1. There are a number of strategies for converting paper-based charts to electronic health records. The major advantage of the total conversion strategy is that all data are converted at once and are available in the EHR. The incremental approach offers significant cost savings since the conversion is done internally by the office administrative staff members who are simultaneously converting the data and learning the new system. A combination of the two approaches is known as a hybrid system, in which some records may be outsourced and others converted in-house.2. The four primary methods of entering live patient data into EHR are dictation and transcription, clinical templates, voice recognition, and scanning. Dictation remains the most traditional and familiar method of documenting patient encounters. Clinical templates have the advantage of providing the most consistent data. Voice recognition can potentially eliminate transcription costs. Document scanning is an efficient way to enter text and images.3. Desktop, laptop, and tablet computers are all examples of computer workstations. The desktop computer is a fixed, hardwired computer that stays in one location and cannot be moved from room to room. A laptop computer is a fully functioning computer that is small enough to be portable. The tablet computer, or tablet PC, is a third type of workstation that contains built-in handwriting and voice recognition software.4. Wireless networks offer a number of advantages compared to wired networks. With a wireless network, portable computers, such as laptops and tablet PCs, can be transported from room to room and still maintain a network connection. This offers major advantages in the health care environment. A wireless network makes it possible for physicians to access medical reference tools in the examination room and at a patient’s bedside. Other tasks, such as basic charge capture, prescription writing, clinical documentation, and messaging, are all more convenient with a wireless network.5. Medical facilities can choose whether to house hardware and software on-site (traditional model) or off-site at an external vendor’s location (ASP model). The core differences between the traditional locally hosted model and the ASP model are where the data are stored and who maintains the hardware and software. In a locally hosted model, the hardware and software required to run an electronic health record program are located on-site at the provider’s location. In application service provider (ASP) solutions, both the data and the software applications are stored and maintained off-site by an external company.6. The clinical information in a patient record must be recorded in standard ways so its meaning can be shared among individuals and organizations in the health care system. The use of different terms to indicate the same condition or treatment complicates retrieval and reduces the consistency of patient care data. Developing standards capable of addressing the enormous complexity of clinical processes is a major challenge for the health care field.7. Clinical vocabularies are sets of common definitions for medical terms that facilitate communication by minimizing ambiguity. A shared vocabulary leads to consistent descriptions of a patient’s medical condition regardless of where the data were created. While vocabulary systems encompass the entire subject field and support detailed descriptions, classification systems organize related terms into categories for easy
retrieval. Classification systems are considered broad ways of organizing information.8. Messaging standards make it possible to transfer data from systems, such as laboratory or pharmacy systems, to an electronic health record system. They are also used to exchange information between different EHR systems. Examples of messaging
standards are HL7, DICOM, NCPDP, and IEEE1073.9. The Medicare Prescription Drug and Modernization Act of 2003 mandated the use of clinical vocabularies and messaging standards in federal agencies. Selected by the Consolidated Health Informatics Initiative (CHI), the standards must be used by all
federal agencies as they develop and implement new information technology systems. About twenty government departments and agencies are affected.
