2020
DOI: 10.1590/1413-81232020254.28922019
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Electronic Medical Records in the American Health System: challenges and lessons learned

Abstract: Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care. Considerable problems have been noted to result from a lack of interoperability and standardization of interfaces amon… Show more

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Cited by 46 publications
(22 citation statements)
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“…They re ect a current reality of suboptimal EMR documentation interfaces and processes in the context of a challenging work reality that limits the will to document to subjects of recognizable practical bene t. This insight holds promise. Modi able checklists and registers, the ability to easily design and run reports, and user-friendly provider interfaces have been identi ed as key elements to promote effective use of the EMR [15]. Kennedy Page and Schadler showed that the time to complete a document decreased and staff satisfaction increased signi cantly among nursing staff after redesigning the EMR with a focus on usability [16].…”
Section: Discussionmentioning
confidence: 99%
“…They re ect a current reality of suboptimal EMR documentation interfaces and processes in the context of a challenging work reality that limits the will to document to subjects of recognizable practical bene t. This insight holds promise. Modi able checklists and registers, the ability to easily design and run reports, and user-friendly provider interfaces have been identi ed as key elements to promote effective use of the EMR [15]. Kennedy Page and Schadler showed that the time to complete a document decreased and staff satisfaction increased signi cantly among nursing staff after redesigning the EMR with a focus on usability [16].…”
Section: Discussionmentioning
confidence: 99%
“…In today's clinical world, electronic data recording, management, and safety are as important as any branches of disease care. One of the reasons for this is that the Electronic Medical Record (EMR) is viewed as a solution to many of the shortcomings of health care systems, and therefore, its importance is realized to improve patient care [22]. The importance of the electronic health record (EHR) system is highlighted by the promise of substantial benefits, including better patient care and decreased healthcare costs, useability and accessibility of records in one hand, while the poor EHR system design with improper implementation invites EHR-related errors jeopardizing the integrity of the information in the EHR, leading to errors that endanger patients safety or decrease the quality of care and serious unintended consequences in another hand [23].…”
Section: Electronic Medical Recordmentioning
confidence: 99%
“…A necessidade e benefícios da adoção de prontuários eletrônicos compartilhados entre os pontos de atenção são ratificados por muitos estudos na medida em que apoiam a comunicação eficaz entre pacientes e prestadores, a integração horizontal e vertical entre serviços de saúde 33 . Embora no país estejamos distantes de políticas públicas que garantam a padronização e interoperabilidade dos prontuários eletrônicos, uma solução intermediária, ainda que não suficiente, seria o aproveitamento máximo das funcionalidades do SIGES que permite a contrarreferência.…”
Section: Dimensões E Componentesunclassified
“…O Manual de Acesso 24 constitui importante instrumento para estabelecimento dos fluxos assistenciais à AE. Contudo, a adesão a protocolos para gerenciamento das transições entre níveis envolve, entre outros aspectos, a padronização de processos, capacitação e explícita definição das responsabilidades entre os prestadores 33 . Muitas são as barreiras reconhecidas para a adesão de médicos às diretrizes de práticas clínicas como: familiaridade, concordância com as evidências e capacidade de superar a inércia de práticas anteriores 34 .…”
Section: Dimensões E Componentesunclassified