Chapter 3 – Medical Record History of Present Illness The patient is a 61 year old female. The patient is complaining that they feel weak‚ their urine is dark‚ nausea‚ pain in the abdomen. Past Medical History Mrs. Carter has suffered from seizures since she was 14 years old. She has been taking Dilantin to help keep her seizures under control and to a minimum. Clear history otherwise. Physical Examination Temperature was 99.8 Pulse was 83 Blood Pressure was 120/84 Abdomen area was swollen
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Abstract Electronic health records (EHR) is more and more being utilized in organizations offering healthcare to enhance the quality and safety of care. Understanding the advantages and disadvantaging of EHR is essential in the nursing profession as nurses would learn its strengths and weaknesses. This would help the nursing profession know how to deal with the weak areas of the system. The topic on advantages and disadvantages of EHR has been widely researched on with different researchers coming
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major health problems. With comments from the medical and political words clashing‚ many‚ including myself for a while‚ didn’t really know what to believe. Thanks to class discussions‚ reliable resources‚ and sheer curiosity‚ I know what
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Electronic cigarettes‚ also known as e-cigs‚ which were created in China 10 years ago‚ are battery powered devices that vaporize liquid nicotine. In the article‚ “Smoke Signals”‚ the author Alessandra Potenza addresses the problems of unregulated electronic cigarettes. Although they can help smokers quit cigarettes‚ they can also cause nicotine addiction. Electronic cigarettes are becoming popular among youth and because they are unregulated‚ U.S. officials are worried. A main problem discussed
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America’s current medical recordkeeping system? How would electronic medical records alleviate these problems? The majority of America’s current medical record keeping is paper based which creates a lot of problems like:- a. Recordkeeping became really difficult with growing numbers of patients and their visits to Medical Practitioner. There are shelves full of folders and papers in corridors. b. It makes it difficult to effective communication‚ referring and access to the records. During emergency
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Electronic Health Record System Conversion! Health Info Fundamentals Practicum After decades of paper based medical records‚ a new type of record keeping has surfaced Electronic Health Record (EHR). EHR is an electronic or digital format concept of an individual’s past and present medical history. It is the principle storage place for data and information about the health care services provided to an individual patient. It is maintained by a provider over time and capable of
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Electronic Health Records The electronic health records fits seamlessly with a central cost-saving of health care reform: to shift U.S. health care from an expensive‚ pay-per-service system based on quantity to one that emphasizes quality. The goal now is to have medical payments reward good care -- in a way that’s difficult to do with paper records. "You really can’t have accountable care without electronic records‚" says Judy Hanover‚ a research director for IDC Health Insights‚ a health care
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student will discuss the national mandate of electronic health records (EHR)‚ and how this mandate is being implemented at the Cleveland Clinic Foundation. Also discussed are how Cleveland Clinic is progressing to achieve EHR‚ and what challenges this brings to patient confidentiality and self-determination. Lastly this student will provide information on the benefits of EHR in healthcare. According to Gunter & Terry (2005)‚ “The electronic health record (EHR) is an evolving concept defined as a
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MIBC 101 Unit 2 Assignment 1. Explain the difference between the hybrid medical record and the EHR. hybrid record A record in which both electronic and paper media are used. electronic health record (EHR) A secure real-time‚ point-of-care‚ patient centric information resource for clinicians allowing access to patient information when and where needed and incorporating evidence-based decision support. (Davis 67-68) 2. List the features of an EHR. Explain how these features are advantageous
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ELECTRONIC RECORD The Health Information Technology for Economic and Clinical Health Act also known as the HITECH Act is part of the American Recovery and Reinvestment Act of 2009 (ARRA) which contains incentives related to health care information technology in general and contains specific incentives designed to accelerate the adoption of electronic health record (EHR) systems among providers. Because this legislation anticipates a massive expansion in the
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