ELECTRONIC RECORD

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ERA Vision
The electronic records challenge is formidable, but as an agency, NARA is committed to addressing this challenge head on. NARA's vision is to create a system that will authentically preserve and provide access to any kind of electronic record, free from dependency on any specific hardware or software, enabling NARA to carry out its mission into the future.

Vivid Description

1.We will be a leader in innovation in electronic records archiving.
In coordination with our Federal partners, we will develop policy and technical guidance to enable responsible electronic records creation and management.
2.With help from our research partners, we will develop and maintain the technical capability to capture, preserve, describe, access and appropriately dispose of any Government electronic record.
3.We will manage a coherent, nationwide, and sustainable system for permanent archival electronic records of the Federal Government.
4.We will develop the capability to manage Federal agency electronic records within the NARA records center system.
5.We will ensure that anyone, at anytime, from any place, has access to the best tools to find and use the records we preserve.
6.Our staff will be capable and consistent users of the electronic tools at every point of the life cycle.
7.We will sustain widespread support from all our stakeholders and customers by listening to their needs, meeting their requirements, and seeking their feedback.

The Electronic Records Challenge
More and more we communicate by computer. That means our records--records of critical importance to every one of us--such as e-mail messages and word-processing documents are increasingly electronic.
In the Federal Government, electronic records are as indispensable as their paper predecessors to document citizens' rights, the actions for which officials are accountable, and the nation's history. Effective democracy depends on access to such records.
Electronic records, however, pose a critical challenge to NARA. In order to fulfill its mandate to provide ready access to essential evidence to the citizens and the Government of the United States, NARA must address and solve the dilemma of preserving and accessing electronic records that are complex by nature, diverse in format and exponentially increasing in volume. The rate of technological obsolescence is such that records created and accessed even two years ago may now be unreadable. Unless this challenge is confronted and surmounted, there will be no National Archives for the digital era.

Archives of the Future
Unlike our College Park building, the archives of the future need not be confined to a geographic location. Digital technology makes possible an archives that is truly national in scope, one that enables people everywhere to gain access to archival holdings through connections to the Internet. But in other ways, ERA will be functionally equivalent to a traditional physical building.
Electronic records collections may be accessible in different locations, but ERA must provide a place to which they can be transmitted by records creators. It must include workspaces where NARA staff can examine records and establish control over them. It must provide reliable technology for storing the records over long periods of time. It must make access to records readily available to users. And it must enable us to preserve records threatened by technological obsolescence and media fragility.
Also like our College Park building, our ERA will require substantial resources, careful and thorough planning, and sustained commitment on the part of management and staff. Doubtless we will encounter challenges in the creation of ERA and shortcomings in the structure we now conceive for it. But ERA will provide opportunities for doing things we have never done before, and for doing things better than ever.

ERA Status
Much remains to be done before the vision of ERA becomes a reality. The necessary projects and tasks fall in two large categories: designing the structure and building it. ERA design activities involve researching and addressing fundamental questions in computer science, engineering, and archival theory; elaborating the archival business model that should be implemented in an ERA system; further articulating the information management architecture that needs to be put into place; and determining the specific system components. ERA has established key research partnerships to facilitate the process. These activities will determine how the system will be built. Actual building will start with final acceptance of a comprehensive design along with a plan for developing, implementing, operating, and maintaining NARA's ERA application

Information Lifecycle

Information Lifecycle

All information has a lifecycle. Information is created, captured in some form, stored and ultimately destroyed or preserved indefinitely. In Federal agencies much of the information should be identified as a Federal record; because it documents government activities or because of the value of the data it contains. Information that is identified as a Federal record is usually placed under records management control, which follows a similar lifecycle: it is identified as a record, captured as a record, stored as a record, and either destroyed or preserved.

Typical RM Program Activities

An effective records management program is the foundation on which an agency can begin automating records management activities or implementing systems to manage electronic records. Some of the major activities of a typical records management program are described in the following. In conjunction with agency Records Management Officers, these activities are performed on an ongoing basis in order to establish and maintain an effective records management program.

IDENTIFY RECORDS AND RECORDS SOURCES

Distinguish records from non-records and uniquely identify the records found. Determine how, how many, and by whom records are being created or received and identify their relationship to the agency's business operations or functions.

DEVELOP FILE PLAN

Specify how records are to be organized once they have been created or received. Identify the classes of records (record series) that an organization produces, and establish how to associate given records within a class to other records in that same class. For example, put all the travel vouchers in a file marked "travel vouchers" or, alternatively, put all travel vouchers for person X in a file marked "person X travel."
DEVELOP RECORDS SCHEDULES

Determine where and how long records need to be retained and what their final disposition will be. Records typically go through a period of active use at the time of, and shortly after, their creation. As records are used less frequently, they become inactive and are often transferred to less expensive storage media or locations. All Federal records must be assigned a final disposition, which must be approved by NARA (44 USC 3303). Records schedules call for the disposition of records based on time, or event, or a combination of time and event. Records are either scheduled for destruction or for transfer to the National Archives for permanent preservation. Determining how long records need to be retained - and under what conditions - can dramatically reduce agency resource outlays and at the same time ensure that agencies are maintaining adequate and proper documentation of agency activities.

PROVIDE RECORDS MANAGEMENT GUIDANCE

Develop and distribute agency-specific policies and procedures for implementing records management activities, including for records created or maintained by contractors for the Federal government. Establish agency-specific recordkeeping practices, specifically establishing what records need to be created in order to conduct agency business. Identify parties within the agency with records management responsibilities, such as records officers or liaisons.

Typical Functions for Managing Records

The management and control of Federal records involves a number of actions taken with respect to individual records or series of records to ensure their authenticity, integrity and reliability, and to preserve their usability over time.

This list of functions may serve as a guide or checklist in defining requirements or specifications for an ERK or ERM system, or in seeking to improve an existing system, to assure that major functional requirements have been addressed.

DECLARE A RECORD: Recognize a record to be a record, identify it as as a record.
CAPTURE RECORDS: Include a record in a system that manages records.
MAINTENANCE AND USE OF RECORDS
ORGANIZE RECORDS: Group records according to a predefined structure to meet business needs.
MAINTAIN RECORDS SECURITY: Protect the integrity of records against unauthorized alteration or destruction.
MANAGE RECORDS ACCESS: Grant or limit the ability of individual(s) to examine records or record groupings.
FACILITATE RECORDS RETRIEVAL: Provide or enable the ability to collect records relevant to a query.
PRESERVE RECORDS: Ensure the physical state of records so they remain usable.
AUDIT/OVERSIGHT: Ensure compliance of agency recordkeeping practices with existing statutes and internal and external regulations

FINAL DISPOSITION OF RECORDS
DESTRUCTION: Eliminate from a system a group of records in compliance with the appropriate records retention schedule so that they cannot be accessed, retrieved or recovered.
TRANSFER: Change legal custody of agency records.

Archives

What's an Archives

An archives is a place where people can go to gather firsthand facts, data, and evidence from letters, reports, notes, memos, photographs, and other primary sources.
The National Archives is the U.S. Government’s collection of documents that records important events in American history. The National Archives and Records Administration (NARA) is the Government agency that preserves and maintains these materials and makes them available for research.
Whether or not you realize it, you probably have an archives in your home. It might be in a filing cabinet in your study, a box in the basement, a chest in the attic. It is your personal archives: a collection of material that records important events from your family’s history.
Both a family’s archives and the nation’s archives
save items to serve as proof that an event occurred;
explain how something happened, whether for personal, financial, or sentimental reasons;
may be located in more than one place.

Personal Archives Versus Federal Archives

Every day Government agencies create new records that might be transferred to the National Archives. NARA’s holdings are created either by or for the Federal Government. The material comes from the legislative, executive, and judicial branches. Whereas your family’s archives is personal, those held by the National Archives are official. Your family’s archives might include your birth certificate. The National Archives holds the original, signed “birth certificate” for our nation—the Declaration of Independence. For more information, visit What's a Record?Your family’s archives are available only to your and family members. The holdings in the National Archives are available to almost everyone.

About Our Nation's Records
More than 95 percent of the records in the National Archives are declassified, meaning they are available to all researchers. NARA employs approximately 3,000 full- and part-time employees to help facilitate the use of its holdings. Many of the records in the National Archives are available on microfilm, and more than 124,000 digital images of documents can be seen through NARA’s Archival Research Catalog (ARC).
Some of the oldest materials in the National Archives are on parchment and date back to the founding of the United States of America. These include the records of the Continental and Confederation Congresses. Some of the more recent holdings include electronic files transferred from the Department of State and are available online through Access to Archival Databases (AAD).

Preservation of Records

To help preserve material, NARA stores archives records in acid-free folders within acid-free boxes that are placed in dark spaces with consistent temperature and humidity.
For many years Federal records were created on paper and stored in files and boxes. These days electronic records are created by government agencies at an astounding rate. To meet this challenge, the National Archives is finding news ways to manage and preserve electronic materials. Learn more about our Electronic Records Archives initiative.

Digital Storage & Archiving

Digital Storage & Archiving
Record Preservation & Management can provide you with a full range of digital recordmanagement services from converting paper documents to electronic format to providing online access to your files.With our web-based data management systems, you can search, select, view, print or email any document you want, anytime you want -- all at the click of a mouse.You can also track the exact location, movement and status of your information, even generate reports and manage your account.You control the information you need, when you need it, all via the Internet from your home or office computer. Here is how the process works:

Conversion
o We arrange for your hardcopy documents to be picked up and delivered to a secure facility.o The documents are prepped (i.e., they are sorted, any staples, clasps or folders are removed, and torn documents are repaired).o Documents are then individually scanned and converted to PDF format, with each digital image double-checked for clarity. As your documents finish scanning, our staff re-assembles them intheir original order, with staples, clasps, and folders in place.o Next, the digital images are indexed (coded) and assigned keywords to facilitate searching.Then your entire data repository is audited for accuracy, and any data entry errors corrected.o Finally, your data is uploaded to our secure servers.

Document Management
Once your files are uploaded, you are basically ready to go.o One of our representatives will help you install document management software on your computer and show you how to use it. It's quick and it's easy. The software applications wework with have been chosen for both an advanced degree of technology and for their user-friendly features.o With this easy-to-use software, you are able to search, access, and view your complete digital archive.o Using your password, protected log-in, and an elaborate choice of permissions that can be assigned to each document, you can then access your account, and:Request specific documents, or search for groups of documents,View, print, fax or email documents online,Generate reports and printouts itemizing or summarizing the records in your digital archive, including history and traffic reports.

CREATION OF AN ELECTRONIC HEALTH RECORD

CREATION OF AN ELECTRONIC HEALTH RECORD

Strategic planning in development of EMR

Strategic planning in development of EMR

Step 1: set up strategy

In providing planning for automated system or using computer system in organization, its must for management department in organization provide basic infrastructure for working project in 5 to 10 years.
Management department must support to the staff that responsibility for planning, develop, providing budgeting training and maintenances system feasibility. For planning automated its must have strategic planning.

Step 2: human resource planning

Using automated system bring changes from manual system to computer system. For makes sure this system effective, all staff must together work in management this system and prepare for received any changes and want to learning computer system.
A group of staff must have training for given responsibility from organization in planning and maintenance of computer project in organization. The staff should make a research and refer to reading material about system for taken of knowledge about the latest technology. We can do observation and questionnaire for identify all system that develop by all agency in the world.

Step 3: identify objective of automated organization

The objective that have been identify are:
1. For providing effective registry services for creator agency. Users can find file that they want through online services and this method is easy for access file from registry without take along time in find of file.
2. For easy identify working of active record, semi active and non-active record through database system. From that it can make easy to organization in making retention schedule.
3. For easy processing of record in registry room organization. From that receiving of data about record can be done fast and effective.

Step 4: identify needed of automation

Planning for automated activities we must identify latest needed and future in record management field. One group of working system must be built up for identify and research information system needed that we do in record management in feasibility the system. The below system should be consider:
1. Processing and registration also document classification that we received and we send out.
2. Maintenance index database file in registry
3. File processing in registry through arrangement from base on file series, distributing, and received back of active file, registration of active file, semi active and non active for providing purpose and feasibility of record retention schedule.

Step 5: financial planning

For feasibility of computer record management, one agency or organization must prepare for budget their money for starting a system and maintenance also update a system for 10 years using. Computer system must be checking time by time for effective system and change with new hardware if the computer system is broken.

Step 6: choosing of computer system

This criteria should be consider when we are choosing a system:
1. Hardware system can do a feasibility of record activities in organization through online between registry with main organization.
2. Hardware system can do accession activities, arrangement, description and access information in organization
3. Equipment can do all registry function in organization
4. Organization can pay their budget for maintenance system and improvement of system

Step 7: providing places

Computer system must have environment planning as air-condition room, telecommunication infrastructure, centralize electric system, security control for data and information in system and also security control from fire or robber on equipment.


Step 8: development system and feasibility

Feasibility of system can be done followed:
1. New system must be clearly
2. Automated system must be work together with old system
3. Testing new system on specialize function for see the effectiveness
4, Feasibility the system step by step or follow the function

Step 9: user education

User and staff registry in organization must have training or teaching about computer system before automated system can be done.


Step 10: future strategic planning

Every organization must identify a future strategy about using computer in organization. Its because infrastructure and equipment facility can be update suitable with needed and organization needed.

Electronic Medical Record

The Importance of an EMR

Making the transition to an electronic medical record is one of the most intelligent business decisions that a practice can make. Determining whether an electronic medical record makes sense in a medical office is not strictly a numbers game - it's a matter of patient care. It is a function not only of finance, but also of the quality of services provided, such as reduction in medical errors and patient education.
To choose the EMR that is best for your practice, consider the following:
Know what you need the system to do. Don't pay for the bells and whistles that your practice will never actually use but also look for systems that will expand to meet your needs.
Carefully review the technical support and clinical updates the vendor provides. Your vendor should be able to provide training and staff support for your system. If they can't, find another vendor who can.
Check that the vendor has experience working with your specialty or similar practice size as well as how existing sites feel about their experience with that vendor.
Your EMR should interface with your practice management software. Be sure to consider what new hardware and equipment interfaces you will need to buy and negotiate the service agreements in advance of purchasing the program. Networking, wiring and hubs will all need to be purchased if implementing a network for the first time.

The Advantages of an EMR
Traditional paper medical records have many drawbacks: they can be incomplete, torn, worn, misplaced, or lost. They also require a lot of storage space in addition to requiring extensive administrative time from your staff. Many physicians maintain this system, because the alternative would be to adopt an electronic format, which many physicians are either uncomfortable or unfamiliar with. However, there are many advantages to utilizing an electronic medical record (EMR) for your practice including:
· Increased access/efficiency: On average, 30% of patient charts are not available during a patient visit, according to a Gartner Group research study. With EMRs, patient information is immediately accessible, which can save every doctor using an EMR around an hour per week that would have been spent waiting for charts to be delivered. That's 52 hours a year waiting for charts instead of seeing patients!
· Security: EMRs can be configured to restrict access to only portions of the medical record or have multiple levels for office personnel that are restricted based on job function. Many EMRs have audit trails that identify anyone who has accessed or added to the record. Be sure the EMR you choose has this feature!
· Improved Documentation: Test and lab results, EKGs and X-rays can all be entered automatically into an EMR, reducing the risk of data entry errors and missing the information altogether. Health maintenance prompts alert physicians and office staff to missing or required patient information that has not been completed. EMRs also remove the problem of illegibility of patient notes since the information will be stored electronically.
· Quality of Care: EMRs can provide decision support at the point of care, which has been shown to reduce adverse antibiotic reactions by 85%. EMRs can also be used to track patient follow-up activity, patient compliance, and patient progress.
· Increased Resources: Once an office successfully converts to an EMR, the space typically used for paper records can be utilized for additional exam rooms, patient education areas or increased office space. Office staff time will no longer be utilized hunting down records and filing: multi-user access will allow staff to update patient records immediately.


Strategic planning in development of EMR

In planning for develop automated system its must for person who responsibility in working storage area in organization. Manager that responsibility in this area must know about technology system or information technology in develop automated system. It is to make sure automated system more effective in organization.

The characteristic of information technology given effectiveness for planning and feasibility automated system in organization:
1. Improvement of computer technology bring us to high storage system in organization and computer processing also the improvement of access information in organization.
2. International system in information management combined together local management.
3. Cost of hardware and equipment and maintenance is to high cost. Every new system in development system must have professional staff.

Electronic Medical Records", (EMR

EMR
Usually in this column, you read about how something in the world of computers works or how to use some new gadget to simplify your work. This time I describe a different scenario; namely, what can happen when physicians let someone else make the decisions regarding access to the information stored in computer files.
Physicians want nothing less than full, immediate access to everything that is available so they can use it to give their patients the best care. But a disturbing trend is developing that may do much to block this goal. Many factions are intent on keeping medical information from the hands of those who need it most.

Centralized storage systems
Private enterprise has long recognized that centralized gathering, storage, and retrieval of information is unwieldy and becoming more so all the time. Members of budgeting, marketing, and personnel departments need to find accurate, updated, ready-to-use information quickly. With the advent of the personal computer and use of such tools as spreadsheets and database software, managers can quickly obtain and review the services they provide. This immediacy allows businesses to adapt to a rapidly changing environment.
Unfortunately, the healthcare industry has been slow to catch on to this new reality. Most hospitals and many large institutions have computer systems that are rooted in the mainframe technology of the 1970s. In many cases, finance-based (ie, scheduling and billing) information is the sole source of data for the entire enterprise. In general, this means that information is stored at another site, and getting at it requires a request that a report be run. Some basic clinical information (eg, patient demographics, numbers of specific diagnoses and procedures) may be obtained in this way. But too often, data are limited, slow in coming, and inaccurate. Reports may be available on paper only, in which case desired information must be transferred manually to a personal computer for further analysis.
Often, healthcare institutions use central storage of information because it allows central control of who can use it. Unfortunately, this may translate into impaired access to information by the very healthcare personnel who need it and could put it to the best use. It seems that at some institutions, policy decisions regarding patient data have been based not on patients' welfare but rather on the perceived need to "protect" the stored information.
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What happens to a patient who must see a colleague rather than his or her regular primary care provider and a test is ordered at that visit? At a follow-up visit, the regular physician cannot access the test result. What about an emergency situation, when all information is critical to the patient's care? What about nurses gathering information on a patient who is coming in for an office visit? What about patients who want access to records so they can better understand their care? What about psychiatric records, which have traditionally been held separate from the rest of the medical record? What about sensitive test results (HIV, GC)? What about access by insurance companies and employers?