Standards and Guidelines for Electronic Medical Record Systems in ...

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Summary Primary Actor Secondary Actors Business Rules Pre-condition(s) Pharmacist wishes to dispense medication PIS EMRs There are dosage/drug interactions rules. Correct Patient Identification Sequence of Events Action/Stimulus Pharmacist searches for/looks up prescription orders. Pharmacist dispenses according to prescription order. The PIS confirms that the dispensing is valid. System Response Either, the PIS: Returns search results of correct patient or Returns duplicate records, in which case pharmacist selects correct patient or Returns no matching record, in which case pharmacist enters demographics to create a new patient record. The PIS checks against drug interaction safety database and patient history The pharmacist dispenses the medication and the PIS transmit dispensing information back to the EMR system. EMR System Interaction to Laboratory Information System Fundamentally, three types of information interactions exist between LIS and EMR in any environment. While these interactions are not interdependent and may stand alone, with fullcomputerized integration, all three will be implemented. These interactions are: i. Patient Identification - Based on the Patient Identifier Cross-referencing (PIX) and Patient Demographic Query (PDQ) profiles. ii. Order transmission - Based on the Laboratory Testing Workflow (LTW) IHE profile iii. Results transmission - Based on the Laboratory Testing Workflow (LTW) IHE profile Standards and Guidelines for Electronic Medical Records Systems in Kenya 47
Ideally, a complete workflow would start with Step 1, Patient Identification, and proceed through to Step 3, Results transmission. However, in resource-constrained settings the greatest value appears to lie in Step 3, Results transmission. While Step 2, Orders, and Step 1, Patient identification, remain important, in some cases these steps will likely remain paper processes. Therefore, these profiles are described below in reverse order. Use Case Title Summary Primary Actor Secondary Actors Results only Laboratory expert wishes to run specific diagnostic tests and transmit results to a clinician. LIS EMRs Business Rules Pre-condition(s) Correct Patient Identification Sequence of Events Action/Stimulus LIS receives diagnostic test results manually through direct data entry or electronically from analyzer. System Response LIS: May store results in pre-existing records, or Create new patient record(s) and store results there. The LIS transmits test results to EMRs/Clinician. The EMRs/Clinician acknowledges receipt of updated records. Post Condition(s) Outstanding issues Test result transmitted into correct patient record and correct patient visit within that record. Identity resolution in situations where there is intermittent EMR-LIS connection. Standards and Guidelines for Electronic Medical Records Systems in Kenya 48
Page 1 and 2: Ministry of Medical Services Minist
Page 4 and 5: Acknowledgements This initial publi
Page 6 and 7: Change Management Process .........
Page 8 and 9: Architecture Enterprise Architectur
Page 10 and 11: and without the ability to share pa
Page 12 and 13: Purpose of this document This docum
Page 14 and 15: Globally, several organizations hav
Page 16 and 17: will be reviewed by the technical w
Page 18 and 19: Section Introduction The section de
Page 20 and 21: The above listed documentation requ
Page 22 and 23: Clinical Decision Support This refe
Page 24 and 25: H = Requirements. These items tare
Page 26 and 27: 4.3. System has the capability to r
Page 28 and 29: 10.2. System has the capability of
Page 30 and 31: 16. Children’s Health 16.1. Syste
Page 32 and 33: The recommendations in this section
Page 34 and 35: Backup Backup is the procedure for
Page 36 and 37: Case Example: Building an EMR syste
Page 38 and 39: o Date medically eligible to start
Page 40 and 41: o Height o Blood pressure o BMI Whe
Page 42 and 43: · Form 711 - Cross-sectional quart
Page 44 and 45: Section Introduction Within the hea
Page 46 and 47: Data Transmission Protocols There a
Page 48 and 49: i. EMR systems ii. Patient Identifi
Page 52 and 53: Use Case Title Summary Primary Acto
Page 54 and 55: Business Rules Pre-condition(s) Cor
Page 56 and 57: Section Introduction The implementa
Page 58 and 59: Requirements 1. Servers and worksta
Page 60 and 61: informatics skills in order to effe
Page 62 and 63: competencies will be of greater use
Page 64 and 65: esponsible for utilizing the inform
Page 66 and 67: expertise, this cadre is also likel
Page 68 and 69: Data Quality and Confidentiality Id
Page 70 and 71: Demonstrate use of mouse functions
Page 72 and 73: Health facility management plays a
Page 74 and 75: A locally stored backup log should
Page 76 and 77: · User related issues could also b
Page 78 and 79: Upgrade Scheduling The EMR system n
Page 80 and 81: Monitoring is an ongoing, continuou
Page 82 and 83: down these alerts on a notification
Page 84 and 85: Hardware requirements Other infrast
Page 86 and 87: System Costs, Ownership and Sustain
Page 88 and 89: their health records upon request o
Page 90 and 91: A. Sample EMR Implementation Plan E
Page 92 and 93: deployment of the EMR (i.e. change
Page 94 and 95: C. EMR Readiness Assessment Checkli
Page 96 and 97: Is there a computer at each point o
Page 98 and 99: D. Security Policy Template Documen
Page 100 and 101:
1.9 Employees shall not access, sto
Page 102 and 103:
E. Information Asset Inventory Name
Page 104 and 105:
G. Sample Service Level Agreement T
Page 106 and 107:
• Determine appropriate incident
Page 108 and 109:
H. Sample EMR Monitoring and Evalua
Page 110 and 111:
Strongly agree Agree Disagree Stron
Page 112 and 113:
Functional areas Attributes Compone
Page 114 and 115:
Functional areas Attributes Compone
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