<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@16d57286922342afbeafa2f3eedcb0d4" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Introduction</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@d769e264268d48b9a2b2bc3cf9ec2786">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@d769e264268d48b9a2b2bc3cf9ec2786" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<p>We now start to talk more about Electronic Health Records. We begin presenting an overview of the clinical informatics specialty and then moving on we will discuss the benefits, challenges, goals and consequences of an Electronic Health Record implementation.</p>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@50f0d501c92b45aeaeea1aa65295612a" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Clinical Informatics - an overview</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@0954769254724783a5f0455a17be2bed">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@0954769254724783a5f0455a17be2bed" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<p>Dr. Charles Safran, MD <br />Chief, Division of Clinical Informatics<br />Beth Israel Deaconess Medical Center</p>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@video+block@03fda1b5ed7b4e95bec23e79041235ed">
<div class="xblock xblock-public_view xblock-public_view-video xmodule_display xmodule_VideoBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@video+block@03fda1b5ed7b4e95bec23e79041235ed" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="video" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Video"}
</script>
<h3 class="hd hd-2">Clinical Informatics</h3>
<div
id="video_03fda1b5ed7b4e95bec23e79041235ed"
class="video closed"
data-metadata='{"end": 0.0, "speed": null, "ytTestTimeout": 1500, "publishCompletionUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@03fda1b5ed7b4e95bec23e79041235ed/handler/publish_completion", "ytApiUrl": "https://www.youtube.com/iframe_api", "showCaptions": "true", "streams": "1.00:-3ffPIE3NOg", "poster": "https://mitx-edx-video-meta-storage.s3.amazonaws.com/media/video-images/5653af568db74e72a6abe051a8be50f7.jpeg?AWSAccessKeyId=ASIA4QDFFSURY244LBXR&Signature=NXIztmeLjXMRJz48kk3T2QjE41s%3D&x-amz-security-token=IQoJb3JpZ2luX2VjEDsaCXVzLWVhc3QtMSJGMEQCIGbnf733%2B4MkXKSyE2gsRlFFY7ttHVoGM287pEwaUEqVAiB6fN20%2F5Ol0FBi6LU1yv%2B9t%2FiCmpK0jruXDOyNd%2FrDxCrCBQiD%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAMaDDg1OTIwNTYzNzQxMSIMw%2B5dojZyNcM2sP1xKpYFGyyK3sGXcdtTUPAZnFQb7cJ%2BhXe345caNpEudZOWlfJu%2Fyq4A5qbjzl1GH0igmFMCeevuSi9HyVHbVsoUd86l6u3d0SuuIZBIO9XQqXYeFCj6nqaWGnOynbemhpH5lhikLsnoLeR8By6DdsOALRvBO6pQHE6VJS5710LjDdCM9mJ2yWWy2qqRX9NantLaH9RTarb9wMWMMhIgxzsGJGcSZKJiCjpSAU%2BmygPZMSqpJnTe%2B7KSh9xsoSHOprOzBix0t6MaVbtjtz9KKKCuctM9dPhP%2FvxeiELbhqoT0g4ratwObKjC%2BCc%2FxMLSZg%2FZU6vhp1SsiXsFN%2Br9xZhh9Mpv4CRQNMUFfSLaI8JyXMovYYdeMBp54NE8sWqn3xn%2Fb3e21icuXfabIvKPzBLfhSl2YSiqj7LRjHXNxMTXr1%2FUYnJJsKe0lzln4xRHYJ17HTr9HMqt2X%2BZnE39McyHbxUPNSJziK4Wtn%2Bn2tv39aCispyh2ZSysl8%2Bs9vkqu2XophgMD8V51PqNC3b6PLhy%2FhCO5BdfKPjGbH2easE%2FZc2QW5IYslILF%2FPGy8d5fvgMs1kCUzEHjSoP9QQrhY4Gu3p4h6%2FrGRnwGiG54NbMOsjyp8imgDqvTm%2FCBzElpGt%2B6If91r%2BfRQ4rRRmFOAS24h2IgZjKPuWzI7NTAQhg0SCaonHuMsjY1f41JZlIhLPvBuyZcgc1gYQ2NHjtTarFkurTz6GRMqOO31rysKopy4Z%2BD7ZikILhZrghBUNW5IBt9R7zcNFW3FyB59pYRCEz5TZRFpcCC8gTvg%2BUrwSetCoeFD%2F9h3Y8UhMTvsSA7xxQtIlzy6IxY%2BrefXzp%2Bz%2BUy8thdvmJlDw60VKFv0HKkOafHuJNehNwAwxdihsQY6sgFIESPRxmE9dhdNDixFYq%2FmIXExARtVa6WWr9EPg6jOeBOyXKAsN23REZTXPb8CoUtgl4Wev7zQ9etYvWeCwgTg2VDs5158dDbo13h6lhZZh2X9HWlPkwK%2FTdmYvi3qcSZbSLvebCfg5IPHIPhki7V%2BLTqEDG9W%2BN1FDlDC%2BmjhO8iZydtkhbzdaTVS9v3XLnco5QVltLIi10QN6zai3UroKG8be%2BNKeRqLra0sO1k%2Besrz&Expires=1713928548", "saveStateEnabled": false, "start": 0.0, "completionPercentage": 0.95, "transcriptAvailableTranslationsUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@03fda1b5ed7b4e95bec23e79041235ed/handler/transcript/available_translations", "autoplay": false, "transcriptLanguages": {"en": "English"}, "autohideHtml5": false, "transcriptTranslationUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@03fda1b5ed7b4e95bec23e79041235ed/handler/transcript/translation/__lang__", "ytMetadataEndpoint": "", "generalSpeed": 1.0, "lmsRootURL": "https://openlearninglibrary.mit.edu", "autoAdvance": false, "completionEnabled": false, "savedVideoPosition": 0.0, "saveStateUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@03fda1b5ed7b4e95bec23e79041235ed/handler/xmodule_handler/save_user_state", "captionDataDir": null, "sources": ["https://d2f1egay8yehza.cloudfront.net/MITHST932017-V007100_DTH.mp4", "https://d2f1egay8yehza.cloudfront.net/MITHST932017-V007100/MITHST932017-V007100.m3u8"], "transcriptLanguage": "en", "recordedYoutubeIsAvailable": true, "prioritizeHls": false, "duration": 467.97}'
data-bumper-metadata='null'
data-autoadvance-enabled="False"
data-poster='null'
tabindex="-1"
>
<div class="focus_grabber first"></div>
<div class="tc-wrapper">
<div class="video-wrapper">
<span tabindex="0" class="spinner" aria-hidden="false" aria-label="Loading video player"></span>
<span tabindex="-1" class="btn-play fa fa-youtube-play fa-2x is-hidden" aria-hidden="true" aria-label="Play video"></span>
<div class="video-player-pre"></div>
<div class="video-player">
<div id="03fda1b5ed7b4e95bec23e79041235ed"></div>
<h4 class="hd hd-4 video-error is-hidden">No playable video sources found.</h4>
<h4 class="hd hd-4 video-hls-error is-hidden">
Your browser does not support this video format. Try using a different browser.
</h4>
</div>
<div class="video-player-post"></div>
<div class="closed-captions"></div>
<div class="video-controls is-hidden">
<div>
<div class="vcr"><div class="vidtime">0:00 / 0:00</div></div>
<div class="secondary-controls"></div>
</div>
</div>
</div>
</div>
<div class="focus_grabber last"></div>
</div>
</div>
</div>
<div class="vert vert-2" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@45607b69bd5643c58aaffe807fd5fbae">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@45607b69bd5643c58aaffe807fd5fbae" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_45607b69bd5643c58aaffe807fd5fbae" class="problems-wrapper" role="group"
aria-labelledby="45607b69bd5643c58aaffe807fd5fbae-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@45607b69bd5643c58aaffe807fd5fbae" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@45607b69bd5643c58aaffe807fd5fbae/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="1"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="45607b69bd5643c58aaffe807fd5fbae-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@45607b69bd5643c58aaffe807fd5fbae-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@45607b69bd5643c58aaffe807fd5fbae-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><div class="choicegroup capa_inputtype" id="inputtype_45607b69bd5643c58aaffe807fd5fbae_2_1">
<fieldset aria-describedby="status_45607b69bd5643c58aaffe807fd5fbae_2_1">
<legend id="45607b69bd5643c58aaffe807fd5fbae_2_1-legend" class="response-fieldset-legend field-group-hd">What is the main interest of the clinical informaticians?</legend>
<div class="field">
<input type="radio" name="input_45607b69bd5643c58aaffe807fd5fbae_2_1" id="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_0" class="field-input input-radio" value="choice_0"/><label id="45607b69bd5643c58aaffe807fd5fbae_2_1-choice_0-label" for="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_45607b69bd5643c58aaffe807fd5fbae_2_1"> Reduce the hospital costs
</label>
</div>
<div class="field">
<input type="radio" name="input_45607b69bd5643c58aaffe807fd5fbae_2_1" id="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_1" class="field-input input-radio" value="choice_1"/><label id="45607b69bd5643c58aaffe807fd5fbae_2_1-choice_1-label" for="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_45607b69bd5643c58aaffe807fd5fbae_2_1"> Improve the delivery of care.
</label>
</div>
<div class="field">
<input type="radio" name="input_45607b69bd5643c58aaffe807fd5fbae_2_1" id="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_2" class="field-input input-radio" value="choice_2"/><label id="45607b69bd5643c58aaffe807fd5fbae_2_1-choice_2-label" for="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_2" class="response-label field-label label-inline" aria-describedby="status_45607b69bd5643c58aaffe807fd5fbae_2_1"> Improve technologies in the medical field
</label>
</div>
<div class="field">
<input type="radio" name="input_45607b69bd5643c58aaffe807fd5fbae_2_1" id="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_3" class="field-input input-radio" value="choice_3"/><label id="45607b69bd5643c58aaffe807fd5fbae_2_1-choice_3-label" for="input_45607b69bd5643c58aaffe807fd5fbae_2_1_choice_3" class="response-label field-label label-inline" aria-describedby="status_45607b69bd5643c58aaffe807fd5fbae_2_1"> Improve the communication between physicians and administrators
</label>
</div>
<span id="answer_45607b69bd5643c58aaffe807fd5fbae_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_45607b69bd5643c58aaffe807fd5fbae_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_45607b69bd5643c58aaffe807fd5fbae" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_45607b69bd5643c58aaffe807fd5fbae">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="45607b69bd5643c58aaffe807fd5fbae-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="45607b69bd5643c58aaffe807fd5fbae-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="45607b69bd5643c58aaffe807fd5fbae-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@aaa2b6b97f304a5eb8a50e6ff10be98d" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Brief History of Electronic Health Records</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@video+block@a5636e773f214c0ab0d0b29cf4f293b0">
<div class="xblock xblock-public_view xblock-public_view-video xmodule_display xmodule_VideoBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@video+block@a5636e773f214c0ab0d0b29cf4f293b0" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="video" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Video"}
</script>
<h3 class="hd hd-2">Brief History of Electronic Health Records</h3>
<div
id="video_a5636e773f214c0ab0d0b29cf4f293b0"
class="video closed"
data-metadata='{"end": 0.0, "speed": null, "ytTestTimeout": 1500, "publishCompletionUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@a5636e773f214c0ab0d0b29cf4f293b0/handler/publish_completion", "ytApiUrl": "https://www.youtube.com/iframe_api", "showCaptions": "true", "streams": "1.00:hImQWUjqcXw", "poster": "https://mitx-edx-video-meta-storage.s3.amazonaws.com/media/video-images/85f7f8aa64c54135965ef976bb8024f7.jpeg?AWSAccessKeyId=ASIA4QDFFSURY244LBXR&Signature=VORzridLf3II1Ksy5LN388%2Fc9%2BA%3D&x-amz-security-token=IQoJb3JpZ2luX2VjEDsaCXVzLWVhc3QtMSJGMEQCIGbnf733%2B4MkXKSyE2gsRlFFY7ttHVoGM287pEwaUEqVAiB6fN20%2F5Ol0FBi6LU1yv%2B9t%2FiCmpK0jruXDOyNd%2FrDxCrCBQiD%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAMaDDg1OTIwNTYzNzQxMSIMw%2B5dojZyNcM2sP1xKpYFGyyK3sGXcdtTUPAZnFQb7cJ%2BhXe345caNpEudZOWlfJu%2Fyq4A5qbjzl1GH0igmFMCeevuSi9HyVHbVsoUd86l6u3d0SuuIZBIO9XQqXYeFCj6nqaWGnOynbemhpH5lhikLsnoLeR8By6DdsOALRvBO6pQHE6VJS5710LjDdCM9mJ2yWWy2qqRX9NantLaH9RTarb9wMWMMhIgxzsGJGcSZKJiCjpSAU%2BmygPZMSqpJnTe%2B7KSh9xsoSHOprOzBix0t6MaVbtjtz9KKKCuctM9dPhP%2FvxeiELbhqoT0g4ratwObKjC%2BCc%2FxMLSZg%2FZU6vhp1SsiXsFN%2Br9xZhh9Mpv4CRQNMUFfSLaI8JyXMovYYdeMBp54NE8sWqn3xn%2Fb3e21icuXfabIvKPzBLfhSl2YSiqj7LRjHXNxMTXr1%2FUYnJJsKe0lzln4xRHYJ17HTr9HMqt2X%2BZnE39McyHbxUPNSJziK4Wtn%2Bn2tv39aCispyh2ZSysl8%2Bs9vkqu2XophgMD8V51PqNC3b6PLhy%2FhCO5BdfKPjGbH2easE%2FZc2QW5IYslILF%2FPGy8d5fvgMs1kCUzEHjSoP9QQrhY4Gu3p4h6%2FrGRnwGiG54NbMOsjyp8imgDqvTm%2FCBzElpGt%2B6If91r%2BfRQ4rRRmFOAS24h2IgZjKPuWzI7NTAQhg0SCaonHuMsjY1f41JZlIhLPvBuyZcgc1gYQ2NHjtTarFkurTz6GRMqOO31rysKopy4Z%2BD7ZikILhZrghBUNW5IBt9R7zcNFW3FyB59pYRCEz5TZRFpcCC8gTvg%2BUrwSetCoeFD%2F9h3Y8UhMTvsSA7xxQtIlzy6IxY%2BrefXzp%2Bz%2BUy8thdvmJlDw60VKFv0HKkOafHuJNehNwAwxdihsQY6sgFIESPRxmE9dhdNDixFYq%2FmIXExARtVa6WWr9EPg6jOeBOyXKAsN23REZTXPb8CoUtgl4Wev7zQ9etYvWeCwgTg2VDs5158dDbo13h6lhZZh2X9HWlPkwK%2FTdmYvi3qcSZbSLvebCfg5IPHIPhki7V%2BLTqEDG9W%2BN1FDlDC%2BmjhO8iZydtkhbzdaTVS9v3XLnco5QVltLIi10QN6zai3UroKG8be%2BNKeRqLra0sO1k%2Besrz&Expires=1713928548", "saveStateEnabled": false, "start": 0.0, "completionPercentage": 0.95, "transcriptAvailableTranslationsUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@a5636e773f214c0ab0d0b29cf4f293b0/handler/transcript/available_translations", "autoplay": false, "transcriptLanguages": {"en": "English"}, "autohideHtml5": false, "transcriptTranslationUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@a5636e773f214c0ab0d0b29cf4f293b0/handler/transcript/translation/__lang__", "ytMetadataEndpoint": "", "generalSpeed": 1.0, "lmsRootURL": "https://openlearninglibrary.mit.edu", "autoAdvance": false, "completionEnabled": false, "savedVideoPosition": 0.0, "saveStateUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@a5636e773f214c0ab0d0b29cf4f293b0/handler/xmodule_handler/save_user_state", "captionDataDir": null, "sources": ["https://d2f1egay8yehza.cloudfront.net/MITHST932017-V008300_DTH.mp4", "https://d2f1egay8yehza.cloudfront.net/MITHST932017-V008300/MITHST932017-V008300.m3u8"], "transcriptLanguage": "en", "recordedYoutubeIsAvailable": true, "prioritizeHls": false, "duration": 362.77}'
data-bumper-metadata='null'
data-autoadvance-enabled="False"
data-poster='null'
tabindex="-1"
>
<div class="focus_grabber first"></div>
<div class="tc-wrapper">
<div class="video-wrapper">
<span tabindex="0" class="spinner" aria-hidden="false" aria-label="Loading video player"></span>
<span tabindex="-1" class="btn-play fa fa-youtube-play fa-2x is-hidden" aria-hidden="true" aria-label="Play video"></span>
<div class="video-player-pre"></div>
<div class="video-player">
<div id="a5636e773f214c0ab0d0b29cf4f293b0"></div>
<h4 class="hd hd-4 video-error is-hidden">No playable video sources found.</h4>
<h4 class="hd hd-4 video-hls-error is-hidden">
Your browser does not support this video format. Try using a different browser.
</h4>
</div>
<div class="video-player-post"></div>
<div class="closed-captions"></div>
<div class="video-controls is-hidden">
<div>
<div class="vcr"><div class="vidtime">0:00 / 0:00</div></div>
<div class="secondary-controls"></div>
</div>
</div>
</div>
</div>
<div class="focus_grabber last"></div>
</div>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@d2317fd1b2b541d7b8e707f9566bbf77">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@d2317fd1b2b541d7b8e707f9566bbf77" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<h4>Evolution of Electronic Health Records in Global eHealth</h4>
<p>New technologies have driven the increasingly rapid expansion of eHealth on a Global scale. Back in the late 1990s desktop PCs were starting to be seen in hospitals and clinics in low income countries. Some were meant to assist managers, and a few had applications to help in the delivery of care- but they tended to end up on the desk of the senior manager either way. Out of that era came EPINFO [Epinfo] with tools for medical research data collection and management, and which came to be used in low income countries like Haiti for collecting data for programmatic management and clinical research. In the late 1990s the first affordable consumer digital cameras became available, with 1 Mega Pixel resolution and floppy disks drives for data storage. Combined with dial-up email this led to the first boom in store and forward telemedicine.</p>
<p>A great challenge was affording, shipping and supporting desktop PCs in low income settings which proved very difficult and expensive. Local collection and storage of data was vulnerable to crashes and thefts and the high power usage of PCs prevented most smaller clinics running them reliably, particularly given the high price of solar power systems then. The Boabab Health system in Malawi was perhaps the first successful attempt to circumvent these challenges in a systematic way and provide energy efficient systems and cost effective and well-engineered power backups[Douglas Plos Med]. Connectivity outside of cities in those days was rare and almost exclusively from Satellite Internet connections – expensive, slow, with long latency and prone to technical problems. </p>
<p>An early example of a successful EHR system in use in a low income environment was the Mosoriot Medical Record System developed in Eldoret, Kenya in 2000. This was designed to support primary care in the rural Mosoriot Medical Center and developed with Microsoft Access. Patients who were seen at the clinic had a form filled out by the registration staff and clinician, and then took that form to the pharmacy if they had a prescription for medications. The forms were entered into the EHR before the patients left the clinic. This system greatly improved the quality and timeliness of documentation and allowed clinical and Ministry of Health (MOH) reports to be generated, and research on public health issues such as STDs and road traffic accidents. </p>
<p>The big technology change began around 2000 with the spread of web based technologies including database backed web sites. The first simple web based EHR systems were starting to be rolled out in the US, and at the same time dial-up internet plus some broadband connectivity was spreading fast in Latin American countries like Peru. The logical next step was to use a web based EHR design for managing clinical data in LMICs. The scale up of treatment of multi-drug resistant TB (MDR-TB) in Peru funded by the Gates Foundation provided an early example. This led to the Partners In Health EHR (PIH-EMR) in 2001, an early “Cloud Based System” which had a server based in Boston, USA and initially dial-up internet access from two clinics in Peru. There were great benefits in this arrangement in allowing the server to be supported and the system upgraded regularly, with the improvements immediately available to the users. Security was managed centrally along with staff training and supervision locally to protect passwords to and teach the principles of data security to staff. Along with site visits, early internet based video-conferencing was used to train and support the team and co-design improvements. </p>
<p>Other projects were also addressing eHealth issues over the last 15 years. Baobab Health in Malawi is one key example (discussed earlier), and Care2X is an open source EHR project for hospitals which has been deployed in Tanzania and other countries for more than a decade[Care2X]. Other EHR systems inspired by Care2X have sprung up in Tanzania, such as Afya Pro [Afyapro] developed by a local programming company.</p>
</div>
</div>
<div class="vert vert-2" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@a316e9781f2247359100be83e116e827">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@a316e9781f2247359100be83e116e827" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_a316e9781f2247359100be83e116e827" class="problems-wrapper" role="group"
aria-labelledby="a316e9781f2247359100be83e116e827-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@a316e9781f2247359100be83e116e827" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@a316e9781f2247359100be83e116e827/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="1"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="a316e9781f2247359100be83e116e827-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@a316e9781f2247359100be83e116e827-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@a316e9781f2247359100be83e116e827-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><div class="choicegroup capa_inputtype" id="inputtype_a316e9781f2247359100be83e116e827_2_1">
<fieldset aria-describedby="status_a316e9781f2247359100be83e116e827_2_1">
<legend id="a316e9781f2247359100be83e116e827_2_1-legend" class="response-fieldset-legend field-group-hd">The following statement, "Electronic Health Records improves workflow" is:</legend>
<div class="field">
<input type="radio" name="input_a316e9781f2247359100be83e116e827_2_1" id="input_a316e9781f2247359100be83e116e827_2_1_choice_0" class="field-input input-radio" value="choice_0"/><label id="a316e9781f2247359100be83e116e827_2_1-choice_0-label" for="input_a316e9781f2247359100be83e116e827_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_a316e9781f2247359100be83e116e827_2_1"> Always True
</label>
</div>
<div class="field">
<input type="radio" name="input_a316e9781f2247359100be83e116e827_2_1" id="input_a316e9781f2247359100be83e116e827_2_1_choice_1" class="field-input input-radio" value="choice_1"/><label id="a316e9781f2247359100be83e116e827_2_1-choice_1-label" for="input_a316e9781f2247359100be83e116e827_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_a316e9781f2247359100be83e116e827_2_1"> Always False
</label>
</div>
<div class="field">
<input type="radio" name="input_a316e9781f2247359100be83e116e827_2_1" id="input_a316e9781f2247359100be83e116e827_2_1_choice_2" class="field-input input-radio" value="choice_2"/><label id="a316e9781f2247359100be83e116e827_2_1-choice_2-label" for="input_a316e9781f2247359100be83e116e827_2_1_choice_2" class="response-label field-label label-inline" aria-describedby="status_a316e9781f2247359100be83e116e827_2_1"> Sometimes True
</label>
</div>
<span id="answer_a316e9781f2247359100be83e116e827_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_a316e9781f2247359100be83e116e827_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_a316e9781f2247359100be83e116e827" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_a316e9781f2247359100be83e116e827">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="a316e9781f2247359100be83e116e827-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="a316e9781f2247359100be83e116e827-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="a316e9781f2247359100be83e116e827-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@ed15585712594503beef2fcfd7f32972" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Paper vs Electronic Records</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@5e27467eed4345aa8e5da25170e6b271">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@5e27467eed4345aa8e5da25170e6b271" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<h4>Paper versus Electronic Records</h4>
<p>Paper medical records or charts have been around for more than a century and will likely still be in use for many years. There are many practical advantages of paper records including: low cost; the speed and simplicity of creating a basic record; minimal training requirements; no power requirements; flexibility of recording including diagrams and summaries; ability to create a narrative story,; and general ability of staff to navigate the book like structure. The downsides of paper records are well known: potentially illegible hand writing, lack of standard structure to data collection and analysis which can make finding key information difficult; difficulty in copying records resulting in frequent cases of missing records; difficulty in analyzing and summarizing records for clinical care or research; and difficulty in managing large records for patients with complex and/or chronic diseases. In high income countries paper records have been updated and improved over the last few decades particularly with the introduction of the problem orientated medical record. This includes four key sections: History (Subjective), Examination (Objective), Assessment and Plan – called a SOAP note in the US. The key clinical problems identified in the patient such as presenting complaints, diagnoses and social circumstances are threads that run through each of the four sections. Some paper records use templates to encourage or mandate collection of key data items in a structured fashion. </p>
<p>An EHR is not just an electronic version of a paper medical record. Instead, an EHR has expanded capabilities which include the facility to collect, store, analyze, and report clinical data. While these individual capabilities form the core of an EHR, an integrated system typically includes a number of other functions. In 2003, the Institute of Medicine in the US, (IOM), issued a recommendation that an EHR have eight core functions [IOM report], as follows: </p>
<ol><ol>
<li>Health information and data (collection and management)</li>
<li>Result management (e.g laboratory tests)</li>
<li>Order management (e.g. drug orders)</li>
<li>Decision support </li>
<li>Electronic communication and connectivity</li>
<li>Patient support (e.g. patient info sheets, patient portal to access part of their record)</li>
<li>Administrative processes and reporting</li>
<li>Public health reporting (e.g. generating lists of notifiable diseases)</li>
</ol></ol>
<p>An important function of EHRs is the ability to summarize the clinical data in a wide variety of fashions. These summaries are typically tailored to specific problem areas and help to pull together the key information in an easily accessible fashion to aid clinical decision making. Chronic disease management requires a long term record of the patient’s diagnoses, investigations, clinical course and treatments. Such data can be difficult to assemble and visualize from paper records, (even in well run hospitals in high income countries), but EHRs have the advantage being able to generate longitudinal perspectives for subsequent review. This was a major driving force for the development of EHRs to support HIV care in African and other low income countries like Haiti.</p>
<p>Another key benefit of EHRs compared to paper records is the ability to scale up to large quantities of data in each record and to large numbers of patients. Managing such large record libraries in high income hospitals is an expensive and complex process and many low income countries do not have traditions of effective paper medical record keeping. Implementation of an EHR may be the first time effective record have been kept, making the process especially challenging but potentially more acceptable in the longer run. </p>
<p>An extensive list of EHR functions is included in a vendor guideline checklist produced by the US National Learning Consortium[EHR vendor selection], but for a first time implementation we recommend concentrating on the core functions first, and then expanding on those as system becomes established. </p>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@8c5b86e8ec964d7fb2b515a6f5c15581">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@8c5b86e8ec964d7fb2b515a6f5c15581" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_8c5b86e8ec964d7fb2b515a6f5c15581" class="problems-wrapper" role="group"
aria-labelledby="8c5b86e8ec964d7fb2b515a6f5c15581-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@8c5b86e8ec964d7fb2b515a6f5c15581" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@8c5b86e8ec964d7fb2b515a6f5c15581/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="0"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="8c5b86e8ec964d7fb2b515a6f5c15581-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@8c5b86e8ec964d7fb2b515a6f5c15581-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@8c5b86e8ec964d7fb2b515a6f5c15581-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><div class="choicegroup capa_inputtype" id="inputtype_8c5b86e8ec964d7fb2b515a6f5c15581_2_1">
<fieldset aria-describedby="status_8c5b86e8ec964d7fb2b515a6f5c15581_2_1">
<legend id="8c5b86e8ec964d7fb2b515a6f5c15581_2_1-legend" class="response-fieldset-legend field-group-hd">Which of the following alternatives is not a downside of paper records?</legend>
<div class="field">
<input type="radio" name="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1" id="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_0" class="field-input input-radio" value="choice_0"/><label id="8c5b86e8ec964d7fb2b515a6f5c15581_2_1-choice_0-label" for="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_8c5b86e8ec964d7fb2b515a6f5c15581_2_1"> Potentially illegiable handwriting
</label>
</div>
<div class="field">
<input type="radio" name="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1" id="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_1" class="field-input input-radio" value="choice_1"/><label id="8c5b86e8ec964d7fb2b515a6f5c15581_2_1-choice_1-label" for="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_8c5b86e8ec964d7fb2b515a6f5c15581_2_1"> Lack of structure data collection
</label>
</div>
<div class="field">
<input type="radio" name="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1" id="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_2" class="field-input input-radio" value="choice_2"/><label id="8c5b86e8ec964d7fb2b515a6f5c15581_2_1-choice_2-label" for="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_2" class="response-label field-label label-inline" aria-describedby="status_8c5b86e8ec964d7fb2b515a6f5c15581_2_1"> Minimal training requirements
</label>
</div>
<div class="field">
<input type="radio" name="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1" id="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_3" class="field-input input-radio" value="choice_3"/><label id="8c5b86e8ec964d7fb2b515a6f5c15581_2_1-choice_3-label" for="input_8c5b86e8ec964d7fb2b515a6f5c15581_2_1_choice_3" class="response-label field-label label-inline" aria-describedby="status_8c5b86e8ec964d7fb2b515a6f5c15581_2_1"> Difficulty in analyzing medical records
</label>
</div>
<span id="answer_8c5b86e8ec964d7fb2b515a6f5c15581_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_8c5b86e8ec964d7fb2b515a6f5c15581_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_8c5b86e8ec964d7fb2b515a6f5c15581" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_8c5b86e8ec964d7fb2b515a6f5c15581">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="8c5b86e8ec964d7fb2b515a6f5c15581-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="8c5b86e8ec964d7fb2b515a6f5c15581-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="8c5b86e8ec964d7fb2b515a6f5c15581-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@272442855f484f7cb8f7b3893a3b88fe" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Goals, Value to Physicians and Incentive to Introduction of EHR</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@video+block@d4663ade081640e88cb7714c5c026e69">
<div class="xblock xblock-public_view xblock-public_view-video xmodule_display xmodule_VideoBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@video+block@d4663ade081640e88cb7714c5c026e69" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="video" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Video"}
</script>
<h3 class="hd hd-2">Goals, Value to Physicians and Incentive to Introduction of EHR</h3>
<div
id="video_d4663ade081640e88cb7714c5c026e69"
class="video closed"
data-metadata='{"end": 0.0, "speed": null, "ytTestTimeout": 1500, "publishCompletionUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@d4663ade081640e88cb7714c5c026e69/handler/publish_completion", "ytApiUrl": "https://www.youtube.com/iframe_api", "showCaptions": "true", "streams": "1.00:ZovvEag2HPk", "poster": "https://mitx-edx-video-meta-storage.s3.amazonaws.com/media/video-images/6bde4338ab9741d6b53c932a476a6f10.jpeg?AWSAccessKeyId=ASIA4QDFFSURY244LBXR&Signature=N9uhmGoaxNORe1Nb46JTsRfmpZA%3D&x-amz-security-token=IQoJb3JpZ2luX2VjEDsaCXVzLWVhc3QtMSJGMEQCIGbnf733%2B4MkXKSyE2gsRlFFY7ttHVoGM287pEwaUEqVAiB6fN20%2F5Ol0FBi6LU1yv%2B9t%2FiCmpK0jruXDOyNd%2FrDxCrCBQiD%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAMaDDg1OTIwNTYzNzQxMSIMw%2B5dojZyNcM2sP1xKpYFGyyK3sGXcdtTUPAZnFQb7cJ%2BhXe345caNpEudZOWlfJu%2Fyq4A5qbjzl1GH0igmFMCeevuSi9HyVHbVsoUd86l6u3d0SuuIZBIO9XQqXYeFCj6nqaWGnOynbemhpH5lhikLsnoLeR8By6DdsOALRvBO6pQHE6VJS5710LjDdCM9mJ2yWWy2qqRX9NantLaH9RTarb9wMWMMhIgxzsGJGcSZKJiCjpSAU%2BmygPZMSqpJnTe%2B7KSh9xsoSHOprOzBix0t6MaVbtjtz9KKKCuctM9dPhP%2FvxeiELbhqoT0g4ratwObKjC%2BCc%2FxMLSZg%2FZU6vhp1SsiXsFN%2Br9xZhh9Mpv4CRQNMUFfSLaI8JyXMovYYdeMBp54NE8sWqn3xn%2Fb3e21icuXfabIvKPzBLfhSl2YSiqj7LRjHXNxMTXr1%2FUYnJJsKe0lzln4xRHYJ17HTr9HMqt2X%2BZnE39McyHbxUPNSJziK4Wtn%2Bn2tv39aCispyh2ZSysl8%2Bs9vkqu2XophgMD8V51PqNC3b6PLhy%2FhCO5BdfKPjGbH2easE%2FZc2QW5IYslILF%2FPGy8d5fvgMs1kCUzEHjSoP9QQrhY4Gu3p4h6%2FrGRnwGiG54NbMOsjyp8imgDqvTm%2FCBzElpGt%2B6If91r%2BfRQ4rRRmFOAS24h2IgZjKPuWzI7NTAQhg0SCaonHuMsjY1f41JZlIhLPvBuyZcgc1gYQ2NHjtTarFkurTz6GRMqOO31rysKopy4Z%2BD7ZikILhZrghBUNW5IBt9R7zcNFW3FyB59pYRCEz5TZRFpcCC8gTvg%2BUrwSetCoeFD%2F9h3Y8UhMTvsSA7xxQtIlzy6IxY%2BrefXzp%2Bz%2BUy8thdvmJlDw60VKFv0HKkOafHuJNehNwAwxdihsQY6sgFIESPRxmE9dhdNDixFYq%2FmIXExARtVa6WWr9EPg6jOeBOyXKAsN23REZTXPb8CoUtgl4Wev7zQ9etYvWeCwgTg2VDs5158dDbo13h6lhZZh2X9HWlPkwK%2FTdmYvi3qcSZbSLvebCfg5IPHIPhki7V%2BLTqEDG9W%2BN1FDlDC%2BmjhO8iZydtkhbzdaTVS9v3XLnco5QVltLIi10QN6zai3UroKG8be%2BNKeRqLra0sO1k%2Besrz&Expires=1713928548", "saveStateEnabled": false, "start": 0.0, "completionPercentage": 0.95, "transcriptAvailableTranslationsUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@d4663ade081640e88cb7714c5c026e69/handler/transcript/available_translations", "autoplay": false, "transcriptLanguages": {"en": "English"}, "autohideHtml5": false, "transcriptTranslationUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@d4663ade081640e88cb7714c5c026e69/handler/transcript/translation/__lang__", "ytMetadataEndpoint": "", "generalSpeed": 1.0, "lmsRootURL": "https://openlearninglibrary.mit.edu", "autoAdvance": false, "completionEnabled": false, "savedVideoPosition": 0.0, "saveStateUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@d4663ade081640e88cb7714c5c026e69/handler/xmodule_handler/save_user_state", "captionDataDir": null, "sources": ["https://d2f1egay8yehza.cloudfront.net/MITHST932017-V007900_DTH.mp4", "https://d2f1egay8yehza.cloudfront.net/MITHST932017-V007900/MITHST932017-V007900.m3u8"], "transcriptLanguage": "en", "recordedYoutubeIsAvailable": true, "prioritizeHls": false, "duration": 371.54}'
data-bumper-metadata='null'
data-autoadvance-enabled="False"
data-poster='null'
tabindex="-1"
>
<div class="focus_grabber first"></div>
<div class="tc-wrapper">
<div class="video-wrapper">
<span tabindex="0" class="spinner" aria-hidden="false" aria-label="Loading video player"></span>
<span tabindex="-1" class="btn-play fa fa-youtube-play fa-2x is-hidden" aria-hidden="true" aria-label="Play video"></span>
<div class="video-player-pre"></div>
<div class="video-player">
<div id="d4663ade081640e88cb7714c5c026e69"></div>
<h4 class="hd hd-4 video-error is-hidden">No playable video sources found.</h4>
<h4 class="hd hd-4 video-hls-error is-hidden">
Your browser does not support this video format. Try using a different browser.
</h4>
</div>
<div class="video-player-post"></div>
<div class="closed-captions"></div>
<div class="video-controls is-hidden">
<div>
<div class="vcr"><div class="vidtime">0:00 / 0:00</div></div>
<div class="secondary-controls"></div>
</div>
</div>
</div>
</div>
<div class="focus_grabber last"></div>
</div>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@121795fbfb0e433cabd1e3a34ba680d1">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@121795fbfb0e433cabd1e3a34ba680d1" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<h4>Clinical Decision Support</h4>
<p></p>
<p>Management of complex conditions can be assisted by the application of Clinical Decision Support systems (CDSS). These are usually based on rules that allow comparison of patient data and determine if certain the actions are required by clinicians. CDSS can warn of inappropriate treatment, inaccurate diagnoses, the potential for adverse drug reactions, or incompatible drug prescribing for example. Designing accurate and useful alerts and reminders in an EHR system is difficult and these notifications can be a source of clinician fatigue and distraction resulting high levels of overriding. Analysis of alert overrides typically show that high alert rejection rates are based on reasonable clinical judgement and often related to missing or inaccurate data, suggesting that there is a need to improve alert specificity and data quality. It is important to recognize that clinicians are trained to make clinical and medical treatment decisions, and therefore CDSS recommendations are considered supportive in nature with the clinician in charge. If less highly trained staff such as Community Healthcare Workers use CDSS the responsibility for accurate an safe advice should potentially fall more on the system developers and the health system.</p>
</div>
</div>
<div class="vert vert-2" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@125e01fd921b4b2ab930dcadeba9627a">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@125e01fd921b4b2ab930dcadeba9627a" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<h4>Standardization of coding and data use</h4>
<p>Standardization of data input maximizes the system capability of an EHR. A paper record on the other hand has limited capacity for structured systematic input, and retrieval of data depends entirely on a manual review of prior notes. These are typically unstructured, and consequently prone to error and misunderstanding although some paper notes make good use of structured forms. Standardized clinical codes that represent diagnoses and treatment decisions enhance the capability to share data amongst clinicians and specialists, and this key attribute reduces ambiguity and misunderstanding. Alignment to service delivery model is also improved through use of EHR technology and standardization.</p>
<p>Standard diagnostic and treatment codes are the cornerstone of information gathering, reporting and analysis. This is the core capability of an EHR in constructing a longitudinal patient record which illustrates trends and interrelationships that would be impossible or inefficient to recreate from a paper-based record. However accurate and specific coding of clinical data is a skilled and time consuming task. </p>
<p>Interoperability describes the capability to transmit patient data to other clinical sites for example an emergency room sending a discharge notice to a primary care physician for follow up, or a laboratory sending results back to the EHR. This is facilitated by standardized codes and structures, allowing the data to be integrated into the patient record in both locations and ensuring the meaning of data is equivalent in each site, a process described as, “semantic interoperability”. </p>
<p>With increasing EHR penetration, more clinical data has become available which is leading to an increase in calls for data by the research community and research funding agencies. Because of the standardization of data elements, EHR data can be more compatible with research protocols than paper based records. However a major concern is ensuring patient data is subjected to privacy and access constraints, irrespective of whether it is paper based or in an EHR. </p>
<p>A valuable capacity of EHRs is to generate follow up lists for patients with chronic illness. Physicians can set outcome targets for each patient as a useful tool for emotional, aspirational and motivational use. Care outcomes can be measured more effectively and quickly with EHR systems than on paper, and as payment models move from treatment activity to patient outcomes in the US and some other countries this will become increasingly important. </p>
<p>EHR systems can be used to improve a number of other non-clinical requirements for example the ability to identify use of resources and supplies and supply management. This can include medications, surgical supplies, food, energy, facilities etc. Clinical data in EHR systems has been shown also to improve drug requirement forecasting.</p>
</div>
</div>
<div class="vert vert-3" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@b72671e9400143c5b478b2cebcfd8bc5">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@b72671e9400143c5b478b2cebcfd8bc5" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_b72671e9400143c5b478b2cebcfd8bc5" class="problems-wrapper" role="group"
aria-labelledby="b72671e9400143c5b478b2cebcfd8bc5-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@b72671e9400143c5b478b2cebcfd8bc5" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@b72671e9400143c5b478b2cebcfd8bc5/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="1"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="b72671e9400143c5b478b2cebcfd8bc5-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@b72671e9400143c5b478b2cebcfd8bc5-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@b72671e9400143c5b478b2cebcfd8bc5-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><div class="choicegroup capa_inputtype" id="inputtype_b72671e9400143c5b478b2cebcfd8bc5_2_1">
<fieldset aria-describedby="status_b72671e9400143c5b478b2cebcfd8bc5_2_1">
<legend id="b72671e9400143c5b478b2cebcfd8bc5_2_1-legend" class="response-fieldset-legend field-group-hd">The goals of an EHR implementation are to improve the quality and convenience of care to:</legend>
<div class="field">
<input type="radio" name="input_b72671e9400143c5b478b2cebcfd8bc5_2_1" id="input_b72671e9400143c5b478b2cebcfd8bc5_2_1_choice_0" class="field-input input-radio" value="choice_0"/><label id="b72671e9400143c5b478b2cebcfd8bc5_2_1-choice_0-label" for="input_b72671e9400143c5b478b2cebcfd8bc5_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_b72671e9400143c5b478b2cebcfd8bc5_2_1"> Practitioners
</label>
</div>
<div class="field">
<input type="radio" name="input_b72671e9400143c5b478b2cebcfd8bc5_2_1" id="input_b72671e9400143c5b478b2cebcfd8bc5_2_1_choice_1" class="field-input input-radio" value="choice_1"/><label id="b72671e9400143c5b478b2cebcfd8bc5_2_1-choice_1-label" for="input_b72671e9400143c5b478b2cebcfd8bc5_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_b72671e9400143c5b478b2cebcfd8bc5_2_1"> Patients
</label>
</div>
<div class="field">
<input type="radio" name="input_b72671e9400143c5b478b2cebcfd8bc5_2_1" id="input_b72671e9400143c5b478b2cebcfd8bc5_2_1_choice_2" class="field-input input-radio" value="choice_2"/><label id="b72671e9400143c5b478b2cebcfd8bc5_2_1-choice_2-label" for="input_b72671e9400143c5b478b2cebcfd8bc5_2_1_choice_2" class="response-label field-label label-inline" aria-describedby="status_b72671e9400143c5b478b2cebcfd8bc5_2_1"> Both, practitioners and patients
</label>
</div>
<span id="answer_b72671e9400143c5b478b2cebcfd8bc5_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_b72671e9400143c5b478b2cebcfd8bc5_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_b72671e9400143c5b478b2cebcfd8bc5" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_b72671e9400143c5b478b2cebcfd8bc5">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="b72671e9400143c5b478b2cebcfd8bc5-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="b72671e9400143c5b478b2cebcfd8bc5-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="b72671e9400143c5b478b2cebcfd8bc5-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@a784d9cb0f8943eb99074de5d29dbfad" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Planning for EHR implementation</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@b5c58cf803b34e8e8d595f1a8909f55f">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@b5c58cf803b34e8e8d595f1a8909f55f" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<h4>Planning for EHR implementation</h4>
<p>One of the key tasks <i>prior</i> to making an implementation decision is to carefully plan for it. This is a detail oriented task and should be described in a way that illustrates the strategic and tactical benefits of the proposed implementation to the practice, clinic or hospital. Especially with a new EHR it is important to carry out a formative evaluation of the proposed implementation (which is undertaken before full implementation). This should include a, “reality check,” on what is involved, how well it if functioning and how it will improve care and administration. Generally speaking, there has been insufficient attention paid to pre-implementation planning for EMRs with few implementations including a formative evaluation or ensuring that lessons learned are incorporated in the implementation process.</p>
<p>Planning reviews, according to Coiera should include both design and evaluation, as follows: </p>
<ol><ol>
<li><b>Requirements analysis: </b>what problem is being addressed by what users in what context? Includes the roles of different users, use cases and success metrics.</li>
<li><b>Functional specification:</b> Convert contextual requirements into formal technical and functional specification documents often including user interface designs.</li>
<li><b>Architectural design</b>: develop an architectural design describing how system components interact with each other including hardware, software and organizational processes (which may be called Enterprise Architecture).</li>
<li><b>System build:</b> Selection of hardware and programming language and translation of architectural design into functional code to control the operation of each step in the system. </li>
<li><b>Unit test:</b> ensuring that each component is functioning as intended and works correctly with others and creating test cases. </li>
<li><b>System integration:</b> Different units that need to share data may need interfaces to be developed. These interfaces and their interactions need to be tested in an integrated manner.</li>
<li><b>Acceptance test:</b> After bench tests, a system needs to be field tested with users in a formal, documented evaluation.</li>
<li><b>User training:</b> training is an essential part of an implementation.</li>
<li><b>Outcome assessment:</b> Once implemented, systems should be evaluated against the success metrics– in a summative evaluation - to ensure that the original objectives are being met.</li>
</ol></ol>
<p>This planning process is complex and combines social, professional and technical needs, inputs and outputs. Consequently, planning for EHR implementation requires inputs and reviews from a wide variety of users. Recognizing their diverse and unique needs is challenging to do well. For example, the way a physician interacts with a system compared to how a patient interacts are very different, and complicated by their relative situation, (age, comfort with technology, technical training, urgency of need and so on). In LMICs this problem can be compounded by major differences in infrastructure, health systems, culture, disease burden, staff training and availability. </p>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@cc75d1a0e15047bd85133d46c36e437c">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@cc75d1a0e15047bd85133d46c36e437c" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_cc75d1a0e15047bd85133d46c36e437c" class="problems-wrapper" role="group"
aria-labelledby="cc75d1a0e15047bd85133d46c36e437c-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@cc75d1a0e15047bd85133d46c36e437c" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@cc75d1a0e15047bd85133d46c36e437c/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="1"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="cc75d1a0e15047bd85133d46c36e437c-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@cc75d1a0e15047bd85133d46c36e437c-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@cc75d1a0e15047bd85133d46c36e437c-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><p>True or False:</p>
<div class="choicegroup capa_inputtype" id="inputtype_cc75d1a0e15047bd85133d46c36e437c_2_1">
<fieldset aria-describedby="status_cc75d1a0e15047bd85133d46c36e437c_2_1">
<legend id="cc75d1a0e15047bd85133d46c36e437c_2_1-legend" class="response-fieldset-legend field-group-hd">"An EHR implementation is a straightforward process which can be easily done by physicians and nurses."</legend>
<div class="field">
<input type="radio" name="input_cc75d1a0e15047bd85133d46c36e437c_2_1" id="input_cc75d1a0e15047bd85133d46c36e437c_2_1_choice_0" class="field-input input-radio" value="choice_0"/><label id="cc75d1a0e15047bd85133d46c36e437c_2_1-choice_0-label" for="input_cc75d1a0e15047bd85133d46c36e437c_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_cc75d1a0e15047bd85133d46c36e437c_2_1"> True
</label>
</div>
<div class="field">
<input type="radio" name="input_cc75d1a0e15047bd85133d46c36e437c_2_1" id="input_cc75d1a0e15047bd85133d46c36e437c_2_1_choice_1" class="field-input input-radio" value="choice_1"/><label id="cc75d1a0e15047bd85133d46c36e437c_2_1-choice_1-label" for="input_cc75d1a0e15047bd85133d46c36e437c_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_cc75d1a0e15047bd85133d46c36e437c_2_1"> False
</label>
</div>
<span id="answer_cc75d1a0e15047bd85133d46c36e437c_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_cc75d1a0e15047bd85133d46c36e437c_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_cc75d1a0e15047bd85133d46c36e437c" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_cc75d1a0e15047bd85133d46c36e437c">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="cc75d1a0e15047bd85133d46c36e437c-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="cc75d1a0e15047bd85133d46c36e437c-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="cc75d1a0e15047bd85133d46c36e437c-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@df8fe4b1e4e2429a961153795fa333c9" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Benefits of EHR</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@video+block@f9f24d54fc6d4a84acddbe1aa2c93515">
<div class="xblock xblock-public_view xblock-public_view-video xmodule_display xmodule_VideoBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@video+block@f9f24d54fc6d4a84acddbe1aa2c93515" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="video" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Video"}
</script>
<h3 class="hd hd-2">Benefits of EHR</h3>
<div
id="video_f9f24d54fc6d4a84acddbe1aa2c93515"
class="video closed"
data-metadata='{"end": 0.0, "speed": null, "ytTestTimeout": 1500, "publishCompletionUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@f9f24d54fc6d4a84acddbe1aa2c93515/handler/publish_completion", "ytApiUrl": "https://www.youtube.com/iframe_api", "showCaptions": "true", "streams": "1.00:ObngmQvbcUU", "poster": "https://mitx-edx-video-meta-storage.s3.amazonaws.com/media/video-images/3e07b1d5d9c8426abdb1cf76fe14f724.jpeg?AWSAccessKeyId=ASIA4QDFFSURY244LBXR&Signature=ikU%2Bt0x1X0MBZAPAR4LRJqe0oWw%3D&x-amz-security-token=IQoJb3JpZ2luX2VjEDsaCXVzLWVhc3QtMSJGMEQCIGbnf733%2B4MkXKSyE2gsRlFFY7ttHVoGM287pEwaUEqVAiB6fN20%2F5Ol0FBi6LU1yv%2B9t%2FiCmpK0jruXDOyNd%2FrDxCrCBQiD%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAMaDDg1OTIwNTYzNzQxMSIMw%2B5dojZyNcM2sP1xKpYFGyyK3sGXcdtTUPAZnFQb7cJ%2BhXe345caNpEudZOWlfJu%2Fyq4A5qbjzl1GH0igmFMCeevuSi9HyVHbVsoUd86l6u3d0SuuIZBIO9XQqXYeFCj6nqaWGnOynbemhpH5lhikLsnoLeR8By6DdsOALRvBO6pQHE6VJS5710LjDdCM9mJ2yWWy2qqRX9NantLaH9RTarb9wMWMMhIgxzsGJGcSZKJiCjpSAU%2BmygPZMSqpJnTe%2B7KSh9xsoSHOprOzBix0t6MaVbtjtz9KKKCuctM9dPhP%2FvxeiELbhqoT0g4ratwObKjC%2BCc%2FxMLSZg%2FZU6vhp1SsiXsFN%2Br9xZhh9Mpv4CRQNMUFfSLaI8JyXMovYYdeMBp54NE8sWqn3xn%2Fb3e21icuXfabIvKPzBLfhSl2YSiqj7LRjHXNxMTXr1%2FUYnJJsKe0lzln4xRHYJ17HTr9HMqt2X%2BZnE39McyHbxUPNSJziK4Wtn%2Bn2tv39aCispyh2ZSysl8%2Bs9vkqu2XophgMD8V51PqNC3b6PLhy%2FhCO5BdfKPjGbH2easE%2FZc2QW5IYslILF%2FPGy8d5fvgMs1kCUzEHjSoP9QQrhY4Gu3p4h6%2FrGRnwGiG54NbMOsjyp8imgDqvTm%2FCBzElpGt%2B6If91r%2BfRQ4rRRmFOAS24h2IgZjKPuWzI7NTAQhg0SCaonHuMsjY1f41JZlIhLPvBuyZcgc1gYQ2NHjtTarFkurTz6GRMqOO31rysKopy4Z%2BD7ZikILhZrghBUNW5IBt9R7zcNFW3FyB59pYRCEz5TZRFpcCC8gTvg%2BUrwSetCoeFD%2F9h3Y8UhMTvsSA7xxQtIlzy6IxY%2BrefXzp%2Bz%2BUy8thdvmJlDw60VKFv0HKkOafHuJNehNwAwxdihsQY6sgFIESPRxmE9dhdNDixFYq%2FmIXExARtVa6WWr9EPg6jOeBOyXKAsN23REZTXPb8CoUtgl4Wev7zQ9etYvWeCwgTg2VDs5158dDbo13h6lhZZh2X9HWlPkwK%2FTdmYvi3qcSZbSLvebCfg5IPHIPhki7V%2BLTqEDG9W%2BN1FDlDC%2BmjhO8iZydtkhbzdaTVS9v3XLnco5QVltLIi10QN6zai3UroKG8be%2BNKeRqLra0sO1k%2Besrz&Expires=1713928548", "saveStateEnabled": false, "start": 0.0, "completionPercentage": 0.95, "transcriptAvailableTranslationsUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@f9f24d54fc6d4a84acddbe1aa2c93515/handler/transcript/available_translations", "autoplay": false, "transcriptLanguages": {"en": "English"}, "autohideHtml5": false, "transcriptTranslationUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@f9f24d54fc6d4a84acddbe1aa2c93515/handler/transcript/translation/__lang__", "ytMetadataEndpoint": "", "generalSpeed": 1.0, "lmsRootURL": "https://openlearninglibrary.mit.edu", "autoAdvance": false, "completionEnabled": false, "savedVideoPosition": 0.0, "saveStateUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@f9f24d54fc6d4a84acddbe1aa2c93515/handler/xmodule_handler/save_user_state", "captionDataDir": null, "sources": ["https://d2f1egay8yehza.cloudfront.net/MITHST932017-V010300_DTH.mp4", "https://d2f1egay8yehza.cloudfront.net/MITHST932017-V010300/MITHST932017-V010300.m3u8"], "transcriptLanguage": "en", "recordedYoutubeIsAvailable": true, "prioritizeHls": false, "duration": 543.59}'
data-bumper-metadata='null'
data-autoadvance-enabled="False"
data-poster='null'
tabindex="-1"
>
<div class="focus_grabber first"></div>
<div class="tc-wrapper">
<div class="video-wrapper">
<span tabindex="0" class="spinner" aria-hidden="false" aria-label="Loading video player"></span>
<span tabindex="-1" class="btn-play fa fa-youtube-play fa-2x is-hidden" aria-hidden="true" aria-label="Play video"></span>
<div class="video-player-pre"></div>
<div class="video-player">
<div id="f9f24d54fc6d4a84acddbe1aa2c93515"></div>
<h4 class="hd hd-4 video-error is-hidden">No playable video sources found.</h4>
<h4 class="hd hd-4 video-hls-error is-hidden">
Your browser does not support this video format. Try using a different browser.
</h4>
</div>
<div class="video-player-post"></div>
<div class="closed-captions"></div>
<div class="video-controls is-hidden">
<div>
<div class="vcr"><div class="vidtime">0:00 / 0:00</div></div>
<div class="secondary-controls"></div>
</div>
</div>
</div>
</div>
<div class="focus_grabber last"></div>
</div>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@615c243c9f794e0285869c30b55a32e0">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@615c243c9f794e0285869c30b55a32e0" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_615c243c9f794e0285869c30b55a32e0" class="problems-wrapper" role="group"
aria-labelledby="615c243c9f794e0285869c30b55a32e0-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@615c243c9f794e0285869c30b55a32e0" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@615c243c9f794e0285869c30b55a32e0/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="1"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="615c243c9f794e0285869c30b55a32e0-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@615c243c9f794e0285869c30b55a32e0-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@615c243c9f794e0285869c30b55a32e0-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><div class="choicegroup capa_inputtype" id="inputtype_615c243c9f794e0285869c30b55a32e0_2_1">
<fieldset aria-describedby="status_615c243c9f794e0285869c30b55a32e0_2_1 description_615c243c9f794e0285869c30b55a32e0_1_1">
<legend id="615c243c9f794e0285869c30b55a32e0_2_1-legend" class="response-fieldset-legend field-group-hd">From the following statements below, what are some possible benefits of an EHR?</legend>
<p class="question-description" id="description_615c243c9f794e0285869c30b55a32e0_1_1"> Select all that apply:</p>
<div class="field">
<input type="checkbox" name="input_615c243c9f794e0285869c30b55a32e0_2_1[]" id="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_0" class="field-input input-checkbox" value="choice_0"/><label id="615c243c9f794e0285869c30b55a32e0_2_1-choice_0-label" for="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_615c243c9f794e0285869c30b55a32e0_2_1 description_615c243c9f794e0285869c30b55a32e0_1_1"> Decrease transcription cost
</label>
</div>
<div class="field">
<input type="checkbox" name="input_615c243c9f794e0285869c30b55a32e0_2_1[]" id="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_1" class="field-input input-checkbox" value="choice_1"/><label id="615c243c9f794e0285869c30b55a32e0_2_1-choice_1-label" for="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_615c243c9f794e0285869c30b55a32e0_2_1 description_615c243c9f794e0285869c30b55a32e0_1_1"> Decrease medication adverse events
</label>
</div>
<div class="field">
<input type="checkbox" name="input_615c243c9f794e0285869c30b55a32e0_2_1[]" id="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_2" class="field-input input-checkbox" value="choice_2"/><label id="615c243c9f794e0285869c30b55a32e0_2_1-choice_2-label" for="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_2" class="response-label field-label label-inline" aria-describedby="status_615c243c9f794e0285869c30b55a32e0_2_1 description_615c243c9f794e0285869c30b55a32e0_1_1"> Improve quality of information
</label>
</div>
<div class="field">
<input type="checkbox" name="input_615c243c9f794e0285869c30b55a32e0_2_1[]" id="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_3" class="field-input input-checkbox" value="choice_3"/><label id="615c243c9f794e0285869c30b55a32e0_2_1-choice_3-label" for="input_615c243c9f794e0285869c30b55a32e0_2_1_choice_3" class="response-label field-label label-inline" aria-describedby="status_615c243c9f794e0285869c30b55a32e0_2_1 description_615c243c9f794e0285869c30b55a32e0_1_1"> Improve the care of chronic conditions (eg: HIV, cancer and etc)
</label>
</div>
<span id="answer_615c243c9f794e0285869c30b55a32e0_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_615c243c9f794e0285869c30b55a32e0_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_615c243c9f794e0285869c30b55a32e0" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_615c243c9f794e0285869c30b55a32e0">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="615c243c9f794e0285869c30b55a32e0-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="615c243c9f794e0285869c30b55a32e0-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="615c243c9f794e0285869c30b55a32e0-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
<div class="xblock xblock-public_view xblock-public_view-vertical" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@vertical+block@db82c9eaf4934eab84de04e9e1ab01a5" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="vertical" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="VerticalStudentView">
<h2 class="hd hd-2 unit-title">Consequences of EHR implementation and Perspectives</h2>
<div class="vert-mod">
<div class="vert vert-0" data-id="block-v1:MITx+HST.936x+1T2019+type@video+block@5a629cd3125e40a2a3c10504c05b9aaf">
<div class="xblock xblock-public_view xblock-public_view-video xmodule_display xmodule_VideoBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@video+block@5a629cd3125e40a2a3c10504c05b9aaf" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="video" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Video"}
</script>
<h3 class="hd hd-2">Consequences of EHR implementation and Perspectives</h3>
<div
id="video_5a629cd3125e40a2a3c10504c05b9aaf"
class="video closed"
data-metadata='{"end": 0.0, "speed": null, "ytTestTimeout": 1500, "publishCompletionUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@5a629cd3125e40a2a3c10504c05b9aaf/handler/publish_completion", "ytApiUrl": "https://www.youtube.com/iframe_api", "showCaptions": "true", "streams": "1.00:_qTUFscXSZU", "poster": "https://mitx-edx-video-meta-storage.s3.amazonaws.com/media/video-images/3b5cfb25c40f46259a4c1d4127a664d9.jpeg?AWSAccessKeyId=ASIA4QDFFSURY244LBXR&Signature=emcZ2z8ndwCFazKRIi%2F2B9Lz2dk%3D&x-amz-security-token=IQoJb3JpZ2luX2VjEDsaCXVzLWVhc3QtMSJGMEQCIGbnf733%2B4MkXKSyE2gsRlFFY7ttHVoGM287pEwaUEqVAiB6fN20%2F5Ol0FBi6LU1yv%2B9t%2FiCmpK0jruXDOyNd%2FrDxCrCBQiD%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAMaDDg1OTIwNTYzNzQxMSIMw%2B5dojZyNcM2sP1xKpYFGyyK3sGXcdtTUPAZnFQb7cJ%2BhXe345caNpEudZOWlfJu%2Fyq4A5qbjzl1GH0igmFMCeevuSi9HyVHbVsoUd86l6u3d0SuuIZBIO9XQqXYeFCj6nqaWGnOynbemhpH5lhikLsnoLeR8By6DdsOALRvBO6pQHE6VJS5710LjDdCM9mJ2yWWy2qqRX9NantLaH9RTarb9wMWMMhIgxzsGJGcSZKJiCjpSAU%2BmygPZMSqpJnTe%2B7KSh9xsoSHOprOzBix0t6MaVbtjtz9KKKCuctM9dPhP%2FvxeiELbhqoT0g4ratwObKjC%2BCc%2FxMLSZg%2FZU6vhp1SsiXsFN%2Br9xZhh9Mpv4CRQNMUFfSLaI8JyXMovYYdeMBp54NE8sWqn3xn%2Fb3e21icuXfabIvKPzBLfhSl2YSiqj7LRjHXNxMTXr1%2FUYnJJsKe0lzln4xRHYJ17HTr9HMqt2X%2BZnE39McyHbxUPNSJziK4Wtn%2Bn2tv39aCispyh2ZSysl8%2Bs9vkqu2XophgMD8V51PqNC3b6PLhy%2FhCO5BdfKPjGbH2easE%2FZc2QW5IYslILF%2FPGy8d5fvgMs1kCUzEHjSoP9QQrhY4Gu3p4h6%2FrGRnwGiG54NbMOsjyp8imgDqvTm%2FCBzElpGt%2B6If91r%2BfRQ4rRRmFOAS24h2IgZjKPuWzI7NTAQhg0SCaonHuMsjY1f41JZlIhLPvBuyZcgc1gYQ2NHjtTarFkurTz6GRMqOO31rysKopy4Z%2BD7ZikILhZrghBUNW5IBt9R7zcNFW3FyB59pYRCEz5TZRFpcCC8gTvg%2BUrwSetCoeFD%2F9h3Y8UhMTvsSA7xxQtIlzy6IxY%2BrefXzp%2Bz%2BUy8thdvmJlDw60VKFv0HKkOafHuJNehNwAwxdihsQY6sgFIESPRxmE9dhdNDixFYq%2FmIXExARtVa6WWr9EPg6jOeBOyXKAsN23REZTXPb8CoUtgl4Wev7zQ9etYvWeCwgTg2VDs5158dDbo13h6lhZZh2X9HWlPkwK%2FTdmYvi3qcSZbSLvebCfg5IPHIPhki7V%2BLTqEDG9W%2BN1FDlDC%2BmjhO8iZydtkhbzdaTVS9v3XLnco5QVltLIi10QN6zai3UroKG8be%2BNKeRqLra0sO1k%2Besrz&Expires=1713928549", "saveStateEnabled": false, "start": 0.0, "completionPercentage": 0.95, "transcriptAvailableTranslationsUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@5a629cd3125e40a2a3c10504c05b9aaf/handler/transcript/available_translations", "autoplay": false, "transcriptLanguages": {"en": "English"}, "autohideHtml5": false, "transcriptTranslationUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@5a629cd3125e40a2a3c10504c05b9aaf/handler/transcript/translation/__lang__", "ytMetadataEndpoint": "", "generalSpeed": 1.0, "lmsRootURL": "https://openlearninglibrary.mit.edu", "autoAdvance": false, "completionEnabled": false, "savedVideoPosition": 0.0, "saveStateUrl": "/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@video+block@5a629cd3125e40a2a3c10504c05b9aaf/handler/xmodule_handler/save_user_state", "captionDataDir": null, "sources": ["https://d2f1egay8yehza.cloudfront.net/MITHST932017-V007800_DTH.mp4", "https://d2f1egay8yehza.cloudfront.net/MITHST932017-V007800/MITHST932017-V007800.m3u8"], "transcriptLanguage": "en", "recordedYoutubeIsAvailable": true, "prioritizeHls": false, "duration": 533.21}'
data-bumper-metadata='null'
data-autoadvance-enabled="False"
data-poster='null'
tabindex="-1"
>
<div class="focus_grabber first"></div>
<div class="tc-wrapper">
<div class="video-wrapper">
<span tabindex="0" class="spinner" aria-hidden="false" aria-label="Loading video player"></span>
<span tabindex="-1" class="btn-play fa fa-youtube-play fa-2x is-hidden" aria-hidden="true" aria-label="Play video"></span>
<div class="video-player-pre"></div>
<div class="video-player">
<div id="5a629cd3125e40a2a3c10504c05b9aaf"></div>
<h4 class="hd hd-4 video-error is-hidden">No playable video sources found.</h4>
<h4 class="hd hd-4 video-hls-error is-hidden">
Your browser does not support this video format. Try using a different browser.
</h4>
</div>
<div class="video-player-post"></div>
<div class="closed-captions"></div>
<div class="video-controls is-hidden">
<div>
<div class="vcr"><div class="vidtime">0:00 / 0:00</div></div>
<div class="secondary-controls"></div>
</div>
</div>
</div>
</div>
<div class="focus_grabber last"></div>
</div>
<div class="xblock-license">
<a rel="license" href="https://creativecommons.org/licenses/by-nc-nd/4.0/" rel="noopener" target="_blank">
<span class="sr">Creative Commons licensed content, with terms as follow: </span><span aria-hidden="true" class="icon-cc"></span>
<span class="sr">Attribution </span><span aria-hidden="true" class="icon-cc-by"></span>
<span class="sr">Noncommercial </span><span aria-hidden="true" class="icon-cc-nc"></span>
<span class="sr">No Derivatives </span><span aria-hidden="true" class="icon-cc-nd"></span>
<span class="license-text">Some Rights Reserved</span>
</a>
</div>
</div>
</div>
<div class="vert vert-1" data-id="block-v1:MITx+HST.936x+1T2019+type@html+block@4c702d29b2d94680a76708b0300bf6cb">
<div class="xblock xblock-public_view xblock-public_view-html xmodule_display xmodule_HtmlBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@html+block@4c702d29b2d94680a76708b0300bf6cb" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="html" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="False" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "HTMLModule"}
</script>
<h4>EHR Choices and Constraints</h4>
<p>Making good choices in EHR selection is critical to the ultimate success of an EHR implementation project. It is also important to recognize that implementation requires a significant human resource commitment in design, implementation and training. There is a strong argument in favor of well-structured evaluations undertaken before choosing a system. Only 35% of US physicians in a 2013 survey indicated satisfaction with their EHR, implying that 65% were dissatisfied and contemplated changing their EHR vendor. This would suggest that they did not undertake a good formative evaluation before implementing their system. This survey also indicated that 17% would definitely change systems, which would imply a significant additional and unnecessary cost in financial and human resources. </p>
<p>Once implemented an EHR tends to lead initially to a loss of physician productivity, partly due to the structured application of the system which is often disruptive to workflow. In addition some patients have reported that they feel that they are not part of the process any longer so the choice of system needs to also consider workflow integration. Failure to rapidly deliver appropriate and accurate data to the clinician at the point of care affects the clinician’s work practice. A 2012 study of Nurses in Turkey indicated that a high proportion of nurses felt that “EHR systems were not well integrated into their workflow.” It is likely that in the longer term the ability to find key data in longitudinal EHR records and to improve diagnosis, patient tracking and laboratory data management will lead to productivity gains, but these are harder to measure than the immediate extra workload for clinicians of data entry. In addition, some well-designed applications reduce clinician workload, such as a system for collecting vital signs data in hospitals in Oxford, UK which reduced nursing time for this activity by 20%. There is also evidence that more effective patient registration and labelling of laboratory samples in Malawi can save clinician time and lab resources. </p>
<p>Lack of system support and upgrades are often a source of concern to physicians and health systems. If a vendor goes out of business, or is acquired by another business, that can lead to a significant change in that vendor’s business relationship, often affecting system upgrades, customization and so on. Vendors and their systems should be included in evaluations. Use of EHRs based on Open Source software can reduce the risks from vendors failing, dropping support for a product or increasing prices, a particular concern in LMICs that typically lack resources to pay for replacement systems.</p>
<p></p>
</div>
</div>
<div class="vert vert-2" data-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@82d694eb4ec8427f853fda9c0edd9c17">
<div class="xblock xblock-public_view xblock-public_view-problem xmodule_display xmodule_ProblemBlock" data-usage-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@82d694eb4ec8427f853fda9c0edd9c17" data-graded="True" data-runtime-class="LmsRuntime" data-course-id="course-v1:MITx+HST.936x+1T2019" data-block-type="problem" data-request-token="3f10095401e811ef8f9e026cc65ec0d9" data-has-score="True" data-runtime-version="1" data-init="XBlockToXModuleShim">
<script type="json/xblock-args" class="xblock-json-init-args">
{"xmodule-type": "Problem"}
</script>
<div id="problem_82d694eb4ec8427f853fda9c0edd9c17" class="problems-wrapper" role="group"
aria-labelledby="82d694eb4ec8427f853fda9c0edd9c17-problem-title"
data-problem-id="block-v1:MITx+HST.936x+1T2019+type@problem+block@82d694eb4ec8427f853fda9c0edd9c17" data-url="/courses/course-v1:MITx+HST.936x+1T2019/xblock/block-v1:MITx+HST.936x+1T2019+type@problem+block@82d694eb4ec8427f853fda9c0edd9c17/handler/xmodule_handler"
data-problem-score="0"
data-problem-total-possible="1"
data-attempts-used="0"
data-content="
<h3 class="hd hd-3 problem-header" id="82d694eb4ec8427f853fda9c0edd9c17-problem-title" aria-describedby="block-v1:MITx+HST.936x+1T2019+type@problem+block@82d694eb4ec8427f853fda9c0edd9c17-problem-progress" tabindex="-1">
Unit Exercise
</h3>
<div class="problem-progress" id="block-v1:MITx+HST.936x+1T2019+type@problem+block@82d694eb4ec8427f853fda9c0edd9c17-problem-progress"></div>
<div class="problem">
<div>
<div class="wrapper-problem-response" tabindex="-1" aria-label="Question 1" role="group"><p>True or False:</p>
<div class="choicegroup capa_inputtype" id="inputtype_82d694eb4ec8427f853fda9c0edd9c17_2_1">
<fieldset aria-describedby="status_82d694eb4ec8427f853fda9c0edd9c17_2_1">
<legend id="82d694eb4ec8427f853fda9c0edd9c17_2_1-legend" class="response-fieldset-legend field-group-hd">"Unintended consequences from the implementation of Electronic Health Records are easily avoided."</legend>
<div class="field">
<input type="radio" name="input_82d694eb4ec8427f853fda9c0edd9c17_2_1" id="input_82d694eb4ec8427f853fda9c0edd9c17_2_1_choice_0" class="field-input input-radio" value="choice_0"/><label id="82d694eb4ec8427f853fda9c0edd9c17_2_1-choice_0-label" for="input_82d694eb4ec8427f853fda9c0edd9c17_2_1_choice_0" class="response-label field-label label-inline" aria-describedby="status_82d694eb4ec8427f853fda9c0edd9c17_2_1"> True
</label>
</div>
<div class="field">
<input type="radio" name="input_82d694eb4ec8427f853fda9c0edd9c17_2_1" id="input_82d694eb4ec8427f853fda9c0edd9c17_2_1_choice_1" class="field-input input-radio" value="choice_1"/><label id="82d694eb4ec8427f853fda9c0edd9c17_2_1-choice_1-label" for="input_82d694eb4ec8427f853fda9c0edd9c17_2_1_choice_1" class="response-label field-label label-inline" aria-describedby="status_82d694eb4ec8427f853fda9c0edd9c17_2_1"> False
</label>
</div>
<span id="answer_82d694eb4ec8427f853fda9c0edd9c17_2_1"/>
</fieldset>
<div class="indicator-container">
<span class="status unanswered" id="status_82d694eb4ec8427f853fda9c0edd9c17_2_1" data-tooltip="Not yet answered.">
<span class="sr">unanswered</span><span class="status-icon" aria-hidden="true"/>
</span>
</div>
</div></div>
</div>
<div class="action">
<input type="hidden" name="problem_id" value="Unit Exercise" />
<div class="submit-attempt-container">
<button type="button" class="submit btn-brand" data-submitting="Submitting" data-value="Submit" data-should-enable-submit-button="True" aria-describedby="submission_feedback_82d694eb4ec8427f853fda9c0edd9c17" >
<span class="submit-label">Submit</span>
</button>
<div class="submission-feedback" id="submission_feedback_82d694eb4ec8427f853fda9c0edd9c17">
<span class="sr">Some problems have options such as save, reset, hints, or show answer. These options follow the Submit button.</span>
</div>
</div>
<div class="problem-action-buttons-wrapper">
</div>
</div>
<div class="notification warning notification-gentle-alert
is-hidden"
tabindex="-1">
<span class="icon fa fa-exclamation-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="82d694eb4ec8427f853fda9c0edd9c17-problem-title">
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification warning notification-save
is-hidden"
tabindex="-1">
<span class="icon fa fa-save" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="82d694eb4ec8427f853fda9c0edd9c17-problem-title">None
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
<div class="notification general notification-show-answer
is-hidden"
tabindex="-1">
<span class="icon fa fa-info-circle" aria-hidden="true"></span>
<span class="notification-message" aria-describedby="82d694eb4ec8427f853fda9c0edd9c17-problem-title">Answers are displayed within the problem
</span>
<div class="notification-btn-wrapper">
<button type="button" class="btn btn-default btn-small notification-btn review-btn sr">Review</button>
</div>
</div>
</div>
"
data-graded="True">
<p class="loading-spinner">
<i class="fa fa-spinner fa-pulse fa-2x fa-fw"></i>
<span class="sr">Loading…</span>
</p>
</div>
</div>
</div>
</div>
</div>
© All Rights Reserved