EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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EHR Optimization, Population Health Top Priorities for Health IT Spending

EHR Optimization, Population Health Top Priorities for Health IT Spending | EHR and Health IT Consulting | Scoop.it

Electronic Health Record (EHR) optimization and population health are high on the spending wish lists of Healthcare Information Technology executives, according to two new industry reports.

Electronic Health Records have been implemented in over 95 percent of hospitals, according to the Office of the National Coordinator of Health IT. But analysis from KPMG finds healthcare organizations are still figuring out how to execute post-implementation strategies that effectively transform data analytics into valuable business outcomes and improve patient outcomes.

 

“[Most] EHRs – which represent thousands of resource hours and millions of dollars spent for many healthcare organizations – were implemented as one-time, factory boilerplate-style system installations,” writes Ralph Fargnoll, KPMG’s Advisory Managing Director. “With the need to realize the value of healthcare IT investments becoming apparent, healthcare leaders now acknowledge that information systems must be implemented as part of more strategic, long-term initiatives,” he states.

Over the next 3 years, 38 percent of CIOs plan to implement additional Electronic Medical Record (EMR) features and focus on system optimization, according to a survey conducted by KPMG and the College of Healthcare Management Executives (CHIME).

 

21 percent of CIOs anticipate making capital investments in accountable care and population health technology over the next 3 years. Other top upcoming capital investment plans include consumer/clinical and operational analytics (16 percent), virtual/telehealth technology enhancements (13 percent), revenue cycle systems/replacement (7 percent), and enterprise resource planning (ERP) systems/replacement (6 percent).

Healthcare CIOs are reportedly embracing the digital age of healthcare, albeit slowly. Thirty-nine percent of survey respondents claim they are “currently working” on a digital business strategy. But only 1 in 2 respondents claims to have a tangible digital business vision and strategy in the works.

A new survey from Philips and HIMSS Analytics of healthcare C-suite and IT directors, also confirms the growth of population health spending.

Three-quarters of respondents already have population health programs in acute care, and nearly two-thirds of respondents in both readmissions and patient education. Priorities for future implementations included:  mobile wellness monitoring devices (58.3 percent), home monitoring devices (45.8 percent), and aging well or elderly care programs (42.5 percent).

 

Additional Survey Findings

  • While care coordination remains a challenge overall in population health management efforts (19.2 percent), financial investment (20.8 percent) and patient engagement and adherence (20.0 percent) are considered the biggest population health challenges in 2017.
  • Cloud-based technology is currently being used primarily for health information exchange (48.3 percent), followed by clinical data storage (34.2 percent). Health organizations plan to prioritize cloud-based technology on managed application deployment (40.8 percent) and big data analytics support (40.8 percent).
  • Community diagnostic imaging centers (68 percent), ambulatory surgery centers (61 percent) and urgent care (60 percent) have seen the highest increases in the deployment  of IT systems, compared to physician's offices in 2016.
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9 Steps to Successful EHR Implementation

9 Steps to Successful EHR Implementation | EHR and Health IT Consulting | Scoop.it

Healthcare organizations need an efficient way to process and share care delivery information to increase productivity, deliver better quality care, save money and ensure compliance.

Properly Switch EHR can deliver on this promise and provide most benefits associated with adopting digital technology.

Are you ready?

It comes as no surprise that technology continues to be an increasingly prominent part of our society.  Technological advancement isn’t going anywhere, but does this mean your organization needs it? Determining whether or not your practice is ready for EHR is the first step toward reaping all the benefits that information technology provides. Get together with business leaders, managers, and other key stakeholders to determine, infrastructure, people, technology and investment challenges that come with this change. Carefully consider whether or not implementing an EHR would be a step toward reaching or exceeding your business goals and strategy.

Be honest about your current status

Before implementing the new system, you must have a clear understanding of where you and your team stand. Do you have a proper infrastructure (internet, computers, printers, scanners etc.)? Does your team run efficiently? Are there any clinical or administrative process that is creating the bottleneck. How information and documentation are currently organized and processed? Is the staff proficient with computers? Are they willing and able to learn? These are important questions to assess your readiness for a successful EHR implementation. Be sure to be critical, honest, and true; inaccurate assessments will only hinder your team’s progress.

Set goals

Goal setting is almost always a constructive pursuit, and when setting goals for your team it is crucial to consider what factors will drive EHR success. Goals should be relevant, specific, measurable, achievable, and deadline oriented. Work with members to brainstorm a set of realistic and attainable goals with a time limit and budget to achieve them. If you haven’t already, assess and fully understand the time needed to complete tasks and work with team members to set standards and requirements. Determine what actions are benefiting your organization and those that are not; identify processes that can be improved and work with your team to strategize and redesign standard operating procedures.

Assign Roles

Delegating clear positions and responsibilities to allow for a smooth and productive transition. Be certain that those in charge fully understand why changes are being made and have the resources and time available to effect such change. Having clear objectives established will help drive the team ownership and productivity. Ensure that team members understand their duties, how to best execute them, and who they can reach out to for assistance, questions, and collaboration. Communication is key in any group environment, especially one undergoing significant change.

Find the best tools for your organization

Tools are only as useful as you make them. Expand your perceptions and be fully aware of all available resources. Your Regional Extension Center (REC), IT and EHR vendors should be able to provide you with the tools necessary to ensure a smooth transition.

Consider cost

$12,000 is the average cost of an EHR system. This includes software, hosting, maintenance, support, and upgrades. Connecting with health information exchange (HIE), customized reports, and premium features may be more. Before jumping in, consult a legal or financial counsel to determine costs and contract terms. Medical associations provide many open source templates and checklists to help.

Pick a certified EHR

It is helpful to pick an EHR that will customize to support the way your organization runs and help achieve your objectives quicker. Take careful consideration of other products such as practice management software, patient portal, text messaging, business intelligence tools, and public health interfaces.

Implement and train

Designate a leader to manage the transition and work closely with them to create a clear plan. Figure out what technological elements will be needed in converting data and paper charts into your new EHR, and what sorts of limitations you may encounter. Consider the value of information such as patient demographics, insurance, and appointments. Familiarize yourself with how HIPPA and business associate regulations will impact your patient services process. In evaluating your current and future workflows, be sure to create a backup plan for problems that you might come across.

Revise and improve

During and after implementation, meet your team and consider whether or not your goals have been met. If so, is there a way to improve efficiency? Do not overlook the need for further training, as efficiency can be compromised if you don’t know how the new system works especially shortcuts. Adjustments often do not go as planned, the continuous evaluation will help reassure the team and fix problematic issues.

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Decoding Meaningful Use For Your EHR System 

Decoding Meaningful Use For Your EHR System  | EHR and Health IT Consulting | Scoop.it

During EHR implementation, it can become confusing to successfully navigate federal and locally-mandated requirements for regulations concerning HIPAA and Meaningful Use. For many healthcare practices, Meaningful Use attestation has become less of a collaboration in good patient care, and more of a headache – but it doesn’t have to be.

Decoding Meaningful Use and understanding its requirements will not only improve implementation and optimization of an electronic health records system, but it will also result in improved clinical processes, and ultimately, better patient outcomes.

 

What is Meaningful Use?

Back in 2009, Meaningful Use was developed by the federal government as a way to regulate electronic health records systems, and ensure that providers are on track to make the most out of those systems. Their incentive programs for Medicare & Medicaid generated incredible interest, and within just a few years, had captured most of the US industry. Last year, the ONC reported that of Critical Access and other eligible hospitals, 95 percent had demonstrated Meaningful Use. Meanwhile, according to CMS, over half a million providers had received over $25 billion in federal payments through the Medicare & Medicaid incentive programs as of this summer.

But this brings up an important question: just who benefits from Meaningful Use? The answer is encouraging. When employed properly, Meaningful Use benefits everybody. Providers and their staff benefit from improved clinical processes, billing and insurance parties benefit from standardization, and patients benefit from better care.

 

Understanding Meaningful Use Incentive Programs

The role of federal incentives is simply to encourage providers to adhere to Meaningful Use requirements through certified EHR systems. Finding vendors that provide certified EHR technology is critical to qualifying for these incentive programs, which have to-date paid tens of billions to providers who have successfully met the requirements of the incentive programs. Not only are these programs designed to improve health outcomes through compliance with important measures, but also encourage certified EHR adoption through effectively lowering the cost of EHR implementation for healthcare organizations.

 

The Future of Meaningful Use and EHRs

Each year, CMS and the ONC release new updates for Meaningful Use. Currently, the incentive programs have been widely successful, with over 500,000 medical practices having attested for Meaningful Use as of this year. And moving forward, there is still a great deal of opportunity for benefit to both providers and their patients.

There will still be significant pressure from the federal government to achieve even more universal adherence to Meaningful Use. Many of the most ambitious goals of the program can only be achieved through near-universal participation including those regarding information exchange. For Medicaid, 2016 represents the final year of beginning participation in the incentive program. And while CMS’ final rule published in 2015 extended through to 2017, the Center for Medicare & Medicaid Services has already begun constructing their 2017 requirements.

Successfully attesting for Meaningful Use isn’t always easy. That’s why it’s crucial to find an EHR vendor that is ready to support you and your practice every step of the way towards successful implementation.

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How EHR is different from EMR?

How EHR is different from EMR? | EHR and Health IT Consulting | Scoop.it

EHR and EMR have been in our vocabulary for nearly 20 years. Since the 1990’s, clinical environments have increasingly relied on technology to function and improve patient care. Today, our methods are becoming incredibly sophisticated, particularly following the application of Stage 3 of Meaningful Use in 2016. Because of this, it’s important to take a look at a commonly misunderstood distinction: EHR (electronic health records) and EMR (electronic medical records).

 

The Basics of EHR vs EMR

Back in 1995, one could arguably use EHR or EMR interchangeably. This is because electronic medical records systems were just that: an electronic version of the medical chart. But as the years have gone by, our technological functionality became more robust, stretching far beyond the exam room or even the clinical setting. In fact, it’s very common now for the patient to have access to their own records, physician communication, and more all from within their home.

It is for this reason that the Office of the National Coordinator for Health Information Technology (ONC) has made a detailed study on EHR vs EMR.

 

How Records Systems Affect Different Parties

One way to better understand records systems in healthcare is to consider how those systems affect different parties. Let’s take a look at EHR vs EMR systems in terms of three different major parties in healthcare.

 

Patients  Improving patient outcomes is one of the largest and most important objectives of healthcare records systems. Patients rarely cross paths with EMRs. However, they are affected by them through follow-up exams, regular checkups, and other indicators over time. EHR systems, on the other hand, enable the patient to view their health reports, contact their healthcare providers, view referrals, pay their bills, and much more.

 

Providers  For providers, records systems not only help to improve patient care through improved data accuracy and alerts such as medication contradictions, but they also help to close gaps in communication and improve clinical workflow efficiency. This is true for both EHRs and EMRs, but the advantage an EHR has over an EMR for physicians is its ability to communicate information beyond the practice to patients, specialists, hospitals, and more. EHRs “move with the patient,” as explained by the ONC, as opposed to staying solely inside the walls of one practice.

 

Vendors  While vendors are responsible for providing a health records system, requirements for those systems can change over time, especially for certified EHR technology. EMRs are no longer sufficient to support a medical practice and its patients. Instead, EHR systems enable vendors to offer comprehensive, customizable services to medical practices that include everything from billing, to charting, to scheduling, and more, all while staying abreast of federal requirements like HIPAA and Meaningful Use regulations.

 

In the end, EHR systems are a direct reflection of how far technological advancements have taken the industry of records systems in healthcare. What once was simply an electronic version of a chart has become a real-time reflection of a patient and their health. This makes an EHR more powerful to the benefit of all parties involved, but in particular, to the patient.

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EHR vs EMR: What are the Key Differences?

EHR vs EMR: What are the Key Differences? | EHR and Health IT Consulting | Scoop.it

Any given industry will tend to develop its own particular vernacular, with inside terms that outsiders typically do not need to understand but are essential for key players to be aware of. Jargon serves to separate professionals from the non-experts and members of the public, and its use also saves time when writing and speaking about various concepts.

A case in point is the healthcare industry, where many people in medical practices have heard the terms “EHR” and “EMR” being bandied about but are not quite sure what they refer to or what the differences are between the two.

The first step in understanding EHR vs EMR is to know that EHR stands for electronic health records and EMR stands for electronic medical records. They are similar applications but have different capabilities that you should become aware of.

 

About Electronic Medical Records

Essentially, EMRs are digital versions of paper charts and are maintained at the doctor’s office. In the early days of digital medical information, clinicians were focused on medical diagnosis and treatment, which explains why they used the term “Medical” in EMR. (By contrast, the “Health” in EHR refers to a patient’s overall health situation and not just medical questions as revealed by diagnosis and lab test results.)

 

Key benefits of an EMR include helping the physicians keep track of data over time and identify which patients need to come in for a checkup, screening, or appointment.

EMRs also help practitioners get a quick glance at the patients’ basic vitals, such as blood pressure and weight. Finally, an EMR enables you to get a better view of the state of the practice and how it is doing in treated patients.

 

However, there are also some disadvantages when it comes to using electronic medical records. For example, you cannot share information about your patients outside of the office.

Consider what happens if you run a family medical practice and you are referring a patient to see a specialist, such as an endocrinologist. Your practice needs to share information with the specialist, but since the EMR is only designed for internal use by one practice, your staff would probably need to print out the patient’s chart and mail it.

 

This means that your EMR files are pretty much the same as paper records at this point. And when the specialist has information to add, the details cannot be transferred back to your EMR without your staff first typing them in from the specialist’s faxed or mailed documentation.

About Electronic Health Records

An EHR contains all of the things an EMR does, but offers much more. EHRs are designed to collect all medical information from all healthcare sources, including multiple physicians, hospitals, and the patient themselves.

Benefits of switching to an EHR system include:

  • Secure when compared to paper records: You can designate specific members of your team to access and change records, as well as conduct audits to detect when people try to gain unauthorized access.

  • Also secure to send and share information with others: The data that you share with other parties, such as a specialist, must be safeguarded so that criminal hackers cannot make off with patient information and commit identity theft and fraud.

  • Important information available in emergencies: The EHR allows patient information to be made present to emergency room doctors immediately with the full medical history and details on any allergies or other issues.

  • Patient portal: A patient portal lets patients enter their own information from the comfort of home using an internet-connected computer, instead of having to fill out stacks of paper forms that your staff will later have to input by hand.

  • Access to advanced tools: An EHR will include tools and various features to help you make better decisions and work more efficiently. For example, you can useanalytics to detect emerging patterns of patient behavior, such as more no-shows to appointments in a certain population or ZIP code.

  • E-prescribing: Electronic versions of traditional prescriptions made by signing a piece of paper from the physician’s Rx pad are more convenient for the doctor, who just needs to transmit the details to the pharmacy. Patients don’t need to wait, since the medicine will be processed while they travel from the doctor’s office.

  • Voice-to-text data entry: Typing in patient details takes longer than speaking. You can activate speech recognition in your EHR to automatically transcribe what the nurse or doctor says, and the text appears on the screen in real time.

  • Reporting: Each report that you need to generate for your practice, such as revenue projections or how many patients have failed to pay their bill after the second notice are much easier to generate, thanks to templates that you customize in the EHR application.

It’s Essential That a Modern Medical Practice Uses Some Form of Electronic Records

Any modern practice needs some form of electronic records. Trying to get by using a paper-based system will simply not do.

What’s more, your practice is eligible to receive financial incentives from Medicare and Medicaid, but only if you are using certified EHR software that allows you to communicate details about patients electronically to insurance providers and public health researchers.

Paper records secured by a mere filing cabinet and a reliance on your staff to only access the details when authorized make for bad business practices in this day and age. With electronic records, you can maintain security by keeping unauthorized individuals from seeing patient information.

 

Electronic records also make for better patient engagement, especially when you consider how much time they save in the clinical setting, allowing your nurses and doctors to spend more time on treatment and less time on record keeping.

A patient portal activated in your electronic records will further boost engagement, since patients can access the system to check on things such as lab results, request an appointment, or send a message to a member of your staff. The more engaged patients are, the better chance you have of retaining them for the long term.

Key Takeaway

  • For professionals working in the healthcare industry, it’s good to have an understanding of EHR vs EMR.
  • EHR stands for Electronic Health Records.
  • EMR stands for Electronic Medical Records.
  • While EHR and EMR might seem to be referring to the same thing, an EHR is more flexible, because it lets you gather information from multiple sources while an EMR only handles local data.
  • Any medical practice that is still relying on antiquated systems based on paper to keep track of patient records will need to upgrade to some form of electronic records in order to remain competitive.
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Essential Questions for Picking EHR Patient Portal Software 

Essential Questions for Picking EHR Patient Portal Software  | EHR and Health IT Consulting | Scoop.it

It’s time to revisit the much undervalued, if much maligned, patient portal. To date, patient portals remain an underutilized resource. But a convergence of trends may change your thinking about their value — especially when selecting or upgrading EHR software. To help with that process, we offer a 10-point checklist for evaluating a patient portal’s usability and functionality. 

Patient Portals: A Mixed Bag

Most of us have used a patient portal, and the reviews are mixed at best. A product of meaningful use requirements, they were mandated as a way to provide patients with timely access to their healthcare.

At their most basic, they’re used to retrieve lab results, ask a question or update patient profiles and insurance providers. Some allow patients to schedule appointments and pay bills. For providers, they represent an opportunity to increase patient engagement, promote loyalty, manage costs and streamline workflows.

In reality, their potential has yet to be harnessed. Hard to access, patient portals are often badly designed, cumbersome to navigate and limited in utility. It’s sometimes easier for patients to pick up the phone and call their provider than to look up their user name or create a new password. For staff and physicians, they require time and resources that aren’t usually billable.

Emerging Trends Impacting Patient Portal Usage and Importance

So beyond next-stage meaningful use requirements, why should the patient portal receive greater consideration in the EHR selection process?

Value-Based Care

First and foremost, as healthcare moves from fee-for-service to value-based care, providers will have further incentive to improve the patient experience, track compliance and manage costs.

In a medical research paper — Patient portals and health apps: Pitfalls, promises, and what one might learn from the other — issued last year, the authors asserted that “the push for reimbursement that relates to value-based care creates an opportunity to develop high-quality patient portals.”

In addition to improving patient health and facilitating wellness, patient portals have the potential to free up staff time, lower call volume (including call backs and phone tag), increase accuracy, reduce duplication and cut down on time spent on patient records, payments and prescription refills.

Data

The future of health and medicine points to the primacy of data. Patient portals can yield a trove of information not captured in a doctor’s visit or clinical interaction — resulting in better population health management and a better ability to track patient engagement and improve adherence to treatment plans.

Patient as Consumer

Patient portals will grow in popularity as patients evolve into healthcare consumers. Increasingly, they want better, faster access to their health information, and to be involved in the medical decision-making process. Patient portals are a natural extension of the trend to go online to select a provider or research medical conditions and treatments. They’re going to expect a positive user experience, rewarding those who do with their loyalty.

Mobile Apps/mHealth

The growing use of mobile apps, smartphones and wearable devices to monitor and upload information about their health and physical activity facilitates more patient self-management and data exchange with their patient portal.

10 Point EHR Checklist for Evaluating Patient Portal Usability

Given the patient portal’s potential and growing importance, how should you evaluate the best portal for your practice or facility?

As a healthcare provider, you can select a standalone patient portal that oftentimes is hosted by a third-party vendor. This approach can result in compatibility issues with your EHR system, requiring your EHR vendor’s cooperation — often at a price.

Alternatively, you can select a patient portal as part of an EHR bundle of services. The good news is that most EHR systems provide a patient portal component. When evaluating their product, you need to remember that patient portals are not all created equal, and can vary in functionality and usability. As such, you need to take into consideration:

  1. Cost – What is the cost to design and activate the portal? Do they provide training, maintenance, troubleshooting and upgrades?
  2. Customization – Do you have flexibility to customize the interface to take into account your practice, specialty and patient profile?  Is it white-labeled to allow for branding?  Do providers have the ability to make refinements?
  3. Patient Management – Does it provide the ability to refill prescriptions, monitor compliance, track patient progress, schedule/cancel appointments, pay bills, upload documents and download practice forms? If they don’t provide all these services, which ones are most important to you?
  4. Communication – How easy is it for patients to send and receive emails and messages? Can patients upload documents? And does it easily and securely integrate with mobile health apps, in a format that providers can use?
  5. Patient Access – How complicated is it for patients to set up an account?  Is it a multi-step process?  Does it incorporate “responsive design” so that it’s accessible and easily readable on a computer screen, mobile device and a smartphone?  
  6. Usability and Navigation – Is the user experience intuitive, consumer-friendly and easy to navigate? Does the portal present information such as test results in a way that patients can understand and interpret? Can it account for sight-impaired patients and patients who don’t speak English?
  7. Content – Can patients view laboratory results and track immunizations, medications and allergies? Can they access personal health data, notes from physicians and medical histories?  Can they renew medications; update their information (insurance, address changes, etc); view discharge and medication instructions; and access an online healthcare library of educational resources?
  8. Security – Is the site HIPAA-compliant to ensure privacy? How secure is the connection in protecting stored data and guarding against data breaches? Does it meet confidentiality and legal requirements for minors? What is the process for setting and resetting passwords?
  9. Workflow automation – Once patient information has been reviewed and approved, can it be uploaded into your EHR (including care plans, clinical visits, insurance coverage, billing) without additional keying or extra work that can result in errors? Can this process be customized to meet your current and future requirements as procedures and policies change? Can it send alerts?
  10. You: The patient portal is evolving, gaining wider acceptance and growing in importance. Not every EHR can address all of these considerations in a manner that meets your needs. Its components are only part of the equation. The other part is you and your commitment.

For starters, do you have a physician champion or super-user who’ll advocate for your patient portal?  Can you ensure that staff are properly trained, and that it’s maintained and regularly upgraded? Are you willing to commit the resources to ensure it’s routinely monitored and being used properly? Do you have the resources to create awareness and educate patients on how to use and maximize its benefits? And do your internal policies and procedures encourage usage?

Ultimately, you can’t guarantee patient compliance or participation. However, you can select a portal that helps you achieve your business goals and meets your patients’ needs.

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Technology can get patients more involved or alienate them

Technology can get patients more involved or alienate them | EHR and Health IT Consulting | Scoop.it

Technology can do a lot to improve care and boost efficiency at healthcare organizations. But if the right steps aren’t taken, it can also make patients feel alienated and ignored by their doctors.

 

Healthcare technology can go a long way to boosting the quality of care and increasing efficiency and performance. Most healthcare organizations seem to agree, as electronic health records (EHR) adoption rates continue to grow, especially among smaller physician practices.

However, as EHR and other health IT adoption quickly increases, it’s important for doctors, management and staff to consider how that technology will impact day-to-day interactions between doctors and patients.

If the proper precautions aren’t taken, technology can act as a wedge between doctors and other people, including nurses, other doctors and patients.

Limit interaction

While electronic systems make it easier for doctors to do their jobs, they also make it easier to do those jobs without interacting with anyone else. For example, tests and treatments can be ordered through the system, eliminating the need to speak with nurses or other doctors. That can take away valuable opportunities for those parties to share information.

Those systems can also make it too easy to copy and paste information between electronic files, Schumann ways. That can eliminate good chances to ask patients to offer more information or apply fresh thinking to a situation.

And, given all the information that’s available in an EHR system, some doctors may be tempted to make more eye contact with the computer screen than with the patient during a visit. Even if that doesn’t affect the quality of the care that’s given, it can have a serious negative impact on patient satisfaction.

Make sure technology doesn’t get in the way

Here are some steps organizations can take to make sure technology doesn’t get in the way of doctors’ relationships with patients and others:

  1. Organize workspaces properly – If doctors use desktop computers to access EHRs in exam rooms, make sure those stations are set up in a way that makes it easier for the doctor to face and look at the patient while working on the computer.
  2. Consider tablets for EHR viewing – Mobile devices such as tablet computers can also be used to access EHRs in a way that retains the same feel as working with a paper chart.
  3. Use technology to increase interaction – Doctors should look for times when they can use the technology they have available to educate patients and get them more involved in their own care. With the number of apps that are around today, doctors can have round the clock correspondence with patients which enables them to become more involved in their their treatment plan.
  4. Have doctors explain what’s happening – Making patients feel better about the change in doctor-patient interaction might be as simple as doctors explaining that although they’ll need to take time to type information into the EHR, they’re still listening. Also, when doctors do something on the computer, they can explain what they’re doing and how it’ll benefit the patient.
  5. Use social media to communicate with your patients – Blogs, websites and social media platforms give your facility the ability to get a large amount of information out to patients. Now instead of articles on how to cure ailments, you can write about how to prevent them.
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