Information System in HealthCare: The Enterprise Medical Record

Johns Hopkins Hospital medical facility is a teaching hospital and biomedical research center of the Johns Hopkins University School of Medicine. The facility is located on Wolfe Street, Baltimore, Maryland, in the US. The institution is widely regarded as one of the best hospitals in the world and has been ranked as the best overall hospital in the US for the past two decades. Being a research hospital, JHH has been at the forefront in coming up with innovative medical procedures (Johns Hopkins Medicine, 2011). Johns Hopkins Hospital was established in 1889 and has been a pioneer of medical procedures in several fields such as neurosurgery, urology, pediatrics, heart surgery, and so on.

The hospital is built on an 8-acre piece of land and is privately owned and managed by the Johns Hopkins Medicine, which also manages other educational and healthcare institutions established under the Johns Hopkins name such as the Johns Hopkins Bayview Medical Center, Johns Hopkins Children’s Center, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and the Johns Hopkins University School of Medicine (Johns Hopkins Medicine, 2011). It is a 918-bed general medical and surgical facility and admits close to 50,000 patients annually. It serves all population segments through its specialized departments that include Children’s Health, Gynecology and Obstetrics, and Pediatrics.

JHH offers a number of both simple and complex medicare and surgical procedures through it several divisions. These divisions include children’s health, pathology, endocrinology and diabetes, gynecology, cancer, cardiac surgery, ear, nose and throat, eyes, hematology, liver tumors, plastic and reconstructive surgery, and so on. It also offers psychological services through its Level I Trauma center that provides the highest level of surgical care to trauma patients (Johns Hopkins Medicine, 2011). JHH is also is a center for research and teaching hospital.

Johns Hopkins Hospital has received numerous accreditations since it was established in 1889. Some of these include the accreditation for its stroke rehabilitation program from the Commission on Accreditation of Rehabilitation Facilities (CARF), accreditation for quality and efficiency of health care delivery by the Utilization Review Accreditation Commission (URAC), and accreditation for provision of the safest, highest quality, best-value health care across all settings by the Joint Commission.

Users of the Health Information

Johns Hopkins Hospital comprises several divisions each handling specific medical conditions. It also consists of several departments that handle different aspects of patient care. All of these departments and divisions require constant access of patient records and health information in order to improve healthcare delivery. As a result, the heads of these departments all have full access to health information. They include Dr. Myron Weisfeldt, Dr. William Guggino, Prof. Gabor Kelen, Dr. Janyne Althaus, Mr. James James Schulen, Jeffrey B. Palmer, Dr. Jonathan Lewis, and Dr. Raymond DePaulo. There are a total of 73 physicians who have much higher information needs than the rest of the staff, hence their full access to patient records. Administrators also have full access as they use the information for planning and other administrative functions. Following them are nurses whose records access is limited to their departments or divisions. Support services and external users have limited access as deemed by the facility’s management.

How Information is Accessed

Johns Hopkins Hospital has been gradually shifting from paper records to electronics records, also known as electronic health records (EHR). These staff has been trained on electronic record systems as the hospital hopes to make a complete switch to EHR in the next four or five years. Currently, Johns Hopkins Hospital uses both paper and electronic records. Paper records are accessed from the facility’s main records office located within the administration block. The office forms a record center where patient records are kept in chronological order. Electronic patient records are accessed through computer systems such as the Enterprise Medical Record.

To access electronic records, a user must connect a computer unit to the local intranet and input the appropriate login details. The system determines the level of access allowed for the user.

Information Systems

One of the information systems used at Johns Hopkins Hospital is the Enterprise Medical Record (EMR), designed by Medical Information Technology, Inc. (Meditech), a leading software vendor in the healthcare informatics business based in Texas. EMR, as its name suggests, is software that keeps patient records for access by various stakeholders. Basically, EMR functions both as an electronic health record system and a primary computerized physician order entry (CPOE) system. It is a decision-support tool.

The EMR software represents a single platform for viewing real-time patient information captured across the continuum of care in the institution and throughout a patient’s lifetime visit to the facility. With EMR, physicians can view real-time data for visits made in any division or department within Johns Hopkins Hospital. The software organizes patient data using pictorial analytic systems such as graphs, flowsheets, and lifetime result views. The system receives regular medical alerts for new and irregular results for patients throughout the continuum of care and correspondingly updates the patient records.

EMR interfaces with other compatible healthcare information system (HCIS), and is fully compatible with all Meditech HCIS systems. The connection can be used to combine data obtained from several divisions into a common platform and this enables a comprehensive view of patient health information in one place.

Ease of Use

The EMR system is not user-friendly. The main menu consists of numerous commands and features and a person who is not well acquainted with the system is bound to have problems using it.


The EMR is a very secure system as it incorporates several security features. It protects the security and confidentiality of patient records by establishing roles-based access and restrictions, for instance, access to information can be prevented based on patient and/or location. Besides, private patient and VIP flags may be used to limit users from accessing information on patients located in confidential areas of whose status has been assigned as private or confidential. User access can also be restricted to specific nursing units or patients assigned to a particular physician (Meditech, 2009).

Upgrade Support

Meditech provides regular upgrades and new module releases that sometimes require that the whole system be redesigned. EMR is bundled together with other Meditech systems of which MEDITECH 6.0 is the most recent release. Due to the complex upgrade procedures, Meditech provides skilled personnel to integrate new systems, workflows, and modules into the previous system. The company also offers training on the upgrade procedure and use of the new system soon after every release.

Strengths of EMR

One of the strengths of EMR is its ability to provide a summary of the patient’s current medical information, as well as a summary of his/her comprehensive visit history (Meditech, 2009). This has improved care provision as physicians are able to have an extensive picture of a person’s medical history regarding illnesses, diagnoses, admissions, pharmacy information, substance use, current and ongoing problems, medication history, and all aspects pertaining to healthcare. It is very useful in decision-making processes.

The security features incorporated on the EMR presents an additional benefit to the system. Medical records require a high level of security and confidentiality, as described above, the system has been designed to ensure that sensitive patient information does not fall into wrong hands (Meditech, 2009).


A weakness of the EMR is that the system is not user friendly. A user must be a trained thoroughly and must have a hands-on training before he/she can optimize the use of EMR. Navigating through the system is also a weakness. With a packed up user interface, it becomes difficult to move from the main menu to smaller menus that handle specific tasks. Consequently, the system needs to have a user-friendly interface. Fortunately, the latest release of the system has had a greatly simplified user interface and can be navigated more easily than its predecessors and once Johns Hopkins Hospital upgrades its system from the current MEDITECH 5.6 with the latest version, these weaknesses will be a thing of the past.

Before installation of the EMR system, experts from Meditech train the company employees on all system functionalities. Later, they install the system with the help of company staff and undertake regular maintenance services. They also carry out routine upgrade and repair processes.


The Enterprise Medical Record (EMR) is a very important element of Johns Hopkins Hospital as it helps physicians in making day-to-day decisions regarding patient care. The strength of the system lies in its ability to present real-time patient information collected from various departments and divisions of the health facility throughout a patient’s lifetime visit. Hence, physicians are able to make medical decisions based on a full patient report. However, the system has weaknesses in ease of use and navigation between menus especially in earlier releases. Fortunately, the latest release of the software is devoid of these problems. Mediates should hasten the upgrade process so that mentioned hurdles can be eliminated.


Johns Hopkins Medicine. (2011). Welcome to the Johns Hopkins Hospital. Web.

Meditech. (2009). Enterprise Medical Record: Functionality Brief. Web.

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