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The economic aspects of the health telematics must be considered from two points of view. The administrative applications are suitable as start-applications, because their data structures and processes are well known, and the calculation of the individual monetary effects have a solid empirical basis. However, only the medical applications will exhaust the real potential of health telematics and only these applications will justify the political and financial effort involved.

Health care is changing because of the need to effectively manage both acute and chronic illness in the delivery of quality patient-centered care. This will force a change from the physician-centric model to one that uses a care team approach in both the hospital and ambulatory settings. The electronic health record promotes communication among team members, knowledge management, and the need to more rapidly translate evidence-based guidelines and performance criteria to the bedside and office. Electronic health records with embedded clinical decision support systems hold great promise. Multiple parties are pushing this agenda forward, which will lead to more comprehensive, efficient quality care. Use of the quality improvement tool as described shows how effective these methods are in managing coronary artery disease. Physicians and all members of the care team need to embrace this evolution.

Reducing the use of paper records through a document management strategy is an essential first step in implementing the electronic health record. Efficient document management can help to decrease claim denials as well as days in accounts receivable-to name only a few benefits.

Physician adoption of electronic medical records will be swift over the next several years, says the chief medical officer with Geisinger Health System. Read about how Geisinger is improving patient care and reducing per member per month costs using EMRs.

Emerging electronic health record models present numerous challenges to health care systems, physicians, and regulators. This article provides explanation of some of the reasons driving the development of the electronic health record, describes two national electronic health record models (currently developing in the United States and Australia) and one distributed, personal model. The US and Australian models are contrasted in their different architectures ("pull" versus "push") and their different approaches to patient autonomy, privacy, and confidentiality. The article also discusses some of the professional, practical, and legal challenges that health care providers potentially face both during and after electronic health record implementation.

No matter what happens in Washington, the push for widespread adoption of electronic health records will not disappear. The value of health IT to providers in reporting the clinical outcomes data needed for quality-of-care incentives is too great to let this happen. What's more, an inquisitive public is demanding that the latest and greatest technology be used to improve patient safety.

Introduction: In times of easy world wide information transfer and reduced economic resources of the community, the presentation of medical departments in the internet becomes more and more important. But realisation is often insufficient., Method: The welcome page is the most important element. It should be appealing and easy to understand. Menues should lead to further information like "employees", "premises", "approach" and "medical information". Quick loading times are neccesary to make surfing more comfortable., Discussion: The internet presentation becomes more and more essential in our days. Legal restrictions, although being reduced in the last years, have to be observed.

Despite growing support for the adoption of electronic health records (EHR) to improve U.S. healthcare delivery, EHR adoption in the United States is slow to date due to a fundamental failure of the healthcare information technology marketplace. Reasons for the slow adoption of healthcare information technology include a misalignment of incentives, limited purchasing power among providers, variability in the viability of EHR products and companies, and limited demonstrated value of EHRs in practice. At the 2004 American College of Medical Informatics (ACMI) Retreat, attendees discussed the current state of EHR adoption in this country and identified steps that could be taken to stimulate adoption. In this paper, based upon the ACMI retreat, and building upon the experiences of the authors developing EHR in academic and commercial settings we identify a set of recommendations to stimulate adoption of EHR, including financial incentives, promotion of EHR standards, enabling policy, and educational, marketing, and supporting activities for both the provider community and healthcare consumers.

Objective: The aim of this study was to estimate the costs of implementing computerized physician order entry (CPOE) systems in hospitals in a rural state and to evaluate the financial implications of statewide CPOE implementation., Methods: A simulation model was constructed using estimates of initial and ongoing CPOE costs mapped onto all general hospitals in Iowa by bed quantity and current clinical information system (CIS) status. CPOE cost estimates were obtained from a leading CPOE vendor. Current CIS status was determined through mail survey of Iowa hospitals. Patient care revenue and operating cost data published by the Iowa Hospital Association were used to simulate the financial impact of CPOE adoption on hospitals., Results: CPOE implementation would dramatically increase operating costs for rural and critical access hospitals in the absence of substantial costs savings associated with improved efficiency or improved patient safety. For urban and rural referral hospitals, the cost impact is less dramatic but still substantial. However, relatively modest benefits in the form of patient care cost savings or revenue enhancement would be sufficient to offset CPOE costs for these larger hospitals., Conclusion: Implementation of CPOE in rural or critical access hospitals may depend on net increase in operating costs. Adoption of CPOE may be financially infeasible for these small hospitals in the absence of increases in hospital payments or ongoing subsidies from third parties.

User Specific templates were created through Cerner PowerNote to fit the need for improving the turnaround time for the Operative notes for Cardiac Surgery Patients. This eliminated the lag time of 37.5hours for Intensive Care Unit staff to access the detailed Operative notes on Cardiac surgery patients.

The paper by Jan Walker and colleagues provides an estimate of savings to be gained by increased health care information exchange and interoperability (HIEI). However, the assumptions on which their analysis was based seem very optimistic and could produce estimates that are not achievable. This commentary outlines some questions about their assumptions and suggests that less-aggressive assumptions could lead to more realistic expectations about the financial implications of achieving interoperability.

After the first session of the American College of Medical Informatics 2004 retreat, during which the history of electronic health records was reviewed, the second session served as a forum for discussion about the state of the art of EHR adoption. Adoption and diffusion rates for both inpatient and outpatient EHRs are low for a myriad of reasons ranging from personal physician concerns about workflow to broad environmental issues. Initial recommendations for addressing these issues include providing communication and education to both providers and consumers and alignment of incentives for clinicians.

Timely completion of Discharge Summaries is a requirement of high quality care. We developed a system for writing electronic Discharge Summaries. DSUM Writer has generated 2464 of 7349 total summaries (34%) and has paid for itself during its first 8 weeks in production. DSUM Writer is a component of a suite of tools (eNote) for electronic physician documentation used to support clinical care, billing and narrative analysis research.

Promoting good regional and national electronic data sharing in healthcare will not be possible unless two goals are accomplished: An electronic health record is widely adopted by healthcare providers and an infrastructure for information sharing is developed, according to a new report from a public/private collaborative called Connecting for Health.

Central Utah Multi-Specialty Clinic, a 59-physician group with practices in nine locations treating 200,000 active patients, documented the economic impact of implementing an electronic medical record. During the one-year period of the study, the clinic experienced direct reductions in spending and increases in revenue of more than $952,000 compared with the prior year, and anticipates cumulative savings of more than $8.2 million over the next five years.

The system will save the hospital an estimated $10 million per year. Computerized physician order entry is integrated with other electronic records at the facility. A done-deal attitude by leadership gets staff on board in 18 months.

In both the medical care and public health arenas, a variety of information systems have been developed to serve providers and program managers. In general, these systems have not been designed to share information with other information systems and provide comprehensive information about a child's health status to the information user. A number of initiatives are underway to develop integrated information systems. In December 2003, All Kids Count hosted an invitational conference "Developing Child Health Information Systems to Meet Medical Care and Public Health Needs." Through a series of plenary presentations and breakout discussion groups, participants developed a series of recommendations about governance, economic issues, information infrastructure, and uses of information from integrated child health information systems (CHIS). Common threads in the recommendations were: (1) development of a national coalition of stakeholders to promote integration of separate child health information systems within the context of ongoing national initiatives such as the National Health Information Infrastructure and the Public Health Information Network, (2) the need to develop the business and policy cases for integrated CHIS, (3) the need to develop agreement on standards for collecting and transferring information, and (4) the need to get the word out about the importance of integrating separate CHIS to improve health and health services.