Electronic Medical Record Management

Introduction:

An Electronic Health Record or Electronic Medical Record Management System is a representation of all a patients’ data that would originally be found in the paper based record. It contains all information ranging from pathology, radiology and clinical information that has been combined and structured in a digital format.

The system is designed to furnish, capture, transcribe and re-present data that accurately capture the state of the patient at all times whenever visited a clinic or hospital. It allows for an entire patient history to be viewed without the need to track down the patient’s previous medical record volume and assists in ensuring data is accurate, appropriate and legible. It reduces the chances of data replication as there is only one modifiable file, which means the file is constantly up to date including the latest personal details when viewed at a later date and eliminates the issue of lost forms or paperwork. Due to all the information being in a single file, it makes it much more effective when extracting medical data for the examination of possible trends and long term changes in the patient.

Goals and objectives:

• To improve patient’s care quality, safety, efficiency, and reduce health disparities.
• Quality and safety measurement.

• Improve patient care coordination.

• Engage patients and families in their care.
• Immunization reporting to immunization registries (In Ayurveda for Swarnaprasha)

• Ensure adequate privacy and security protections.
• Pharmacy stock maintenance.
• Suggestion pop-ups.

Technical features:

• Digital formatting enables information to be used and shared over secure networks.
• Track the patient care. (e.g. Ayurvedic prescriptions, medicines used, treatments done) and outcomes (e.g. blood pressure and other vital statistics.)
• Trigger warnings and reminders.
• For medicine stock and other issues.
• Send and receive orders, reports, sms reports, calling facilities, and lab reports or diagnostic reports.

Health Information Exchange:

• Technical and social framework that enables information to move electronically between organizations.
• Reporting to public health departments when needed.
• ePrescribing, online consultation, and online monitoring of patients.

• Mobile applications for patients for appointments and to track their vitals and health status.

Using an EMR to read and write a patient's record is not only possible through a workstation but, depending on the type of system and health care settings, may also be possible through mobile devices that are handwriting capable (there are devices called digital writers.)

Electronic Medical Records may include access to Personal Health Records (PHR) which makes individual notes from an EMR readily visible and accessible for consumers.

Some EMR systems automatically monitor clinical events, by analyzing patient data from an electronic health record to predict, detect and potentially prevent adverse events, highlighting allergies etc. This can include discharge/transfer orders, pharmacy orders, radiology results, laboratory results and any other data from ancillary services or provider notes. This system greatly reduced the number of missed critical opportunities.

As Electronic Medical Record Management or EMR is much popular in corporate hospitals and public sectors, as they are utilizing in best possible way to save time, man power, and money, and ultimately minimizing the errors in day-to-day activities.

AYURVEDIC HOSPITALS:

As Allopath hospitals face some challenges, similarly in Ayurvedic field, we do face certain challenges in day to day activities when it comes to practice and patient handling work. As ayurvedic professionals find some difficulties when it comes to delivering health care to the patient.

In order to improve the standards and quality based service, there are certain bodies who come forward for accreditation process. Basically A standard Ayurvedic Hospital does have certain methods in hospital and with the recent standardization methods in the field of Ayurveda, Government bodies and associations started encouraging Ayurvedic Hospitals to improve themselves by certifying them or accreditation methods based up on fulfilling certain criteria. They are AYUSH, NABH (National Accreditation Board for Hospitals & Healthcare Providers), AHAMA etc.

Similar to General Practice, there are certain methods and steps which are taken place in classical way such as when it comes to clinical practice or hospital practice. In Ayurvedic Hospitals, the method of diagnosis and assessment of patient criteria is different from allopath system of medicines.

· When a patient visits Hospital he or she enters Reception.

· From Reception, patient is directed to departments or to consultation chamber.

· Ayurvedic doctors utilize their Ashtavidha Pariksha, or Dasha vidha pareeksha skills, Roga and Rogi Pariksha Skills in classical way, Prakrithi Analysis and so on or according to department.

· From Consultation Patient may be directed to reception or counselor or resident medical officer (RMO) for needful.

· Here, if doctors prescription is only medicines, patient may go to pharmacy and buy medicines and clarifies doubts with doctor or resident medical officer and go away from hospital.

· If doctors are prescribing treatments, patient is directed to visit RMO again who will explain about treatments. When patients are ready for the treatments they will visit hospital for certain time period and take the treatment.

· Another scenario is IP admission. When patient is directed for admission, one should follow all the methods and procedures as prescribed by doctor on daily basis such as treatments, nursing care, Panchakarma treatments etc.

Difficulties and Challenges in Ayurvedic Hospitals:

During the course of examination the challenges we face are:

Time: If the flow of patients is more, doctors who are consulting may not find time to cover all these assessment criteria. Sometimes ayurvedic doctors may miss their examination criterion.

Paper Work: Starting From Reception work, OPD Card, Treatment Schedule Preparation, and other paper work which may create confusion among the staff and ultimately we may fail to deliver what we want.

Man Power: For covering each section of patient handling methods from reception level, front office level, in order to provide maximum customer satisfaction/patient satisfaction we may need man power.

Challenges at different levels:

At Front Office Level: Many a times front office staff may not be in a position to handle the patients when it comes to collect the OP card of the patient or to search the same in the files where they may waste their time that may reflect on patient satisfaction levels.

At the level of IP Facilities: When Doctor consults and put a patient for IP facility, one should closely monitor patient activities and progress in proper passion where we may miss some information to note down or we may face some technical difficulties.

Pharmacy Level: Many of the times, doctors may not know about the stock of medicines which they prescribe to the patients and there may be confusion and rewriting prescription and sometimes doctors may lose their confidence during re-prescribing medicines.

Accounts and Billing Level:

Most of the time accountant may face some confusions in billings when there is no proper coordination with the front office staff regarding patient handling and collecting the charges and issuing bills to the patient.

Research Purposes: Most of the times, doctors do lose the patient’s data when they want to recollect for some research purposes or to follow up the patient for certain reason. When there is no proper paper work done or when there are certain fields missing to be filled regarding the patient’s condition, doctors may lose interest in doing research.

ROLE OF EMR SYSTEM IN AYURVEDIC FIELD:

By considering all above challenges we face in day-to-day operations of ayurvedic hospitals, the EMR system seems to be best possible solution to achieve goals and give maximum patient satisfaction and clinical results.

If the demands and requirements are met with ayurvedic doctor, EMRs are very much helpful in daily practice not only for Hospitals but for individual ayurvedic practitioners. (Even for Siddha, Homeopathy, and Yoga& Naturopathy, or Unani Doctors).

By giving inputs on Ayurvedic sections like Prakrithi Analysis charts, Ashtavidha Pariksha, Dasha Vidha pareeksha, and other classical examination methods, medicines and details, indications in the software, one can enter or retrieve data according to requirements of Ayurvedic doctors, by doing so, one can achieve many advantages where you get professional satisfaction and financial growth can be achieved.

BENEFITS OF EMR IN AYURVEDA:

· Front Office: Data Entry at Front office level and Integrating websites with the software.

· Patient data can be retrieved as and when needed.

· Patient analysis can be done in simple methods.

· Patient follow-up is easier.

· Data management of patients is easier.

· Data security can be fulfilled at all levels. (Reception, doctors, pharmacy and other sections of hospital)

· At consultation room: Filling certain fields like presenting complaint, chief complaints, vitals and prescriptions.

· At RMO level: Entering Maximum Data of the patient when it comes to classical examination methods in terms of ayurveda that include prakrithi pareeksha, Nadi pariksha, Ashtavidha Pariksha, Roga and Rogi Pariksha, other vitals, physical examination, history etc.

· Counseling: Counseling and Post Counseling entry on daily basis in columns provided.

· Pharmacy: Medicines updating, including indications of medicines in software. Pharmacy Stock maintenance can be done accordingly.

· Accounts: Billing and Accounting details.

· IP Facilities: Updating all vitals and other columns on daily basis.

· Data statistics: Statistics like total number of patients, charges, pending charges, etc.

· Leads and Lead Analysis: Source of the patient: Just Dial, Sulekha, Getit, Ask Laila, and Electronic media statistics on monthly basis and as and when needed basis.

· Research Purpose: Analyzing the patients, and diseases. For example, how many diabetic patients visited to our hospital, that can be highlighted in single click. Disease wise analysis and progress of patients can be analyzed which are helpful for research purpose.

· Other requirements: Columns for various sections like Yoga column, diet column, and exercises column, Panchakarma treatments column.

· Article sections: Integration of our website to this software.

· Others: We can minimize the paper work.

· Man power can be utilized for other hospital works.

· Research work can be improved and patient analysis can be done in easier way.

· Professional skills can be improved.

· Reporting and Mailing facility in easier way in simple steps or single click.

· Bigger hospitals can connect their departments and integrate the software and update the patient details. Eg: If patient is indicated to visit Kayachikitsa OPD as well as shalya Tantra OPD, So, patients details can be entered accordingly in different sections provided.

Conclusion:

By establishing EMR system in all Ayurvedic practitioner’s practice, and in Ayurvedic Hospitals one can achieve their goals at par with allopath system of medicines in terms of development in research activities and technicality and giving best health care the patients. One can improve the patient care, quality, safety, efficiency, and reduce health disparities, and are very important to fulfil the basic needs of an Ayurvedic Practitioner’s requirement and to fulfil Ayurvedic Hospital Requirements.

As software companies booming up and are coming forward, offering tailor-made tools based on requirement of Ayurvedic doctors and definitely it is possible in the field of Ayurveda. These software providers give online solutions and individual software based on the needs and requirements of individuals or hospitals.

Popular sites for references:

Clinveda: http://www.plus91online.com/site/

Needstreet: https://www.needstreet.com/

Ayurvedic Consultants: Easy Ayurveda: http://www.easyayurveda.in/.

AyurHis: http://www.mecit.com/product_ayurhis.php.

Insta Health Solutions: http://www.instahealthsolutions.com/

RX Mantra: http://www.twelve77.com/

DocEngage: https://www.docengage.in/.