The Electronic Health Record to Support Women's Health

The Electronic Health Record to Support Women's Health

Emma Parry (The University of Auckland, New Zealand)
Copyright: © 2009 |Pages: 12
DOI: 10.4018/978-1-60566-078-3.ch005
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Abstract

The seamless electronic health record is often hailed as the holy grail of health informatics. What is an electronic health record? This question is answered and consideration is given to the advantages and disadvantages of an electronic health record. The place of the electronic health record at the centre of a clinical information system is discussed. In expanding on the advantages several areas are covered including: analysis of data, accessibility and availability, and access control. Middleware technology and its place are discussed. Requirements for implementing a system and some of the issues that can arise in the field of women’s health are elucidated. Finally, in this exciting and fast moving field, future research is discussed.
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History

Computers have developed with a speed that has surprised even those working in the industry. The well known “Moore’s law” postulates a doubling of computer performance every year to 18 months (Schaller & Schaller, 1997). The medical profession have traditionally shunned computers in their practice as a just another time-wasting device, however in recent years computers have shown themselves to be useful and time-saving (Horwood & Richards, 1988). One of the most striking features of the development of EHR, has been the widespread adoption of administration, billing and laboratory systems ahead of the clinical record.

In 1968 the first attempt to use computers in obstetrics was initiated by Thatcher in Australia (Thatcher, 1968). A pilot system was introduced in Australia at the Royal Hospital for Women, Sydney in 1968. In 1971 a pilot study was set up at St Thomas’s Hospital in London (South & Rhodes, 1971) and in Victoria Australia(Cope, Greenwell, & Mather, 1971) whilst in America, the Duke University Medical Centre also went on line in their obstetric department in 1971. All these systems were based around a mainframe computer, which were cumbersome and slow. These were the first ‘microcomputers’ which were within reach of smaller companies in terms of price.

In these early systems information was entered after the event (a retrospective system) by trained computer staff. The medical and midwifery staff had no role in data entry. It is well recognised data entered in this fashion is less accurate than data entered by a user (e.g. midwife) prospectively (at the time of the event).

As new faster microprocessors were developed, along with improved software and user interfaces, user based systems could be developed (Chard, 1987; Horwood & Richards, 1988; Lilford & Chard, 1981). The advent of the personal computer in the early 1980’s made computers more accessible, smaller and cheaper (Shipton, 1979). The possibility of having computers in clinical areas began to be raised. Interest in computers in Obstetrics increased again. During the 1980’s many hospitals developed systems, although most of these were retrospective in their method of data collection. One of the first hospitals to develop a prospective data collection system was King’s College Hospital in London (Horwood & Richards, 1988). This system, EuroKing, relied on staff using a barcode reader and code book to take a booking history. This group found that with this system, the time to take a full booking history fell from one hour to ten minutes.

Complete Chapter List

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Editorial Advisory Board
Table of Contents
Foreword
Neil Pattison
Preface
Emma Parry, David Parry
Acknowledgment
Emma Parry, David Parry
Chapter 1
Peter Stone
Improving women’s health is a vital task for the world. The consequences of obstetric and gynecological disease are serious both for the women... Sample PDF
An Introduction to Women's Health and Informatics
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Chapter 2
Premila Fade
Principlism (derived from common sense morality) is the most common theory used within the healthcare sphere. The elements of this theory are... Sample PDF
Women's Health Informatics: The Ethical and Legal Issues
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Chapter 3
David Parry
Recording information about symptoms, observations, actions, and outcomes is a key task of health informatics. Standardization of records is vital... Sample PDF
Coding and Messaging Systems for Women's Health Informatics
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Chapter 4
Gareth Parry
Women’s health in primary care is a large part of the generalist’s practice. Information technology (IT) is now an integral part of the generalist’s... Sample PDF
Women's Health Informatics in the Primary Care Setting
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Chapter 5
Emma Parry
The seamless electronic health record is often hailed as the holy grail of health informatics. What is an electronic health record? This question is... Sample PDF
The Electronic Health Record to Support Women's Health
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Chapter 6
Graham Parry
Information technology and communication systems have made imaging in women’s health easier at many levels. There are now many commercial systems on... Sample PDF
Imaging and Communication Systems in Obstetrics and Gynecology
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Chapter 7
Emma Parry
Pregnancy is unique in medicine in providing a discrete event with a fixed end. It is well suited to data collection and statistical assessment.... Sample PDF
Statistical Measures in Maternity Care
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Chapter 8
Kiran Massey, Tara Morris, Robert M. Liston
Our ultimate goal as obstetric and neonatal care providers is to optimize care for mothers and their babies. As such, we need to identify practices... Sample PDF
Building Knowledge in Maternal and Infant Care
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Chapter 9
Malcolm Battin, David Knight, Carl Kuschel
Neonatal care is an extremely data-intensive activity. Physiological monitoring equipment is used extensively along with web-based information tools... Sample PDF
Informatics Applications in Neonatology
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Chapter 10
Jenny Westgate
During pregnancy the fetus requires an adequate supply of oxygen and clearance of carbon dioxide which is a waste product of metabolism. In fetal... Sample PDF
Computerizing the Cardiotocogram (CTG)
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Chapter 11
Liron Pantanowitz
Automation and emerging information technologies are being adopted by cytology laboratories around the world to augment Pap test screening and... Sample PDF
Computer Assisted Cervical Cytology
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Chapter 12
Laurie Elit, Susan Bondy, Michael Fung-Kee-Fung, Prafull Ghatage, Tien Le, Barry Rosen, Bohdan Sadovy
Ovarian cancer affects 2,400 women annually in Canada with a case fatality ratio of 0.70. There are several practice guidelines that indicate women... Sample PDF
Informatics and Ovarian Cancer Care
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Chapter 13
Jamila Abuidhail
Information and communication technologies include computers, telecommunication, digital networks, and television. Using informatics in healthcare... Sample PDF
Women's Health and Health Informatics: Perinatal Care Health Education
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Chapter 14
Shona Kirtley
In an age where health professionals lead very busy working lives, electronic information sources provide ease of access to vast amounts of health... Sample PDF
Electronic Information Sources for Women's Health Knowledge for Professionals
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Chapter 15
David Parry
Decision analysis techniques attempt to utilize mathematical data about outcomes and preferences to help people make optimal decisions. The... Sample PDF
Computerised Decision Support for Women's Health Informatics
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Chapter 16
Michelle Brear
The influence of organizational factors on the success of informatics interventions in healthcare has been clearly demonstrated. This health... Sample PDF
Organizational Factors: Their Role in Health Informatics Implementation
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Chapter 17
Josipa Kern
When things go well then often it is because they conform to standards (ISO, 2005). According to the Oxford Dictionary of Modern English, there is a... Sample PDF
Standardization in Health and Medical Informatics
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Chapter 18
Elske Ammenwerth, Stefan Gräber, Thomas Bürkle, Carola Iller
This chapter summarizes the problems and challenges which occur when health information systems are evaluated. The main problem areas presented are... Sample PDF
Evaluation of Health Information Systems: Challenges and Approaches
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Chapter 19
Pirkko Nykänen
eHealth refers to use of information and communication technologies to improve or enable health and healthcare. eHealth broadens the scope of health... Sample PDF
eHealth Systems, Their Use and Visions for the Future
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Chapter 20
Nilmini Wickramasinghe, Santosh Misra, Arnold Jenkins, Douglas R. Vogel
Superior access, quality and value of healthcare services has become a national priority for healthcare to combat the exponentially increasing costs... Sample PDF
The Competitive Forces Facing E-Health
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About the Contributors