronic Health Records
Learning Objectives
2
Describe some early examples of electronic medical
records
Discuss lessons learned from the early EHR
implementations
Discuss how the attributes that were identified for a
computer-based patient record in the 1991 Institute of
Medicine report relate to the concept of meaningful
use
Discuss differences between the terms electronic
health record (EHR) and personal health record (PHR)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
The Computer-Based Patient Record
1991
Criteria for CPR











Source: (Dick, et al.,1991)

3
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
The Computer-Based Patient Record
Two editions: 1991 and 1997

Recommendations for CPR
Gold standard
Vendor community


Source: (Dick, et al., 1997)

4
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Problem list
5
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Problem list
Health status measures
6
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Problem list
Health status measures
Rationale for decision making
7
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Problem list
Health status measures
Rationale for decision making
Records integration
Other settings
Other time periods
8
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Problem list
Health status measures
Rationale for decision making
Records integration
Other settings
Other time periods
Protection of confidentiality
9
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Problem list
Health status measures
Rationale for decision making
Records integration
Other settings
Other time periods
Protection of confidentiality
Timely access
Simultaneous
Remote
10
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Tailored views
11
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Tailored views
Access to local and remote databases
Medical literature
Clinical guidelines









Source: (Miller, et al., 2005)


12
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Tailored views
Access to local and remote databases
Medical literature
Clinical guidelines
Clinical problem solving assistance
Decision support tools
13
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Tailored views
Access to local and remote databases
Medical literature
Clinical guidelines
Clinical problem solving assistance
Decision support tools
Structured data entry by physicians
Defined vocabulary
14
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Tailored views
Access to local and remote databases
Medical literature
Clinical guidelines
Clinical problem solving assistance
Decision support tools
Structured data entry by physicians
Defined vocabulary
Assessment
Quality and cost
15
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
IOM Criteria for CPR
Tailored views
Access to local and remote databases
Medical literature
Clinical guidelines
Clinical problem solving assistance
Decision support tools
Structured data entry by physicians
Defined vocabulary
Assessment
Quality and cost
Flexible and expandable
16
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Cover Sheet of VISTA EHR
Health IT
Workforce
Curriculum
Version 3.0/Spring
2012
History of Health Information
Technology in the U.S.
Evolution of Functional
Requirements for EHRs
Lecture b
17
Electronic Health Record
System Capabilities
IOM Committee on Data Standards 2003
CPR versus EHR
EHR assumes involvement of patients






Source: (Institute of Medicine, 2003)
18
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Electronic Health Record
System Capabilities
Direct care functions

Supportive functions

Information infrastructure
19
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Electronic Health Record
System Capabilities
Direct care functions
Care management
Clinical decision support
Operations management and communication
20
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Electronic Health Record
System Capabilities
Direct care functions
Care management
Clinical decision support
Operations management and communication
Supportive functions
Clinical support (e.g., demographics)
Measurement, analysis, research,
reporting
Administrative and financial
21
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Electronic Health Record
System Capabilities
Information Infrastructure Functions
Security
Records management
Unique identity, registry and directory
services
Health informatics and terminology
standards
Interoperability
Management of business rules
Workflow


22
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Meaningful Use
Major current recommendations
Computerized Provider Order Entry (CPOE)
Clinical Decision Support (CDS)
Electronic Prescribing (E-prescribing)
Structured documentation of quality measures
Up-to-date problem lists and diagnoses
Providing patients with health information
electronically
Information exchange
23
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
History of Electronic Health Records (EHRs)
Summary
1991 IOM report still the gold standard
Most systems today still do not meet all of
the IOM criteria
Early systems met many of the criteria
Broader development of EHRs with
HITECH

24
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
Some of the material in this presentation is
also included in the following book and is
used with permission:

Smaltz DH, Berner ES. The executives guide to electronic health
records. Chicago IL: Health Administration Press; 2007.
25
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b
History of Electronic Health Records
References Lecture b
References
Dick RS, Steen EB, Detmer DE. The computer-based patient record: an essential technology for healthcare.
Revised Edition. Washington, DC: National Academy Press; 1997.
Institute of Medicine. Committee on Data Standards for Patient Safety, Board of Health Care Services. Key
capabilities of an electronic health record system. Letter report. Washington (DC): The National Academies Press;
2003 Jul.
Miller RA, Waitman LR, Chen S, Rosenbloom ST. The anatomy of decision support during inpatient care provider
order entry (CPOE): empirical observations from a decade of CPOE experience at Vanderbilt. J Biomed Inform.
2005 Dec;38(6):469-85.
Smaltz DH, Berner ES. The executives guide to electronic health records. Chicago (IL): Health Administration
Press; 2007.
Images
Slide 17: Available from:
http://www.va.gov/VISTA_MONOGRAPH/docs/2008_2009_VistAHealtheVet_Monograph_FC_0309
26
Health IT Workforce Curriculum
Version 3.0/Spring 2012
History of Health Information Technology in the U.S.
Evolution of Functional Requirements for EHRs
Lecture b

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