The Electronic Medical Records Use Principles

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Guideline Developers

The guideline in question is aimed at providing information for physicians regarding the principles of using electronic medical records (EMRs). Its developers are specialists from the Doctors Technology Office (2022), and the database of the organization is the source of the document. The parties involved are the direct stakeholders as the overall inter-disciplinary team includes doctoral staff engaged in working with EMRs. The aspects of functionality, cost, safety, and other nuances regarding the application of the technology under consideration are evaluated from the perspective of physicians.

Funding the Guideline Development

Special funding principles are mentioned in the guideline, including both the work itself to develop an appropriate list of instructions and the conditions for introducing EMRs into the practice of medical personnel. The key board overseeing the distribution of funds is the General Practice Services Committee. Conditions for financing appropriate steps to introduce EMRs are presented from the perspective of the Canadian Ministry of Health, and individual conditions are presented for clinics promoting the use of this digital technology. There is no data that any of the developers of the recommendations funded the researchers who provided the relevant evidence. One of the key reasons for this is that references to other standards and practice guidelines are included as the supporting resources.

Development Strategy

As the elements for the development strategy, the guideline team presents a valid plan based on an analysis of all the conventions and characteristics of introducing EMRs into medical practice. Both organizational nuances are reflected, including the criteria of security, support, costs, and other factors, and practical recommendations related to remote access, storage, and additional implementation features. As a component that enhances the credibility of the guideline, distinctive conditions are shown from a regional perspective of following the recommendations. The principles of work in different health systems are emphasized, which increases the practical significance of the guideline and allows for evaluating it in an accessible way from various positions.

Identifying, Selecting, and Combining Evidence

The key algorithm that shows the validity of collecting evidence in the considered guideline is the use of links to other creditworthy documents containing the relevant regulatory rules. Selecting the resources involved is not justified except from the perspective of their national relevance. Combining the evidence base is carried out through the inclusion of valid links to third-party resources within the individual sections of the guideline regarding practical recommendations and theoretical justifications.

Literature Review

Since the guideline was made not by a team of researchers but by representatives of a medical organization, a comprehensive literature review was not conducted. In addition, the list of recommendations was last updated in the spring of 2022, which indicates the relevance of the information provided. Mirza et al. (2018) note that conducting a literature review is relevant to those works where the identification of causal relationships is performed, as well as the establishment of the impacts of a particular phenomenon. The guideline under consideration concerns professional recommendations and does not imply assessing the deep functional characteristics of EMRs from a research perspective.

Options and Outcomes

Important options for EMR adoption are listed in the guideline, and clear workflows are presented based on the steps offered. The use of specific tools and strategies is described in the context of achieving relevant operational objectives, such as notification procedures or risk mitigation approaches. The roles of individual participants involved are listed because this aspect is an essential clarification on the topic of distribution of authority, and the responsibilities for expected outcomes are provided.

Levels of Evidence

Each section of the recommendations in the guideline contains relevant evidence pointing to valid sources with up-to-date references to state regulations. The scholarly base concerns only general terminology, and traditional academic resources are not used as references. At the same time, since the topic of the guideline is about the application of professionally formulated work strategies, the main focus on normative documentation is justified, and sufficient evidence has been given.

Explicitness of Recommendations

The prevailing number of sections of the guideline offers an assessment of the course of action aimed at the effective implementation of EMRs in medical practice. As a result, value judgments are not open-ended and explicit, but they are clear from the context. The implementation results themselves are described from different perspectives, which is an important criterion in evaluating the topic raised. Moreover, individual cases of application of EMRs are described, which increases the practical value of the recommendations and expands the range of application of the guideline.

Peer Reviewing and Testing

No information is provided regarding the procedures of peer review and testing the results of the guideline. The main reason for this is that the legal framework is the main evidence resource, and the key focus is on the practical use of relevant recommendations in the context of the national health system. As a result, the aspects of physicians’ work are described in accordance with the considered conditions for the implementation of EMRs as creditable and do not require additional testing. The features of the organizational implementation process are also presented on the basis of existing regulations that do not require peer review.

Intent of Use

The main intent of the use of the considered guideline is considered in the context of the national health system. In addition, some regional conventions for introducing EMRs into physicians’ practice are presented with evidence in the form of relevant references to regulatory documents. Local principles for establishing a workflow using the advanced technology are not specified, and only special cases are offered for study as alternative situations.

Clinical and Personal Relevance of the Recommendations

From a clinical perspective, the proposed recommendations are relevant since the necessary principles of organizing the treatment process using EMRs are given. In addition, the responsibilities of the actors involved are defined, and this contributes to establishing smooth control over the technology and calculating a cost-benefit ratio. The latter perspective, according to Reis et al. (2017), is a significant option in the analysis of EMRs. For me, the recommendations presented will be useful because I have studied the conventions and specific aspects of the organization of the care process using the technology. This will help me avoid mistakes in practice and speed up documentation, which is usually a routine procedure.

Feasibility, Availability, and Uniqueness of the Recommendations

The recommendations are feasible and clearly aimed at assisting healthcare professionals. The practical benefit is justified by the aforementioned opportunities to speed up work with documentation and reduce the risk of making mistakes when interacting with patients. As the resources cited, human personnel are mentioned, but specific tools are not listed. The focus is on the fact that the practice of using EMRs differs from the traditional approach to working with patient data. Implementation outcomes can be measured through standard care, for instance, by evaluating patient admission time to compare the results before and after technology implementation.

References

Doctors Technology Office. (2022). Physician’s guide to electronic medical records (EMR): Frequently asked questions. Web.

Mirza, S., Clay, R. D., Koslow, M. A., & Scanlon, P. D. (2018). COPD guidelines: A review of the 2018 GOLD report. Mayo Clinic Proceedings, 93(10), 1488-1502. Web.

Reis, Z. S. N., Maia, T. A., Marcolino, M. S., Becerra-Posada, F., Novillo-Ortiz, D., & Ribeiro, A. L. P. (2017). Is there evidence of cost benefits of electronic medical records, standards, or interoperability in hospital information systems? Overview of systematic reviews. JMIR Medical Informatics, 5(3), e26. Web.

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