ISCAP Proceedings: Abstract Presentation
Finding a Cure for the Educational Electronic Health Records System Problem
Matt Campbell
University of South Alabama
Amy Campbell
University of South Alabama
Abstract
Nascent Healthcare Information Systems programs (or Health Informatics - HI) struggle with many pressing issues. One of the most important among them is identifying appropriate instructional materials and clinical software that allow the students to experience the types of systems they will support and design once they enter the workforce. While there are several commercially available Electronic Health Record (EHR) Systems on the market, there are drawbacks to using them for classroom instruction. The primary drawback is the cost of licensing and providing technical support to students. Our requirements for educational EHR software include:
1. Being reasonably priced;
2. Introduces students to basic EHR features (e.g., Practice management and Clinical Information systems and report generation) as well as advanced features (e.g., clinical decision support and Health Information Exchanges);
3. Allows students and faculty administrators access to support the system (including setting up accounts, designing reports, troubleshooting errors, and exchanging data);
4. Minimal labor-intensive support of complex client/server software for faculty;
5. Allow technical students (computing) and non-technical (nursing or allied health) backgrounds to participate effectively in assignments.
The sourcing options included:
1. Obtaining software from a local vendor for free or at a reduced price and hosting it ourselves.
2. Paying for access to EHR software hosted by large commercial vendors.
3. Adopting a textbook that includes an education-focused EHR and associated assignments.
4. Having the students build their own EHR system that they then supported themselves.
Our evaluation of options 1 and 2 observed a “Goldielocks” effect where option 1, while cheapest, resulted in a labor-intensive responsibility on faculty to support both the client software installed on student’s machines as well as the server and back-end software, and option 2, which provided the most realistic clinical experience and the best user and technical support, was prohibitively expensive (~$5000/month for a 10-seat sandbox). Although option 3 has an EHR designed specifically for students, at the time of our evaluation, we identified only one educational EHR product on the market for HI students and there were concerns related to minimal administrative access.
Evaluation of option 4, having students build their own EHR system and supporting it, was found to be the most optimal solution as it met all stated requirements. MS Access and MySQL Server are available to our students for free, allowing students to build their database systems at no additional cost. This flexibility also allowed the instructor to include assignments on any desired functionality and gave both students and faculty administrative access to the system. While faculty must support students in troubleshooting errors and in creating a connection to the MySQL-based Health Information Exchange, this process was much easier than supporting complex specialized client/server software and gave the student accountability in their creation. Lastly, because faculty provide the basic programming code it allowed students with more advanced technical backgrounds to customize it while still providing basic understanding for those with a non-technical background.
Keywords: Electronic Health Records System, Health Informatics Education