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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Are Providers Satisfied With Their EHR?

Are Providers Satisfied With Their EHR? | EHR and Health IT Consulting | Scoop.it

Physicians are expected to document encounters with patients. This ensures there is a record of crucial information for decision-making and dispute. A decade ago, around 90% of physicians updated their patient records by hand. By the end of 2014, 83% of physicians had adopted EHR systems. The combination of government incentives, advances in technology, and improved outcomes and operations fueled this growth.

When healthcare providers have access to complete and accurate information, patients receive better care and have better outcomes. Electronic Health Records (EHRs) improve providers’ ability to diagnose disease and reduce medical errors. EHRs further help providers meet patient demands, provide decision support, improve communication, and aid in regulatory reporting.

A national survey of providers highlights their perspective on the benefits of having EHR in their practice:

  • 94% of providers report that their EHR makes records readily available at point of care.
  • 88% of providers report that their EHR produces clinical benefits for the practice.
  • 75% of providers report that their EHR allows them to deliver better patient care.

As the adoption of EHR grew over the last 10 years, so too did the need to change EHR systems within health systems, hospitals, and private medical practices. Growth in M&A activity fueled many healthcare organizations to combine data through EHR data conversion. Provider dissatisfaction has played a key role in encouraging change in EHR systems, also increasing EHR data conversion activity.

A study completed by Health Affairs showed, by and large, providers recognize the important advances that EHRs enable. Fewer than 20% of all providers said they would return to paper records. That being said, providers also noted negative effects of current EHRs on their professional lives and on patient care.  While excited about the possibilities provided by EHRs, providers have ultimately found poor usability that does not match clinical workflows, time-consuming data entry, interference with patient interaction, and too many electronic messages and alerts.

According to a 2014 survey of physicians conducted by AmericanEHR Partners:

  • 54% indicated their EHR system increased their total operating costs.
  • 55% said is was difficult or very difficult to use their EHR to improve efficiency.
  • 72% said it was difficult or very difficult to use their EHR to decrease workload.
  • 43% said they had not yet overcome productivity challenges associated with their EHR implementation.

These concerns about EHR usability are in alignment with others, including the American Medical Informatics Association, researchers, and practicing physicians. Given the rate at which many healthcare organizations have adopted EHRs, these organizations find themselves unable to wait for the long-run fixes. Healthcare organizations are now looking to change EHR providers in order to fix many of the providers’ concerns.

As healthcare organizations begin the process of changing EHR providers, there is an increased need for solutions to provide access to and maintain the integrity of data stored in the legacy systems. When this need arises, healthcare organizations have the choice to archive the legacy data, run multiple systems simultaneously, or complete an EHR data conversion.

Given the complexity of the data and variety of potential solutions, one might suppose that handling legacy data would be a complex affair. In many ways, that is true. However, it doesn’t have to be. To learn more about the state of EHRs and potential solutions for maintaining access and integrity of legacy data.

Technical Dr. Inc.'s insight:
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Top 10 Epic EHR stories of 2017

Top 10 Epic EHR stories of 2017 | EHR and Health IT Consulting | Scoop.it

The biggest electronic health record company made plenty of big news this past year, beginning with the scoop that it would develop new technology aimed at smaller hospitals.

 

Epic Systems, and its founder and CEO Judy Faulkner were the subjects of well-read news throughout 2017. Here are the top 10 Epic Systems news stories as gauged by our readers' interest:

 

1. Epic CEO Judy Faulkner reveals two new EHR versions are in development

"We're developing some really nifty new software," Epic founder and CEO Judy Faulkner told Healthcare IT News at HIMSS17 in Orlando this past February.

Epic is ready to make good on its promise to provide new versions of the EHR technology, she said, including Sonnet, which has a lower price point, and is aimed at hospitals that don't require all the bells and whistles of the full Epic EHR

"We're finding that people need different things," said Faulkner. "If you are a critical access hospital, you don't need the full Epic. The two new versions of Epic in development can provide a pathway to adding all the features at a later time."

Earlier this month, Epic announced that Sonnet would be available starting in March.

 

2. Epic CEO Judy Faulkner standing behind switch from EHRs to CHRs

"Because healthcare is now focusing on keeping people well rather than reacting to illness, we are focusing on factors outside the traditional walls," Faulkner told Healthcare IT News.

"'E' has to go away now. It's all electronic," Faulkner said at the company's user group meeting in late September 2017. "We have to knock the walls down whether they're the walls of the hospital or the walls of the clinic." As she sees it, the 'E' should be replaced with a 'C,' for "comprehensive."

 

3. Epic to jump into medical billing, currently hiring for new unit

A want ad popped up on the Epic Systems website, looking for "bright, motivated individuals to join our new billing services team as we enter the world of medical billing.

"Our goal is to simplify the payment process by helping Epic organizations with the complexities of submitting claims and posting payments," the ad read. "Attention to detail is vital as you'll be posting payments and denials; reconciling payment files, claims, and statements; resolving posting errors; and calling payers to follow up on outstanding or unpaid claims."

 

4. Epic sued over millions in alleged anesthesia over-billing

In November, Epic was hit with a False Claims Act suit that alleged the company's billing system double bills the government for anesthesia services. According to the suit that was made public last November, an alleged glitch in the system resulted in hundreds of millions of dollars of overbilling. The company responded that the plaintiff's suit stemmed from "a fundamental misunderstanding of how claims software works."

 

5. Allscripts, Cerner, Epic signal more open EHRs ahead

Top executives at three electronic health record companies –  Allscripts, Cerner and Epic – revealed in March 2017 they were working to make their EHRs more open, embracing APIs as a means to enable third-parties to write software and apps that run on their platforms. Epic, for its part, was working on two new versions of its EHR and developing Kit to go with its Caboodle data warehouse (as in Kit and Caboodle). CEO Judy Faulkner said Kit "is making everything very open."

 

6. CVS-Aetna merger will make an even bigger giant out of Epic

While early reports in mid-December about the planned $77 billion merger between CVS, an Epic customer, and Aetna focused on massive market share in the pharmacy and insurance realms, there was also the implicit promise of a new era in analytics, interoperability and population health. Alan Hutchison, Epic's vice president of population health, said that by using Epic's Care Everywhere and Share Everywhere interoperability tools, CVS and Aetna could provide the community with information and insights to improve care.

 

7. Epic tops 2017 Best in KLAS awards, securing top spot for 7th straight year; see complete winners

At the end of January 2017, Epic Systems again landed the top spot for Overall Software Suite in the 2017 Best in KLAS: Software and Services report. The win marked the seventh consecutive year Epic took top honors in the report, draws from healthcare provider feedback. Epic also earned the top Overall Physician Practice Vendor and Best in KLAS awards in eight segments.

 

8. What happened when GE tried to buy Epic and Cerner and was shut down within 5 minutes

Former General Electric CEO Jeffrey Immelt revealed at the beginning of December that GE had once tried to acquire Epic and Cerner at different times. He said Faulkner told him, 'No, not interested." Immelt recalled the meeting lasting less than five minutes. (As for Cerner, the price was too high.)

 

9. How the Coast Guard's ugly, Epic EHR break-up played out

What began as a straightforward software contract with Epic resulted in the U.S. Coast Guard starting its entire EHR acquisition process over some seven years after it began. EHR implementations are notorious budget-busters often fraught with missed deadlines and other unforeseen complications, but for an organization to abandon the project altogether and embark on a new beginning is uncommon. Indeed, this occurrence includes some finger-pointing from both sides. So, what exactly went wrong?

 

10. Mayo Clinic kicks off massive Epic EHR go-live

Mayo Clinic hit a milestone this year with its $1.5 billion system-wide Epic implementation. The first 24 sites went live on July 8. The organizations said Epic will replace Mayo's existing three EHRs, which include rivals Cerner and GE Healthcare, as the hospital system's sole electronic health record platform.

 

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

 
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5 EHR Benefits We Seem to Have Forgotten About

5 EHR Benefits We Seem to Have Forgotten About | EHR and Health IT Consulting | Scoop.it

Here are a few of the guaranteed EHR benefits:

  1. Legibility of Notes: Physicians' handwriting has been the topic of many jokes. While it’s funny to joke about, it’s not funny if you’re the physician receiving one of those illegible notes or the billing office trying to get paid based on some illegible chart note. The beauty of an EHR is that the notes are all typed in a font that can easily be read. The whole issue of physician handwriting goes out the window.
  2. Accessibility of Charts: Charts are more accessible in an EHR in two distinct ways. First, the concept of a lost chart basically disappears in the EHR world. When you want the chart, you search by the patient’s name or other identifier and instantly have access to the patient chart. No more searching through the chart room, the lab box, the nurses’ box, the box on the exam room door, etc. for the lost chart. Second, the chart can be accessed from anywhere in the world. Gone are the late night phone calls which require you to drive to the office to view the chart. An EHR can be accessed anywhere you have Internet.
  3. Multiple Users Accessing the Chart: How quickly we forget the fact that only one person could use the paper chart at a time. In fact, entire workflows were created around the fact that two people couldn’t work on the paper chart at the same time. In an EHR, the nurse, doctor, front desk, HIM, and billing staff can all work on the chart at the same time.
  4. Disaster Recovery: Many people are afraid of disaster situations with their EHR. While this is an important topic, an EHR can be so much better in a disaster than a paper chart. If your chart room goes up in flames, what could you do? Not much. Your charts were lost. In the EHR world, you can easily create multiple backups and store them in multiple secure locations including secure offsite storage. This takes some thoughtful planning to do it right, but EHR makes it possible to store multiple copies of your data which minimizes your risk of lost data. This is so much better than a paper chart in a disaster. With a cloud-based EHR this redundancy is often built in, and there is little or nothing you need to do.
  5. Drug to Drug and Allergy Interaction Checking: Yes, we’ve had Epocrates in our pocket for a long time. That was a huge improvement over those stacks of books on the shelf. However, EHR takes that one step further. Your EHR knows about your patients’ list of allergies and the drugs they’re taking. These extra pieces of information can provide a much deeper analysis of any drug you’re looking to prescribe. I don’t remember a prescription pad ever alerting you to an issue with an allergy when you were writing the script.

Obviously this is just a small list of the guaranteed benefits. We could create an even longer list of the possible, probable, and future benefits of an EHR as well.  I’ll just cap it off with one simple example. How are you going to handle pharmacogenomic medicine on paper? It’s coming. The simple answer is that you’re not doing pharmacogenomics on paper. You’re going to need technology, and it will likely be connected to your EHR.

While I still don’t think we’ve realised all of the benefits that we could have (and many might say should have) from an EHR, we shouldn’t forget the many benefits an EHR has already provided. Far too often we evaluate our current EHR implementation against the perfect EHR as opposed to the alternative. EHR software has already provided a lot of benefits, but the most exciting thing is that we’re really just getting started. The future benefits will be even more impactful than the benefits we’re receiving today.

Technical Dr. Inc.'s insight:
Technical Dr. Inc.'s insight:

Contact Details :
inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com/tdr

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What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration

What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration | EHR and Health IT Consulting | Scoop.it

Participation in pay-for-performance plans like MACRA’s Quality Payment Program (QPP) poses new challenges for resource-strapped healthcare organizations. Many provider sites lack the time and technical expertise needed to retool their EHR implementation to document new metrics under value-based reimbursement models like the Merit-based Incentive Payment System (MIPS).

Nonetheless, that is precisely what clinicians must do to deliver on quality reporting requirements. When using EHR documentation tools, many factors must be considered for a provider to get credit on having met clinical quality measures (CQMs). How that information gets stored in the EHR directly affects reporting. Many healthcare organizations are finding that customizing an EHR to recognize when a measure has been met—preferably in a manner that poses as few interruptions to patient engagement as possible—is easier said than done.

 

Overcoming EHR Limitations

Many outpatient and inpatient settings still struggle with common EHR data management headaches. As clinicians bring new quality measures into the EHR, those underlying data management issues can foil even the best-laid reporting plans.

Discrete Data Capture

The push to better document clinical quality is causing a transition in EHRs to focus more on structured or discrete data that is easier to trend over time. Unfortunately, many healthcare providers still receive patient data from healthcare affiliates via fax. Those faxed documents show up as attachments in the patient chart and are not fully integrated into the patient data file. If that information was sent via HL7 interface instead, details on the care rendered by that hospital or other healthcare entity would flow into the EHR as discreet data variables. For many providers today, capturing that information in a manner that makes it usable in reporting and analytics still requires timely, manual data entry.

Documentation and Data Consistency

Provider sites with multiple clinicians may also encounter issues related to the slightly different way that each EHR user documents care. MIPS and other quality programs require consistency and a high degree of specificity in clinical documentation. If a clinician does not get diagnosis specifics into the patient chart, that patient may not be included in the CQM calculation they need to be included in. Many clinicians are having to modify their documentation process during patient encounters so they and the staff can capture all the necessary information in the EHR.

Clinical documentation will have even bigger repercussions under the Cost component of MIPS, which is slated to be factored into performance scores in coming years. Take, for example, a patient that is in for the flu. That patient has a certain anticipated cost impact (the average Medicare spending per beneficiary), calculated based on past medical history and services rendered. If a patient goes to a physician and has the flu but also has diabetes, heart failure, and asthma, that flu patient is probably going to cost more to care for. If the physician only submits the flu diagnosis and fails to document patient co-morbidities then the healthcare organization will not get the same allowance under the MIPS Cost category and could be labeled as “higher cost” than a comparable provider encounter for a patient that required fewer resources to care for.

Clinicians, coders, and staff need to make a mental transition away from “we’re submitting claims” to “we’re submitting data” to better serve clinical reporting initiatives and patient care analysis.

 

Making Informed CQM Selections

Beyond adapting to new data management processes, clinicians reporting under value-based programs also have a great deal to learn as they layer in additional quality measures under MACRA. One of the biggest challenges clinicians and administrators face is selecting the best measures for their specific healthcare organization. With limited spare time on their hands, many healthcare teams are leaning on outside expertise to help them evaluate the implications of various measure selections.

Measures Without Benchmarks

Many quality measures under MACRA are carry-overs or “relics” from other reporting programs. For these CQMs, providers can look to prior performance averages to evaluate the likelihood of success should the healthcare organization elect to report on those measures. That data does not exist for some CQMs, which are referred to as “measures without benchmarks.” On measures that have no benchmark data available, providers will be limited to a maximum of three reporting points instead of the ten points available on measures with benchmarks established.

To further complicate things, details on the availability of some benchmark data will not be calculated until after the March 2018 QPP reporting deadline. Providers may wish to further diversify or report on additional measures that could help offset low point earnings on measures without benchmarks.

Topped Out Measures

Another CQM caveat that providers should be aware of relates to “topped out” measures. These relic measures from other reporting programs are very engrained in many healthcare settings. Medication reconciliation, for example, was a requirement under Meaningful Use. Widespread adoption and universally high compliance rates on that measure makes it more difficult for clinicians to out-perform peers. Achieving maximum points on such measures requires a perfect or near-perfect score.

Keep average performance thresholds in mind when evaluating CQM selections, not just the healthcare entity’s individual performance track record. Look at a broader set of measures to maximize MIPS score potential. Clinicians could earn more points by scoring 70 percent on a non-topped out measure than they would earn scoring 95 percent on a topped out measure. Some topped out measures will likely be eliminated in future years to help diversify CQMs, as was the case under Meaningful Use.

Understanding the intricacies of CQM selection and EHR data management will be vital to success under value-based payment programs. Healthcare administrators and clinicians who proactively work to better understand the impact of various measures and streamline EHR processes will be best positioned to maximize program incentives.

 

Does your organization have the resources it needs to successfully navigate MIPS? Learn how Pivot Point can help with your value-based strategy.

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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Pros and Cons of Patient Access to Electronic Medical Records

Pros and Cons of Patient Access to Electronic Medical Records | EHR and Health IT Consulting | Scoop.it

Doesn’t it seem faintly ridiculous that patients have to jump through hoops to get access to information that, since it is in digital format, would be so readily available to them? Today’s patients are quite accustomed to being able to access data on demand, from whatever location on Earth, as long as they have Internet access and a mobile device or laptop computer.

 

They can, for example, log into their financial institution’s website to check their latest details. Parents of school-aged children routinely access a portal developed by their school to get information about upcoming tests, new requirements, and so on.

Furthermore, the advent of email, text messaging, and social media updates has lead to people becoming accustomed to easy communication with one another. But think about how much of an effort it is for patients to communicate with a medical practice (waiting on hold on the phone to leave a message for a nurse practitioner, for example, and then having to wait more for a reply that might not come until the following day).

 

You may have already deployed a patient portal for your organization, but are not quite sure about the protocols for sharing information. Or, you are somewhat familiar with patient portals, but you’re still not sure whether it’s a good idea to even have one and you would like more information before making an investment in this software solution.

 

Familiarizing yourself with the pros and cons of patient access to electronic medical records is essential before you pull the trigger and launch a patient portal at your organization.

Modern medical practices that have forward-thinking leaders will already have electronic health record or EHR software installed or are about to deploy it. An EHR is a database of all the records for your patients. It’s much more efficient than an antiquated, paper-based method for organizing charts in your practice. The EHR lets you keep track of all important information, from medical history, current diagnosis, details of the treatment plan and any medications that have been prescribed.

One feature of Electronic Medical Records software that medical professionals should be aware of is the patient portal, along with its benefits and potential drawbacks.

Pros of Allowing Patients to Have Access to their Electronic Medical Records

A major pro of patient portals is that they improve patient engagement. Engaged patients are more likely to stay loyal to a practice as compared to other organizations that don’t make much of an effort to connect.

Your staff can easily receive messages from patients over the portal, in a process that’s as easy as email. This cuts down on a lot of wasted time on both ends (patients forced to stay on hold to leave a message by phone, and staffers having to write down the message).

 

A patient portal reduces the total amount of time spent on the phone and can cut down on unnecessary visits. What’s more, it has been proven to reduce the number of no-shows.

Patients will be happier, since they can access their medical information using their own electronic devices, even when on the go.

They will also appreciate being able to check prescription information and request refills online. When patients need to schedule an office visit, they simply sign into the portaland make a request. This makes things easier for them as well as for your staff.

 

Finally, a patient portal eliminates one of the great drudgeries of modern medicine: patients having to fill out a big stack of paper intake forms before they have their first meeting with the doctor.

You can let them input their information through the portal (such as at a kiosk in your waiting area, or from the patient’s computer). They won’t have to fill in their address or list of allergies more than once, and your staff won’t have to transcribe information from potentially messily handwritten documents.

Cons of Allowing Patients to Have Access to their Electronic Medical Records

While there are a number of clear benefits to using a patient portal with your EHR or EMR, there are also some drawbacks to be aware of, so you can address them head-on.

For example, when you enable outside access to your EHR information via a portal, data security concerns will naturally come up. The system must use strong passwords and should include the latest encryption and other protections. Otherwise, patient data could be compromised, leading to fraud and identity theft.

A portal can be tough for some patients to comprehend, especially if they have been used to doing things the old-fashioned way. However, you can educate and acclimate patients to the portal when you explain the benefits to them.

There is also the issue of patients being exposed to more medical jargon then they are used to, including acronyms and strange Latin terms for body parts. But they can always look up terms they are unfamiliar with, or simply ask a member of your team for an explanation.

 

Your older patients may not be very tech-savvy, which could hinder their efforts to log in and access data through the portal. But portals interfaces can be easily simplified and a simple training brochure or online video could make a big difference in getting more patients used to the idea of using the system.

It’s natural to have a number of questions about installing an EHR and activating a patient portal for your practice. Once you have a better idea of how patient portals can empower your staff as well as your patients, you’ll be on your way toward deploying one in your organization.

Key Takeaway:

  • Electronic health record or EHR software enables you to activate a special patient portal.
  • A patient portal is a great way to let patients access their own information on demand.
  • One con to keep in mind with patient portals is that some patients may not have much experience with computers, preventing them from getting the most out of it.
  • Another drawback is the potential for data breaches, so you’ll need to work with a vendor that provides robust, secure EHR software.
  • Patients will appreciate being able to check into the system to set an appointment or request a prescription refill.
  • Your staff will waste less time because patients can leave them electronic messages via the portal, instead of having to stop what they are doing to respond to a call.
  • Patients find it liberating to gain more access to their lab test results through the portal, rather than waiting for the report to come by surface mail or a phone call from the physician.
Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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