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UCL Institute of Health Informatics

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Electronic Health Records

In this module we examine the latest internationally recognised approaches to the management of clinical information, focusing on the expanding roles for the health record and the development of electronic health record architectures to meet these. The module deals with practical issues such as standardisation, security, barriers to adoption and the professional challenges in developing clinical data standards for shared electronic healthcare records.

The overall aim of this module is for students to have a sufficient understanding of the fundamental nature of health record information and the ways in which such information might formally be represented and managed and shared electronically, to equip students to play an active role in the design, development, procurement or adoption of EHR systems in their future careers. Students should know about the requirements for rich interoperability between EHR systems, and the extent of maturity in this discipline towards achieving this.

Module code

CHME0006

UCL credits

15

Module organiser

Dr Dionisio Acosta Please direct queries to courses-IHI@ucl.ac.uk

Who can study this course?

Anyone with a direct or supportive role in healthcare (clinicians, nurses, etc), healthcare managers, health informaticians, IT staff

Admission requirements

A minimum of an upper second-class Bachelor's degree in a relevant discipline from a UK university or an overseas qualification of an equivalent standard. Students who do not meet these requirements but have appropriate professional experience will also be considered. Students who have previously undertaken CPD may apply for accreditation of prior learning.

Content

  • Learning from paper records
  • History and evolution of health records
  • Evolution of hospital and general practice computing
  • Case study of example clinical information systems
  • Models of shared care and integrated care, eHealth challenges in delivering person centred care
  • Towards delivering the EHR: challenges and eHealth programmes
  • Clinical engagement with the EHR
  • EHR requirements statements.
  • EHR interoperability standards to support shared patient care, including the current international
  • Standard for EHR Communication and HL7 version 3 Reference Information Model.
  • Clinical data structures, EHR archetypes, and how shared definitions of these contribute to good practice and to meaningful record sharing.
  • EHR architectures and an example model of shared care in north London.
  • Personal health records and models of shared care
  • EHR archetypes: practical exercise: review clinical examples and compose an archetype
  • Semantic interoperability
  • Terminology binding to archetypes
  • Reflection and discussion relating to the assignment

Teaching and learning methods

Blended learning: web-based distance learning in the UCL Virtual Learning Environment plus a 3-day face-to-face teaching session, webinars, self-study, tutorials, seminars and workshops including substantial use of examples of real clinical systems.

Assessment

Summative assessment: Written report worth 100% of the overall module mark.

Selected reading list

Chao, C.-A., (2016) The impact of electronic health records on collaborative work routines: A narrative network analysis. Int J Med Inform 94, 100–111. doi:10.1016/j.ijmedinf.2016.06.019

Han, J.E., Rabinovich, M., Abraham, P., Satyanarayana, P., Liao, T.V., Udoji, T.N., Cotsonis, G.A., Honig, E.G., Martin, G.S. (2016) Effect of Electronic Health Record Implementation in Critical Care on Survival and Medication Errors. Am. J. Med. Sci. 351, 576–581. doi:10.1016/j.amjms.2016.01.026

Lammers, E.J., McLaughlin, C.G. (2016) Meaningful Use of Electronic Health Records and Medicare Expenditures: Evidence from a Panel Data Analysis of U.S. Health Care Markets, 2010-2013. Health Serv Res. doi:10.1111/1475-6773.12550

Lowes, L.P., Noritz, G.H., Newmeyer, A., Embi, P.J., Yin, H., Smoyer, W.E. (2016) “Learn from Every Patient” Study Group, 2016. “Learn From Every Patient”: implementation and early results of a learning health system. Dev Med Child Neurol. doi:10.1111/dmcn.13227

Nguyen, L., Bellucci, E., Nguyen, L.T. (2014) Electronic health records implementation: an evaluation of information system impact and contingency factors. Int J Med Inform 83, 779–796. doi:10.1016/j.ijmedinf.2014.06.011

Hyppönen, H., Saranto, K., Vuokko, R., Mäkelä-Bengs, P., Doupi, P., Lindqvist, M., Mäkelä, M. (2014). Impacts of structuring the electronic health record: A systematic review protocol and results of previous reviews. International Journal of Medical Informatics 83, 159–169. doi:10.1016/j.ijmedinf.2013.11.006

Zwicker, M., Seitz, J., Wickramasinghe, N., (2014) Identifying Critical Issues for Developing Successful e-Health Solutions, in: Wickramasinghe, N., Al-Hakim, L., Gonzalez, C., Tan, J. (Eds.), Lean Thinking for Healthcare, Healthcare Delivery in the Information Age. Springer New York, pp. 207–224.