Courtney is a High school Health Information Management teacher with a diverse background in the healthcare field. She also holds a MBA from Cleveland State University.
Technology has utterly changed the medical field. Consumers now expect to have unlimited access to their health information at their fingertips, in addition to receiving care from their provider without entering a medical office. Both eHealth (electronic health) and mHealth (mobile health) have allowed these services to be possible.
The federal government, in addition to states, local government, and professional guidelines have mandated the use of eHealth to reduce errors and improve the efficiency of patient care.
Electronic Health (eHealth)
Let's go over some eHealth applications first.
EMR & EHR Applications
One of the most widely used eHealth applications is the electronic medical record (EMR), which is a digital version of a patient's medical history from a single facility. However, many organizations are using applications that allow a patient's record to be viewed by multiple medical facilities. These records are known as electronic health records (EHRs).
Electronic health records allow for improved continuity of care because records can be shared easily between health care providers; specialists; hospitals; and nursing homes. Information sharing is therefore not limited to geographic regions.
The leading EHR companies include:
- GE Healthcare
- Practice Fusion
- Athena Health
Organizations complete a needs analysis to determine their requirements for use, cost/affordability, and ease of use.
Computerized Physician Order Entry (CPOE)
Another eHealth process is computerized physician order entry (CPOE), which allows medical professionals to enter medical data or instructions electronically. Healthcare providers have the ability to prescribe medication and create orders for labs, radiology, etc.
The use of CPOE eliminates mistakes that can occur from non-legible handwriting and transcription errors. CPOE has allowed for health providers to utilize ePrescribing to prescribe their patient's medication electronically, creating a safeguard to check possible interactions, allergies, proper medication selection/dosage, legibility of prescription orders, and proper dispensing and administration.
Clinical Decision Support (CDS)
Clinical decision support (CDS) systems provide information to healthcare professionals to aid in diagnosis and treatment of patients. CDS is comprised of various tools, including automated alerts and reminders to providers and their respective patients, clinical guidelines, orders sets specific to condition, patient education materials, diagnostic support, and documentation templates.
These tools allow information to easily and readily be accessed in one place, making healthcare more efficient.
Mobile Health (mHealth)
Within eHealth is mHealth (mobile health), which uses mobile devices to communicate with patients and health services. Applications include mobile telemedicine, emergencies, health monitoring and surveillance, and access to information for healthcare professionals at the point of care. Mobile devices include mobile phones, tablets, patient monitoring devices, personal digital assistants (PDAs), laptops and more.
Many facilities and offices utilize mHealth to input patient data and communicate pertinent information to patients and/or other providers. The patient can receive information via text messages, secure patient portals, email, and instant message or chat. This often eliminates the need to schedule follow-up visits or in-office consultations.
Patients also have the ability to access their medical record through patient portals from their mobile devices, allowing health information at their fingertips. Patients can access test results, orders, messages, and access their health record electronically.
Telemedicine allows for remote delivery of healthcare services to patients. It's a convenient, cost-efficient method that eliminates the need for patients to travel to the provider's office, and therefore frees up provider treatment time as well.
Populations of patients who benefit include:
- Chronic disease patients
Say Ms. Jones has been diagnosed with diabetes and requires follow up visits every three months to discuss blood sugar levels and for a medication review. With telemedicine, Ms. Jones saves travel and wait time while her doctor can schedule more patients with the freed up time.
- Post-hospitalization care
Sally has been recently discharged from the hospital after having a biopsy. Using telemedicine allows her to receive the results in the privacy/comfort of her home at her convenience.
- Assisted living communities
Rolling Hills Assisted Living Community benefits from using telemedicine for routine office visits of their residents. The providers provide services more quickly, efficiently, and conveniently to patients. The provider would not have to travel to the facility and the residents would not have to leave for treatment, with the exception of those patient requiring immediate hands-on care.
By utilizing telemedicine, schools eliminate the need to have a full-time nurse on staff and could outsource services at a lower cost. This will cut down on the number of students who visit the clinic unnecessarily.
With mHealth, healthcare providers can monitor patient vitals remotely, say while making rounds, being out of the office/facility, or delivering information to other providers.
Patients in need can also be detected early and close the gap on when information is communicated about a patients condition. The use of remote patient monitoring combined with telemedicine also allows for treatment of chronic illnesses and post hospitalization to be possible.
Sarah is an infant patient in the NICU unit. Her temperature, pulse, heart rate, and breathing are being monitored. Her breathing has slowed. Nurse Tonya is notified by the patient monitoring system to her mobile device while she is in the room with another patient. Now she knows to check in on this patient immediately.
eHealth and mHealth (achieved through the use of wireless devices) have improved both the ability to deliver information and the quality of patient care.
Electronic Health includes the use of:
- electronic medical record (EMR) - a digital version of a patient's medical history from a single facility.
- electronic health record (EHR) - also a patient's electronic record but viewable by multiple medical facilities.
- clinical decision support (CDS) - systems that provide information aiding in diagnosis and treatment of patients. Tools include automated alerts, clinical guidelines, orders sets specific to condition, patient education materials, diagnostic support, and documentation templates.
To improve accuracy and reduce errors, healthcare providers have the ability to use computerized physician order entry (CPOE), allowing providers to enter prescriptions electronically (ePrescriptions), as well as labs, radiology, etc.
Telemedicine allows for optimum patient convenience and efficiency by allowing the provider to treat the patient's remotely, without ever stepping foot in the office. Patients also have the ability to schedule appointments, check their results, view visit summaries, bills, future appointments, and message their provider remotely.
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