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Electronic Health Records Requirements from the Psychiatry Point of View: The Result of an 18 Month Implementation Experience

Author: Ryan Kumar Ray

Primary Advisor: Sriram Iyengar, PhD

Committee Members: Luciana Cofiel, Rodrigo Dias, Priscila Matias Roedel, Marco Antonio Gutierrez, Helena Brentani

Masters thesis, The University of Texas Health Science Center School of Health Information Sciences at Houston.

Abstract:

Background: This case report presents an evaluation of an electronic health record (EHR) system implementation at a tertiary psychiatric institution. This report presents the perceived benefits and limitations for hospital administration, clinical practice and research after 18 months of the EHR system implementation. In particular, there is an emphasis on presenting the perceived system limitations relevant to psychiatry.

Methods: Perceived benefits and limitations that have been reported have been gathered through a series of meetings with the project implementation team, psychiatric clinicians and members from the IT organization of the hospital campus; the information presented in this report is based off information that was collected from January 2011 through18 months post-implementation.

Results: Perceived benefits were primarily related to administrative aspects of clinical operations. Some specialized psychiatric processes were not supported by the system, limiting specialized patient care and research in the area.

Conclusion: In order to improve patient care, EHR systems must provide support for specialized psychiatric processes. Functioning as a best practice it is therefore necessary to evaluate the EHR system regarding its capacity to support specific processes of this particular medical specialty, psychiatry. Special attention should be given to the multidisciplinary aspect of psychiatric treatment, clinical workflowand patient workflow within psychiatric care and legal/cultural issues associated with the implementation context.

Keywords: Electronic health records, implementation, psychiatry, mental health, behavioral health.