Electronic Health Record Implementation: A Review of Resources and Tools.

Implementing an electronic health record (EHR) can be a difficult task to take on and planning the process is of utmost importance to minimize errors. Evaluating the selection criteria and implementation plan of an EHR system, intending interoperability, confidentiality, availability, and integrity of the patient health information data, while ensuring timely, accurate, and regulatory compliant generation of reports is a critical task. This article discusses the selection and implementation plan that will primarily consist of assessing existing institutional workflows for each department, and it outlines the necessities and inclinations of the institution to include in the EHR system for the organization to function properly. Resources and tools are included to assist in the selection of the product as well as ideas on how to train staff and evaluate staff readiness. Regulatory requirements are also included for consideration during the initial process. EHR increases the logistic productivity of workflows and offers a safer way to care for patients. To ensure efficiency, there is a series of steps the provider's staff must follow to ensure proper implementation and handling of the EHR system. Before using the implemented EHR, it is recommended to have a testing protocol in place to ensure areas of possible staff confusion are identified and controlled. Using a proper implementation strategy for a new EHR system can facilitate success, minimize delays, and increase health care worker's satisfaction and decrease the chances of usability being compromised.

Influence of Acute Antipsychotic Treatment on Cardiorespiratory Coupling and Heart Rate Variability.

A major contributing factor associated with increased cardiac mortality in patients with schizophrenia (SCZ) seems to be a dysfunction of the autonomic nervous system (ANS). The link between ANS dysfunction and SCZ is multifactorial, but some reports suggest that the use of antipsychotics could be implicated. This case illustrates the time course of autonomic improvement in response to antipsychotic treatment in an inpatient with SCZ in acute psychosis. To this end, we documented markers of autonomic function during hospitalization. Heart rate variability (HRV; cardiac autonomic modulation) analysis showed an increased variability over time (from Day 1 to Day 3), with strongest reaction at Day 3. The respiration analysis showed an increased respiratory variability over time (from Day 1 to Day 3) suggesting improved autonomic modulation in response to the pharmacotherapy. Cardiorespiratory coupling (CRC; surrogate of cardiorespiratory synchrony and cardiovagal modulation) showed an increasing influence of heart rate on respiration and increased from Day 1 to Day 3. The concurrent improvement of psychosis and autonomic function in response to antipsychotic treatment in this patient suggest a potential cardio protective role of antipsychotics in the acute setting. Prospective trials aimed at examining the cardiovascular implications of acute psychosis treatment in patients with schizophrenia are warranted.