Final report ehr1

[Electronic Health Record]
Chapter 1
Introduction
Gujarat Technological University
1.1 Phase-1 Summary
Team-ID: 130010355
Project-Team Member:
[Department of Computer Science & Engineering] Page 1

1.2 Phase-II Summary
This document outlines the software requirements for an electronic health record
(EHR) data analysis clinical decision support system. It will cover the overall

description of the system, specific requirements as well as modeling requirements,
diagrams and a description of a prototype to be built to demonstrate the system’s
functionality.
1.3 Introduction of Problem
Published requirements for the EHR are available principally via ISO18308. They
are statements defining the generic features necessary in any Electronic Health Record
(EHR) for it to be communicable and complete, retain integrity across systems,
countries and time, and be a useful and effective ethico-legal record of care. Examples of
requirements are provided in four themes: EHR functional Requirements; Ethical, legal,
and security requirements; Clinical requirements; Technical requirements.
1.4 Problem statement And Explanation
1.4.1 Problem Statement
Problem lists can be a healthcare organization’s best friend or worst nightmare.
Electronic record systems can extend the benefits or compound the issues. The same
forces that make problem lists valuable for patient care and secondary data uses can also
create barriers to clinical efficiency. This practice brief explores the use and maintenance
of problem lists in health records with a special focus on how electronic environments
support additional functionality for sharing information and supporting continuity of
care.
1.4.2 Description
Computer-based hospital information systems emerged in the late 1960s. At that
time they were primarily used for collecting and routing orders and accessing laboratory
test results. These early systems collected clinical information, but their major purpose
was to capture charges to comply with reimbursement requirements, not assist
physicians with delivering patient care.
Dr. Lawrence Weed introduced the problem-oriented medical record more than
40 years ago. It was a new concept for health record keeping that reflected the
physician’s logical thinking for delivering patient care. Weed suggested that the primary
organization of the medical record should be by medical problem and that all diagnostic
and therapeutic plans be linked to a specific problem.

Historically, the information retrieved from a patient-physician relationship
centered on what is termed the “problem list.” In many settings the problem list has
evolved into a virtual table of contents in an EHR presenting a holistic view of the
patient. In the problem-oriented medical record model all data associated with the patient
can be linked to a list of problems.
Safe and efficient patient care relies on a clinical workflow that assesses
problems documents interventions, and evaluates the effects of treatment. The problem
list is expected to support these activities in an effective and concise fashion.
Technology offers the opportunity to achieve this goal while retaining information
across the healthcare systems and reducing redundant processes.
1.5 Usefulness of Project to Industry/User/Society
This project is useful to doctors as it totally reduces the paperwork from their
side for writing prescriptions in paper and it reduces lot of time in viewing the past
records of patients on paper. Whereas, on patient side with the help of patient ID the
patient can schedule appointment in our system with doctor & also with the help of Case
ID it will differentiate that how many times the particular patient had fixed cases in our
system. For e.g.; Suppose Patient having ID=1 has registered with our system. During
appointment, it will get Case ID related to particular or diagnosis he selects. For another
problem he will get another Case ID so that he can view his/her past problems more
genuinely. In short single patient has one P_ID & many case ID. The system will
improve the quality of medical care by providing a wealth of data from various sources
to medical professionals, by promoting the use of best practices and tracking treatment.
1.5.1 Project Plan
• GANTT CHART:-
Gantt chart is a project scheduling technique. Progress can be represented easily
in a Gantt chart, by coloring each milestone when completed. The project will start in the
month of January and end after 4 months at the end of April.
A Gantt chart is a graphical representation of the duration of tasks against the
progression of time. It is a useful tool for planning and scheduling projects. A Gantt
chart is helpful when monitoring a project's progress. A Gantt chart lays out the order in
which the tasks need to be carried out.
A Gantt chart is a type of bar chart that illustrates a project schedule. Gantt charts
illustrate the start and finish dates of the terminal elements and summary elements of a
project. Terminal elements and summary elements comprise the work breakdown

structure of the project. Gantt charts also show the dependency relationships between
activities. Gantt charts can be used to show current schedule status.
The Gantt chart is constructed with a horizontal axis representing the total time
span of the project, broken down into increments (days, weeks, or months). The Gantt
chart is constructed with a vertical axis representing the tasks that make up the project.
System Design
Detailed Design
Coding
Unit Testing
Test Plan
Testing
Working  February March April May
Month
Fig-1.5.1 Gantt chart

1.6 Technology Requirements
• System Requirements:-
Front-End:- Microsoft ASP.NET with C#
Database: - MySQL Server 2008
Software: - Microsoft Visual Studio 2010
Operating System: - XP/Win7/Win8
Reporting Tool: - Microsoft SAP Crystal Report
• Hardware Requirements:-
Microprocessor: - Pentium IV series or above.
Memory: - 512 MB Minimum.
Hard-Disk Space: - 10 GB Minimum.
1.7 Background Theory
1.7.1 Characteristics of Electronic Health Record Systems
The Electronic Health Record (EHR) System will facilitate the staff of the
hospitals to have electronic health records of patients. The following will be the main
characteristics of the EHR:
 Create, update and view patient’s electronic health records
 Add medical documents, images and scanned copies to patients health record

 Able to search for patient’s from all the Drexel network of hospitals.
 Provide referrals to Drexel Specialists
 Generate e-prescriptions
Terminals and laptops at particular hospital systems will be able to connect to it using a
web service. The data entered and uploaded will be saved on the data servers. This data
will be accessible by all the hospitals in the network. If a patient has visited that hospital
earlier, his record will be updated with the existing conditions and no new record will be
created.
1.7.2 Basic Concept and Terminology
An electronic health record is a collection of patient health information generated
by one or more meetings in any care delivery setting. An EHR typically includes patient
demographics, progress notes, problems, and medications, vital signs, past medical
history, immunizations, laboratory data and radiology reports. It’s said to streamline
clinicians’ workflow, and it has the ability to generate a complete record of a clinical
patient encounter.
EHRs focus on the total health of the patient. They go beyond standard clinical
data collected in the provider’s office and include a broader view of the patient’s care.
EHRs’ most notable benefit includes a secure sharing of data, which, in turn, results in
more open communication and more involvement on the patient’s part.
1.7.3 Various Terminologies Used In EHR
Physician office: A place where nonfederally employed physicians provide
direct patient care in the 50 states and the District of Columbia; excludes radiologists,
anesthesiologists, and pathologists.
Any EMR/EHR system: Obtained from "yes" responses to the question, "Does
this practice use electronic medical records or electronic health records (not including
billing records)?"
Basic EMR/EHR system: A system that has all of the following functionalities:
patient history and demographics, patient problem lists, physician clinical notes,

comprehensive list of patients' medications and allergies, computerized orders for
prescriptions, and ability to view laboratory and imaging results electronically.
Intent to apply for Medicare or Medicaid EHR Incentive Programs:
"Medicare and Medicaid offer incentives to practices that demonstrate 'meaningful use
of health IT.' At this practice, are there plans to apply for these incentive payments?"
Chapter 2
Literature Survey
2.1 Literature Review about EHR
Several evidence-based reviews conclude that some types of health information
technology (IT), particularly electronic health records (EHRs) with advanced
functionalities, have reduced medication errors and improved care processes, adherence
to evidence-based guidelines, patient engagement, and patient satisfaction. Despite these
potential benefits, health care providers were initially slow to adopt EHRs. In 2008,
approximately 1.5 percent of non-federal acute care hospitals reported having a
comprehensive EHR system and 7.6 percent had a basic EHR system. Similarly,
approximately 17 percent of office-based physicians used an EHR that met the criteria of
a basic system in 2008.
The purpose of this literature review is to provide examples of how organizations
are implementing and optimizing the use of health IT/EHRs from peer-reviewed
publications and the gray literature by examining the context and organization specific
factors, barriers and facilitators, and “lessons learned” associated with the successful
implementation and optimal use of EHR systems. HITECH states that the “[The Office
of the National Coordinator [ONC] shall prepare a report that identifies lessons learned
from major public and private health care systems in their implementation of health
information technology”.

Fig 2.1 Percentage of office based EHR physician with EHR System: US 2001-2013
2.2 Comparative Statements about EHR
With the government backing the concept of electronic health records (EHR),
and with technology being used in every walk of life, more and more hospitals are
looking into implementing EHR systems. A national survey of U.S. hospitals was
conducted in February/March 2005 to identify the status of EHR systems in hospitals
regarding the core functionalities implemented (as identified by the Institute of
Medicine), and to determine the perceived benefits, risks, and barriers to adoption of
EHR systems in relation to the size of the hospital.
The overall status of EHR systems and the effects of using them are topics of
growing interest to researchers. A recent study, conducted in 2006 by the Healthcare
Financial Management Association (HFMA), surveyed senior healthcare finance
executives at hospitals and health systems of various sizes and regions. The purpose was
to identify how healthcare financial executives view the barriers to EHR adoption and
the actions government can take to encourage adoption. Based on the 176 responses, the
functions in which the greatest number of hospitals reported significant progress were
order entry (38 percent), results management (27 percent), and electronic health
information/data capture (23 percent). The most significant barriers were lack of national
information standards and code sets (62 percent), lack of available funding (59 percent),
concern about physician (51 percent), and lack of interoperability (50 percent).
Health information technology professionals and governmental leaders are promoting
EHRs. David Brailer, former national coordinator for health information technology,
emphasized the important role that EHR systems play in improving quality, increasing
patient safety, increasing operational efficiency, and reducing costs. President Bush

announced that most Americans will have EHRs within the next 10 years to allow
doctors and hospitals to share patient records nationwide.
2.3 Motivation Survey about EHR
2.3.1 Time and Effort
Studies dating back to 1996 cite concerns with the speed of entry and limited
physician acceptance of electronic healthcare documentation systems. Clinicians
frequently complain that a system requires too many clicks to get to the problem list and
that using the documentation system takes too much effort and cuts into patient time.
The amount of human resources required to create and maintain the patient
problem list is often significant. Healthcare providers and organizations should plan
ahead to include the number of hours required to support this feature in clinical and
administrative workflows in EHR systems.
2.3.2 Search Functionality for Providers
Physicians who are accustomed to writing down their diagnosis on paper
problem lists in some cases are now required to electronically search through thousands
of options to retrieve the specific diagnosis needed to accurately describe the patient’s
disease process. This frustrating process may lead to incorrect or nonspecific data in a
patient’s medical record due to inefficient search capability.
2.3.3 Multiple Uses and Needs
The problem list serves a variety of uses for clinicians and no clinicians in
diverse healthcare settings. It can provide a succinct view of a patient’s health status and
therefore must be used and maintained to meet different needs. A primary care physician
is concerned with chronic and acute conditions. A specialty provider may focus only on
a subset of problems relevant to that area of medicine. An emergency provider may
address only the critical acute presenting problems. Other clinicians may use the
problem list for tracking conditions that should be addressed for specific care delivery
goals.
Coding professionals use the problem list to confirm or clarify documentation
found in other parts of the health record. To address billing needs, the problem list may
be used as a source of diagnostic information. Problem list entries may be linked or
integrated with other parts of the EHR to minimize duplication and improve
documentation. Key information about a patient (e.g., drug-seeking behavior or other

pertinent facts affecting care or treatment) may be added to the problem list as a means
of communication to all providers, since the problem list is intended for review at every
patient encounter.
2.3.4 Administrative Maintenance
Administrative management issues surrounding an EHR problem list must be
resolved during the mass customization of a data entry platform. The primary challenge
is to provide tools that balance patient care with the taxonomy of data standardization.
The flexibility required by a variety of clinicians to document complex, patient-oriented
care. is at odds with the structure required by a standardized set of terminology
describing discrete conditions, events, and measurable outcomes.
2.2.5 Clinical Management Maintenance
A significant barrier facing the clinical end user is problem list clutter. Without
careful management, the shared problem list accumulates multiple diagnoses and
symptoms that may or may not be accurate to the patient’s true condition. Eventually,
the list may become useless due to length and inaccuracy, and often the list is either
appended to or displayed with each patient encounter. If the list is filled with
inaccuracies, the clinical documentation is viewed as suspect and becomes a potential
liability.

Chapter 3
Design
3.1 UML Diagrams
3.4.1 E-R Diagram

Fig3.4.1. E-R Diagrams
An ER model is an abstract way of describing a database.
3.4.2 Data Flow Diagrams
A data flow diagram (DFD) is a graphical representation of the flow of data through
an information system. A data flow diagram can also be used for the visualization of
data processing (structured design). A data flow diagram could be a context level
diagram (LEVEL 0), LEVEL 1, LEVEL 2.
• CONTEXT LEVEL DIAGRAM (LEVEL 0)

This level shows the overall context of the system and its operating environment
and shows the whole system as just one process.
• LEVEL 1
This level (level 1) shows all processes at the first level of numbering, data
stores, external entities and the data flows between them. The purpose of this level is to
show the major high level processes of the system and their interrelation
• LEVEL 2
This level is a decomposition of a process shown in a level 1 diagram, as such
there should be level 2 diagrams for each and every process shown in a level 1
diagram.
DFD DIAGRAMS FOR EHR SYSTEM:

3.4.3 Use-case Diagram

Use case diagrams are considered for high level requirement analysis of a
system. So when the requirements of a system are analyzed the functionalities are
captured in use cases.
So we can say that uses cases are nothing but the system functionalities written in
an organized manner. Now the second things which are relevant to the use cases are the
actors. Actors can be defined as something that interacts with the system.
The actors can be human user, some internal applications or may be some external
applications. So in a brief when we are planning to draw an use case diagram we should
have the following items identified.
• Functionalities to be represented as an use case
• Actors
• Relationships among the use cases and actors.
SYMBOLS & NOTATIONS:
 Actor:
An actor represents a role that an outsider takes on when interacting with the
business system. For instance, an actor can be a customer, a business partner, a supplier,
or another business system. Every actor has a name:
 Association:
An association is the relationship between an actor and a business use case. It
indicates that an actor can use a certain functionality of the business system—the
business use case:
 Business Use-Case:

A business use case describes the interaction between an actor and a business
system, meaning it describes the functionality of the business system that the actor
utilizes:
 Include Relationship:
They include relationship is a relationship between two business use cases that signifies
that the business use case on the side to which the arrow points is included in the use
case on the other side of the arrow. This means that for one functionality that the
business system provides, another functionality of the business system is accessed.
USE-CASE DIAGRAM FOR EHR SYSTEM:-

Fig 3.4.3 Use-Case Diagram
Description: - In our use-case diagram, there are 3 main actors involved in our
system which is doctor, patient & laboratory. Here, doctor is generalized into 4 types
which we include in our project & they are dermatologist, gynecologist, orthopedic &
general physician.
3.4.4 Class Diagram

A class diagram is an illustration of the relationships and source
code dependencies among classes in the Unified Modeling Language (UML). In this
context, a class defines the methods and variables in an object, which is a specific entity
in a program or the unit of code representing that entity. Class diagrams are useful in all
forms of object-oriented programming (OOP).
SYMBOLS & NOTATIONS:-
 Active classes:-
Active classes initiate and control the flow of activity, while passive classes store
data and serve other classes. Illustrate active classes with a thicker border.
 Associations:-
Associations represent static relationships between classes. Place association
names above, on, or below the association line. Use a filled arrow to indicate the
direction of the relationship. Place roles near the end of an association. Roles represent
the way the two classes see each other.
CLASS-DIAGRAM FOR EHR SYSTEM:-

Fig 3.4.4 Class Diagram
Description: - In Class Diagram, There are various classes like doctor, patient,
etc. in our System which functions same as we explained in use case diagram.
3.4.5 Sequence Diagram
A sequence diagram is an interaction diagram that details how operations are
carried out: what messages are sent and when. Sequence diagrams are organized
according to time.

SYMBOLS & NOTATIONS:
 Class roles:-
Class roles describe the way an object will behave in context. Use the UML
object symbol to illustrate class roles, but don't list object attributes.
 Activation:-
Activation boxes represent the time an object needs to complete a task.
 Lifelines:-
Lifelines are vertical dashed lines that indicate the object's presence over time.
SEQUENCE DIAGRAM FOR EHR SYSTEM:-

Fig.3.4.5 Sequence Diagram
Description: - In sequence diagram, there are 4 objects in our system like patient,
doctor, Laboratory and database. Here, patient can view his previous records by logging
through in our system. Also doctor can diagnosis & prescribe medicines to patients,
generates medicines report if lab test not required. Otherwise doctor will add lab test &
send to laboratory. Laboratory will select the lab test given by doctor & perform lab test
& generate lab tests reports. Finally, doctor view the lab test report & generates E-
prescription.
3.4.6 Collaboration Diagram

A collaboration diagram describes interactions among objects in terms of
sequenced messages. Collaboration diagrams represent a combination of information
taken from class, sequence, and use case diagrams describing both the static structure
and dynamic behavior of a system.
SYMBOLS & NOTATIONS:-
 Class Roles:-
Class roles describe how objects behave. Use the UML object symbol to
illustrate class roles, but don't list object attributes.
 Association Roles:-
Association roles describe how an association will behave given a particular
situation.
 Messages:-
Unlike sequence diagrams, collaboration diagrams do not have an explicit way to
denote time and instead number messages in order of execution. Sequence numbering
can become nested using the Dewey decimal system. For example, nested messages
under the first message are labeled 1.1, 1.2, 1.3, and so on. The a condition for a
message is usually placed in square brackets immediately following the sequence
number.
COLLABORATION DIAGRAM FOR EHR SYSTEM:-

Fig 3.4.7 Collaboration Diagram
Description: - In collaboration diagram, there are same objects as we explained in
sequence diagram, which describes the same flow as in sequence diagram.
Chapter 4
Implementation

After having the user acceptance of the new system developed, the
implementation phase begins. Implementation is the stage of a project during which
theory is turned into practice. During this phase, all the programs of the system are
loaded onto the user's computer.
During this phase, all the programs of the system are loaded onto the user's
computer. After loading the system, training of the users starts. Main topics of such type
of training are:
• How to execute the package
• How to enter the data
• How to process the data (processing details)
• How to take out the reports
After the users are trained about the computerized system, manual working has to
shift from manual to computerized working. The following two strategies are followed
for running the system:
In our System there are various modules in our system from which system flow
will continues smoothly. Here, we will consider only those modules that our system has
major dependent on it. These Modules are displayed in snapshots below:-
4.1 WORKING DEMO:-
EHR HOMEPAGE

Fig. EHR Homepage
Description: - This is our homepage of our system. In this page, we have 3 logins
for patient, doctor & laboratory. For Patient, he/she first of all registers on our page by
clicking on signup menu.
PATIENT SIGNUP

Fig. Patient signup
Description: This is the patient signup page. In this page, new patient will enter
all the details which are required by our system for further processing. In this page,
every patient is assigned P_ID automatically when he/she registers with our system &
this id will be used when patient makes or fixed appointment with doctor. Here, as soon
as patient will enter his/her id & all her basic details such as name, gender, age etc. will
be retrieved automatically.
PATIENT LOGIN

Fig. patient login
Description: This is our patient’s login page. In this page patient will login with
our by giving username & password which he/she will give during registration. After
that patient will selects hospital & then it will go for make or request an appointment to
doctor.
MAKE APPOINTMENT

Fig. Make Appointment
Description: - This is our make appointment page. In this page, patient will
request for an appointment with doctor of particular area or department. In this page,
patient is assigned with case_id, so this id will be used by doctors in order to retrieve
basic details of patients while prescribing medicines, adding lab tests etc. Also the
case_id will also be used by laboratory section in order to know details of patients for
which he/she has to perform lab tests.
VIEW APPOINTMENT

Fig. View Appointment
Description: - This is the view appointment page. This page is viewed by doctors
after login in order to view appointments that are requested by patients of particular
diagnosis type. From diagnosis type, it will select the diagnosis page of that particular
department in which the doctor treats the patient.
OUR MODULES:
 Dermatologist:

 Gynecologist:-

 Orthopedic:-

 General Physician:-

4.2 MODULES FLOW:-

Fig.Diagnosis Page(orthopaedic)

Fig. Diagnonise diseases

Fig. Medicines Page (Orthopedic)

Fig.Select Labtest(orthopaedic)

Fig. Perform labtest(laboratory section_Orthopedic)

Fig. Labtest Report(Laboratory Side)
Chapter 5

Testing & Analysis
Chapter 6

Expected Outcomes & Conclusion
Expected Outcomes
When health care providers have access to Electronic health records (EHRs) patients
receive better medical care. EHRS can improve the ability to diagnose diseases and
reduce—even prevent—medical errors, improving patient outcomes.
• EHRs aid in diagnostics.
• EHRs can reduce errors, improve patient safety, and support better patient
outcomes
o A qualified EHR not only keeps a record of a patient's medications or
allergies, it also automatically checks for problems whenever a new
medication is prescribed and alerts the clinician to potential conflicts.
o Information gathered by a primary care provider and recorded in an EHR
tells a clinician in the emergency department about a patient's life-
threatening allergy, and emergency staff can adjust care appropriately,
even if the patient is unconscious.
o EHRs can expose potential safety problems when they occur, helping
providers avoid more serious consequences for patients and leading to
better patient outcomes.
o EHRs can help providers quickly and systematically identify and correct
operational problems. In a paper-based setting, identifying such problems
is much more difficult, and correcting them can take years.
• EHRs May Improve Risk Management By:
o Providing clinical alerts and reminders
o Improving aggregation, analysis, and communication of patient
information
o Making it easier to consider all aspects of a patient's condition
o Supporting diagnostic and therapeutic decision making
o Gathering all relevant information (lab results, etc.) in one place
o Support for therapeutic decisions

o Enabling evidence-based decisions at point of care
o Preventing adverse events
o Providing built-in safeguards against prescribing treatments that would
result in adverse events
o Enhancing research and monitoring for improvements in clinical quality
• Using EHRs to Improve Quality of Care
o Breast Cancer
o Diabetes
o Chlamydia
o Colorectal Cancer
• Using EHRs to Improve Documentation and Coding
o Based on level of medical decision-making, ~50% of visits under-coded
o Rural family practice implementing EHR + Practice Management (EPM)
system
o Increased case mix (type or mix of patients treated by a hospital or unit)
by 10% over 2 years from 1.34 to 1.47
o EHR documentation templates in multi-specialty clinic
• EHRs can improve public health outcomes
EHRs can also have beneficial effect on the health of groups of patients.
Providers who have electronic health information about the entire population of
patients they serve can look more meaningfully at the needs of patients who:
 Suffer from a specific condition
 Are eligible for specific preventive measures
 Are currently taking specific medications
This EHR function helps providers identify and work with patients to
manage specific risk factors or combinations of risk factors to improve patient
outcomes.

• E-prescription
Paper prescriptions can get lost or misread. With electronic prescription (e-
prescribing), doctors communicate directly with the pharmacy. An e-prescribing
system can save lives (by reducing medication errors and checking for drug
interactions), lower costs, and improve care. It is more convenient, cheaper for
doctors and pharmacies, and safer for patients. In short, e-prescribing is an
important, high-visibility component of progress in health information exchange.
• Improve in Efficiency and Saving cost
o Improved medical practice management through integrated scheduling
systems that link appointments directly to progress notes, automate
coding, and managed claims
o Time savings with easier centralized chart management, condition-
specific queries, and other shortcuts
o Easy access to patient information from anywhere
o Tracking electronic messages to staff, other clinicians, hospitals, labs, etc.
o Automated formulary checks by health plans
o Order and receipt of lab tests and diagnostic images
o Links to public health systems such as registries and communicable
disease databases
• Electronic Health Records Reduce Paperwork
o EHRs can reduce the amount of time providers spend doing paperwork.
o Administrative tasks, such as filling out forms and processing billing
requests, represent a significant percentage of health care costs. EHRs can
increase practice efficiencies by streamlining these tasks, significantly
decreasing costs.
o In addition, EHRs can deliver more information in additional directions.
EHRs can be programmed for easy or even automatic delivery of information
that needs to be shared with public health agencies or for the purpose of
quality measurement.

• Electronic Health Records Reduce Duplication of Testing
Because EHRs contain all of a patient's health information in one place, it is
less likely that providers will have to spend time ordering—and reviewing the
results of—unnecessary or duplicate tests and medical procedures. Less
utilization means fewer costs.
Conclusion:
An electronic health record (EHR) is an evolving concept defined as a
systematic collection of electronic health information about individual patients or
populations. It is a record in digital format that is theoretically capable of being shared
across different health care settings. The system is designed to re-present data that
accurately captures the state of the patient at all times. EHR will improve health care
professional’s decision & patients’ outcome.
The widespread use of EHR is inevitable due to HITECH Act .It allows for an
entire patient history to be viewed without the need to track down the patient’s previous
medical record volume and assists in ensuring data is accurate, appropriate and legible. It
reduces the chances of data replication as there is only one modifiable file, which means
the file is constantly up to date when viewed at a later date and eliminates the issue of
lost forms or paperwork. Due to all the information being in a single file, it makes it
much more effective when extracting medical data for the examination of possible trends
and long term changes in the patient and also Healthcare Organization that use EHR
have seen a reduction in mortality, complication & cost. Healthcare Organization that
use EHR have seen a reduction in mortality, complication & cost.

References
• Leffingwell, Dean and Widrig, Don (2003) Managing Software
Requirements: A Use- Case Approach, 2nd. Edition, Addison Wesley
Longman.
• Team #5‟s Project Proposal document: Info627_assignment0_Team5.doc
• Sumanth Nalluru, Anusha Shetty, Fangwu Wei, “Health Records
System at Drexel Convenient Care Center” ,2010.
• James Drallos, Jordan Clare, Joseph Korolewicz, Daniel Laboy,
“EMR data Analysis”.
• David LLOYD , Dipak KALRA, “EHR Requirements”.
• Fredric Blavin, Christal Ramos, Arnav Shah, Kelly Devers, “
• Lessons from the Literature on Electronic Health Record Implementation”,2013.
• William R. Hersh, “The Electronic Medical Record: Promises and Problems”,
Biomedical Information Communication Center, Oregon Health Sciences
University, BICC, 3 18 1 S. W. Sam Jackson Park Rd., Portland, OR 97201.

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