Paper-Based Versus Electronic Medical Record Keeping Essay Example for Free

Paper-Based Versus Electronic Medical Record Keeping Essay For many years, physicians’ offices documented all data in paper-based medical charts. Now, the physician or clinician records the medical data into a computer. Information stored in this manner is known as an electronic-based medical record or EMR. By definition, an EMR is a computerized record of the important health information regarding a patient including the care of that individual and the progress of that patient’s condition (Bonewit-West, Hunt, Applegate, 2009). The use of computers in physicians’ offices is not new. For decades, physicians have used computers and practice management software primarily to schedule appointments and for billing. The government has offered physicians incentives designed to encourage the adoption of electronic medical records to promote medical information accessibility, better patient care, greater efficiency, and financial savings (Hamilton, 2010). In the face of advancing technology, small medical offices must compare the cost, ease of use, and maintenance of electronic medical record systems versus paper-based record keeping. The cost of keeping paper-based and electronic medical records is not just about the actual price tag of the record-keeping systems. The cost of keeping an electronic medical record system (EMR) begins with the initial purchase and implementation of the hardware and EMR software. There are also ongoing maintenance expenses, loss of revenue associated with temporary loss of productivity due to converting paper charts to electronic ones, and the training of the staff (Menachemi Collum, 2011). The way these record systems are stored is very different and can greatly affect the cost as well. EMR records are stored on a server, digitally, in a secure computer database within the office practice (Hamilton, 2010). On the other hand, the cost of keeping a paper-based medical record requires certain supplies. File folders, folder labels, chart dividers, paper, and writing instruments are needed. Shelves are commonly used to hold and organize the charts for ease of accessibility by the staff. A growing medical practice may often require many shelving units that take up valuable office space. Storage boxes are required to store outdated charts or charts no longer in use (Bonewit-West et al., 2009). If there is not enough space in the office, then physicians may often have to pay for off-site storage (Hamilton, 2010).  The process of using a paper-based medical record system is relatively easy. However, there are some factors to consider. To use a paper chart, the medical staff must locate and retrieve it, make sure the appropriate documents accompany the chart, and have it ready for the physician. The physician or the medical staff must allocate enough time to accurately document the chart for each patient. Any chart, whether it is paper or electronic, needs to be comprehensible, so clear writing is imperative when recording using a paper chart (Bonewit-West et al., 2009). Meanwhile, using an EMR system requires the use of a computer. This can be a desktop model, laptop, or a tablet type device. The patient records are kept digitally within the EMR system and are accessed via the computer. This type of record-keeping system does not require the addition of paper documents. Al l paper documents are scanned into the EMR system or electronically obtained from other pertinent sources. Once paper documents are scanned into the EMR system, they become part of the patient’s permanent record and are no longer needed. This process requires EMR training of the medical staff, which is normally performed by the vendor supplying the EMR software. The physician and the medical staff must learn how to operate the new system and acclimate to the new paperless charting method. Learning an EMR program and using it with ease can take several months or more (Bonewit-West et al., 2009). The ease of use with both of these systems differs in the fact that paper-based records need to be filed properly in order to locate them when needed. Filing can be very time-consuming and paper-based records can be easily lost or destroyed. Even though electronic records are stored digitally on a server within the medical office, the medical staff will still need to enter the patient data into the EMR system. Electronic records need to be backed up daily because they can be lost due to fail ure of the hardware (Hamilton, 2010). Regular maintenance is required for both paper-based and electronic record keeping. The maintenance differs greatly between the systems and is ongoing regardless of which system is being used in the medical office. The routine maintenance of an electronic medical record system requires hiring network professionals to monitor and maintain the network. Some examples of maintenance tasks may include performing data backup once every twenty-four hours, storing a database backup offsite, and  archiving backup media once every month. There is also maintenance on the hardware and software. Hardware must be replaced and software will have to be upgraded regularly. A product specialist may need to run utilities for different applications within the EMR system. There will be ongoing training for all users of the electronic medical records system (Menachemi Collum, 2011). In contrast to electronic medical records, maintenance of paper charts require that they are examined periodically to make sure the chart remains in good condition since these charts will become worn over time. The charting of each patient should be complete, legible, and performed in a timely fashion. Paper charts that are outdated, that are deemed inactive or charts of patients who expired will have to be placed in boxes and put into storage (Hamilton, 2010). There are vast differences between paper-based and electronic medical record-keeping systems. One system is entirely manual while the other requires manual data entry combined with computerization. For decades, physicians and staff of medical practices have used only the manual or paper-based method of keeping medical records. Change can be costly and frustrating, but with the advancement of technology, coupled with the government requiring the use of EMR, small medical offices must explore the cost, ease of use, and maintenance involved in making this important change in the way of keeping medical records. References Bonewit-West, K., Hunt, S. A., Applegate, E. J. (2009). The medical record. In Todays Medical Assistant: Clinical Administrative Procedures. St. Louis, Mo: Saunders/Elsevier. Hamilton, B. (2010). Electronic health records (2nd ed.). New York, NY: McGraw-Hill Higher Education. Menachemi, N., Collum, T. (2011). Benefits and drawbacks of EHRs. Risk Management and Healthcare Policy, 4, 47-55. Retrieved from doi:10.2147/RMHP.S12985.

Fashion in the Elizabethan and Jacobean era

Fashion in the Elizabethan and Jacobean era Similarities and differences between Elizabethan and Jacobean Era fashion. The Elizabethan and Jacobean Era fashion had a lot of similarities along with many differences. They both had a unique way of fashion whereby fashion to them brought great and better organize and proper foundation. The Elizabeth era were more into the v shape clothing whereby the clothes were more to fit the shape and body structure. While during the Jacobean era more of the â€Å"U† shaped clothing was worn. The Jacobean Era came up to be so enticed by ruffs, where clothing made from shiny, smooth silk satins and play of light on these fine fabrics. But the French or wheel farthingale from the Elizabethan Era had be replaced with a softer mode of kilting the gown skirts. The open jacket and gown shaped like the letter â€Å"U† were now being worn over the abdomen. They both on the other hand, used clothing as a way to distinguish and set standards, differential their time and build a society of more civilized and great power. The Elizabethan Era was into being quite elegant and classy .It was just another fashion conscious era, in which the way to show their personality and individuality was through their way of style and fashion. They were more known on fashion ideas and the way people found self-expression through it. In the beginning of the Elizabethan Era, women dressed casual and formal and The Elizabethan Era simply refers to a period, which was under the reign of Queen Elizabeth. The Elizabethan Era is also known as the Golden Age in History. This was the time when one saw the great new formation of English literature. It was also a brief period, which saw some amount of internal peace between the English Reformation and the clashes between other communities. Clothing in the Elizabethan Era also saw an influence of geometric shapes. They took time and effort in showing of the natural shape and structure of their individual bodies. They decorated their body with fine materials that was quite great in amount, size and quality. They did this so to perceive an impression of a small waist. And this was not only shown in women but men as well, where they also wanted really thin body so to show their masculinity. One would also need to note that the Elizabethan Era was one such period, which saw a proper division of class. With it, fashion was a way to distinguish great class and status. The Sumptuary Laws were passed that stated the kind of clothing one would have to wear. Fashion also saw many changes and in the beginning of the Elizabethan Era, one can notice that the Elizabethan clothing was styled to cover every part of a womans body. Elizabethan clothing was also characterized by the kind of class one belonged to. People who belonged to the lower strata of society wore clothing made from materials like wool, sheepskin and even linen. People who belonged to this category were not allowed to wear materials in silk or even have velvet trimmings. Mens clothing in the Elizabethan Era also witnessed quite a few changes. Men wore ‘jerkins which were shirts with buttons down in the front. Men who belonged to the upper class also wore fine silk hats with a single feather. Shoes were always made of fine quality leather. Long, flowing cloaks and tall hats were also added to the kind of clothing worn in the Elizabethan Era. These laws were passed by Queen Elizabeth and were also known as Statutes of Apparel. It was basically done to clearly demarcate the social structure existing in the Elizabethan Era. The Queen herself and only her relations were allowed to wear clothing that used gold or gold tissue as an embellishment. In the Jacobean Era, as the ruff grew in size and ornamentation, the rest of the clothing became more simple and elegant but if one was to look carefully, one will notice clothing made from shiny, smooth silk satins and painters who reveled in the play of light on these fine fabrics. The drape of these glorious textiles was emphasized by the arrangement of the fabric over the hips. Another style exists about the same time. Open-front jackets or gowns reveal brightly colored brocade stomachers shaped in a low U over the abdomen. The style is best portrayed in Rubens Portrait of himself, where his first wife, Isabella Brant. Most of the portraits of women drawn of the Jacobean Era, they featured women wearing the ornate stomachers, whish are usually in only bit of color in an outfit of the rest of which is shockingly black. This stomachers seems to be the Dutchwomans outlet for panache. The bodice is still quite structured, varying from a shockingly low necking to a high collar, but the gown skirts or petticoats have become softer and no longer appear to be worn with a farthingale. The ornate decoration of the Elizabethan period also seems to be subsiding. It is being replaced by the sumptuous silks and minimal trim that so clearly mark the Stuart fashions to come The Fashion in the Elizabethan Era and Jacobean Era both gave way to a new era o fashion and clothing. They brought out some of the ideas in which are still present in todays dressing. It is quite obvious that they centered on fashion and many other things, but with it they brought great changes to the world as a whole. The changes and influence they had and still have on the world is quite enormous. The doors they open for us and the eyes they widened are those that let us all to build our own way and new way of STYLE.

17th Century Seduction Poems Are Relevant In The 21st Century Essay exa

During the 17th century, certain poets wrote poems with the specific purpose of persuading a woman to have sexual intercourse with them. Three of these seduction poems utilize several strategies to do this: Andrew Marvell’s â€Å"To His Coy Mistress,† and Donne’s â€Å"A Valediction: Forbidden Mourning† and â€Å"The Flea.† Some of the reasoning used by both poets is similar to the reasoning used today by men to convince women to have sexual intercourse with them. These gimmicks vary from poem to poem but coincide with modern day rationalization. The tactics used in 17th century seduction poems are relevant and similar to the seduction tactics used in the 21st century. Through his writing, Andrew Marvell uses several strategies to get a woman to sleep with him. In his seduction poem, â€Å"To His Coy Mistress,† Marvell first presents a problem and then offers his solution to the problem. Marvell sets up a situation in which he and his lover are on opposite sides of the world: â€Å"Thou by the Indian Ganges’ side/ Shouldst rubies find; I by the tide/ Of Humber would complain†¦.† (5-7). He has set up a circumstance in which his lover is in India and he is in England; however, this situation can be interpreted as a metaphor for sexual distance. Marvell then goes on to profess his love for this woman, telling her that he will always love her, saying â€Å"...I would/ Love you ten years before the flood† (7-8) and saying that his â€Å"vegetable love should grow/ Vaster than empires and more slow† (11). This suggests that he is promising permanence in their relationship. In doing so, Marvell is also trying to pac ify his lady’s fears of sexual relations. He wants his lover to feel secure and confident about having intercourse with him. In the second stanza, Marvell turns his attention to another â€Å"problem† that his lover might pose by not sleeping with him. He writes, â€Å"But at my back I always hear/ Times winged chariot hurrying near† (21-22). Marvell is concerned about death in this situation. He is now pleading to his woman because he feels threatened by time. He tells her that time is running out and that they had better sleep together before it is too late. Marvell solidifies this argument a few lines later by presenting the idea of death and the fact that they can not have sexual intercourse once they are dead. He writes, â€Å"The grave’s a fine and private place/ But none, I think, do there embra... ...l love, like Marvell in â€Å"His Coy Mistress,† is still used to get women in bed. It makes them feel secure in a relationship, which in turn makes them more likely to have sex with their partner. Building up the relationship, like Donne in â€Å"A Valediction: forbidden Mourning,† will also make a woman feel secure in a relationship in modern times by establishing dependability; it also romanticizes the relationship. If a woman feels she is being swept off her feet by Prince Charming, she will be more likely to get in bed. Allaying a woman’s fears will also convince her to consent to sex, much like in Donne’s first stanza of â€Å"The Flea.† He reassures his woman that sex is not a big deal. These days sex really has become quite inconsequential and men do not have difficulty pointing that out to a woman they are trying to sleep with. Generally, many of the basic ideas expressed in 17th century poetry are similar to those presented today in re lationships. Making excuses, finding arguments, allaying fears, and professing true love are all still utilized to speed along the occurrence of sexual relations.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  

The Rime of the Ancient Mariner Essay -- Papers

The Rime of the Ancient Mariner The Rime of the Ancient Mariner, as a product of its culturally inscribed author, presents a confused Unitarian world view consistent with that of the Romantic Movement of its time. It attempts to exemplify this view within an unpredictable and often mysterious universe, and by rebuking the hegemonic ideologies held by the text’s cultural antagonists, seeks to grant the awareness of an often unreasonable world populated by its reader’s passionate persona. Applying a world-context centred reading to Samuel Taylor Coleridge’s, The Rime of the Ancyent Marinere, demands the awareness of the Neo-Classical era’s hegemonic position over the newly flourishing Romantic Movement of late eighteenth century Europe. Inherent in this awareness is the philosophical concern in The Rime of the Ancyent Marinere, with the issue of Neo-Classic determinism versus Romantic free will. These two philosophical perspectives, unique to their own era, are locked in contention throughout the poem and therefore struggle for dominance; as determined by the reader of the text. A resistant reading of The Rime of the Ancyent Marinere explores the concept of determinism, which as an ideology is diametrically opposed to Coleridge’s own beliefs in passionate action and free will; beliefs privileged by the author’s subscription to the Romantic Movement during the text’s construction. Due to its unique time of construction, The Rime of the Ancyent Marinere itself represents a sense of philosophical uncertainty. Its ideologies, as inspired by a pioneer of the Romantic Movement, are inevitably influenced by the author’s own Neo-Classical background. As a culturally inscribed composer of the text, the idealistically passion... ...ibuting factor to Southey’s inability to decode the poem’s meaning, lay in the style with which he read it, a style bestowed upon him by his cultural background. Such a background rigidly opposed alternate methods of experiencing poetry, such as trying to feel it rather than to understand it. In such a way, The Rime of the Ancyent Marinere represented a paradigm shift in the way poetry was interpreted; a dynamically different form of experience to what was traditionally accepted. Through this shift, and supported by his culture-breaking contemporaries, Coleridge in his writing of The Rime of the Ancyent Marinere was proposing a new means of experiencing and interpreting the universe; a new cultural perspective. The depth of this perspective that is available to the reader is determined by what the reader, as a culturally inscribed individual, brings to the text.

Essay --

Markus Zusak Markus Zusak was born on June 23rd, 1975 in Sydney, Australia. His mother is German, and his father is Austrian. When he was just a boy, his parents told him stories about what happened during world war two, and these stories would eventually inspire him to write The Book Thief. He even included specific events that he learned about from his mother, such as the parade of Jews, and when Munich was bombed. He began writing when he was but a teenager, and stated that his inspiration came from The Old Man and the Sea, and What’s Eating Gilbert Grape. Importance of Setting The Book Thief is set in a small fictional German town called Mulching, which is said to be right outside of Munich. The story begins in the midst of the troubles of world war two, when Hitler has been in power for a decent amount of time. Zusak wanted to portray the story of the German side of things, showing how information about what Hitler was doing was not commonly known. He wanted to show the struggles that can happen in even the smallest towns, emphasizing Nazi influence throughout the book. Some Germans full of pride, others with regret, even more with fear. This is just a small town, but even what they do has consequences, and this shows how much of an actor you had to be to stay alive if you disagreed with the Gestapo. List of Characters Death The introduction of death is an oddity that should be expected, as a spiritual superstition given form should always have some sort of mystery about them. Death is the narrator of The book Thief, telling the readers the tales that he finds interesting while supplanting seemingly meaningless interjections of facts and other such trivial things. In the beginning of the book, he tells us o... ...t. She makes money by doing the laundry of the rich people in Mulching, but secretly hates it and them. Her love for her husband Hans is great, and enjoys Liesel’s company just as much, even if she doesn’t show it. Max Vandenburg A Jew who has been living in secret with the Hubermanns in their basement. He befriends Liesel and has been steadily learning how to read with her help. With Liesel’s inspiration, he starts to draw and write his own books, basing them off his life and his visions. He titles the two books â€Å"The Standover Man† and â€Å"The Word Shaker†. Hitler is a recurring thought for him, as he imagines himself fighting him in a fist fight, which makes sense considering that Max was always ready and willing for fighting other people when he was younger. Max is forced to leave after Hans makes a mistake and shows his compassion for people. Rudy Steiner

Discussion of the Dispossession of Lolita’s sexuality in Vladimir Nabokov’s Lolita

In the novel Lolita, the concept of sexuality is greatly emphasized by the author. It is apparent in the character of Lolita and Humber that one is in control over the other. Humbert possesses greater power over Lolita to make all her needs possible.On the other hand Lolita uses sex as her way of gaining things that she desires. There is a big complex relationship between the tow since Lolita is in dispossession of her sexuality and Humbert is in possession of it.The sexual relationship of the two main characters can be considered unnatural because Lolita is only on her 12 years. But since Lolita is in dispossession of her sexuality she agreed to the consummation of their relationship although giving the consent to sexual relations with an old man is really no consent.She can by no means what so ever be held accountable for, or be said to legitimately consent to, the sexual relationship between the two.   The question of power and control between the two main characters in Vladimir Nabokov’s Lolita is crucially linked to the fundamental weakness and vulnerability of both the erotically obsessed Humbert Humbert and the childish object of his obsession, Lolita herself.The first instance of Humbert’s attempting to bribe and pacify Lolita with material offerings occurs at the point in the narrative where she first learns of her mother’s death.   This is also the point, following their first full-fledged sexual encounter, where Lolita initiates the practice of sardonic reference to the immorality and illegality of their relationship.   She has actually suffered internal injury from their intercourse and does not yet seem to have a manipulative purpose for verbally goading her stepfather/lover.â€Å"You chump,† she said, sweetly smiling at me.   â€Å"You revolting creature.   I was a daisy-fresh girl, and look what you’ve done to me.   I ought to call the police and tell them you raped me.   Oh, you dirty, dirty old man.† (Nabokov 141)Humbert then informs her of Charlotte Haze’s death.   Lolita’s grief and indignation are announced by the fact that in their next lodging they take separate rooms.   Humbert has already cited a list of purchases he has made in hopes of mollifying her—everything from a box of candy to a travel clock to a new wardrobe of summer dresses.   But it is her complete childish dependency and vulnerability that bring her to him.â€Å"At the motel we had separate rooms, but in the middle of the night she came sobbing into mine, and we made it up very gently.   You see, she had absolutely nowhere else to go† (Nabokov 142)Lolita â€Å"works† hard in order to get her allowance. It is atypical for her to do a work like that at her age because it means that she needs to have sex with him to get everything that she needs and wants.   Humber will ask Lolita to perform sexual favors for him so that he can give him allowance in retur n.This is one of the visible proofs that he is in control over her sexuality. The control is not only based on a psychological level but also on a physical level. Everything that she needs, from a simple candy or cartoon magazine and a visit to a movie house will not be easily granted if she will not perform any sexual encounter with Humbert. Although there are several times that she gains fulfillment by getting her desires, she is still in no control of the situation or her sexuality.â€Å"Her weekly allowance, paid to her under condition she fulfill her basic obligations, was twenty-one cents at the start of the Beardsley era-and went up to one dollar five before its end.This was more than generous arrangement seeing she constantly received from me all kinds of small presents and had for the asking any sweetmeat or movie under the moon-although, of course, I might fondly demand an additional kiss, or even a whole collection of assorted caresses, when I knew she coveted very badly some item of juvenile amusement† (Nabokov 183-184).Lolita becomes, in effect—and as a result of forces brought relentlessly to bear on her essentially vital and resilient nature, she is a live-in prostitute of the most venal nature. â€Å"O Reader!   Laugh not, as you imagine me, on the very wrack of joy noisily emitting dimes and quarters, and great big silver dollars like some sonorous, jingly and wholly demented machine vomiting riches; and in the margin of that leaping epilepsy she would firmly clutch a handful of coins in her little fist† (Nabokov 184).That understated â€Å"little fist† line is the moral center of this passage.   Lolita is still a child.   Whatever her learned capacity for degenerate bargaining, what she loses—and what she knows she is losing—by her required performance of sexually â€Å"paradisal philters† is the carefree childhood to which she is entitled by the developmental norms of her society.Even in school. Lolita experiences great trouble connecting with the boys in the way her teachers feel she should. She displays behavior that is really differently from the other girls. This also strengthens the fact of the argument that Humbert is in possession of her sexuality, and she cannot do anything about it.   â€Å"Dolly Haze, she said is a lovely child but, the onset of sexual maturing seems to give her trouble† (Nabokov 193).  Humbert deprives Lolita of every possibility of salutary contact with males her own age.   In fact he deprives her of performing any and all activities that will drive her away from his desires for addictive gratification.   Part of this is his fear that Lolita will tell other people the kind of life thay have whenever they are together.Participation in school theatricals becomes a particular source of tension for Humbert.   This issue is resolved, in typical fashion, by an unusually exciting favor.   During a visit to her school, Humber t comes to a classroom where Dolly is quietly studying in the company of another girl. â€Å"I sat beside Dolly†¦and unbuttoned my overcoat and for sixty-five cents plus the permission to participate in the school play, had Dolly put her inky, chalky, red-knuckled hand under the desk† (Nabokov 198).

Literary Theme Essay Essay

The Privilege of Freedom â€Å"Only the educated are free.† Said by Epicetus, this simple quote demonstrates the importance of education. A solid education will provide for an excellent future and give one freedom: freedom to take on a career, to jump at opportunities, and to make choices. There is no saying where the future might take an educated man. Dangarembga uses highly educated and successful characters to illustrate the privilege of education and the power, control, and freedom that it provides. Dangarembga shows that education can change a life for the better by presenting the main character, Tambu, with the privilege of attending an outstanding school. When Tambu is given the opportunity to live with her uncle and go to the mission school, she is thrilled to become educated. Before her brother died, â€Å"the needs and sensibilities of the women in† her â€Å"family were not considered a priority,† and school was not an option for her (Dangarembga 12). Education has provided Tambu with the privilege to escape her old life on the homestead and â€Å"take another step upwards in the direction of† her â€Å"freedom† (Dangarembga 186). Also, education has given Tambu the power to use her education to control the rest of her life. â€Å"By the time she has finished Form Four,† she â€Å"will be able to take† her â€Å"course, whatever it is that† she chooses (Dangarembga 183). â€Å"In time,† she â€Å"will be earning money,† which will then lead to a career and onto the rest of her life (Dangarembga 183). The wealth that Tambu will earn when she is successful will provide for her and her entire family. Education builds the foundation of Tambu’s future, and â€Å"the prospect of this freedom† is unlimited (Dangarembga 186). The character, Babamakuru, is used by Dangarmebga to demonstrate that one educated relative effects an entire family. Education is â€Å"not just an individual blessing† but one that extends to all members of a â€Å"less fortunate family† (Dangarembga 89). For example, Dangarembga shows that one educated man can support the whole family. Babamakuru, â€Å"who had obtained a Bachelor’s Degree in South Africa,† is extremely generous and provides resources and opportunities for his entire family (Dangarembga 13). Whenever Babamakuru goes to visit the homestead, he comes bearing food, gifts, and supplies for the family to thrive off of. Also, Babamakuru is responsible for Tambu’s education and her coming to the mission school. To Tambu’s family, â€Å"Babamakuru was God†, â€Å"big brother to all†, and â€Å"his divinity† filled them â€Å"with awe† (Dangarembga 70, 36, 88). â€Å"As an early educated African,† Babamakuru has â€Å"found himself in positions that enable him to organize his immediate world and its contents as he wished† (Dangarembga 88). His great power has insulated him â€Å"from the necessity of considering alternatives unless they were his own† (Dangarembga 88). Education has given him opportunities that have led to great power and control over others; nobody â€Å"dares to challenge his authority† ((Dangarembga 117). Without a well-educated, successful man like Babamakuru, Tambu’s family would not be as the same. Throughout Nervous Conditions ¸ Dangarembga exemplifies the key role that education plays in becoming wealthy and successful. The basis of a good future begins with education. Such a privilege can lead to so many new things, and when one is educated, the possibilities are endless. Works Cited Dangarembga, Tsitsi. Nervous Conditions. New York: Seal, 1989.