EHR

Julius Elfe Email: jle10e@my.fsu.edu
 * EHR Application **

Ryan De Vera Email: rjd11d@my.fsu.edu

Clarence L Harrison Email: clh10d@my.fsu.edu

Dakota Morrison Email: dbm11@my.fsu.edu


 * Problem Statement **

In hospitals today there is a growing need for the storage and retrieval of medical data. The problem though that arises from this is that even with the EHR systems that are in place it is still hard to retrieve the most relevant information on patients in an effective manner. The reason for this issue is because of how confusing the interface of current EHR systems is and how it is difficult for the user to actually utilize those systems properly and effectively.
 * **Who- ** The area that our group members decided to focus on was the EHR system and the people it will affect in a negative manner. The primary targets that we would like to focus on are the physicians and clinicians who utilize EHRs on a regular basis for data management and clinical decision making compared to the secondary targets which would be our patients who would probably use the EHRs for only viewing purposes.
 * **What- ** The main issue that our group wanted to address with the EHR system was how it was causing confusion for the users when trying to properly use the system because of how they lacked the proper training to use the system effectively and efficiently. Our group felt that this was a big issue because of how it impacts the physicians who are using these systems to document the records. If the user were trying to input information in the wrong areas of the system then the system would use that data incorrectly when giving out things ranging from treatments to medication which would not be good for the patients and physicians who are using that system as method to avoid causing harm to patients.
 * **When – **<span style="font-family: 'Times New Roman',serif;">Based on when the EHR is used the most likely time that problems would most likely occur would be during patient and physician interaction. The reason why this would seem to be the most likely time that the error would occur at this time is because this is the time where the exchange of the information between the physician and patient can be hard to effectively and properly categorize in the EHR system and thus the information could become less useful when trying to come up with forms of treatment for the patient. In our team’s opinion this should be fixed as soon as possible so that EHRs can be more a useful tool for everyone ranging from the physicians to patients.
 * **<span style="font-family: 'Times New Roman',serif;">Where- **<span style="font-family: 'Times New Roman',serif;"> The most likely area that problem would occur at is at the hospital because this is where the clinicians and physicians are inputting the data into the EHR systems and this would be the time where most of the errors would take place due to end user issues. Another area that could be affected is possibly at home because this is where most patients would try and view the EHR system and this could be problematic if the design of the system is too complicated for the user to understand since they are not professionally trained in fully understanding how to use an EHR for personal use at home.
 * **<span style="font-family: 'Times New Roman',serif;">Why- **<span style="font-family: 'Times New Roman',serif;"> It is important to fix this problem because it could help benefit both the physicians and clinicians have a better system to help their patients and keep better records to have a more organized system to refer to when helping patients. If the problem were to be fixed then it would mean that there would be more investment in EHR systems instead of using other outdated methods of documenting patient information. The consequence of not promoting ways to help fix this problem would mean that there would have to be a different system to help manage records of patients and also a better way to help document them for the physicians who are providing care.


 * <span style="font-family: 'Times New Roman',serif;">Evidence to support the problem **

<span style="font-family: 'Times New Roman',serif;">Based on a work from October 2011 there has been around 100 flaws ranging from end user usability issues to the system not having usable work functions for workers causing the system to be as useful or productive in the work environment. What was showcased in this example was not even an EHR system that is used commercially which had more flaws with the same issues stated and some more such as flexibility issues included in the mix of flaws stated within the report (Viitanen et al, 2011). <span style="font-family: 'Times New Roman',serif;">Another source also creates the idea that having an EHR can have a costly impact on basic working operations and this in turn meant an increased workload which might not be as beneficial as previously thought since it would mean more data input from clinicians. This scenario shows how even with all the new types of information gathered it could mean it would mean that it would take a higher level of critically thinking to put the most relevant information as possible and derive as much of that from conversation between them and the patient which could be a very difficult task to handle in an efficient manner (Jenkings et al, 2007).


 * <span style="font-family: 'Times New Roman',serif;">Potential Solutions **

<span style="font-family: 'Times New Roman',serif;">After reviewing the current technical interface issues with EHR and PHR systems, our solution would be to simplify the user experience by providing a logical and concise user interface mobile application so that end users can interact with their personal health records more effectively. This mobile application can also solve clinician side interface issues by logically organizing data in terms of medical relevance and physician preference settings. <span style="font-family: 'Times New Roman',serif;">Another solution our group believe will aid in the simplification and transferring of personal health records would be with a PHR card with microchips in the card that holds your personal health data, this solution may also be beneficial in medical emergency situations where EMTs may swipe your health card and have your relevant medical history on hand so to treat you quicker and more efficiently. <span style="font-family: 'Times New Roman',serif;">A solution that might benefit the physician or clinician in inputting relevant medical information about a patient is to have a mobile device which can help them collect as much information as possible and then help them determine which parts of the conversation can help the patients in the most effective way possible.


 * <span style="font-family: 'Times New Roman',serif;">Research on Existing/Alternative solutions attempted by others **

<span style="font-family: 'Times New Roman',serif;">Based on the article 4medica iEHR they were focusing on targeting the core areas in which to provide their service which would give the most accurate form of information to supply the best product for healthcare locations that were using their systems to help patients. This solution also wanted to help aid the decision making processes which in our opinion was very important to consider when developing a system to help other facilities in the health field (“4medica |Solutions For: Hospitals, Labs & Imaging Centers, HIEs & ACOs”, 2014). <span style="font-family: 'Times New Roman',serif;">The solution offered had very small costs and risks. What this service provided was a way to quickly and effective have a new system in place that would help facilities transition into a new environment where redundancy and errors of the file and paper system would be a thing of the past (“4medica |Solutions For: Hospitals, Labs & Imaging Centers, HIEs & ACOs”, 2014).


 * <span style="font-family: 'Times New Roman',serif;">Feasibility of Solutions **

<span style="font-family: 'Times New Roman',serif;">The concept of reducing the data pulling up less data and instead getting the most critical data from an EHR system would take a lot of work in targeting key words or variables. This would be a huge undertaking because of hard it would be to rewrite the code that pulled up that information, but with some time it would be very possible to help create a system that uses this code to help benefit clinicians and physicians who are taking care of patients. <span style="font-family: 'Times New Roman',serif;">Creating a card that held information on a patient at all times would be a very hard to implement because of how the different standards would get in the way of making this idea come to fruition. The reason why this would be hard to implement is because many hospitals have different EHR systems and creating a universal card that adjusted to each system would just be too difficult. <span style="font-family: 'Times New Roman',serif;">Lastly the development of a mobile device that would have access to EHR system would be more manageable because of how it would conform to a hospitals EHR system rather having to be adjusted to the hospitals EHR system. Instead of being adjusted to the system it would just simply utilize the system automatically built that had all the necessary functions that pulled the relevant information for physicians and clinicians.


 * <span style="font-family: 'Times New Roman',serif;">Our Chosen Approach **

<span style="font-family: 'Times New Roman',serif;">What our group decided to focus on was mobile device application that would basically be a way to help physicians and clinicians work on the fly while still having access to information no matter their location within the hospital. What this approach would allow us to focus on is data retrieval and the interoperability issues of hospitals. We would also focus on the interface of our mobile application because we wanted to also help physicians and clinicians use the system more effectively and efficiently rather than being confused on how to use it while at work.


 * <span style="font-family: 'Times New Roman',serif;">Timeline for Completion **

<span style="font-family: 'Times New Roman',serif;">August- Group formation <span style="font-family: 'Times New Roman',serif;">September- Topic Selection and Two Page Proposal <span style="font-family: 'Times New Roman',serif;">October- Research on topic and application wireframe <span style="font-family: 'Times New Roman',serif;">November- Application Template Demo and also later in the month Final Presentaion <span style="font-family: 'Times New Roman',serif;">December- Final Report


 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Workloads and Roles of Team Members **

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">The way that we divided roles was basically letting each member have input in all areas of research. Then when it came to creating the demo application mockup design we also worked on it together and had everyone work on each page together. All the members did the work together and we had no problems in dividing roles since we all worked on it together.

__<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Ryan Devera __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Worked on the research of topic, presentation slides, and application demo wireframe. The area that he focused on the most was the revision of all work before submission of the assignment.

__<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Julius Elfe __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Worked on the application demo wireframe, presentation slides, research of topic. The area he made his contributions were in the presentation preparation and application demo wireframe because of his expertise in making wireframes.

__<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Clarence L Harrison __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Worked on the research of topic, application demo wireframe, and presentation slides. The area that he made most of his contribution on was the topic we need to research and creation of the base application demo wireframe.

__<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Dakota Morrison __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Worked on the application demo wireframe, presentation slides, and research of topic. The area that he showed the most contribution and area of knowledge was presentation of slides and also helped supply ideas and wireframes for our application template demo.


 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Meeting Minutes **

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">9/17/2014 __<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Old Business __ __<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">New Business __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">The group members were all present and this set the ground work to create a Google doc to help create, view, and edit our work. The person to submit the work was Ryan Devera since he had the time to review the work of everyone and also compile it all together in a professional manner.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Group formation and brainstorming session for the project
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Consensus of EHR application project
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Research for the proposal on topic
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Addressed the 5 W’s needed for the proposal
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Finding evidence of EHR application statistics information
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Came up with solutions that our application would be able to provide clients and users
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Submission of collected before September 24th

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">10/29/2014 __<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Old Business __ __<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">New Business __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">The group members were all present. Basically collaboration was done through the Google doc and Clarence set up an account to create the wireframe. Once the application demo was done we talked about each section the presentation slides and once Ryan Devera reviewed the work. After the presentation we all worked on the feedback report and submitted that on time.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Submitted the proposal for EHR application to the class Wiki Space Page
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Member assigned the task of creating sections of our mock application
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Formulation of presentation format which consisted an introduction of the problem, suggested solutions, and an application template preview demo of wire frame
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Submission of the work stated above in a document
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Also a feedback review sheet of classmates were also submitted in a separate report

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">11/24/14 __<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Old Business __ __<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">New Business __ <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">The group members were all present. We are in close contact with one another through Facebook and text messages. The main task is to finish up the presentation and application design improvements. Once that is done we are to work together collaboratively on Google Doc and then finally submit our Final Report before the deadline on December 8th.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Mock-up of application for EHR mobile device is designed
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Powerpoint with suggested solutions, address to problem, and application demo created
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Class feedback report written and submitted
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Final report submission on December 8th
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Final Presentation submission of slides on November 24th
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Include the feedback to our present and alter our application demo to the feedback
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Finally once the final report is submitted group members work is evaluated

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">
 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Application Wireframes **


 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Final Solution **

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Basically we wanted to create a service where our mobile application would help condense the information shown on EHR system yet it would be effective at for the users to make the best clinical decisions based on what they were looking for on the device. This was to help users have a more simplified yet effective tool in providing the best care for patient visiting the hospital.


 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Next Steps **

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Our future goal is to let this system be usable in more active situations like when driving a patient in critical condition to the hospital we want our product to be used as way to document and report all the symptoms that the patient is experience during the ride from the accident scene to the hospital. Yet with more improvements it can even be a way to also help categorize even more information such as billing information and insurance providers that patient is currently using.


 * <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Work Cited **

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">4medica | Solutions For: Hospitals, Labs & Imaging Centers, HIEs & ACOs. (n.d.). Retrieved December 8, 2014, from <span style="color: windowtext; font-family: 'Times New Roman',serif; font-size: 12pt;">[]

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Jenkings, K. N., & Wilson, R. G. (2007). The challenge of electronic health records (EHRs) design and implementation: Responses of health workers to drawing a 'big and rich picture' of a future EHR programme using animated tools.//Informatics in Primary Care, 15//(2), 93-101.

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Viitanen, J., Hypponen, H., Laaveri, T., Vanska, J., Reponen, J., & Winblad, I. (2011). National questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability.//International Journal of Medical Informatics, 80//(10), 708-725. doi:10.1016/j.ijmedinf.2011.06.010 [doi]