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127-482: Geisinger Health System ( GHS ) is a regional health care provider to central, south-central and northeastern Pennsylvania . Headquartered in Danville, Pennsylvania , Geisinger services over 3 million patients in 45 counties. On March 31, 2024, Risant Health completed its acquisition of Geisinger Health System. Geisinger is named after Abigail Geisinger, widow of iron magnate George Geisinger. Its flagship facility
254-466: A residency . As of August 2021, there are 11 major facilities operated by Geisinger Health System: Geisinger has partnered with for-profit behavioral health operator Acadia Healthcare to operate some of its facilities. For comparison, in 2023 the Pennsylvania average operating margin and total margin were 2.26% and 3.44% respectively. The Pennsylvania average uncompensated care percent of NPR
381-643: A 2016 Johns Hopkins University study that demonstrated linkages between asthma and fracking . In 2021, a Regeneron-led study partially based on genetic data from the MyCode biobank identified a genetic variant that appears to lower obesity risk. On January 1, 2017, Geisinger acquired the Commonwealth School of Medicine in Scranton, Pennsylvania . Opened in 2008, the school had struggled financially prior to its acquisition. Geisinger agreed to assume
508-984: A Farmer in Pennsylvania, To the Inhabitants of the British Colonies , which were published in the Pennsylvania Chronicle between December 2, 1767, and February 15, 1768. When the Founding Fathers convened in Philadelphia in 1774, 12 colonies sent representatives to the First Continental Congress . The Second Continental Congress , which began in May 1775, authored and signed the Declaration of Independence in Philadelphia, but when Philadelphia fell to
635-766: A century, the Pennsylvania General Assembly met at various places in the Philadelphia area before it began meeting regularly in Independence Hall in Philadelphia for 63 years. However, events such as the Paxton Boys massacres of 1763 had made the legislature aware of the need for a central capital. In 1799, the General Assembly moved to the Lancaster Courthouse. The Pennsylvania General Assembly met in
762-661: A combination of a convolutional neural network and a heterogenous graph model. When a health facility has documented their workflow and chosen their software solution they must then consider the hardware and supporting device infrastructure for the end users. Staff and patients will need to engage with various devices throughout a patient's stay and charting workflow. Computers, laptops, all-in-one computers, tablets, mouse, keyboards and monitors are all hardware devices that may be utilized. Other considerations will include supporting work surfaces and equipment, wall desks or articulating arms for end users to work on. Another important factor
889-537: A comprehensive technology system and may involve errors of either commission or omission. These unintended adverse events typically stem from human-machine interfaces or organization/system design." The Joint Commission cites as an example the United States Pharmacopeia MEDMARX database where of 176,409 medication error records for 2006, approximately 25 percent (43,372) involved some aspect of computer technology as at least one cause of
1016-470: A genetic biobank and screening program called MyCode, which sequences the genetic code of volunteer patients to screen them for risk markers of diseases. As of 2018, MyCode had obtained genetic information from over 200,000 patient volunteers. This bank of genetic material has also been used for medical research purposes. In 1967, Geisinger was awarded a federal grant to study the effectiveness of medications to prevent heart attacks or their recurrence. In 1974,
1143-520: A grant that incorporated all lands included in the original Virginia Company of Plymouth Grant and other lands. This grant was in conflict with the Dutch claim for New Netherland , which included parts of today's Pennsylvania. On June 24, 1664, the Duke of York sold the portion of his large grant that included present-day New Jersey to John Berkeley and George Carteret for a proprietary colony. The land
1270-451: A heavy snowstorm, presumably because of a faulty flue . The General Assembly met at a nearby Methodist Church until a new capitol could be built. Following an architectural selection contest, Chicago architect Henry Ives Cobb was asked to design and build a replacement building. However, the legislature had little money to allocate to the project. When they dubbed the roughly finished, somewhat industrial Cobb Capitol building complete,
1397-500: A large pool, and uses this information to assist with the creation of "new treatments or innovation in healthcare delivery" which overall improves the goals in healthcare. Combining multiple types of clinical data from the system's health records has helped clinicians identify and stratify chronically ill patients. EHR can improve quality care by using the data and analytics to prevent hospitalizations among high-risk patients. EHR systems are designed to store data accurately and to capture
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#17327868769951524-457: A leader in technology and healthcare. Similarly, Philadelphia has a concentration of university expertise. Healthcare, retail, transportation, and tourism are some of the state's growing industries of the postindustrial era. As in the rest of the nation, most residential population growth has occurred in suburban rather than central city areas, although both major cities have had significant revitalization in their downtown areas. Philadelphia anchors
1651-653: A merger with Geisinger, stating that with the presence of a Geisinger clinic in Lewistown and with Geisinger offering health insurance, a monopoly might result from the merger, ultimately hurting instead of helping local healthcare. The full merger and integration of Geisinger-Lewistown Hospital into Geisinger Health System received final approval from the Pennsylvania Attorney General and the Pennsylvania Department of Health and
1778-409: A much quicker rate. Natural language processing is increasingly used to search EMRs, especially through searching and analyzing notes and text that would otherwise be inaccessible for study when seeking to improve care. One study found that several machine learning methods could be used to predict the rate of a patient's mortality with moderate success, with the most successful approach including using
1905-465: A number of smaller clinical care facilities and pharmacies. The Geisinger Clinic is one of the largest doctors groups in the United States, employing 5,164 medical professionals at 289 locations. The organization offers internal health insurance plans to the public within its coverage area. Geisinger also conducts medical research and operates both Geisinger Commonwealth School of Medicine and
2032-787: A patient's record is not only possible through a workstation but, depending on the type of system and health care settings, may also be possible through mobile devices that are handwriting capable, tablets and smartphones. Electronic Medical Records may include access to Personal Health Records (PHR) which makes individual notes from an EMR readily visible and accessible for consumers. Some EMR systems automatically monitor clinical events, by analyzing patient data from an electronic health record to predict, detect and potentially prevent adverse events. This can include discharge/transfer orders, pharmacy orders, radiology results, laboratory results and any other data from ancillary services or provider notes. This type of event monitoring has been implemented using
2159-482: A person's status from stable to unstable very quickly. With paper documentation it is very easy to not properly document the administration of medication, the time given, or errors such as giving the "wrong drug, dose, form, or not checking for allergies" and could affect the patient negatively. It has been reported that these errors have been reduced by "55-83%" because records are now online and require certain steps to avoid these errors. Electronic records may help with
2286-560: A physician performs tests in the office, it might reduce his or her income. Doubts have been raised about cost saving from EHRs by researchers at Harvard University , the Wharton School of the University of Pennsylvania , Stanford University , and others. In 2022 the chief executive of Guy's and St Thomas' NHS Foundation Trust , one of the biggest NHS organisations, said that the £450 million cost over 15 years to install
2413-414: A program that drives patients unable to arrange their own transportation to medical appointments or pharmacies. Geisinger incorporates electronic health records (EHRs) and genomics into its healthcare practices. Geisinger first adopted EHRs in 1996. By 2002, it was using Tel-a-Nurse, a service that allowed patients to call and receive medical advice from nurses informed by EHRS. In 2007, Geisinger opened
2540-596: A range of data, including demographics , medical history, medication and allergies , immunization status, laboratory test results, radiology images, vital signs , personal statistics like age and weight, and billing information. For several decades, electronic health records (EHRs) have been touted as key to increasing of quality care. Electronic health records are used for other reasons than charting for patients; today, providers are using data from patient records to improve quality outcomes through their care management programs. EHR combines all patients demographics into
2667-444: A rapid pace. According to a 2012 survey by Physicians Practice , 62.6 percent of respondents (1,369 physicians, practice managers, and other healthcare providers) say they use mobile devices in the performance of their job. Mobile devices are increasingly able to sync up with electronic health record systems thus allowing physicians to access patient records from remote locations. Most devices are extensions of desk-top EHR systems, using
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#17327868769952794-459: A relative decrease in time by 65% has been recorded (from 130 to 46 hours). The Healthcare Information and Management Systems Society , a very large U.S. healthcare IT industry trade group, observed in 2009 that EHR adoption rates "have been slower than expected in the United States, especially in comparison to other industry sectors and other developed countries. A key reason, aside from initial costs and lost productivity during EMR implementation,
2921-577: A result, many have conducted studies like the one discussed in the Journal of the American Medical Informatics Association , "The Extent And Importance of Unintended Consequences Related To Computerized Provider Order Entry," which seeks to understand the degree and significance of unplanned adverse consequences related to computerized physician order entry and understand how to interpret adverse events and understand
3048-593: A study called "DiscovEHR". The program uses gene sequencing by the biotechnology company Regeneron Pharmaceuticals . The National Institutes of Health awarded a grant of US$ 5.5 million to the research program in 2016. The program was expanded to include whole exome sequencing in 2018. Using the patient volunteers' genetic data stored in its MyCode program, Geisinger has conducted or collaborated on genetic research studies aimed at identifying potential links between genetic variants and risk factors for certain diseases. Geisinger contributed data from 35,000 of its patients to
3175-417: A subsidiary health management organization (HMO), was started in 1985. On December 4, 2012, it was announced that Geisinger Health System and Lewistown Hospital had signed a non-binding letter of intent for a merger. Geisinger's Frank Trembulak said the non-binding letter refers to the specifics of how the merger will work and that there is a "binding agreement to merge". Independent physicians have opposed
3302-512: A trade journal suggests that since anyone using an EMR can view the patient's full chart, it cuts down on guessing histories, seeing multiple specialists, smooths transitions between care settings, and may allow better care in emergency situations. EHRs may also improve prevention by providing doctors and patients better access to test results, identifying missing patient information, and offering evidence-based recommendations for preventive services. The steep price and provider uncertainty regarding
3429-418: A variety of software to communicate and access files remotely. The advantages of instant access to patient records at any time and any place are clear, but bring a host of security concerns. As mobile systems become more prevalent, practices will need comprehensive policies that govern security measures and patient privacy regulations. Other advanced computational techniques have allowed EHRs to be evaluated at
3556-408: Is a way of helping people understand their own health condition and involving them actively in its management. Challenges with sharing the electronic health record with patients includes a risk of increased confusion or anxiety if a person does not understand or cannot contextualize the testing results. In addition, many EHRs are not designed for people of all educational levels and do not consider
3683-434: Is an electronic application for recording personal medical data that the individual patient controls and may make available to health providers. While there is still a considerable amount of debate around the superiority of electronic health records over paper records, the research literature paints a more realistic picture of the benefits and downsides. The increased transparency, portability, and accessibility acquired by
3810-478: Is cost efficient. Due to the digital information being searchable and in a single file, EMRs (electronic medical records) are more effective when extracting medical data for the examination of possible trends and long term changes in a patient. Population-based studies of medical records may also be facilitated by the widespread adoption of EHRs and EMRs. The terms EHR, electronic patient record (EPR) and EMR have often been used interchangeably, but differences between
3937-592: Is difficult to remove data from its context. Providing patients with information is central to patient-centered health care and this has been shown to have some positive effects on health outcomes. Providing patients with access to their health records including medical histories and test results via an electronic health record is a legal right in some parts of the world. There is some evidence that patient access may help outcomes. Sharing their electronic health records with people who have type 2 diabetes may help these people to reduce their blood sugar levels . It
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4064-630: Is how all these devices will be physically secured and how they will be charged that staff can always utilize the devices for EHR charting when needed. The success of eHealth interventions is largely dependent on the ability of the adopter to fully understand workflow and anticipate potential clinical processes prior to implementations. Failure to do so can create costly and time-consuming interruptions to service delivery. Per empirical research in social informatics , information and communications technology (ICT) use can lead to both intended and unintended consequences . A 2008 Sentinel Event Alert from
4191-849: Is in Duncannon in Perry County . According to the U.S. Department of Housing and Urban Development 's 2022 Annual Homeless Assessment Report , there were an estimated 12,691 homeless people in Pennsylvania. Among Pennsylvania residents, as of 2020, nearly three out of four, 74.5%, are native to the state and were born in Pennsylvania, 18.4% were born in a different U.S. state, 1.5% were born in Puerto Rico , U.S. Island areas, or born abroad to American parent(s), and 5.6% were foreign born. Foreign-born Pennsylvanians are largely from Asia (36.0%), Europe (35.9%), and Latin America (30.6%) with
4318-611: Is lack of efficiency and usability of EMRs currently available." The U.S. National Institute of Standards and Technology of the Department of Commerce studied usability in 2011 and lists a number of specific issues that have been reported by health care workers. The U.S. military's EHR, AHLTA , was reported to have significant usability issues. Furthermore, studies such as the one conducted in BMC Medical Informatics and Decision Making, also showed that although
4445-603: Is maintained even if data breaches occur. There are concerns about the efficacy of some currently applied pseudonymization and data protection techniques, including the applied encryption. Documentation burden : While such records could enable avoiding duplication of work via records-sharing, documentation burdens for medical facility personnel can be a further issue with EHRs. This burden could be reduced via voice recognition , optical character recognition , other technologies, involvement of physicians in changes to software, and other means which could possibly reduce
4572-428: Is possible for an EHR to increase physician productivity by providing a fast and intuitive interface for viewing and understanding patient clinical data and minimizing the number of clinically irrelevant questions, but that is almost never the case. The other way to mitigate the detriment to physician productivity is to hire scribes to work alongside medical practitioners, which is almost never financially viable. As
4699-610: Is the 33rd-largest by area and has the ninth-highest population density among all states. The largest metropolitan statistical area is the southeastern Delaware Valley , which includes and surrounds Philadelphia, the state's largest and nation's sixth-most populous city. The second-largest metropolitan area, Greater Pittsburgh , is centered in and around Pittsburgh , the state's second-largest city. The state's subsequent five most populous cities are Allentown , Reading , Erie , Scranton , and Bethlehem . Pennsylvania's history of human habitation extends thousands of years before
4826-1542: Is the Geisinger Medical Center (GMC) located in Danville, with nine other hospitals: Geisinger Bloomsburg Hospital in Bloomsburg, Pennsylvania, Geisinger Wyoming Valley (GWV) and Geisinger South Wilkes-Barre - both located in Wilkes-Barre, Geisinger-Community Medical Center (GCMC) located in Scranton , Geisinger Jersey Shore Hospital (GJSH) located in Jersey Shore, Pennsylvania, Geisinger Lewistown Hospital (GLH), in Lewistown, Pennsylvania, Geisinger Muncy Medical Center (GMCM), in Muncy Pennsylvania, Geisinger Shamokin Community Hospital (GSACH) in Shamokin, Pennsylvania, and Geisinger St. Lukes in Orwigsburg, Pennsylvania. Geisinger has clinics throughout northeastern and western Pennsylvania , located in Wilkes-Barre , Pittston , Mountaintop, Nanticoke, Wyoming , Scranton , Dallas , Plains , Kingston , State College , and other surrounding cities and towns. Geisinger Health Plan,
4953-464: Is the fifth-most populated state in the U.S. after California , Texas , Florida , and New York . In 2019, net migration to other states resulted in a decrease of 27,718, and immigration from other countries resulted in an increase of 127,007. Net migration to Pennsylvania was 98,289. Migration of native Pennsylvanians resulted in a decrease of 100,000 people. 7.2% of the population was foreign-born as of 2021. Pennsylvania's center of population
5080-865: The British in the Philadelphia campaign , the Continental Congress moved west, where it met at the Lancaster courthouse on Saturday, September 27, 1777, and then to York . In York, the Second Continental Congress adopted the Articles of Confederation , largely authored by Pennsylvania delegate John Dickinson, that formed 13 independent States into a new union. Later, the Constitution was written, and Philadelphia
5207-474: The Canadian province of Ontario to its northwest via Lake Erie . Pennsylvania was founded in 1681 through a royal land grant to William Penn , the son of the state's namesake . Prior to that, between 1638 and 1655, a southeast portion of the state was part of New Sweden , a Swedish Empire colony. Established as a haven for religious and political tolerance, the colonial-era Province of Pennsylvania
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5334-746: The Commonwealth of Pennsylvania ( Pennsylvania Dutch : Pennsilfaani ), is a U.S. state spanning the Mid-Atlantic , Northeastern , Appalachian , and Great Lakes regions of the United States . It borders Delaware to its southeast, Maryland to its south, West Virginia to its southwest, Ohio and the Ohio River to its west, Lake Erie and New York to its north, the Delaware River and New Jersey to its east, and
5461-536: The Declaration of Independence the following year. On December 12, 1787, Pennsylvania was the second state to ratify the U.S. Constitution . In July 1863, the Battle of Gettysburg , fought over three days in and around Gettysburg , was the bloodiest and most decisive battle of the American Civil War , claiming over 50,000 Union and Confederate fatalities and repelling Robert E. Lee 's invasion of
5588-791: The Delaware River in the east and the Susquehanna River in central Pennsylvania. The second tribe, the Susquehannock , spoke an Iroquoian language and were based in Western Pennsylvania from New York state in the north to West Virginia in the southwest, including the Susquehanna, Allegheny , and Monongahela rivers near present-day Pittsburgh . European disease and constant warfare with several neighboring tribes and groups of Europeans weakened these two tribes, and they were grossly outpaced financially as
5715-482: The Delaware River to the east, 80°31' W to the west, and the 42° N to the north, except for a short segment on the western end where a triangle extends north to Lake Erie . The state has five geographical regions: Allegheny Plateau , Ridge and Valley , Atlantic Coastal Plain , Piedmont , and Erie Plain . Pennsylvania's diverse topography produces a variety of climates, though the entire state experiences cold winters and humid summers. Straddling two major zones,
5842-627: The Dominican Republic , China , Mexico , and Vietnam . Electronic health records An electronic health record ( EHR ) also known as an electronic medical record (EMR) or personal health record (PHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include
5969-569: The Epic Systems electronic patient record across its six hospitals, which will reduce more than 100 different IT systems down to just a handful, was "chicken feed" when compared to the NHS's overall budget. The implementation of EMR can potentially decrease identification time of patients upon hospital admission. A research from the Annals of Internal Medicine showed that since the adoption of EMR
6096-884: The Hurons and Iroquois blocked them from proceeding west into Ohio during the Beaver Wars . As they lost numbers and land, the Hurons abandoned much of their western territory and moved closer to the Susquehanna River, and the Iroquois and Mohawk tribes moved further north. Northwest of the Allegheny River was the Iroquoian Petun , who were fragmented into three groups during the Beaver Wars:
6223-833: The Northeast megalopolis and is associated with the Northeastern United States . Pittsburgh is part of the Great Lakes megalopolis and is often associated with the Rust Belt . During the September 11, 2001, terrorist attacks on the United States , the small town of Shanksville, Pennsylvania , received worldwide attention after United Airlines Flight 93 crashed into a field in Stonycreek Township , located 1.75 miles (2.82 km) north of
6350-517: The Secretary of War under President Abraham Lincoln . Control of the machine was subsequently passed on to Cameron's son J. Donald Cameron , whose ineffectiveness resulted in a transfer of power to the more shrewd Matthew Quay and finally to Boies Penrose . The post-Civil War era, known as the Gilded Age , saw the continued rise of industry in Pennsylvania. Pennsylvania was home to some of
6477-791: The Spanish–American War . Pennsylvania was an important industrial center in World War I , and the state provided over 300,000 soldiers for the military. On May 31, 1918, the Pittsburgh Agreement was signed in Pittsburgh to declare the formation of the independent state of Czechoslovakia with future Czechoslovak president Tomáš Masaryk . In 1922, 310,000 Pennsylvania miners joined the UMW General coal strike , which lasted 163 days and shut down most coal mines within
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#17327868769956604-672: The United States . Pennsylvania has 51 miles (82 km) of coastline along Lake Erie and 57 miles (92 km) of shoreline along the Delaware Estuary . Of the original Thirteen Colonies , Pennsylvania is the only state that does not border the Atlantic Ocean . The boundaries of the state are the Mason–Dixon line (39°43' N) to the south, Twelve-Mile Circle on the Pennsylvania- Delaware border,
6731-609: The University of Pennsylvania in Philadelphia . The university, one of nine colonial colleges , was the first college established in Pennsylvania and one of the first in the nation. Today, it is an Ivy League university, which is routinely ranked among the world's best universities. Dickinson College in Carlisle , founded by Benjamin Rush and named after John Dickinson, was the first college founded after Revolutionary War and
6858-624: The county commission and freedom of religion , which were subsequently replicated in many of the Thirteen Colonies . What had been Upland on the Pennsylvania side of the Pennsylvania-Delaware border was renamed Chester County when Pennsylvania instituted its colonial governments on March 4, 1681. Penn signed a peace treaty with Tamanend , leader of the Lenape, which began a long period of friendly relations between
6985-509: The seventh-largest metropolitan area in the country and one of the largest metropolitan areas in the world, and Pittsburgh is the center of the nation's 27th-largest metropolitan areas. As of 2020, the Lehigh Valley in eastern Pennsylvania is the nation's 69th-largest metropolitan area. Pennsylvania also has six additional metropolitan areas that rank among the nation's 200-most populous metropolitan areas. Philadelphia forms part of
7112-617: The "absence of mandatory reporting enforcement of H-IT safety issues limits the numbers of medical device reports (MDRs) and impedes a more comprehensive understanding of the actual problems and implications." A 2010 Board Position Paper by the American Medical Informatics Association (AMIA) contains recommendations on EHR-related patient safety, transparency, ethics education for purchasers and users, adoption of best practices, and re-examination of regulation of electronic health applications. Beyond concrete issues such as conflicts of interest and privacy concerns, questions have been raised about
7239-514: The 15th U.S. president and was the first president to be born in Pennsylvania. The Battle of Gettysburg , the major turning point of the American Civil War , took place near Gettysburg in July 1863. An estimated 350,000 Pennsylvanians served in the Union Army forces, including 8,600 African American military volunteers . The politics of Pennsylvania were for decades dominated by the financially conservative Republican -aligned Cameron machine , established by U.S. Senator Simon Cameron , later
7366-417: The 45th President of the United States Donald Trump occurred. Pennsylvania is 170 miles (274 km) north to south and 283 miles (455 km) east to west. Of a total 46,055 square miles (119,282 km ), 44,817 square miles (116,075 km ) are land, 490 square miles (1,269 km ) are inland waters, and 749 square miles (1,940 km ) are waters in Lake Erie . It is the 33rd-largest state in
7493-428: The 48 states. The Philadelphia Naval Shipyard served as an important naval base, and Pennsylvania produced important military leaders, including George C. Marshall , Hap Arnold , Jacob Devers , and Carl Spaatz . During the war, over a million Pennsylvanians served in the armed forces, and more Medals of Honor were awarded to Pennsylvanians than to individuals from any other state. The Three Mile Island accident
7620-408: The Americas began, at least two major Native American tribes inhabited Pennsylvania. The first, the Lenape , spoke an Algonquian language and inhabited the eastern region of the state, then known as Lenapehoking . It included most of present-day New Jersey and the Lehigh Valley and Delaware Valley regions in eastern and southeastern Pennsylvania. The Lenape's territory ended somewhere between
7747-412: The Central Pennsylvania Chapter of the Arthritis Foundation awarded a grant to Geisinger to study the potential treatment of Raynaud syndrome with drugs normally used to treat high blood pressure at that time. Geisinger has a database of electronic health records (EHR), and set up a genetics research program called MyCode in 2007. The use of EHR allows longitudinal study of patient outcomes through
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#17327868769957874-543: The Dutch began settling the Delmarva Peninsula by establishing the Zwaanendael Colony on the site of present-day Lewes, Delaware . In 1638, Sweden established the New Sweden Colony in the region of Fort Christina on the site of present-day Wilmington, Delaware . New Sweden claimed and, for the most part, controlled the lower Delaware River region, including parts of present-day Delaware, New Jersey, and Pennsylvania, but settled few colonists there. On March 12, 1664, King Charles II of England gave James, Duke of York
8001-508: The EHR as a tool supporting particular work. Several possible advantages to EHRs over paper records have been proposed, but there is debate about the degree to which these are achieved in practice. Several studies call into question whether EHRs improve the quality of care. One 2011 study in diabetes care, published in the New England Journal of Medicine , found evidence that practices with EHR provided better quality care. EMRs may eventually help improve care coordination. An article in
8128-469: The EHR exist. The health information systems literature has seen the EHR as a container holding information about the patient, and a tool for aggregating clinical data for secondary uses (billing, audit, etc.). However, other research traditions see the EHR as a contextualised artifact within a socio-technical system. For example, actor-network theory would see the EHR as an actant in a network, and research in computer supported cooperative work (CSCW) sees
8255-498: The Geisinger-Lewistown School of Nursing. The organization also has a charitable arm, the Geisinger Foundation. In 2015, Geisinger launched a patient satisfaction program called ProvenExperience, which offers refunds of co-pays or deductibles to patients unhappy with their medical treatment or other aspects of care. In 2017, it started the Fresh Food Farmacy, a program that provides free healthy foods and nutrition advice to low-income patients with diabetes . In 2018, Geisinger introduced
8382-427: The General Assembly refused to occupy the building. In 1901, political and popular indignation prompted a second contest that was restricted to Pennsylvania architects; Joseph Miller Huston of Philadelphia was chosen to design the present Pennsylvania State Capitol that incorporated Cobb's building into a magnificent public work, finished and dedicated in 1907. James Buchanan , a Franklin County native, served as
8509-417: The Louisiana Public health information exchange linking statewide public health with electronic medical records. This system alerted medical providers when a patient with HIV/AIDS had not received care in over twelve months. This system greatly reduced the number of missed critical opportunities. Within a meta-narrative systematic review of research in the field, various different philosophical approaches to
8636-409: The Netherlands confirmed the English conquest on July 21, 1667, although there were temporary reversions. On September 12, 1672, during the Third Anglo-Dutch War , the Dutch reconquered New York Colony / New Amsterdam , establishing three County Courts, which went on to become original Counties in present-day Delaware and Pennsylvania. The one that later transferred to Pennsylvania was Upland. This
8763-440: The North, leading to the Union's preservation . Throughout the late 19th and 20th centuries, the state's manufacturing-based economy contributed to the development of much of the nation's early infrastructure, including key bridges, skyscrapers , and military hardware used in U.S.-led victories in World War I , World War II , and the Cold War . Pennsylvania's geography is highly diverse. The Appalachian Mountains run through
8890-439: The Petun of New York, the Wyandot of Ohio, and the Tiontatecaga of the Kanawha River in southern West Virginia. South of the Allegheny River was a nation known as Calicua, which may have been part of the Monongahela culture . In the 17th century, the Dutch and the English each claimed both sides of the Delaware River as part of their colonial lands in America. The Dutch were the first to take possession. By June 3, 1631,
9017-563: The Quakers and the Indians. Additional treaties between Quakers and other tribes followed. The Treaty of Shackamaxon of William Penn was never violated. Between 1730 and when the Pennsylvania Colony was shut down by Parliament with the Currency Act in 1764, the Pennsylvania Colony made its own paper money to account for the shortage of actual gold and silver. The paper money was called Colonial Scrip . The Colony issued bills of credit, which were as good as gold or silver coins because of their legal tender status. Since they were issued by
9144-499: The U.S. Joint Commission , the organization that accredits American hospitals to provide healthcare services, states, 'As health information technology (HIT) and 'converging technologies'—the interrelationship between medical devices and HIT—are increasingly adopted by health care organizations, users must be mindful of the safety risks and preventable adverse events that these implementations can create or perpetuate. Technology-related adverse events can be associated with all components of
9271-742: The United States and the United Kingdom have introduced the use of EMR systems. EMS Encounters in the United States are recorded using various platforms and vendors in compliance with the NEMSIS (National EMS Information System) standard. The benefits of electronic records in ambulances include: patient data sharing, injury/illness prevention, better training for paramedics, review of clinical standards, better research options for pre-hospital care and design of future treatment options, data based outcome improvement, and clinical decision support. Health Information Exchange Using an EMR to read and write
9398-422: The ability to exchange records between different EMR systems were perfected ("interoperability" ), it would facilitate the coordination of health care delivery in nonaffiliated health care facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance. However, it
9525-583: The adoption of electronic medical records may increase the ease with which they can be accessed by healthcare professionals, but also can increase the amount of stolen information by unauthorized persons or unscrupulous users versus paper medical records, as acknowledged by the increased security requirements for electronic medical records included in the Health Information and Accessibility Act and by large-scale breaches in confidential records reported by EMR users. Concerns about security contribute to
9652-480: The center of the state; the Allegheny and Pocono mountains span much of Northeastern Pennsylvania ; close to 60% of the state is forested . While it has no ocean shoreline, it has 140 miles (225 km) of waterfront along Lake Erie and the tidal Delaware River. Pennsylvania is the fifth-most populous state in the United States , with over 13 million residents as of the 2020 United States census . The state
9779-429: The city's population as of 2000. In the 20th century, as Pennsylvania's historical national and even global leadership in mining largely ceased and its steelmaking and other heavy manufacturing sectors slowed, the state sought to grow its service and other industries to replace the jobs and economic productivity lost from the downturn of these industries. Pittsburgh's concentration of universities has enabled it to be
9906-574: The council, was passed in 2016 to go into effect in 2018 to protect the processing of personal data, including that for purposes of health care, the General Data Protection Regulation . Threats to health care information can be categorized under three headings: These threats can either be internal, external, intentional and unintentional. Therefore, one will find health information systems professionals having these particular threats in mind when discussing ways to protect
10033-443: The deal, Geisinger would operate as an independent subsidiary, folded into a new non-profit group called Risant Health; the transaction was completed on March 31, 2024. Geisinger Health System serves over half a million patients across multiple states in the Northeastern United States . Geisinger's primary geographical area of coverage is central and northeastern Pennsylvania . As of September 2021, it operates 11 hospitals as well as
10160-614: The development of labor unions helped them gain living wages. However, the rise of unions also led to a rise of union busting with several private police forces springing up. Pennsylvania was the location of the first documented organized strike in North America, and Pennsylvania was the location of two hugely prominent strikes, the Great Railroad Strike of 1877 and the Coal Strike of 1902 . The eight-hour day
10287-510: The documentation burden to below paper-based records documentation and low-level documentation. Theoretically, free software such as GNU Health and other open source health software could be used or modified for various purposes that use electronic medical records i.a. via securely sharing anonymized patient treatments, medical history and individual outcomes (including by common primary care physicians). Ambulance services in Australia,
10414-484: The earliest known signs of human activity in Pennsylvania and perhaps all of North America, including the remains of a civilization that existed over 10,000 years ago and possibly pre-dated the Clovis culture . By 1000 CE, in contrast to their nomadic hunter-gatherer ancestors , the native population of Pennsylvania had developed agricultural techniques and a mixed food economy. By the time European colonization of
10541-658: The error. The British National Health Service (NHS) reports specific examples of potential and actual EHR-caused unintended consequences in its 2009 document on the management of clinical risk relating to the deployment and use of health software. In a February 2010, an American Food and Drug Administration (FDA) memorandum noted that EHR unintended consequences include EHR-related medical errors from (1) errors of commission (EOC), (2) errors of omission or transmission (EOT), (3) errors in data analysis (EDA), and (4) incompatibility between multi-vendor software applications or systems (ISMA), examples were cited. The FDA also noted that
10668-417: The fifth and currently the sixth-largest city after decades of being among the top three. After 1990, as information-based industries became more important in the economy, state and local governments put more resources into the old, well-established public library system. Some localities, however, used new state funding to cut local taxes. New ethnic groups, especially Hispanics and Latinos , began entering
10795-577: The first. At the time, Pennsylvania was the most ethnically and religiously diverse of the thirteen colonies. Because a third of Pennsylvania's population spoke German , the Constitution was presented in German so those citizens could participate in the discussion about it. Reverend Frederick Muhlenberg , a Lutheran minister and the first Speaker of the U.S. House of Representatives , acted as chairman of Pennsylvania's ratifying convention. For half
10922-704: The foundation of the colonial Province of Pennsylvania in 1681. Archaeologists believe the first settlement of the Americas occurred at least 15,000 years ago, during the Last Glacial Period , though it is unclear when humans first inhabited present-day Pennsylvania. Between 10,000 and 16,000 years ago, Native Americans crossed the two continents, arriving in North America . Meadowcroft Rockshelter in Jefferson Township includes
11049-571: The government and not a banking institution, they were interest-free, largely defraying the expense of the government and therefore taxation of the people. It also promoted general employment and prosperity, since the government used discretion and did not issue excessive amounts that inflated the currency. Benjamin Franklin had a hand in creating this currency, whose utility, he said, was never to be disputed. The currency also met with "cautious approval" by Adam Smith . In 1740, Franklin also founded
11176-431: The health information of patients. It has been found that there is a lack of security awareness among health care professionals in countries such as Spain. The Health Insurance Portability and Accountability Act (HIPAA) has developed a framework to mitigate the harm of these threats that is comprehensive but not so specific as to limit the options of healthcare professionals who may have access to different technology. With
11303-428: The implementation of electronic medical records systems has been a great assistance to general practitioners there is still much room for revision in the overall framework and the amount of training provided. It was observed that the efforts to improve EHR usability should be placed in the context of physician-patient communication. However, physicians are embracing mobile technologies such as smartphones and tablets at
11430-560: The importance of its management for the overall success of computer physician order entry. In the United States, Great Britain, and Germany, the concept of a national centralized server model of healthcare data has been poorly received. Issues of privacy and security in such a model have been of concern. In the European Union (EU), a new directly binding instrument, a regulation of the European Parliament and of
11557-479: The increase of clinical notes being shared electronically as a result of the 21st Century Cures Act , an increase in sensitive terms used across the records of all patients, including minors, are increasingly shared amongst care teams, complicating efforts to maintain privacy. Personal Information Protection and Electronic Documents Act (PIPEDA) was given Royal Assent in Canada on 13 April 2000 to establish rules on
11684-484: The land be called New Wales, but there were objections to that name, so he recommended Sylvania (from the Latin silva : "forest, woods"). The King named it Pennsylvania (literally "Penn's Woods") in honor of Admiral Penn. The younger Penn was embarrassed at this name, fearing that people would think he had named it after himself, but King Charles would not rename the grant. Penn established a government with two innovations,
11811-567: The largest chocolate manufacturer in North America. Heinz Company was also founded during this period. These huge companies exercised a large influence on the politics of Pennsylvania; as Henry Demarest Lloyd put it, oil baron John D. Rockefeller "had done everything with the Pennsylvania legislature except refine it". Pennsylvania created a Department of Highways and engaged in a vast program of road-building, while railroads continued to see heavy usage. The growth of industry eventually provided middle class incomes to working-class households after
11938-529: The largest steel companies in the world. Andrew Carnegie founded the Carnegie Steel Company in Pittsburgh and Charles M. Schwab founded Bethlehem Steel in Bethlehem . Other titans of industry, including John D. Rockefeller and Jay Gould , also operated in Pennsylvania. In the latter half of the 19th century, the U.S. oil industry was born in Western Pennsylvania , which supplied
12065-417: The majority of the state, except for the southeastern corner, has a humid continental climate ( Köppen climate classification Dfb ). The southern portion of the state has a humid subtropical climate. The largest city, Philadelphia , has a humid subtropical climate (Köppen Cfa ). Summers are generally hot and humid. Moving toward the mountainous interior of the state, the winter climate becomes colder,
12192-401: The models are now being defined. The electronic health record (EHR) is a more longitudinal collection of the electronic health information of individual patients or populations. The EMR, in contrast, is the patient record created by providers for specific encounters in hospitals and ambulatory environments and can serve as a data source for an EHR. In contrast, a personal health record (PHR)
12319-522: The need to increase information technology staff to maintain the system. The U.S. Congressional Budget Office concluded that the cost savings may occur only in large integrated institutions like Kaiser Permanente, and not in small physician offices. They challenged the Rand Corporation 's estimates of savings. "Office-based physicians in particular may see no benefit if they purchase such a product—and may even suffer financial harm. Even though
12446-465: The needs of those with a lower level of education or those who are not fluent in the language. Accessing the EHR requires a level of proficiency with electronic devices which adds in a disparity for those without access or for those who have a mental or physical illness that restricts their access to the electronic system. Electronic medical records could also be studied to quantify disease burdens – such as
12573-549: The new Geisinger-Lewistown Hospital became effective on November 1, 2013. From 2001 through mid 2015, Glenn Steele served as Geisinger's president and chief executive officer. Steele left Geisinger in 2015, with David Feinberg joining as president and CEO. In December 2018, Jaewon Ryu was named interim president and CEO. Prior to the announcement, he previously served as the health system's executive vice president and chief medical officer since 2016. On April 26, 2023, Kaiser Permanente announced it would acquire Geisinger. As part of
12700-442: The north-central region with York , Carlisle , and the state capital Harrisburg on the Susquehanna River in the east-central region of the state. Altoona and Johnstown are in the state's west-central region. The state's three-most populated cities, in order of size, are Philadelphia, Pittsburgh, and Allentown. As of the 2020 U.S. census , Pennsylvania had a population of 13,011,844, up from 12,702,379 in 2010. Pennsylvania
12827-627: The number of cloudy days increases, and snowfall amounts are greater. Western areas of the state, particularly locations near Lake Erie , can receive over 100 inches (250 cm) of snowfall annually, and the entire state receives plentiful precipitation throughout the year. The state may be subject to severe weather from spring through summer into autumn. Tornadoes occur annually in the state, sometimes in large numbers, such as 30 recorded tornadoes in 2011; generally speaking, these tornadoes do not cause significant damage. Cities in Pennsylvania include Philadelphia , Reading , Lebanon , and Lancaster in
12954-718: The number of deaths from antimicrobial resistance – or help identify causes of, factors of, links between and contributors to diseases, especially when combined with genome-wide association studies . This may enable increased flexibility, improved disease surveillance , better medical product safety surveillance, better public health monitoring (such as for evaluation of health policy effectiveness), increased quality of care (via guidelines and improved medical history sharing ), and novel life-saving treatments. Privacy : For such purposes, electronic medical records could potentially be made available in securely anonymized or pseudonymized forms to ensure patients' privacy
13081-654: The old Dauphin County Court House until December 1821 when the Federal -style Hills Capitol, named for Lancaster architect Stephen Hills , was constructed on a hilltop land grant of four acres set aside for a seat of state government in Harrisburg by the son and namesake of John Harris, Sr. , a Yorkshire native who founded a trading post and ferry on the east shore of the Susquehanna River in 1705. The Hills Capitol burned down on February 2, 1897, during
13208-429: The remainder from Africa (5%), North America (3.1%), and Oceania (0.4%). The state's largest ancestry groups, expressed as a percentage of total people who responded with a particular ancestry for the 2010 census, were German 28.5%, Irish 18.2%, Italian 12.8%, African Americans 9.6%, English 8.5%, Polish 7.2%, and French 4.2%. As of 2018, the top countries of origin for Pennsylvania's immigrants were India ,
13335-411: The resistance shown to their adoption. Handwritten paper medical records may be poorly legible, which can contribute to medical errors . Pre-printed forms, standardization of abbreviations and standards for penmanship were encouraged to improve the reliability of paper medical records. An example of possible medical errors is the administration of medication. Medication is an intervention that can turn
13462-498: The school's nearly $ 40 million debt as part of the acquisition. Geisinger Commonwealth School of Medicine received a $ 3.4 million grant from the federal government in 2017 to promote diversity and provide opportunities for disadvantaged communities. In order to "fix the primary care shortage facing the organization", Geisinger announced a program in 2019 to cover full tuition plus a $ 2,000 monthly stipend for 40 students committing to work at Geisinger for at least four years after completing
13589-404: The southeast, Pittsburgh in the southwest, and the tri-cities of Allentown , Bethlehem , and Easton in the central east, known as the Lehigh Valley . The northeast includes the former anthracite coal mining cities of Scranton , Wilkes-Barre , Pittston , Nanticoke , and Hazleton . Erie is located in the northwest. State College is located in the central region. Williamsport is in
13716-483: The standardization of forms, terminology, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. However, standardization may create challenges for local practice. Overall, those with EMRs that have automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs. EMRs can be continuously updated (within certain legal limitations: see below). If
13843-462: The state of a patient across time. It eliminates the need to track down a patient's previous paper medical records and assists in ensuring data is up-to-date, accurate and legible. It also allows open communication between the patient and the provider, while providing "privacy and security." It can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date and decreases risk of lost paperwork and
13970-581: The state to fill low-skill jobs in agriculture and service industries. For example, in Chester County , Mexican immigrants brought the Spanish language , increased Catholicism , high birth rates, and cuisine when they were hired as agricultural laborers; in some rural localities, they made up half or more of the population. Stateside Puerto Ricans built a large community in the state's third-largest city, Allentown , where they comprise over 40% of
14097-827: The state. In 1923, President Calvin Coolidge established the Allegheny National Forest under the authority of the Weeks Act of 1911. The forest is located in the northwest part of the state in Elk , Forest , McKean , and Warren Counties for the purposes of timber production and watershed protection in the Allegheny River basin. The Allegheny is the state's only national forest. Pennsylvania manufactured 6.6 percent of total U.S. military armaments produced during World War II , ranking sixth among
14224-534: The state." The ensuing hostilities became known as Pontiac's War . After the Stamp Act Congress of 1765, delegate John Dickinson of Philadelphia wrote the Declaration of Rights and Grievances . The Congress was the first meeting of the Thirteen Colonies , which convened at the request of the Massachusetts assembly; nine of the 13 colonies sent delegates. Dickinson then wrote Letters from
14351-549: The town. All 40 civilians and 4 Al-Qaeda hijackers on board were killed. The hijackers had intended to crash the plane into either the United States Capitol or The White House . After learning from family members via air phone of the earlier attacks on the World Trade Center , however, Flight 93's passengers revolted against the hijackers and fought for control of the plane, causing it to crash. It
14478-533: The unification of the states. Established in 1773, it was ratified on September 9, 1783, five days after the Treaty of Paris . James Smith wrote that in 1763, "the Indians again commenced hostilities, and were busily engaged in killing and scalping the frontier inhabitants in various parts of Pennsylvania. This state was then a Quaker government, and at the first of this war the frontiers received no assistance from
14605-466: The use of health IT could generate cost savings for the health system at large that might offset the EHR's cost, many physicians might not be able to reduce their office expenses or increase their revenue sufficiently to pay for it. For example, the use of health IT could reduce the number of duplicated diagnostic tests. However, that improvement in efficiency would be unlikely to increase the income of many physicians." One CEO of an EHR company has argued if
14732-534: The value they will derive from adoption in the form of return on investment has a significant influence on EHR adoption. In a project initiated by the Office of the National Coordinator for Health Information , surveyors found that hospital administrators and physicians who had adopted EHR noted that any gains in efficiency were offset by reduced productivity as the technology was implemented, as well as
14859-576: The vast majority of kerosene for years thereafter. As the Pennsylvania oil rush developed, Pennsylvania's oil boom towns, such as Titusville , rose and later fell. Coal mining, primarily in the state's Coal Region in the northeast region of the state, also was a major industry for much of the 19th and 20th centuries. In 1903, Milton S. Hershey began construction on a chocolate factory in Hershey, Pennsylvania ; The Hershey Company grew to become
14986-408: The ways in which the physician-patient relationship would be affected by an electronic intermediary. During the implementation phase, cognitive workload for healthcare professionals may be significantly increased as they become familiar with a new system. EHRs are almost invariably detrimental to physician productivity, whether the data is entered during the encounter or sometime thereafter. It
15113-498: Was 1.39%. The Pennsylvania average portion of NPR paid by Medicare and Medical Assistance was 35.4% and 14.9% respectively. The average payment per inpatient day for Medicare and Medical Assistance was $ 2,725 and $ 2,958 respectively, while commercial payers paid an average of $ 5,960 per inpatient day. Pennsylvania Pennsylvania ( / ˌ p ɛ n s ɪ l ˈ v eɪ n i ə / PEN -sil- VAY -nee-ə , lit. ' Penn's forest country ' ), officially
15240-550: Was eventually adopted, and the coal and iron police were banned. At the beginning of the 20th century, Pennsylvania's economy centered on steel production, logging , coal mining , textile production, and other forms of industrial manufacturing . A surge in immigration to the U.S. during the late 19th and early 20th centuries provided a steady flow of cheap labor for these industries, which often employed children and people who could not speak English from Southern and Eastern Europe . Thousands of Pennsylvanians volunteered during
15367-727: Was known for its relatively peaceful relations with native tribes, innovative government system , and religious pluralism . Pennsylvania played a vital and historic role in the American Revolution and the ultimately successful quest for independence from the British Empire , hosting the First and Second Continental Congress in Philadelphia , which formed the Continental Army and appointed George Washington as its commander in 1775, and unanimously adopted
15494-765: Was not yet in British possession, but the sale boxed in the portion of New Netherland on the West side of the Delaware River. The British conquest of New Netherland began on August 29, 1664, when New Amsterdam was coerced to surrender while facing cannons on British ships in New York Harbor . The conquest was completed in October 1664, when the British captured Fort Casimir in what today is New Castle, Delaware . The Treaty of Breda between England, France, and
15621-543: Was once again chosen to be cradle to the new nation. The Constitution was drafted and signed at the Pennsylvania State House in Philadelphia, now known as Independence Hall , the same building where the Declaration of Independence was previously adopted and signed in 1776. On December 12, 1787, Pennsylvania was the second state to ratify the U.S. Constitution , five days after Delaware became
15748-556: Was partially reversed on February 9, 1674, when the Treaty of Westminster ended the Third Anglo-Dutch War and reverted all political situations to the status quo ante bellum . The British retained the Dutch Counties with their Dutch names. By June 11, 1674, New York reasserted control over the outlying colonies, including Upland, and the names started to be changed to British names by November 11, 1674. Upland
15875-439: Was partitioned on November 12, 1674, producing the general outline of the current border between Pennsylvania and Delaware. On February 28, 1681, Charles II granted a land charter to Quaker leader William Penn to repay a debt of £16,000 (around £2,100,000 in 2008, adjusting for retail inflation) owed to William's father. The transaction represents one of the largest land grants to an individual in history. Penn proposed that
16002-441: Was the most significant nuclear accident in U.S. commercial nuclear power plant history. The state was hard-hit by the decline and restructuring of the steel industry and other heavy industries during the late 20th century. With job losses came heavy population losses, especially in the state's largest cities. Pittsburgh lost its place among the top ten most populous cities in the United States by 1950, and Philadelphia dropped to
16129-657: Was the only one of the four aircraft hijacked that day that never reached its intended target and the heroism of the passengers has been commemorated. Since 2003, the Tekko anime convention has been held annually in Pittsburgh. In October 2018, the Tree of Life – Or L'Simcha Congregation , a conservative Jewish synagogue, experienced the Pittsburgh synagogue shooting , which resulted in 11 fatalities. On July 13, 2024, near Butler, Pennsylvania , an assassination attempt on
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