CPR or Computer-Based Patient Record is an integrated system that saves patient information. It contains not only a patient's health status but also his/her demographic and financial information.
The information is collected from billings and laboratories. It creates a link between medical entry, multiple databases, and electronic communication systems. CPR aims to reduce organizational expense, improvement in the quality of care, and implementation of a data stream. A CPR system should ensure data mining and strong connectivity.
It replaces the paper medical chart and should meet clinical requirements. The implementation of a CPR makes the revenue management better because of improved administrative performance and workflow. The term CPR was initiated by the IOM in a 1991 report, Computer-based Patient Records: An Essential Technology for Health Care.
The majority of people didn’t find the difference between CPR and EMR (Electronic Health Records). Drazen, Vice President of emerging practices at First Consulting Group in Waltham, Mass, says-
“The important concept is that we don’t just want to automate current records; we want to create new systems that support improved patient care and reduce time and other costs spent in managing information. We call it a CPR because the Institute of Medicine identified it as a CPR in their study. Why argue with the IOM?"
Whereas, Peter Wagemann, Executive Director of the Medical Records Institute, Newton, Mass finds these terms similar. He said,
"Unfortunately, there is no one official name and no standards organization has the power to make a call."
Computer-Based Patient Record Technologies
Over the years, healthcare organizations have seen a steady growth towards developing CPR systems. The development of these systems began decades ago, and some of them are still in development.
Unfortunately, no current system can support CPR. Some clinical information systems that closely feature the CPR system are visualized by the committee that shares similar traits. They manage a dictionary to maintain the contents of the internal CPRs.
Furthermore, the systems report and retrieve the data flexibly. Lastly, the patient data recorded contains the date and time of the transaction, thus providing a chronological history of the patient's record.
Here are the key attributes of computer-based technologies.
Databases and Database Management System
The most desirable model for CPR systems includes either a distributed database design that consists of computers and databases but with logical central control of the record; or an integrated physical database that is centrally located, or a hybrid of these approaches.
No matter what you choose, the main requirements are control and organizational integrity of the record for each patient. The selection of the database management system is important to the performance and growth of the system.
Today’s CPR system focuses on providing a view of the complete patient record. The problem with this approach is the increased potential it carries for avoiding confidentiality mechanisms.
Different records of patients are distributed among different computers, and thus, confidentiality becomes difficult. The CPR of the future will include text, videos, full-motion video, and other media files. It is extremely complex, and no single database management system is capable of retrieving the range of patient data.
Data Acquisition and Data Retrieval
The organization of data shows that it can quickly share the crucial information needed in different settings. Response time has been proven to be a crucial factor in successful CPR systems. The same data can be represented with different combinations to different healthcare professionals. Customizing data is difficult, but it will attract consumers.
Data Acquisition is extremely challenging when it comes to CPR. The data in the CPR is entered at its source and by the user, and it should be accessible to different CPR systems. Data entry by members of the health team is sensitive.
Also, data entry by clerk or intermediary has several drawbacks. It introduces errors because the person entering the information and receiving it are different. It makes instant feedback to healthcare professionals impossible. Furthermore, it delays the availability of important information.
To establish a diagnosis, healthcare professionals use patient information in text form. With the CPR system, the experts search and retrieve information like a text from the database management system using languages.
Over the years, the ability of the computer system to extract meaning from data has been slower because of its greater complexity. Automated speech recognition is adding uniformity and consistency to vocabularies.
In the 1990s, this technology was found in discharge summaries, and different parts of the CPRs were used to generate codes for billing.
Image Processing and Storage
The digitization data is permitting different intensity resolution data, which allows the computer to interpret images with medium to high contrast.
Imaging is used by radiologists, dentists, pathologists, and other specialists. Paper record store images separate from the chart. CPR systems in the future, when linked to PACSs, allow healthcare professionals to view pictures at the workstation.
System Communications and Network Infrastructure
Caring for patients needs healthcare workers to interact with experts. The patient information is complex and includes sounds, videos, text, and audio. The evolving Integrated Services Digital Network (ISDN) is capable of high-speed transmission over public telephone networks.
History of Automated Medical Records
The patient record should be kept secure in any way. Despite many technological advancements in the healthcare sector, the patient record of today is similar to that of 50 years ago. Patient record failure sometimes creates trouble for healthcare professionals and other practitioners when data is mismatched. A proper patient record improvement helps in improving the healthcare system of the nation. Earlier, in 1991, the General Accounting Office reported on automated medical records and found three major ways in which patient records can benefit healthcare.
Firstly, it improves healthcare delivery by offering medical personnel with faster data retrieval and proving more versatility in data display. Secondly, it can enhance outcomes research programs by capturing clinical information for evaluation. Lastly, it can increase hospital efficiency by improving staff productivity and reducing costs. Several sources concluded that GAO saves and reduces hospital costs by $600 per patient. Other investigators found improved care and better outcomes for patients.
Later, the Institute of Medicine (IOM) undertook a study to check for patient’s records and explored the functional requirements and technological advances. In general, the IOM committee examined the current state of the medical record systems and identified impediments to the use of improved record systems. It also developed a research agenda to enhance the medical record system. It recommended policies to achieve further improvements.
During its work, the IOM committee used different definitions. For instance, it defined a computer-based patient record as an electronic patient record that resides in a system and supports users by providing accessibility to reminders, alerts, and CDSS
. A secondary patient record contains selected data to help non-clinical users. Patient care evaluation refers to utilization review and legal audits. It is the set of components and is usually located within a healthcare provider setting.
A patient record system manages administrative and clinical functions. A Medical information system is the set of formal arrangements and concerns about the health of individual patients. It stores the patient's record and then processes it on the computer.
Experience With CPR System
Several healthcare facilities are using computers for a long time. Initially, it was used to focus on the business and financial functions of healthcare. In 1959, two experts described a hypothetical health computing system that could address clinical problems.
By the mid of 1960, other experts claimed that over five areas of medical practice would be affected, including the utilization of hospital services, medical diagnosis, laboratory analysis, and more. Early experiences showed that clinical computing would require a significant time to overcome the challenges.
Future Computer-based Patient Records should enhance communication capabilities and include links to bibliographic and research databases. Furthermore, it should also support video and provide electronic capability within different settings.