Applications of E-Health in

Healthcare:

electronic medical record (EMR)

Prepared by:
Ass. Prof. Dr. Amal Diab Ghanem Atalla

Assistant Professor in Nursing Administration Department

Faculty of Nursing

Alexandria University
Introduction
Definition of e-Health
e-Health refers to using information and communication technologies (ICT) in
health services and information management. It encompasses a range of tools,
applications, and services aimed at improving the efficiency, quality, and
accessibility of healthcare.
Types of e-Health Applications
1. Telemedicine
Telemedicine involves remote diagnosis and treatment through
telecommunications technology. This includes video consultations, remote
monitoring, and online prescriptions.
2. Electronic Health Records (EHRs)
EHRs allow for the digital storage and management of patient health information.
They improve the efficiency of healthcare delivery and enhance communication
between providers.
3. Health Mobile Applications
Mobile health apps help patients manage their health through reminders,
medication tracking, and fitness monitoring. They empower individuals to take an
active role in their health.
4. Health Information Portals
These platforms provide patients with access to their medical records, lab results,
and educational materials, promoting patient engagement and self-management.
Benefits of e-Health

1. Improved Access to Care

e-Health applications break geographical barriers, allowing patients in rural or
underserved areas to access specialist care.
2. Cost Reduction
By reducing the need for physical visits and enabling remote monitoring, e-Health
can lower overall healthcare costs for patients and providers.
3. Enhanced Quality of Care
e-Health tools facilitate better data sharing and collaboration among healthcare
professionals, leading to improved diagnosis and treatment.
4. Increased Patient Engagement
e-Health applications encourage patients to take an active role in their health,
fostering better adherence to treatment plans.
Telemedicine in Detail

Overview
Telemedicine allows for real-time consultations, which can be particularly
beneficial for patients with mobility issues or those living in remote areas.
Applications
- Emergency Consultations: Immediate access to specialists during emergencies.
- Chronic Disease Management: Regular monitoring and consultations for
conditions like diabetes and hypertension.
- Case Studies
Numerous healthcare organizations have successfully implemented telemedicine,
reporting improved patient satisfaction and outcomes.
Electronic Health Records (EHRs)
Definition of EMR
An electronic (digital) collection of medical information about a person that is
stored on a computer.
An electronic medical record includes information about a patient’s health
history, such as diagnoses, medicines, tests, allergies, immunizations, and
treatment plans.
Electronic medical records can be seen by all healthcare providers who are
taking care of a patient and can be used by them to help make recommendations
about the patient’s care. Also called EHR and electronic health records.
EHR contains the patient's records from doctors and includes demographics, test
results, medical history, history of present illness (HPI), and medications.
❖ How is EMR different from an EHR?
EMRs are part of EHRs and contain the following:
• Patient registration, billing, preventive screenings, or check-ups
• Patient appointment and scheduling
• Tracking patient data over time
• Monitoring and improving the overall quality of care
The decision to choose an EMR over an EHR depends on what functions are
most useful to a hospital, office, or clinic
❖ Evolution from paper to electronic
The idea of computerizing patients’ medical records has been around for years,
but only in the past decade has it become widely adopted. Prior to the electronic
health record (EHR), a patient’s medical records consisted of handwritten notes,
typed reports, and test results stored in a paper file system. Today paper medical
records are used in fewer healthcare facilities.
• Paper-based systems were not secure and prevented easy access to patient
file information for all stakeholders.
Beginning in 1991, the IOM (a division of the National Academies of Sciences,
Engineering, and Medicine) sponsored studies and created reports that led the
way toward the concepts we have in place today for electronic health records.
During their evolution, EHRs have had many other names, including electronic
medical records, computerized medical records, longitudinal patient records, and
electronic charts.
In 2003, the IOM chose the name electronic health records, or EHR, because
“health” means “a state of well-being,” and the goal of computerizing medical
records is to improve the delivery of safe, quality care focused on patients’ health
❖ Key Functions of EMRs
Electronic medical records expand how physicians and clinicians can record and
use information about their patients.
EMRs have a few key functions for both medical professionals and their patients.
Charting: Medical history and diagnoses automatically enter a secure, digital
space to be recorded.
Patient Portals: Patients have direct access to their medical information with
EMRs.
E-Prescribing: Pharmacies receive prescriptions with the e-prescribing function
of most EMRs quicker than before.
Order Entry: EMRs make it easier for providers to store and send orders for lab
tests and more.
Decision Support: Along with the handy patient portal, most EMRs have
functions that help patients manage certain aspects of their healthcare.
❖ Types of Electronic Health Records (EMR) and (EHR)Systems
1. Cloud-Based EMR Software
A cloud-based EMR software allows data to be accessed online. Remote access
to information is a primary feature of cloud-based EMR software. Medical
information about patients is stored securely “in the cloud.”
2. Mac EMR Software
Mac EMR software, as can be assumed by the name, includes software
compatible with all Apple devices. There are Mac-native options, which are
designed exclusively for the Mac operating system.
3. ONC-Certified EMR Software
ONC-certified EMR software refers to any software that meets requirements set
by the Office of the National Coordinator for Health Information Technology
(ONC).
4. Behavioral/Mental Health EMR Software
EMRs for behavioral and mental health providers offer a different range of
features. These features are more specific to the needs of mental health clinics,
therapists, and group clinics
5. Medical Billing Software
Processing patient statements and insurance claims can be more manageable with
medical billing software. There are software systems that integrate with EMRs to
form a complete and robust administrative department.
❖ Electronic medical record software & other EMR models
1. Software
This is the "traditional" model of EMR software, where companies require
practice to physically install software onto a computer or server at the practice
location.
EMR software like this is usually associated with high up-front costs needed just
to get the infrastructure up and running.
2. Application Service Provider
With an ASP, the software lives on the vendor's system instead of the practice's
own servers.
3. Software as a Service (SaaS)
With the SaaS model, all clients access a single instance of the latest, most
updated EMR software online.
4. Cloud-based Services
A cloud-based service takes the technological advantages of a SaaS and goes even
further.
❖ Components of an Electronic Medical Record System
1-Progress note entry.
Just the way doctors and nurses write notes on sheets of paper in their patients’
charts, medical professionals using EMRs take notes about their patient’s state of
being, symptoms, appearance, and so on with a note entry tool.
2-Patient call log.
The call log should document any relevant phone calls and conversations between
physicians and their patients.
3-Data module input system.
To round out the notes taken during patient discussions, a comprehensive EMR
allows physicians to upload scans of documents and images, and record dictation.
4-Prescription management system.
Among the most important features of any prescription management system is
the ability to input a patient’s allergies and to note any medications the patient is
currently taking, to help ensure no negative
reactions occur.
5-Backup system.
As with any virtual (or even non-virtual) system containing large quantities
of sensitive information, backup and disaster recovery plans are crucial.
❖ Factors influencing the implementation of EMR.
Pre-implementation into 4 categories
➢ Awareness and understanding of the electronic medical record
All participants were aware of the upcoming EMR launch within the service.
➢ Engagement in the launch process
All participants indicated that they had been engaged on some level during the
implementation process for the new EMR.
➢ Effect on workload
The majority of participants discussed the perceived effect of the EMR on their
workload. Generally, participants were concerned that the EMR may negatively
impact workload, particularly for clinical staff who would be required to
complete data entry tasks.
➢ Standardization and completeness of data
Participants perceived the EMR to be beneficial for improving the quality of
clinical data collected within their centre in the future.
Post-implementation into 5 categories
➢ Standardization and completeness of data
Both administrative and clinical staff indicated the benefits of interoperability
with the main hospital EMR and center-wide access to the same information in
the EMR.
➢ Effect on workload
The EMR was perceived to have both positive and negative impacts on
workload. A participant reported that the EMR increased efficiency by making
information more accessible.
➢ Feature completeness and functionality
A number of participants raised concerns about issues with features, or
functionality of features in the EMR, and ranged in a degree of severity, from
usability to issues affecting data quality and workload.
➢ Learning curve
There were some concerns about the difficulty in remembering how to enter data
into the new EMR fields, particularly for staff that didn’t interact with it regularly.
➢ Buy-in from staff
Some participants raised concerns about the lack of buy-in to the EMR across
clinical disciplines that work within and in collaboration within the centre, which
led to gaps in available information.
❖ System Requirements of EMRs

➢ Requirements Collection

➢ Flowchart
The proposed system has eight different pages, including the home page. The
Home :The page has access to seven pages and these pages are (Registration,
About, Login, Appointments, Employees, Patients)

❖ Non-Functional Requirements of EMRs

Ease of Use
The Ease of use is an important non-functional requirement that focuses on how
the finished product would look, especially for its intended users.
Scalability
is the capability of a system to handle a growing amount of work or expansion to
meet business needs. A system is considered scalable if it has the potential to be
enlarged to accommodate growth.
Availability
is a non-functional attribute, it is the probability that a system will work as
required when needed during the period of the mission.
Security
Users of any system are highly concerned about their personal information is
private and secure. Security focuses on recognition and resistance to attacks.
Performance
People tend to overestimate their own patience if the system did not respond in
a specific short time, people will complain about it.
❖ Benefits and Advantages
For Patients:
• Fewer errors compared to paper records.
• Better and quicker care.
• Track results and data over time.
• Improve treatment and diagnosis.
• Identify patients who require screenings and preventive care.
• Better patient health data security and privacy.
• Supports data-based decisions.
• Receive follow-up support like reminders, web links, and self-care
suggestions.
• Patients can access their records, view prescriptions, and follow
recommended lifestyle changes.
For general:
o Providing accurate, up-to-date, and complete information about patients at
the point of care
o Enabling quick access to patient records for more coordinated, efficient
care
o Securely sharing electronic information with patients and other clinicians
o Helping providers more effectively diagnose patients, reduce medical
errors, and provide safer care
o Improving patient and provider interaction and communication, as well
as healthcare
o Enabling safer, more reliable prescribing
o Helping promote legible, complete documentation and accurate,
streamlined coding and billing
o Enhancing privacy and security of patient data
o Helping providers improve productivity and work-life balance
o Enabling providers to improve efficiency and meet their business goals
o Reducing costs through decreased paperwork, improved safety, reduced
duplication of testing, and improved health
❖ Disadvantages

➢ Prone to Hacking: While digital records are safer and more secure than
maintaining physical papers, data breaches have become common.
➢ Require Updates

➢ Device Management