The Medical Gopher is a computer-based physician order entry system. The foundation of Gopher took place at Regenstrief. It is designed by clinicians to make life of other clinicians easy. Gopher is basically a platform which facilitates clinical data entry and management, clinical decision support, electronic data capture for research and visualization of clinical data. Gopher works towards supporting patient safety, improve quality of care and user satisfaction and promote provider efficiency.
In 1991, the Institute of Medicine (IOM) examined the issues of medical record system and it was inferred that computer based patient entry is an integral part of EHR. The basics of CPOE systems as seen in Gopher includes dealing with data capture such
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One of the interesting features developed include ‘contextual alerting’. This will reduce alert fatigue. Most of the complaints are related to alerts that are clinically insignificant. In the latest Gopher system, alerts are triggered based on context (patient, provider and institution). Based on the relevance level which depends on context, the alerts are classified as interruptive, uninterruptive or suppressed. The alert is created and stored in a component called as relevance adjustment module (RAM). This is used for drug-drug interaction alerts. RAM facilitates displaying alerts for trainees and medical students interruptively whereas reduced frequency for the experienced ones. Thus clinical knowledge level along with the clinical knowledge is taken into consideration. However, if an alert is suppressed over again and again, the system asks for justification. If proper justification is provided then the alert will be suppressed for the patient for future. This is described as use of learning …show more content…
The inpatient setting was targeted by Gopher in 1990. At present, it supports 350 bed hospital, 12 community health centers, 79 clinics providing primary care, subspecialty, mental health, women and children’s health, and senior services. (1) Gopher has worked towards clubbing Clinician Physician Order Entry (CPOE) with Clinical decision support (CDS). It has an effective and efficient order entry system however, the interface had remain unchanged for nearly 25 years. In the year 2009, Regenstrief started rebuilding Gopher and in 2010, work on a new web-based version of Gopher was initiated. The new Gopher like the previous one supports clinical care and research. It also supports innovation related to research and clinical care. The knowledge that was accumulated over 25 years and several literatures on CPOE system helped in renovating Gopher. The original Gopher was DOS based. However, the current version was written in Java and JavaScript. The new Gopher was made with an intention to give the feel of consumer web applications. For example, order carts were used to add orders like labs, medication etc. This helped them to reduce training requirements and make it user friendly. In 2012, Gopher was certified for both ambulatory and inpatient settings. The new Gopher is now in use by over 1100 users a day, including an average of 433 physicians caring for over 3600 patients daily.
Computerized Physician Order Entry (CPOE), is also known as Computerized Provider Order Management (CPOM). CPOE is a process of automated or electronic entry record of health care physician on different types of instructions on how to treat patients, especially patients that are hospitalized under a physician’s care. CPOE is one of the most remarkable system that is being used in the healthcare system to effectively reduce the amount of medication errors. The University of Health Care System might be in the process of rolling out the CPOE portion out of the EMR project, however, they did not do a thorough investigation on what CPOE is and whether or not it would have a positive impact on the EMR project. They should have not taken the step to start the project without already knowing the basics of CPOE. They might have had thought that since it is a computerized system everything would turn out okay and there would not be any problems. However, they fall short to recognize that the user’s knowledge and experience with using the CPOE system would have a significant influence on the effectiveness and productivity of the actual system.
Recommend which system is the best choice to meet meaningful use requirements in this particular setting. Both Cerner and CPSI have helped hospitals meet CMS Stage 1 and Stage 2 requirements. However, Cerner provides a modular concept that larger hospitals are using more than complete inpatient systems to achieve MU (Zieger, 2013). In 2014, EHR vendors said eight hospitals had attested to MU Stage 2, and Cerner was used twice as much as CPSI (Gregg, 2014). Concerning Computerized Physician Order Entry (CPOE), CPSI System had the broadest reach in community hospitals; nevertheless, the software was missing functionality and usability (KLSA Enterprises, 2010, p. 6). Therefore, CPSI’s CPOE was significantly below the market-average due to low physician satisfaction (KLAS Enterprises, 2010, p. 6). KLAS Enterprises (2010, p. 2) reported Cerner clients were happier the more they adopted CPOE.
Springfield General Hospital (SGH) is committed to high quality healthcare for patients, and providing tools to support physicians, nurses and pharmacists. SGH leadership approved the computerized physician order entry (CPOE) system as a solution to reduce prescription errors, and the results of the CPOE project are disappointing. The data show increased prescribing errors after implementing the CPOE; resulting in increased costs for adverse drug events, rather than the planned cost reduction (Spector, 2013). This change management plan provides the SGH board of directors and executive management team pragmatic steps to increase quality for patients by assessing the root issue of hospital
For years now, the healthcare system in the United States have managed patient’s health records through paper charting, this has since changed for the better with the introduction of an electronic medical record (EMR) system. This type of system has helped healthcare providers, hospitals and other ambulatory institutions extract data from a patient’s chart to help expedite clinical diagnosis and providing necessary care. Although this form of technology shows great promise, studies have shown that this system is just a foundation to the next evolution of health technology. The transformation of EMR to electronic heath record system (EHR) is the ultimate goal of the federal government.
It was just yesterday when Electronic health records was just introduced in healthcare industry. People were not ready to accept it due to higher cost and consumption of time associated in training people and adopting new technology. Despite of all this criticism, use of Internet and Electronic Health records are now gaining its popularity among health care professionals, as it is the most effective way to communicate with patient and colleagues. More and more hospitals and clinics are getting rid of paper base filling system and investing in cloud base storage.
However, Mr. Williams shares with the CPOE model physicians can digitally write a script, look up patient DRG list, DRG interactions, DRG reactions, and DRG allergies. The CPOE model reduces more information to make a sound educated decision to provide quality service and care to patients. Computer Physician Order Entry (CPOE) “provides the most advanced implementations of such systems that provide real-time clinical decision support such as dosage and alternative medication suggestions, duplicate therapy warnings, and drug-drug and drug allergy interaction checking” (Glandon, Slovensky, and
Currently, we use the electronic health record system called Computer Programs and Systems, Inc. (CPSI). CPSI is “a l...
The implementation of the Clinical Decision Support System (CDSS) was to allow physicians the ability diagnoses patients with the use of evidence based decisions. Physicians can explore relevant medical information through the CDSS from reliable medical experts, clinical guideline extractions and alerts of new and different phases of patient management without the interruption of the medical organization’s workflow (Chiarugi, Colantonio, Emmanouili...
...nce an incident that may not be seen as such by staff working in the same environment but, if the staffs have frequently witness that the same incident occur; they may stop reporting the incident. However, database application system can save charting time which could be utilized to provide care to residents. Administration function like medical records, risk assessments, daily reports and coding requires documentations from the service users` electronic medical record database to enhance the EHR, which link the EHR data with databases containing standardized assessment information from external healthcare systems. If the database is not similar as to what other healthcare systems use, it is impossible to share information from EHR database with other clinical application systems.
Van Doormaal, J. E., Mol, P. G., Zaal, R. J., Van Den Bemt, P. M., Kosterink, J. G., Vermeulen, K. M., & Haaijer-Ruskamp, F. M. (2010). Computerized physician order entry (CPOE) system: expectations and experiences of users. Journal of Evaluation in Clinical Practice, 16(4), 738–743. doi:10.1111/j.1365-2753.2009.01187.x
Tan & Payton (2010) describe the electronic health record (EHR), which dates back to the 1950s. These computer-based patient records have evolved into complex systems with many capabilities. They were designed to provide healthcare professionals with a comprehensive picture of a patient’s health status at any time and are meant to automate and streamline the workflow of the healthcare professional (Tan & Payton,
Health information management involves the practice of maintaining and taking care of health records in hospitals, health insurance companies and other health institutions, by the use of electronic means (McWay 176). Storage of medical information is carried out by health information management and HIT professionals using information systems that suit the needs of these institutions. This paper answers four major questions concerning health information systems.
Our clinical knowledge is expanding. The researcher has first proposed the concept of electronic health record (EHR) to gather and analyze every clinical outcome. By late 1990s computer-based patient record (CPR) replaced with the term EHR (Wager et al., 2009). The process of implementing EHR occurs over a number of years. An electronic record of health-related information on individual conforms interoperability standards can create, manage and consult with the authorized health professionals (Wager et al., 2009). This information technology system electronically gather and store patient data, and supply that information as needed to the healthcare professionals, as well as a caregiver can also access, edit or input new information; this system function as a decision support tools to the health professionals. Every healthcare organization is increasingly aware of the importance of adopting EHR to improve the patient satisfaction, safety, and lowering the medical costs.
Marvel studios needs kill Captain America off in the Marvel Cinematic Universe because it would be accurate to the comic books. According to an article on Word Press, “Before the release of Captain America: Civil War, fans speculated Steve Rogers’ death as that was the case in the comics. Although Cap doesn’t die in the Infinity War comics, he does get defeated in Issue #4 of the Infinity Gauntlet series, on which Avengers: Infinity War is most likely based. It is unclear whether he dies or not in the Infinity Gauntlet series. The Russo Brothers might want to kick the Infinity Gauntlet story up a notch by killing off Steve, or just kill him because his death is overdue since the events of Civil War”(“6 Reasons Why It Makes Sense To Kill Off
Electronic Medical Record (EMR) provides convenient access to the staff of the clinic. It also provides quick access to patients’ information each time staff wants to retrieve the data. Other than that, the system could help in solving record movement problems and at the same time improve the quality of the process. In terms of security, using the EMR is more secured compared to manual system as it can be restricted to certain user for example to medical officer and receptionist. The user needs to login into the system so that it can be easily monitored and identified who uses the system. As for the b...