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EHR CH2.docx - Chapter 2 EHR Timeline - - Between 206 BCE...

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Chapter 2EHR Timeline-Between 206 BCE and 8 ADEoChunyu Yi keeps the first known medical record-Between 1790 and 1821oSome of America’s earliest hospital begin keeping patient records, including New YorkHospital, Pennsylvania Hospital, and Massachusetts General Hospital-1860soPhysicians treating Civil War soldiers keep standardized records-1917oThe American College of Surgeons (ACS) develops a hospital standardization programMaintaining a Legal Health Record-The health record, whether paper or electronic, is thelegal recordfor a healthcare organization.Thus, there are many standards a health record should follow to protect the healthcareorganization.For a health record to be used as evidence in a court case, it needs to follow four basicprinciples. The record must be:oDocumented following normal routinesoKept in the regular course of healthcare businessoRecorded during or close to the time the event happenedoRecorded by a person with knowledge of the eventsHealthcare facilities must routinely assess policies and procedures regarding record keeping to ensuretheir records are legally sound.1970s-Dr. Lawrence L. Weed and Jan Schultz develop a medical record software program called PROMIS(Problem-Oriented Medical Information System)1990s-The US Department of Veterans Affairs’ Computerized Patient Record System (CPRS) is the firstlarge-scale deployment of electronic health records (EHRs)2009-The American Recovery and Reinvestment Act of 2009 (ARRA) outlines federal incentives foradopting EHRs2016-Patient medical records are comprehensive, portable, and accessibleHealth Record
-Contain essential elements of clinical, administrative, financial, and legal information that playkey roles in a patient’s current and future health care.-To manage and research improvements and innovations.-The concept of EHRs has emerged from the growing partnership between healthcare andtechnology. The integration of EHRs in the health care practice is built on the foundation ofhealth record content.History of the Health Record-According to the US National Library of Medicine, ahealthcare facility“includes hospitals,clinics, dental offices, outpatient surgery centers, birthing centers, and nursing homes.”-Hippocrates, considered one of the most important figures in medical history, and his followerswere among the first to describe and document many diseases and medical conditions.However, Chunyu Yi, a famous Chinese physician of the Han dynasty who died around 8 CE, keptthe first known health record. He tracked his patients’ names, residences, occupations, diseaseinformation, diagnoses, and prognoses.-Between 1790 and 1821, some of America’s earliest hospitals began keeping patient records,including New York Hospital, Pennsylvania Hospital, and Massachusetts General Hospital. Healthrecords, historically restricted by the documentation habits of each individual healthcareprovider, began to evolve in the US during the Civil War (1860).

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