Ambulatory Care and its Health Records

Tahirah Khabir

Ambulatory care is medical care that is offered on an outpatient base

this could be services such as diagnosis, observation, treatment, or
rehabilitation services. Ambulatory care provides care to patients who do not
need to be admitted to a hospital for treatment purposes. This type of care is
also referred to as outpatient care. Patients choose the outpatient care
rather than being admitted in a hospital for treatment. Many patients believe
that the services are faster, easier, and cheaper in price. Various hospitals
provide ambulatory care in their emergency rooms, urgent care clinics, and
doctor's offices.

Hospital do not rely on a single system it has a group of systems in

various departments that are linked together. The ambulatory EMR or the
AMR provides a means to share overall medical records that contains, a
patient problem list, medication list, allergy list, radiology images and data,
laboratory data, and a patient care plans. The main goal of the AMR is to
improve record accuracy and completeness.
What is an ambulatory medical record or AMR, it is files that are stored
electronically about individual patients particularly outpatient medical
records. These typically includes all outpatient surgeries and care that did
not contain being admitted to a hospital. The format of the AMR system data
determines its convenience, electronic data can take one of three forms:
digital images, text files or discrete data. All three data forms are merged
into an AMR system in different ways. Discrete data offer the greatest

flexibility and usability of any data formats. Codified data is discrete data
that uses codes to represent medical concepts. Discrete data can be
instantly searched, retrieved, combined, and reported in a variety of ways.
Text files are searchable, but searches have a tendency to take a long time
and generate a high volume of low relevancy results. Digital image data is
retrieved and displayed by a computer. Diagnostic images includes X-rays,
CAT scans, and marked drawings. Scanned documents are paper forms, old
paper records, and dictated notes. In order for digital image data to have
meaning understanding of how it works is needed by a health personnel.
Document image data requires a human being to read the information.
An AMR is said to be somewhat comparable to an electronic medical
record or EMR. The main difference is that the EMR house inpatient care
information. Over the past decade, electronic health records have become
widely adopted. Professional organizations, the government, and social
forces all contribute to EHR and AMR adoption. AMR systems offer distinct
workflow advantages over paper records. Point-of-care documentation is
critical to the success of AMR.
There are various vendors who offer an ambulatory AMR system there
is Citrix, EpicCare, Healthland Ambulatory, and Athena to name a few. So
exactly what do an AMR system do, when an authorized user inputs patient
information into the AMR it automatically transfers to other documentation
portals. This system becomes very helpful to the healthcare organization,
because it reduces data entry and minimize possible errors. Instantly other

authorized users have access to patient information. The AMR is the

provider to provider communication connection system. The Ambulatory
AMR has security controls built in that will limit access only to authorized
users. These systems will also enforce restrictions on the information and
features available to different users or groups. These are called the audit
control. The audit trail lets personnel know who created, accessed, or
updated patient information at any given time. Another good aspect of the
AMR system is that each and every order is electronically signed off either by
a physician, nurse practitioner, physician assistant, or even pharmacist.
Pharmacist has the ability to send electronic prescription to the
patients pharmacy of choice. Ambulatory AMRs need to be capable of
electronic prescribing to outside pharmacies in order to have the full
efficiency. Pharmacist can also send patient information to prescription third
party administrators even healthcare providers, if needed and only with the
patients authorization or consent.
The AMR applications are equipped with a work list that displays
scheduled procedures and appointments that are activate. This sort of
application is useful to prevent double booking, double ordering or possible
abuse of the healthcare system by patients. This is also a good way to watch
for glitches in the system. Other features of the AMR system consist of a full
patient medication history list, it has a built-in fax option, the system
supports mail-order prescription services, alerts to incoming renewal
requests, and it has a medication tracking option. The AMR gives providers

their own preference options. They can set it to receive alerts from other
departments about the results on test ordered, they can get phone calls from
the patient or patient family members, new referral alerts, incoming
prescription renewal alerts, and immunizations that are due alerts. Overall
AMR systems are used to assist physicians with patient care, it makes a job
less stressful with all the added tools and bonuses.
A few articles I found interesting were Electronic Health Records in
Ambulatory Care A National Survey of Physicians and Ambulatory
Electronic Medical Record and Shared Access 2009. Both articles
discuss the great importance of an AMR system and how it successfully aids
physicians when they are in the field. The AMR is a much needed database
that should have been implemented many years ago.
http://www.nejm.org/doi/full/10.1056/NEJMsa0802005#t=article
Electronic Health Records in Ambulatory Care A National Survey
of Physicians
Catherine M. DesRoches, Dr.P.H., Eric G. Campbell, Ph.D., Sowmya R. Rao,
Ph.D., Karen Donelan, Sc.D., Timothy G. Ferris, M.D., M.P.H., Ashish Jha, M.D.,
M.P.H., Rainu Kaushal, M.D., M.P.H., Douglas E. Levy, Ph.D., Sara Rosenbaum,
J.D., Alexandra E. Shields, Ph.D., and David Blumenthal, M.D., M.P.P.
N Engl J Med 2008; 359:50-60July 3, 2008DOI: 10.1056/NEJMsa0802005
https://healthit.ahrq.gov/ahrq-funded-projects/ambulatory-electronicmedical-record-and-shared-access/annual-summary/2009
Ambulatory Electronic Medical Record and Shared Access - 2009

Project Name: Ambulatory Electronic Medical Record and Shared Access

Principal Investigator: DeLuca, Michael, M.B.A., M.S.
Organization: Sarah Bush Lincoln Health Center
Limited Competition for AHRQ Transforming Health Care Quality through
Information Technology (THQIT)

Work cited