EHR TIMELINE

EHR TIMELINE

1920

1959

First medical record

Documents included details about the patient's medical history, plan of care, and patient care outcomes.

telemedicine

• Reimbursement and government regulations were a barrier • Today, most patients say they are satisfied with or would recommend virtual appointments • Concerned about clinical quality being maintained • Remote Patient Monitoring tools have not yet emerged

1965

Medicare & Medicaid

The US government is an INFLUENCER who can sometimes accelerate more effective HIT adoption. They are policy setters and payers.

1982

voice recognition

1996

HIPPA

2000

2009

HITECH

2014

CORHIO HIE

+3 years..

additional players

Benefits will be reached when system analysts understand how clinicians think and work

+10 years...

references

• A common obstacle is the enormous cost of implementing Electronic Health Records (Daim 2016) • Fueled by nineteen billion dollars, the American Recovery and Reinvestment Act of 2009 (Recovery Act) was born. This act accelerated the national adoption and implementation of health information technology (Malhotra 2014). • The Recovery Act authorizes the Centers for Medicare & Medicaid Services (CMS) to provide payments to physicians and hospitals who become “meaningful users” of an electronic health record system (Centers for Medicare and Medicaid 2010).

Patients start to fear about having their medical records available online for 'everyone' to see. This concern does not help the push for electronic medical records. Even today people worry with computer breaches happening if they will ever be secure. Another concern is employers having access to their records (Daim 2016). HIPPA mandated security and privacy of health data. This allowed for a more effcient and effective health care system and encouraging the use of electronic data interchange. (Malhotra 2014).

Telemedicine

• The first people to use video communication for medical purposes were clinicians at the University of Nebraska. The university established a two-way television setup to transmit information to medical students across the campus. Just within five short years the university connected with a hospital to perform video consultations.

• Lack of clarity about the value of telehealth is one reason it has been slow to adopt (Daim 2016). Yet others have adapted the diffusion of innovation (DOI) framework to the study of innovations (Daim 2016).

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• Medicare is an insurance program administered by the United States government providing healthcare insurance to people aged 65 and over, or individuals with disabilities (Centers for Medicare and Medicaid 2010). Medicaid provides insurance for low-income families. • According to the Centers for Medicare and Medicaid Services National Health Expenditure 43 million Americans are enrolled in Medicare and 53 million are enrolled in Medicaid (Daim 2016). • On average a patient who has Medicare insurance will have five or more illnesses and will visit 13 different outpatient physicians and fill 50 prescriptions per year (Daim 2016 ).

The goal has always been to increase hospital efficiency, accountability and the quality of patient care.

Nursing stakeholders are critical since they are daily users of technology and can have a profound impact on the adoption of innovations. They often act as champions and key decision-makers when adopting the technology (Daim 2016).

• Microsoft
• Amazon
• Google
• Nurses