EHBiZ Magazine (GROUP 3)

EHBiZ EXCLUSIVE

Electronic Health Business Record

ISSUE JUNE 2020

IN THIS ISSUE EHBIZ.

EDITOR'S NOTE ISSUES IN
ELECTRONIC
OVERVIEW OF HEALTH BUSINESS
EHBIZ RECORD

GETTING KNOW GAME 1
BUSINESS RECORD
MANAGEMENT TOOLS USED FOR
ELECTRONIC
CURRENT ISSUES IN HEALTH BUSINESS
THE WORLD RECORD

INTRODUCING BENEFITS OF
ELECTRONIC IMPLEMENTING
HEALTH BUSINESS EHR IN THE FIELD
RECORD

IN THIS ISSUE EHBIZ.

GAME 2

CHALLENGES IN INITIATIVE IN
IMLEMENTING EHR IMPROVING EHR

POLICY OF EHR NEWS ARTICLE
RELATED TO
GAME 3 BUSINESS RECORD
MANAGEMENT

GLOSSARY

REFERENCES

Editor's Note

-CHIEF EDITOR-

NURAFRIENA ASYIEKIN YUSRI
(2017275654)

Nurafriena Asyiekin Binti Yusri is the given name for the

editor for EHBiZ who passionately showers her all commitment
in completing this e-magazine for the user’s reading. To be
attentive and ambitious in such a young age at 22 years old
currently and live separately in Kajang with the others editor
does not decline her goals in remains focus instead. She
graduating from the previous education background in
Selangor Matriculation College, Banting has enabled her to
make place in pursuing Bachelor Science Hons of Information
System Management in one of the public universities known as
Universiti Teknologi MARA (UiTM) that is located in Puncak
Perdana Campus.

-GRAPHIC EDITOR-

FARISHA AZYYATI ZAMERI
(2017275674)

Hi! I’m Farisha Azyyati binti Zameri. Everyone enjoy calling

me Echa. I’m from Muar, Johore. I am final year student from
UiTM Puncak Perdana pursuing Bachelor Science Hons of
Information System Management . Before entering university
life, I previously attending matriculation majoring in
Accountant.  I enjoy meeting new people and finding ways to
help them have an uplifting experience.

Editor's Note

-CONTENT EDITOR-

AISYAH ABDUL RAZAK
(2017660668)

Aisyah Abdul Razak, 25 is responsible as a content editor

in EHBiZ who work with marketing and graphic design to
create an overall positive user experience. In addition, she is
graduating from previous education background in Diploma
Computer Networking, Indera Mahkota Kuantan has enabled
her to take a place in pursuing Bachelor Science Hons of
Information System Management in Universiti Teknologi MARA
(UITM) that is located at PuncakPerdana, Selangor.

-ASSISTANT EDITOR-

HIDAYATUL NASUHA BINTI
MOHD ZUKI
(2017275732)

Hidayatul Nasuha Mohd Zuki, 23 and responsible as an

assistant editor in EHBiZ and currently pursuing Bachelor
Science Hons of Information System Management in Universiti
teknologi MARA (UITM) that is located in Puncak Perdana,
Selangor. She was able to complete this magazine with her
knowledge and commitment to get new experience and also
for the user’s reading.

OVERVIEW OF EHBIZ

An electronic health record (EHR) is a computerized
variant of a patient's paper outline. EHRs are
constant and is a patient-focused records thatmake
data accessible in a split second and safely to
approved clients. While an EHR contains the clinical
and treatment accounts of patients, an EHR
framework is worked to go past standard climical
information gathered in a supplier's office and can
be comprehensive of a more extensive perspective
on a patient's consideration. EHRs are an essential
piece of wellbeing IT and can contain a patient's
clinical history, analyse, meds,treatment plans,
inoculation dates, hypersensitivities, radiology
pictures, and research centre and test outcomes. It
additionally permits access to confirm based
instruments that suppliers can use to sttle on
choices about a patient's consideration just as
robotize and smooth out supplier work process. One
of the key highlights of an EHRis that wellbeing
data can be made and overseen by approved
suppliers in an advanced configuration fit for being
imparted to different suppliers across more than
one human services association. EHRs are worked to
impact data to other human services suppliers and
association. We are all now aware that by the
present of EHR helps assemble a more advantageous
future for our country.

EHR has been exists since a long time ago with the improvement of
technology. It helps the professional detects and retrieved illness stored
in a database to enhance their service towards providing a better
quality of nation’s health. Across with the known current virus
attacking all around the world. The scientists as well as doctors found
EHR convenient in solving this pandemic quickly. Gigantic health care
framework disturbances brought about by the corona-virus pandemic
re-affirm, for some, the significance of electronic health records (EHRs)
and patient information. These records are urgent for enhancing care,
lessening clinical mistakes, improving coordination among suppliers,
and enabling patients to take part in their own consideration. In any
case, similar difficulties that EHRs looked before the pandemic have
additionally been brought into sharp alleviation by the present
emergency.

Inside this magazine, we will be discussing and go through more
details about the information and explanation of Electronic Health
Business Record. The issue, benefits, challenges and policy related to
the EHR is reviewed by the previous research due to the experienced
held by the record management process. However, there is still lack
somewhere in handling the record, therefore EHR will be peer reviewed
on how to improve it difficulties and complication. We hope that the
information provided will benefit and enhance the readers on
understanding about EHR.

EHBIZ: ELECTRONIC HEALTH RECORD BUSINESS JUNE 2020

GETTING KNOW
BUSINESS
RECORD
MANAGEMENT

Business record management is one of the essential part in your organization no matter what size your
company is, any data or crucial information that are related to your organization such a medical report,
financial, procedure and policies of the company, taxes or any related to the operations must be
properly taken care and maintained. Business record must be kept until six years and below followed
the rules and procedure your company has decide and will be handled by the record management in
your organization.  A business record may appear in any form such as transactions receipt or content in
any valuable information in documentation that related to the organization. Documentation may exist
in contracts, memos, paper files, electronic files, reports, emails, videos, instant message logs or data
records. Paper based records may be stored as manual in the record management or in the storage.
Digital records may be stored on storage media in-house or in the cloud.

The aim of records management is
to help an organization keep the
important documentation or
reports that are available for
business in some small to large
businesses. Other than that,
spreadsheets are used to track
where records are stored, but larger
organizations may find records
management software sets that are
tied to both a categorization and a
data maintenance schedule to be
more useful.

Current Issues

A century ago, one would The sheer amount of records that
prescribe a letter to an assistant organizations need to deal with is
who would format and file the an essential feature of record
document appropriately which is management, as proper policy
being part of the record implementation would remove
management process that person redundant documents.
would handle such documents
regularly. Managing records has Nowadays, there are many
developed a high incidence of
passion lately. issues related in business records

Once held hostage to an image management around the
of outdated file cabinets in the
basement, accessed only when world. Here are the issues that
needed for legal purposes, record
management is now known as a usually happened in business
crucial component of knowledge
management, a vital mechanism records involving
that goes beyond but all involves
record management. around the world.

Auto -

CATEGORIZATION

It is one of the ongoing challenges of It had been said that when a paper
record management where the records was is generated to be indexed, the
persuading users to declare records and process is more likely to be regarded
properly classify them after a document as an integral part of the job. This
was used. One way around this challenge is method is considerably more
from the time of development, to collect successful than later announcing
documents through an ECM program. ECM the text as a
stands for Enterprise Content Management record.

No Longer Independent

There is the technology available to
support a more integrated records
management approach. Mark Mandel
who is the manager of records
management practice at Open-Text
said that the significant ECM systems
now provide record management, and
the implementation of a separate
records management system is no
longer necessary or desirable.

EHBiZ GOVERNANCE OF

INFORMATION

The wide significance of records
management also points to the
need for the records management
officer to have interdisciplinary
skills. Jason R. Baron, director of
litigation in the Office of General
Counsel at the National Archives
and Records Administration state
that records management should be
engaged with everything from
sourcing to e-discovery, and the
heads of state should have the
capabilities to match this range of
activities. It is because managing
records is an essential cornerstone
of good governance.



LITERATURE

REVIEW

INTRODUCING

ELECTRONIC

HEALTH

BUSINESS RECORD

Before the 1960s, all health records had been kept on sheets of paper and in
manually paper files. Diagnoses, lab results, visit records, and prescriptions for
treatment were all written and preserved using pieces of paper linked with each
other in the health record of a patient. These records were classified using the
last name of the patient, last several numbers of the security number of the
patient, or any other reference number of the chart. Lockheed formed an
electronic system, then known as a health information system, in the mid-1960s.
Other technology and engineering firms have begun developing systems for
electronic medical records for hospitals and universities. The federal government
and the Department of Veteran Affairs’ implementation of VistA which
originally known as Decentralized Hospital Computer Program (DHCP) began
using Electronic Health Record (EHR) in 1970.

More centered efforts had been made by the 1980s to improve any use of
EHR amongst healthcare providers. In the mid-1980s the Institute of Medicine
(IoM) performed a paper record use analysis and reported the findings in 1991.
By 2004, with the establishment of the Office of the National Coordinator (ONC)
for Health Information Technology (IT), there is a need to turn medical records
into EHRs was accepted nationally. Presently, the EHR is an efficient and
effective resource for managing healthcare records for a patient, for interacting
with patients and other providers, and for promoting the connection between
patients and healthcare professionals.

According to PCC EHR Solution, Electronic Other than that, electronic health
Health Record (EHR) is an electronic version of records (EHRs) bring resources to
a documentary record of a patient. EHRs offer improve patient care, integrate
the benefit of ensuring patient care information success metrics into clinical care and
that is available to multiple authorized users in promote clinical study. One of an
a safe manner. While EHRs differ in quality EHR's main features is that
content, they are mostly structured to also authorized providers can build and
include the patient's medical and clinical history, maintain health information in a
diagnosis, medicines, immunization dates, digital format that can be accessed
allergies, radiology images, and laboratory and with other providers across more than
test results, amongst many other information. one healthcare institution. Presently,
EHRs can complement information from the EHR is an efficient and effective
multiple sources to provide a more complete resource for managing healthcare
overview of patient care, even though in actual records for a patient, for interacting
practice this has clearly proven complicated to with patients and other providers, and
accomplish for promoting the connection between
patients and healthcare professionals.
No more rearranging thru all the
paper files, having to wait for faxes or
finding paperwork to be able to
provide quality care to the patients.



ISSUES IN ELECTRONIC HEALTH RECORD

Aisyah Abdul Razak

Expanded reception of electronic health record (EHR)
frameworks by medicinal services associations have prompted
the spread of the utilization of EHR as an auxiliary information
source in both IS and bolster regions. The EHR information
must be appropriately misused, which would prompt top-notch
results and improved reproducibility.

Nonetheless, the nature of the EHR information utilized may
change altogether and may affect the aftereffects of the
exploration. In this paper, we initially examine the three
principal issues of information quality in the EHR information.
These issues are non-standard clinical coding plans and missing
information of EHR information.

INTRODUCTION

In the previous decade, the utilization of Electronic Health
Records (EHR) in medicinal services associations (HCOs)
has expanded significantly because of late advances in
social insurance innovations and changes in government
approache(for example HITECH Act 1). This expanded
utilization of EHR frameworks has prompted the catch of
monstrous measures of patient information, opening open
doors for use as an optional information source to explore.
In data frameworks, we have seen EHR information utilized
for medical clinic work process examine illness the
executives, clinical choice emotionally supportive networks
and patient-focused consideration, among others. While
there is a lot of accentuation on displaying assignments in
contemplates utilizing EHR information, information quality
is frequently not examined in detail in look into including
EHR information in IS. Like most kinds of observational
information, EHR information can be influenced by quality
issues, for example, imprecision and missing qualities, which
lead to issues in the examination. Thusly, the utilization of
EHR information in IS investigate requires more very much
characterized quality edges.

N O N S T A N D A R DCLINICAL CODING PLAN

Gaurav Jetley (2019) one of the Given the plan utilized, the
significant information quality issues information can be coded uniquely
identified with the utilization of EHR in contrast to different plans. All
information in look into is the things considered, course, having
utilization of clinical coding plans. As various coding plans can present
a rule, coding plans are utilized to information quality issues, for
portray and characterize information, example, error and imprecision. In
which includes allocating crude addition, clinical coding also
perceptions to classes speaking to involves of concepts such as clinical
explicit subjects or points dependent conditions
on similitude's or contrasts between
perceptions.

MISSING INFORMATION

He Zhang (2019) the second EHR information might be
significant information quality issue in shortened if the patient has
EHR information identifies with imperceptibly information in the
missing characteristics, missing EHR dataset previously, during or
property information and longitudinal after the finish of the perception
truncation for perceptions. The time frame. For instance, missing
culmination of the information is data on illness determination and
portrayed as the nearness of the total related timestamps for a patient
truth of the perception in the moved from another office are
information. Missing traits, missing frequently not recorded in the
quality information and longitudinal EHR datasets. The deficiency of
truncation of perceptions impede EHR information can prompt
information from giving total truth information quality issues, for
about the perceptions concerned. For example, vulnerability because of
instance, if we have missing data on missing qualities that can prompt
the date and time of the remedy of the predisposition of presumptions
medication to the patient, it is and a critical number of missing
troublesome, to come clean about information that can prompt
when the solution was given and inadequate information for
whether the patient is still on the examination.
medication

WHAT IS According to the American National Information
DATA Systems Dictionary, information quality concerns the
exactness, idealness, precision, and culmination of the
QUALITY? information that makes it reasonable for use. In this
manner, although EHR information quality is frequently
viewed as just inside the tight extent of information
check and approval, information quality ought to
likewise be worried about the similarly basic part of
guaranteeing that EHR information is proper for their
utilization. Keeping up the nature of wellbeing
information is broadly perceived as risky, .

These incorporate deficient administration structures
to guarantee total, convenient and exact detailing of
information; insufficient principles, preparing and
procedural rules for information assortment partners;
discontinuity and irregularities between information
assortment administrations; and the necessity for new
administration techniques that utilization precise and
significant information to help the oversaw care
condition. The board and hierarchical elements, just as
compelling mechanical systems, influence the capacity
to keep up information quality. Firth et al. explain this
relationship by drawing a similarity between the
creation and creation of information. Along these lines,
they determine a chain of importance, adjusted from
global ISO 8402 item quality norms, of information
quality obligations, going from the executives
downstream to singular strategies and instruments.

CONCLUSION

Blemished information has a significant negative effect on the
exactness of the results of science disclosure. In this part, we centre
around DQ issues, which rely essentially upon befuddling causes, not
obvious for the investigator Information. The essential "remove
message" that we intend to transmit is Information examiners ought
to likewise consider master information on the general setting and
the information itself how they were gathered, prepared and
investigated. About DQ, a few explicit issues in EHR information
should be settled (for example Absence of standards, imperfect
clinical coding, time synchronization). In the meantime, it is still
exceptionally hard to guarantee that the EHR information is precise,
finished, important, ideal, adequately nitty gritty and satisfactorily
spoke to and they keep up enough logical information to advance
dynamic.





Photo

TOOLS USED FOR ELECTRONIC
HEALTH BUSINESS RECORD

NURAFRIENA ASYIEKIN YUSRI

ABSTRACT

Electronic health records report a person's consideration. Expanding on this, populace the
executive’s tools can be utilized with collected electronic health records (or datasets) to
audit different parts of care and plan for the consideration of bigger patient populaces.
This may incorporate activities to help adherence to rules for wellbeing advancement,
illness counteraction and the administration of long-term conditions. These datasets can
likewise be "mined" to search for infection patterns what is more, utilized as a method for
distinguishing potential mistakes, including missed or deferred analyse.

INTRODUCTION

Bates D (2010) stated electronic tools can importantly affect healthcare in essential care. All
around planned and executed, the utilization of data and correspondence innovations in
healthcare administration conveyance can connect healthcare workers with each other
also, with patients and families so as to give excellent consideration that is more secure,
progressively solid, increasingly proficient, fair and practical. When deliberately utilized
over the wellbeing framework, eHealth can empower wellbeing frameworks to work
adequately, also, bolster wellbeing administrations to convey incorporated, composed
intercessions that draw in patients and address their requirements over the wellbeing
continuum, Sing H (2010). Specialists from around the globe distinguished that key
vulnerabilities for tolerant wellbeing in each wellbeing framework incorporate
correspondence and cooperation, requesting and translation of indicative tests,
information the executives, changes between levels of care, and fulfilment of patient
records said Kreswell K (2013). EHR tools assist with tending to these vulnerabilities by, for
instance, giving choice help to solutions furthermore, test orders, improving
documentation and correspondence for handovers between suppliers, following and
sharing symptomatic test outcomes, and upgrading information observing and
examination. It must be underlined that electronic devices support, instead of supplanting
the skill of advanced groups of medicinal services suppliers. Accomplishing more secure
essential consideration requires attentive joining of EHR into essential consideration
administration conveyance. It likewise requires a change in perspective away from
responsive methodologies towards approaches that improve nature of care, fortify supplier
tolerant associations what is more, engage patients and families as fundamental
accomplices in care.

BUSINESS INTELLIGENCE   BI & CLINICAL DATA SETS

According to Reinschmidt, J. (2000) The Based on (Lamon, J., 2006) Clinical datasets
meaning of BI Intelligence fluctuates among gives an incredible situation in which joined
scientists. BI changes data into information investigations of both organized and
and has the ability of "placing the correct data unstructured datasets can demonstrate
under the control of the correct client at the productive and valuable. Applying BI
perfect opportunity to help the dynamic advancements on clinical datasets has
procedure". The BI innovation incorporates a numerous advantages in improving the quality
few programming applications for extraction, and wellbeing of human services conveyance.
change and stacking, information With an expanding need to convey Electronic
warehousing, database inquiry and revealing, Health Records (EHR) and Electronic Medical
multidimensional/online systematic handling, Record (EMR), there is additionally a
information investigation, and information comparing need to apply information mining
mining and representation. The four advancements to extricate quality information
significant parts of BI comprise information and surmising rules from the data put away in
distribution center, information sources, those electronic records in order to give
information bazaar, and question and continuous choice backings to clinicians and
revealing instruments, Branon, N. (2010). BI social insurance suppliers. Most clinical
devices are broadly utilized as middleware datasets are not organized and applying BI
between value-based applications and choice advancements guarantee quality information
help applications. In particular, BI advances extractions and investigation. Clinical choice
are utilized to abbreviate the delay between emotionally supportive networks are as of now
information securing and dynamic. With outfitted with induction rules or rationales to
regards to health informatics, BI is helpful and help clinicians and social insurance suppliers
is viewed as another frontier of information at the purpose of care. The nature of advices
mining. Branon, N. (2010) stated BI innovation radiating from clinical choice emotionally
stages are picking up fame in the human supportive networks is controlled by the
service area as a result of their capacity to nature of information mining advancements
"assist the executives with settling on better utilized. Henceforth, in the event that the
choices in the exceedingly intricate and business rationales or potentially induction
regularly changing business condition, to rules are imperfect, at that point they could
outsmart the opposition, to maintain the present machine-related mistakes that will
business in the most proficient manner, to prompt misdiagnosis and wrong meds,
genuinely comprehend their client base, and to (Coiera, E., 2006). This is the reason it is
convey individualized items and significant that the BI innovation is utilized
administrations" . More explicitly, BI offers the and applied properly on clinical datasets to
potential for social healthcare organizations to help quality information extractions and
"adequately oversee and influence their examination.
information to improve budgetary and
operational execution and the nature of
patient consideration", Sahay, B. (2008). In
addition, the utilization of the BI innovation in
EHR empowers medicinal services suppliers to
get the necessary clinical data effectively and
effectively.

PATIENT SELF-MANAGEMENT
TOOLS

In such illness management, including  MOBILE TOOLS
prescription adherence, sickness observing,
sound way of life decisions and side effect the According to (Hocevar, J., 2010)
board, happens outside of the formal healthcare
framework. Tolerant self-administration is along Electronic tools are basic to associate
these lines’ principal for better wellbeing care.
Various intercessions utilizing electronic devices individuals from the social insurance
have been created to encourage understanding
self-administration for normal conditions, for group, including network wellbeing
example, asthma, hypertension, and diabetes,
Bonney, W. (2012). With an expanding number of laborers. Portable advances are turning
individuals utilizing cell phones and gadgets,
there is extraordinary enthusiasm for into a significant asset for wellbeing
encouraging their accessibility and powerful use
to improve wellbeing care conveyance and administration conveyance because of
wellbeing. Constant input from avoidance to
finding, treatment and checking are a portion of their convenience and wide
the advantages significant to improving
wellbeing; different advantages incorporate acknowledgment. Healthcare
framework wide following of prescription stock-
outs and start to finish following of meds, crisis organization in remote and country
call focuses and data get to. Versatile applications
to help self-administration are extending quickly zones can especially profit by utilizing
in number also, scope, however to date there is
blended and restricted proof about the adequacy cell phones to remain associated with
of these instruments. Watkins, T. J. in 2009,
precise surveys of cell phone and tablet information assets and data frameworks
applications have discovered ambiguous impacts.
On the other hand, audits of online intercessions as they give care. Cell phone
for way of life and healthful conduct change have
commonly positive results, especially where there applications for information passage,
is collaboration included. Text informing updates
and choice help likewise frequently have positive electronic choice help, work helps, what
results. Financial and geographic elements might
be a hindrance to getting to medicinal services is more, the utilization of instant
offices, particularly among the most poor and
helpless populaces. A number of low-salary messages as updates are instances of
nations have begun to embrace electronic devices
to help persistent self-administration to fill in the versatile instruments in expansive use
hole of access to social insurance. Research by
WHO discovered that 77% of low-pay nations like stated on International
were utilizing instant messages or other portable
specialized devices to improve treatment Organization for Standardization in
concordance, Wadsworth, T (2009).
2008. Such apparatuses can help

increment wellbeing specialist's

commitment inside the networks they

work and increment shared

correspondence between network

wellbeing laborers to encourage backing

and sharing of good practice, (Agrawal,

R., 2007).

CONSLUSION More secure essential consideration is key to
the United Nations Sustainable Improvement
Primary care services are at the core of Goals, especially to guarantee sound lives and
human services in numerous nations. They advance prosperity for all at each age.
give a passage point into the healthcare Understanding the size and nature of
framework and straightforwardly sway on mischief in essential consideration is
individuals' prosperity what's more, their significant since a noteworthy extent of
utilization of other medicinal services assets. social insurance is offered in this setting, yet
Dangerous or inadequate essential there is little clearness about the best
consideration may increment dismalness and approaches to address security issues at this
preventable mortality and may prompt the level. This review sums up the proof and
pointless use of scant clinic and authority experience for the use of electronic devices
assets. Therefore, improving safety in and advancements to improve understanding
essential consideration is basic when security in essential care. Nonetheless, EHR
endeavouring to guarantee all-inclusive tools and advance would be executed in
wellbeing inclusion and the supportability of combination with other significant
social insurance. viewpoints shrouded in this arrangement.



BENEFITS OF IMPLEMENTING
ELECTRONIC HEALTH RECORD

Aisyah Abdul Razak

Electronic health records (EHRs) have been being used since
the 1960s. Electronic health records (EHRs) have developed
among wellbeing data innovation as "significant use" to improve
the quality and proficiency of medicinal services. Their
potential in improving the consideration procedure is broadly
perceived. Besides, a few examinations have brought up the
effect of EHRs on decreasing social insurance structures'
expenses and expanding incomes. Data and correspondences
innovation arrangements have been brought into the private
matured consideration framework to improve the viability and
productivity of matured consideration, any way to date, the
genuine advantages have not been methodically examined. The
point of this examination was to recognize the advantages of
electronic wellbeing records (EHR) in private matured
consideration administrations and to look at how the
advantages have been accomplished.

Medicinal services associations over the EHR has allowed the wellbeing framework
United States have made the change from the chance to move from paper-based
a paper-based report the executives’ wellbeing records to electronic wellbeing
framework to putting away records records. The EHR take-up involves
electronically. An electronic health record numerous benefits including cost decrease,
(EHR) is a modernized assortment of improved nature of care, advancing proof-
patient data in an advanced configuration. based medication, record keeping (JoséLuis
The significance of electronic health et al., 2013). Therefore, EHR is viewed as an
records is that they encourage the sharing effectiveness upgrading, financially savvy
of patient information, for example, innovative change (Häyrinen, Saranto, and
clinical records, graphs, drugs and test Nykänen, 2008).
results over different human services
conditions. EHR permits organized clinical
information to be shared between
approved wellbeing partners to improve
the nature of social insurance conveyance
and to accomplish gigantic investment
funds(JoséLuis, Alemán, Señor, Ángel, and
Lozoya, 2013).

INTRODUCTION

IMPROVED NATURE OF CARE

According to the Gallagher Healthcare The auxiliary utilization of EHR
(May 23,2018) Mechanized notes are information offers potential upgrades
regularly simpler to peruse than a to inquire about, general wellbeing
doctor's penmanship. This decreases the investigation quality estimation, and
danger of blunders and misunderstand security checking. Wide reception of
that can contrarily affect the nature of EHRs can present these benefits by
patient consideration. All endeavours to expanding the measure of wellbeing
improve care regardless of whether data that is promptly accessible to
through clinical and essential research such an extent that basic research
or quality improvement require powerful questions can be examined through
information. quick information inquiry of differing
databases.

COST DECREASE

EMRs help improves clinical practice The expenses of EMR usage were
the board by expanding practice the genuine estimated esteem. Be
efficiencies and costs reserve funds. As that as it may, the advantages were
one model, a centre or doctor practice determined by utilizing the
can hope to build income and distinction between real estimated
abatement costs by changing over the qualities and anticipated qualities
experience structure to advanced without the EMR framework. In this
configuration to lessen charging way, when the information was not
mistakes and income misfortune. accessible, capital sums were
Correspondence is upgraded among dictated by the assessments of
clinicians, labs and wellbeing plans as specialists, for example, clinical
data can be gotten to from anyplace. record overseers, care floor medical
EMRs set aside cash by lessening caretakers, and IT engineers.
redundancies in clinical consideration,
by disposing of exorbitant assignments
of making paper outlines and work
concentrated administration of paper
graphs

CONCLUSION

The EHR can improve social insurance profitability and
productivity to more readily serve general wellbeing. A
wealth of medicinal services data can be overseen through
databases by utilizing electronic clinical records, and this
makes information more handily shared among suppliers
and associations. Key deciding for the creation and reception
of electronic wellbeing records in the nation, making a group
of specialists to survey the potential obstructions and create
systems to dispense with them, and allotting budgetary
assets can assist with beating most significant barriers to
the appropriation ofelectronic wellbeing records



CHALLENGES IN IMPLEMENTING
ELECTRONIC HEALTH RECORD
(IN RECORD MANAGEMENT & PATIENT ENGAGEMENT)

Hidayatul Nasuha Mohd Zuki

An Electronic Health Record or commonly called as EHR in
the world of healthcare development refers to a system that
have a storage of patient’s data and information in a digital
form. EHR can be easily used in a clinical workflow and
available for all the authorized users anytime and anywhere.
Due to the several benefits it offers, EHR has become the
most important tools in any hospital including private and
healthcare specialist all over the world. this tool can lower
the costs and removes any medical error that lead to
improvement of the diagnostics and patient safety. The
implementation of the EHR system in the healthcare world
can gives a big effect to the record management and
contributes to higher patient engagement.

INTRODUCTION

Information technology has increasingly been used to help the sharing
of information across teams and groups of healthcare staff. In the hope
of apprehending more effective and safer care, many countries are
actively following the implementation of electronic health record (EHR)
systems through making major investments in these projects.
Nowadays, there are many patients must be treated and keep their
data longer for a safety measures and several hospitals have facing
problems in keeping the data and information of the patient using
manual forms. Some of the country started to have concerns in medical
healthcare so they provided EHR to the hospitals so that it can be
improved in the digital forms. It is also can digitally share to others
provider without wasting much time by using technology
communication and connection within the hospital so that the
authorized people can use it easily

Patients also can have engagement using EHR by showing their data
and information. As we can see, EHR have been promoting in the
medical practice and as a result it shows a significant increase in
recent years. These systems provide a wide function that a healthcare
can use and can store all data and information about the patients. It is
not easy to implement the EHR in the healthcare system due to lacks
technologies provides in most of the hospitals. There are several
possible challenges in implementing an electronic health records
system in the records management and patient engagement. Being
concerned of the challenges in advance will help the providers to avoid
it and make the change process easier.

COST IMPLEMENTATION OF EHR

It is not surprising to heard that the Hospitals that want to implement this
implementation of the system is system need to be prepared for the cost
much expensive due to technologies as it may cause other unforeseen
that must be considered in the problems and cause cost overruns. The
process. The implementation, and hospitals should be prepared with a
optimization of the EHR will include proper plan and get ready with huge
in the budget of the capital and it budget as it will make a different to the
will cost quite expensive follow by improvement of the healthcare record
the cost per provider. The management. Finding financial resources
implementation involves several for EHR implementation is one of the
steps which is setting up the major hurdles, especially for smaller
hardware components, determine establishments.
software costs and installing
process, implementation assistance,
training for the staff, ongoing
network fees, and maintenance The
cost of implementing this system
involves several sectors whether
implicit or explicit

STAFF RESISTANCE

Some of the workers including nurses Prior to implementing the EHR system,
in the record management are reluctant the staff needs to be given detailed
and do not have proper learning on how training about the new workflow. The
to use the newest technologies in this specialist and the medical team has to
modern era. Not anyone in the sectors spend more time and put in additional
will be open minded and positive in the effort to identify the new system. It is
idea of implementing the EHR in record a time-consuming process and a
management. In addition, there are difficulty for both the staff and the
health physicians who are uncertain management. Small and mid-sized
about the effectiveness of electronic organizations worry the cost and loss
health records. There are some case of business during the training process
where the staff lack awareness about
the recent technological developments
and the complete benefits of it but
when they are asked to go for a
training, they resists and give much a
lot of reasons to avoid the training

DATA
PRIVACY

Other challenges that might occur in implementing the EHR in
patient engagement and record management is the data privacy that
recorder in the system. The stakeholders often express worries over
the risk of data leakage due to a natural disaster or a cyber-attack.
The government has enforced a national policy to protect the privacy
of personal health data. In case of a security breach, the organization
may get into a legal trouble and must spend millions of dollars to
settle the dispute. Hence, it becomes a major responsibility of the
provider to ensure data security of the EHR. It is also can affect the
patient engagement in using the digital record because they do not
want their data to be leak to the unauthorized people that can give
problems to them.

CONCLUSION The EHR implementation percentage has gone up
rapidly in recent years. Later, health IT experts, as
well as managers and staff, have come up with
strategic solutions to solve the common
challenges faced by providers in the
implementation of EHR. The early step of EHR
implementation is to come up with a complete
strategic plan for the activities in the future.
Allocate responsibilities and tasks for the team
members, identify the physician champions, and
create a space for mutual support and trust. Make
sure the team is ready with the emergency plans
too. Labour Force productivity may decline, and
workflow may go out of order or even patients
may get annoyed during the implementation
phase. An important point to consider here is that
planning is the key to successful EHR
implementation.



POLICY OF ELECTRONIC
HEALTH BUSINESS
RECORD

NURAFRIENA ASYIEKIN YUSRI

ABSTRACT

To comprehend the complexities of the developing electronic health record framework, it
is supportive to comprehend what the health data framework has been, is currently, and
requirements to become. The clinical record, either paper-based or electronic, is a
correspondence instrument that bolsters clinical dynamic, coordination of administrations,
assessment of the quality and viability of care, research, awful insurance, instruction, and
accreditation and administrative procedures. It is the business record of the medicinal
services framework, reported in the typical course of its exercises. The documentation
must be validated and, if it is written by hand, the sections must be decipherable.

INTRODUCTION

Today, the main role of the documentation continues as before help of patient
consideration. Clinical documentation is frequently filtered into an electronic framework
quickly and is normally finished when the patient is released. Record fulfilment times must
meet certifying and administrative prerequisites. The electronic health record is intuitive,
and there are numerous partners, analysts, and clients of the documentation. Since the
legislature is progressively associated with subsidizing health care services, offices
effectively survey documentation of care. A second impediment of the paper-based
clinical record was the absence of security. Access was constrained by entryways, locks,
distinguishing proof cards, and dreary sign-out systems for approved clients. Unapproved
access to quiet data set off no alarms, nor was it recognized what data had been seen.
The electronic health record (EHR) can be seen by numerous clients all the while and uses
a large group of data innovation apparatuses. Patients routinely audit their electronic
clinical records and are keeping personal health records (PHR), which contain clinical
documentation about their analyses from the doctor or human services websites.The
doctor, practice, or association is the proprietor of the physical clinical record since it is
its business record and property, and the patient possesses the data in the record, Odom,
W, B. (2009). Although the record has a place with the office or specialist, it is really the
patient's data important said the Office of the National Coordinator for Health
Information Technology which referring to a statement of “not just a collection of data
that you are guarding, it’s a life”.

PRIVACY AND CONFIDENTIALITY

As indicated by Richard Rognehaugh, it is the privilege of people to keep data about
themselves from being uncovered to other people; the case of people to be let alone,
from observation or obstruction from others, associations or the government .The data that
is shared because of a clinical relationship is viewed as private and must be secured,
Harman, L, B. (2006). The data can take different structures counting recognizable proof
information, findings, treatment, and progress notes, also, lab results and can be put away
in numerous media for instance paper, video, electronic records. Data from which the
character of the patient cannot be learned. Quiet data ought to be discharged to others
just with the patient's authorization or as permitted by law. This is not, notwithstanding, to
state that doctors cannot access tolerant data. Data can be discharged for treatment,
instalment, or authoritative purposes without a patient's approval. The patient, as well, has
government, state, and legitimate rights to see, get a duplicate of, and change data in
their health record. The way to protecting privacy is ensuring that lone approved people
approach data. The way toward controlling access constraining who can see what starts
with approving clients. In a doctor practice, for instance, the practice manager
distinguishes the clients, figures out what level of data is required and doles out
usernames and passwords. Fundamental principles for passwords incorporate
necessitating that they be changed at set stretches, setting a base number of characters,
and denying the reuse of passwords. Numerous associations and doctor rehearse adopt a
two-level strategy to confirmation, including a biometrics identifier check, for example,
palm, finger, retina, or face acknowledgment.

SECURITY An ongoing study found that 73 percent of
doctor’s text different doctors about work,
The expanding worry over the security of Greene A, H. (2011). The most effective
health record comes from the ascent of method to keep the data in these trades
EHRs, expanded utilization of cell phones, secure is a significant concern. It is
for example, the cell phone, clinical impossible to control what data is being
character burglary, and the broadly transmitted, the degree of detail,
foreseen trade of information between and regardless of whether interchanges are
among associations, clinicians, government being caught by others, what pictures are
offices, and patients. If patients' trust is being mutual, or whether the cell phone is
sabotaged, they may not be direct with the encoded or secure. In accordance to
doctor. For the patient to confide in the American Health Information Management
clinician, records in the workplace must be Association (2012), cell phones are to a
ensured. Clinical staff must know about the great extent intended for singular use and
safety efforts expected to ensure their were not planned for concentrated the
patient information and the information executives by a data innovation (IT)
inside their practices. division. PC workstations are occasionally
lost, however cell phones can without much
of a stretch be lost, harmed, or taken.
Encoding cell phones that are utilized to
transmit classified data is critical.

INTEGRITY & AVAILABILITY

According to American Health Information Management Association
(2012), Notwithstanding the significance of protection, privacy, and
security, the EHR framework must address the trustworthiness and
accessibility of data. Uprightness guarantees that the information is
precise and has not been changed. This is an expansive term for a
significant idea in the electronic condition since information trade
between frameworks is getting normal in the social insurance industry.
Information might be gathered and utilized in numerous frameworks all
through an association and over the continuum of care in walking
rehearses, clinics, recovery focuses, etc. This information can be
controlled purposefully or accidentally as it moves between and among
frameworks. Highlights of the electronic health record can permit
information uprightness to be undermined. Take, for instance, the capacity
to reorder, or "clone," content effectively starting with one advancement
note then onto the next. This training spares time yet is unsatisfactory
because it expands hazard for patients and obligation for clinicians and
associations. Another possibly dangerous element is the drop-down menu.
Drop-down menus may restrain decisions (e.g., of determination) with the
goal that the clinician cannot precisely record what has been
distinguished, and the need to pick rapidly may prompt mistakes.
Clinicians and merchants have been attempting to determine
programming issues, for example, screen structure and drop-down menus
to make EHRs both easy to understand and precise, American Health
Information Management Association (2009).

If the system is hacked or gets over-burden with demands, the data may
get unusable. To guarantee accessibility, electronic health record
frameworks regularly have repetitiv segments, known as adaptation to
internal failure systems, so if one segment falls flat or is encountering
issues the framework will change to a reinforcement part.

CONCLUSION

Health records strategy was accepted to to give productive records administrations.
anticipate the respectability utilization of
the records among the records staff. High IRMT (1999) included that if new records
or low respectability conduct could be
resolved from the degree of strategy enactment or new health enactment was
implementation. To be sure, if the strategy
were formally supported however had an proclaimed, at that point move ought to be
absence of requirement, the uprightness
conduct of the staff would be lower. made to urge the administrators to
Human services administration conveyance
could be progressively straightforward if incorporate arrangements for medical
the staff were increasingly responsible in
safeguarding the protection and privacy of clinic records administrations. Such
the patient data in this computerized
period. Another strategy ought to consider enactment may be encircled to oblige
the administration of the records life cycle
and continuum care in a safe electronic emergency clinics to build up and keep up
condition,
an exhaustive records administration at a

proper least norm, including the

arrangement for non-clinical and semi-

current records and, if nearby conditions

permit, to give a suitably qualified records

supervisor proficient oversight of

departmental records frameworks.



INITIATIVE IN IMPROVING

ELECTRONIC

HEALTH BUSINESS RECORD

FARISHA AZYYATI ZAMERI

ABSTRACT

eElleeccttrroonniicc vehresaioltnhs orfechoeradltsh-caarree
ieuitrmhrehenneehsaelllfceeeocceveaorcccnooelerttttiirrmetnahrrrddolooosbeasshrrnnneecteieniiifieptccccoaogcrnoa.onlor,tlrlrilhnntHdpybraiiheaceccigbleiltlaaanuailianelhlercttelg.enhthtrsheaateattsanlpIrnocthms.ntohdare,Adeprrrtcmtenlserieorencceamecgfoopkaoleo,deerretrdmorinecsmndhhvtstabg.aeeri,fdrotaaeTaaewnifllthocnottoriyiecesdnhhlfrl,
noeftwsoorfktswiasrkee, y thoaradpwraordeuctaivned IT TwicrMpnehorafoocenoyrojrseresermucodfomtva.onetWrinierhoi,gi,notnhwwirtteeaitttls’oh,ediskewvimapetnarpooetnrploofevfootvicensritosrdeayrenodlgnyaodiaivucbiefcrofbnoeioecnlhaseutcesttclrtaestealrirttscoahetcindnaeiedcnistarcesheetmiecobimaaonillcritoetdthayf-..
pastolursectoshheeeansntEatHbcaRolbemlaenotpdtuPhtCmeinsragakaneopdrpdPloimcDcaotAtob'isorils.int'syw, souurskcinhegaasdsieerve,ivcbeeurst-

TveprIoaholNdlresleeiosurdTuilsbysoelRecusoattpOfrofeeEocfHrDoiinaRtrdhltUoheiauaeftssCwiprbsaisdTettuecicetIoihvnmOmataerecis,Neoawtpnyrheseioducafilhlatitpatiysrrtoiiiconapsnbto,.ohsnWueautlehsrasveiienndnregytec,hdleaefacadylmteiptroeiarlaynrgaciocctt,uaichtrrheeeeea,otletodfhmomimwreoenrpscgslteoeidhmrndoecesssinep(otsiEtf,tHahErlRaseHsd,RsE)iooHwwloRieetgrriiyeens,
bpshmareorodvaoibtdtoleehrsisnet.goe.EteIHnhnsRettseerpawatdthoioeeufnldhitnofsljodopriunmurgrnaedtayieotndaaainldtediadgihrtreaeecllvlpyooi,rnldumgstiaoacknbliinonguiicntiiatthnheseeaairlswtphieiatcrthaiertetonhtessoi,hvrdaeordrecettcoihtisresiwowlinoti-hnlmlgfoaintkrahiunlelngyr,
processes. Unfortunately, while EHRs are now a staple part of day-to-day healthcare,
nadodteadll toof tithseswupoprkoloseadd obfentehfeitusshearsv,ewoicthcumrraendy. Idnosctetoardsonfoswavsipnegntdiminge,mthoerey aticmtueaollny
tiEnhHterRodsdoutcchteaodnr swtphheeenyrte.diAnocwcwhoiirtcdhhinppgaatptoieeranwt2so0.rk1T6thyirspeicpcaoolrlntyt,crdaoosnctstsuomrwseitsdhpleetnshdseatthlmimanoesatbttehwfiroodreeoxfEttrHhaRehtowiumaress
oannoEtHhResr asntudddyesskhwoworekdfotrheavtepryrimhoauryr ocfadrieredctocctlionricsasl fpaecnettaimlmeowsitthspixathieonutrss. Ionn20d1at7a,
hsanhalaoflryots,fiEsoHfffRriocsmea-rbEeaHsaRewdoavpsertirmeaaortfyypecinaceraerlgd1yo1. cS.4too-hrwsohuraretpwocorartnkeddbaleyy.sdAaoninddetihtnoeaytawSctekarlneefuotshrdiinsgMpaerondbicEleiHnmRe.apFnoodlrl
realize its prospective benefits?

LET INNOVATION LEASH
dsrhieHAErneeiaenHdomtcgltvevwRfoaepiar,cergrflncdoieiavnfnclefsycieignted,eriist,ochoanoiaaaeinif,nsnrnnedctfsdpohetbseireregnormatcieioibnEtlhlladlawlgHnetntuloihRmeocsle,esoensewdcgtkvwrayhnheithbreoeirhtnisearcwlietpenuslholgc,ewiyhtdtieiastgiitamshanteorhsdttesgeihhseseefbmnpuiseoneeropEuhttrebetHahhsinhcinleeeRlledehytrrr. cwvbrutdat2eooenosee0etdenmsv1bbhdretces8ip,noloio.uitlkfsrnmaptersWutroewegecvmrtbherhhihsfeelifaeywcmitrartcemthosshoee'msisbrrlifcenee?oiieltsfuelrtvhlumslhaHeedsberepsieeoarshfbUdvusatobriino.ecncenSudrdtteaei.itolecsktoswrraott.sfbethlwnalThyyrrcowoeooe,aetp-duohtpsetsaguherdhnoyholidereaf'ejdsestngnswwtckdoEEdhttaoiHHoeenotorrRRepdiogkffr
uotiIwmnhnbinatpstohtaotvorirnuautoacttficntohuotnaorneviittnsidhenaexoglrtrsitudnooaeifnrlorsledyreqtumaousmaritcreterehiinaoedantnsthbi.norleogidInnufecungvllohientvfhrilecaoeetiepaaid omnbEnssaHctoRioskf. tcwrpehhleacaartetnefnoagdtrrelomeyifncslragolotumtosneecnoshttoyeohmedewaertrshtsh.haiartiTndghmg-oipso.nabiersitwlyet.hacTepohpmsetyspatahrontarieevtoess

CONTINUOSLY IMPROVING EHRs WORKFLOW

Wufinrhsdetetrhgteoimrease,parnarectpoilpcatecimeasdizoaptittiossnanoplrdEoHjeRoctnf,oer,itthoiesr apMsaosrrtoecooifvaetterh,defodcreltisnhiiegcanimlppwrrooocvrekesfmlsoewfnostrowEfHEillRHRaaslns,do
tcstorrwcilaimieehktooorgovaecpmnnharithoPkststpdeinfrieaneavdttlordouinahaetnlnwoonhinnrtnaougcateiwsgnbwsynerogwsllcsteyrthitiknhtihaHinfhgamasieltneootncttpEauwGdoeorplHtapoctornhReahlvadpyCnnicrelnweaayaotfngpincgrolotroercuGirerEoog,kolgataHvnyfueautBri.elRdonleknlyorJasetwihs.nsBit.rmasogtrwnoirddsyTocsNneghBthirh,onchvkeoaeohggeef,ussrulaalweolitoldcn,dauwhnpagCtsielbdecelIeiiwyOeoshssasr, wrovdpitittfnnerahoaeerohfcgcsrlrtouomoleasksuereun.oiumdrwvgminsezebpaihntlaiylFthnaeeEtiboyeoiilviHno.mesrngaRhnicrlpiieousntebirH,aenawvaoenoxttmotavsieasestlnsitavnhrmprgiyepgeniioptdnrygtaraltbthelfihcuetesne,oeatdsrciescoecacucskacmeblwslttirtisnlchnr.euoiy,ilaeiccclrcminnsoiihtaraogaHnlbnrnkteetewoieiionaonosnuoesulgfocrttrdheruhoktseeisrchffttcaatlthaeoaehcesttermfwohedoeesfr
should be achieved on an ongoing basis. lmanodrescvaipaeb.le in the changing healthcare

JOIN VENTURES & PARTNERSHIPS AROUND
COUNTRY

A few joint ventures and collaborations around the country put together the creators
of EHR software and clinical institutions where large and small organizations are
ayitmnhonvaeudoysltaevbhreeeevdevb.wnTerotohnuraidtsrdheowewsrnoihasirninlkaegdlissyfpooonaruowrtrtbinlohfleiontorhrgrsiezhptvoioapenr.irstnFyiveooaesnrns.edintTbsahmutdeaotdrnneiifncegyaeyor,aeouifrnamyoeroteawhunweyahrilsarlripevneewegwcabtatroerddtessosnptiyenphonrayudatorccutwwoi,cinotlilhsrnkbeigd.enefOortgtahrhabeaienlerewfftthrfihmooialmreent,
tshoaftt,waasrep.aIrntnuesres,ryroeusecaoruclhd,pyaoruticmipiagthet ibneonseubojrecstesv,eoranlcweaoyrs sinertihaellyd.eYvoeulompmigehnttboef
tocolrincpilcrionaivlciidanlefoc, rocmnosmaetpiqoleunexcintocynebssau.llaStanoncmtesea.tgYimaoieunssctaalnsliosmvtpreolrinctightlyey,epvnliasccuoeaultrdhaigesepreloalneyvlnoaeonektdacsnl,indtiacfseakel cle,offfneitacetieunnrtecissy
strong, and we need it in one place, now, one or two clicks away in the clinic.
.

.rilTinekeIvfpeceryhesaonstuos.eYmlnoaotgaruaeyllt)mifwvtaaeeomyarokimnlniyne.tgemFhdiefagottduorritceefaiinanwbemdhigg.oagTrghoearaurkospecuotpoishmrosefpsupoaleiaknlooseysn,-pmicrotahoinncendattieanacmddien.soreySouoslenoouteirusoswtrfecshelefiefsftwfyhtooioetruthrwayytorooheruuekirnawIvrTaeiet(shnpInmdryfeoaooprlurlaemhrrraseafsadtiriloeamtonns,
oaparnrreogdadanuaciczgotar.netTsieohunemtnloiekgreotgeytroaoomuutrpshu,eowpsr.iotahTftohwrueetaygrdieoownvuialebllnth.udamovrb'esreuslsloaemroegfrooputrhopejemrcetfeasmtitnihlgyastpohrnyeesemicdaiailnhtsehlepumsfinrdogirmeycotaulnyr

BID TO SUPPORT

pchifcAfsaoaoarnocrdnvmyigiheolsbiprtentaelanlaiempntsionece.ttitnonayefbrgoTarcaeouhnhoremreyernoldywitfn,oapehlaeualriknnotaoidtinpsrnhegeygarvaorsailncauybebioaEstoeluHvhsudteeRotuvrfcscluiuaepaaosswwot.ueeewHselrrdds.deeinoTlrtpffhtheifhnaetaeaegsoytrr
technology, are stuck in their old .
wnnooottrkifnlsostwwaslilt,ecddhoetdhneotnowenwanutpttdhoaetaedsafpoetra, thhuaarevvees
eaapeyywmoocclxxiaatuuppctnkhurreeeiandserrttiilhogseneelyeittnntbuehhccslsuereeeomesFinfsaiuitaatanosrwrssnatfoamthatdEwaireco,ueHlraynicmncRrooietionofcuoemgmriryafetaopfnoa,isue,ckrseyryteieeoeocaonnuruochtnttrrmcielsvyetelewep,hpxslnaeiapfens,nenebtgibysdar,ilsseueyyyksna.oooecnouuuierdsfrrr,

C Ebmuleercrnetolryuotnaibcyshdpeoeacclttuholarrstee.cdAocrdscsoouradrrcienegntoootf HcinsEsfluoinukylyporHootgnesstewRsachttleoelneetoipglinvimmpyozrdeleoeynassanrcat,tctoisethoaoenbusan,ttcasvpseahEcheernciHoksssahdsadRtrnstbeaupstaiuncdc.rorieetdmeoatMxdealeapptmairdsclhdrdesnotoeestcoyivroviv,trenieethenlooodegleaoitnoaafngptpftklratemoeetahmlitmcnytfecgiittdeteconaiiiehvcvaintrraeeeedesnstl
O eriacgKoNholimeneaoxffresodkpavniwMneteimelatreghadeellmoi,randcecflateitecsvhcMopdnleoeiipcnrnetnrroaceafisxoctuovldtiifhacanisiueaeodelotienectsnedUpassrftaseleNotohtn.rfrrhwcMree,fdTauesashah.tUulctsaotbRestnuyaoetseirspbihuvses,roeteeDotrouraheabrc1sSft.renclli3cecoPtdye4hmyhsEhn0apeoeHiitlot%rerioillRepsssyyfrl chiRmaaeprvceeroo.rtvdWoissisetfehotrtoaohuubarretgtttoEaealrerlgscfeutrtrtigouihnrnetic.manindHdek,aewleteph
N hperoacveilsysinefslueanncdedthbiyngEsHRtsh. at are
C
L
U
S
I
O
N