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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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The digital transition to EHR - is it worth it?

The digital transition to EHR - is it worth it? | EHR and Health IT Consulting | Scoop.it

When it comes to using electronic health record (EHR) software, whether in a traditional practice or a multidisciplinary office, it usually comes down to just one question: Is it worth it?

 

For the vast majority of cases, the answer is Yes.

 

Why?

Great efficiency, lower expense;Increased collections;Improved third-party audit results;

 

Worth the effort?

 

Not all software is created equal, so choose your system wisely, accounting not only for what you need in your clinic now but also for how you see your clinic down the road.

 

For a limited time, the government is prompting you to adopt EHR software in your practice through funds provided by the HITECH Act (part of the American Recovery and Reinvestment Act). You can collect up to $44,000 over the next five years by adopting certified EHR, depending on your Medicare-allowed charges submitted each calendar year.

 

No doctor should implement EHR software solely for the incentive. But if you’re already considering it, the incentive is icing on the cake.

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Are EHRs an expensive crutch that deter direct patient-physician communication?

Are EHRs an expensive crutch that deter direct patient-physician communication? | EHR and Health IT Consulting | Scoop.it

We often hear - "EMRs are plagued by problems and inefficiencies that harm patient care and potentially, security and privacy--some day when they are perfected and work the way physicians work, we will flock to them. Data access can be more convenient, but data entry is terrible."

 

Kenneth Mandl, associate professor at Harvard Medical School and Boston Children's Hospital Informatics Program, and one of two authors of an article published this week in the New England Journal of Medicine, agrees.

 

He points out that we're in an EHR "trap": vendors, he says, have perpetuated a falsehood that EHRs must use specialized IT software, and that the EHR must have all-in-one functionality.

 

The article points out that only some components of an EHR need to be specific to healthcare, and that others, such as documentation tools and cloud storage, can be generic and often are better than what is being offered.

 

The industry should rely on a standard database format and standard apps, and use technologies that are common in other industries.

 

There's no reason we can't integrate different software systems into EHRs. We can use different platforms and software; we do it every day.

 

Demand that products be allowed to integrate, get data in and out and exposed through different interfaces.  Think of ways to integrate with emerging technologies.

 

And we'll see more technologies that work side by side.

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Africa's mHealth breakthroughs to pave way for U.S.

Africa's mHealth breakthroughs to pave way for U.S. | EHR and Health IT Consulting | Scoop.it

The United States will look to Africa to gain knowledge about advances in mobile health technologies because Tanzania, among other countries, already has maternal child health and community health worker programs that rely on smart phones.

 

While it’s still the early days of mHealth and the digital revolution, “we will see huge breakthroughs in Africa and South Asia,” said Jeffrey Sachs, director of the Earth Institute at Columbia University, speaking at a Monday afternoon mHealth Summit 'Super Session' on global implications for mHealth technologies.

 

“Those breakthroughs will eventually become breakthroughs in the U.S. when it addresses the high costs of its healthcare system and frees up $750 billion a year in waste,” Sachs said.

 

Mobile phones have been used to deliver messages about maternal and child health to mothers who live in areas that are remote or lack communications and other services. Mobile technology can make a difference, getting critical [pregnancy] stage-based information to expectant moms


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Electronic Health Record Use In US Hospitals Has Doubled In Last Two Years - Medical News Today

Electronic Health Record Use In US Hospitals Has Doubled In Last Two Years - Medical News Today | EHR and Health IT Consulting | Scoop.it
Electronic Health Record Use In US Hospitals Has Doubled In Last Two YearsMedical News TodayThe percentage of US hospitals using health information technology such as Electronic Health Records has more than doubled in the last two years, according...

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Why Hospitals Don't Deliver Great Service

Why Hospitals Don't Deliver Great Service | EHR and Health IT Consulting | Scoop.it
Hospitals try to deliver the best health outcomes. But many also aim to provide high levels of customer service, and they're falling short. They need a culture change.

 

Hospitals try to deliver the best health outcomes. That's a given. But many also aim to deliver high levels of customer service. On that latter goal, healthcare systems are falling short. Here's why: Truly improving service demands a culture that intentionally champions a focus on the patient.

Managers must be equipped to drive employee engagement in their departments.

 

What healthcare systems urgently need are clear intentions and strategies at the leadership level. These will determine whether a service mindset can exist within a hospital. What's more, getting employees engaged and connected to this mission will ultimately determine whether they live out that mindset each day.

 

Gallup has found that a service-centered culture requires:

a committed leadership team that champions a philosophy that is aligned with serviceemployee commitment to providing outstanding service and qualitythe strategic alignment of the organization's plan, policies, and procedures with the goal of being service-focusedan established process to document and disseminate organizational knowledge and efficienciesan ongoing commitment to improving performance and using proven tactics
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Patients describe what they consider good customer service - amednews.com

Patients describe what they consider good customer service - amednews.com | EHR and Health IT Consulting | Scoop.it
Doctors' knowledge and the office experience are more important than price in creating satisfaction, according to a new survey.

 

When it comes to satisfying patients as customers, practices need well-trained physicians, easy access to patients’ histories and long appointments — or at least the impression of long appointments, according to a Harris Interactive Poll issued Sept. 10.

“As other industries try to build customer loyalty, they are setting certain expectations for service,” said Vaughn Kauffman, principal and leader of the payer advisory practice at the consulting firm PwC. “And consumers are carrying those expectations into health care.”

 

Harris researchers surveyed 2,311 adults between July 16 and 23. Eighty-four percent had visited a doctor’s office in the past 12 months. Of this group, 83% were satisfied or very satisfied with the encounter. When compared with other service industries, satisfaction scores were higher for restaurants and banks but lower for car dealers and health insurers.

 

Consultants who work with medical practices say many factors that go into making patients satisfied customers are easier to address than they sound. It’s important to do so, however, because satisfaction is becoming more critical in health care. Keeping patients happy can play a part in earning quality pay and persuading patients to come back and refer the practice to others.

 

95% of patients say the amount of time spent with a doctor is an important satisfaction factor. 

For instance, 97% rated a doctor’s knowledge, training and expertise as important or very important with regard to creating a positive customer experience, although this factor is not readily changeable.

 

“That’s a given,” said Meryl D. Luallin, a partner with the SullivanLuallin Group in San Diego, which works with practices to improve the patient experience. “Patients take a doctor’s skills and training for granted. When you board a plane, you don’t stop by the cockpit to ask to see the pilot’s license. Patients typically make the assumption that somebody at the practice has already vetted the doctor.”

 

Other factors important to patients are easier to tackle. For example, 94% considered a physician being able to access a patient’s medical history as important or very important. Experts on the patient experience said this issue can be improved at practices with paper charts if physicians view them before entering the exam room. For physicians with electronic medical records who are not able to access the information until they are in the exam room, consultants suggest an introduction to the patient and then a brief explanation along the lines of, “I’m going to review your records, and then I’m going to give you my undivided attention.”

 

“It’s a little more challenging with electronic records because of the way a physician accesses the chart,” Luallin said.

 

This may help patients feel as if they have had a longer visit. Ninety-five percent in the Harris survey said time spent with the doctor is important or very important in being satisfied with the experience, but this does not necessarily mean lengthening appointments, which may be impractical or financially impossible for a practice. Consultants suggest that physicians sit in front of a patient rather than stand. Physicians who don’t look as if they are about to run out the door may give patients the impression of a longer visit.

“It’s all in the body language,” Luallin said.

 

Other surveys have suggested that consumers are less price-sensitive about health care than other industries but are more attuned to the service aspects. For example, a report on 6,000 consumers issued in July by PwC found that 69% said price was the No. 1 driver when considering leisure airline travel, but this was true for only 8% considering health care services. Forty-two percent said personal experience was the most important factor when choosing a doctor or hospital, but this was true for only 17% considering an airline ticket purchase.

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5 Ways Pinterest Can Be Used for Patient Education in Healthcare | ParkerWhite Brand Interactive

5 Ways Pinterest Can Be Used for Patient Education in Healthcare | ParkerWhite Brand Interactive | EHR and Health IT Consulting | Scoop.it

Pinterest is an image-driven social network that has rocketed in popularity in the last couple of years. Pinterest works as a way to visually organize things on the Internet via “Boards,” which act kind of like folders, to organize thoughts into certain categories or interests. As more and more people use the Internet to search about healthcare, Pinterest is a way to organize the information they find, also allowing for them to share content easily with others. The other potential benefit from Pinterest is to reach people when they’re in various Internet “mindsets.” It can be a way to reach the patient when they’re not necessarily concerned with a particular problem at the moment (i.e. searching for specific health information for an issue they have right now). Pinterest can provide a medium for reaching patients to remind people of the many aspects of their life in which health plays an important role.

 

Pinterest is a good medium for patient education because many people learn best visually. Images can help convey information that would be much harder to digest in words. It can also serve as a good reference, and is more shareable.

 

1. How the body works2. How medical procedures work


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Patient Engagement and Use of Electronic Health Tools

Patient Engagement and Use of Electronic Health Tools | EHR and Health IT Consulting | Scoop.it

To accelerate adoption of electronic tools for increasing patient engagement the Center recommends the following:

Build awareness of benefits of electronic tools for patient engagementDevelop and disseminate principles, standards, policies, strategies, and best practices for using electronic tools to engage patientsBuild awareness of benefits of health care-related electronic tools among consumersIncrease federal, state and private sector incentives for the use of electronic tools to support engagement of patients in their healthcare

The report acknowledges the challenges to increasing patient engagement including:

Need for additional training and education on patient engagement in medical schools, residency programs, and continuing medical education programsDeepening patient-centered care and engagement at the cultural levelTaking steps to limit the amount of time in a traditional office visitCost and complexity of reaching out to and engaging individuals outside of an office settingAddressing communication needs of under served populations
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Why IT Companies Are Important For Doctors?

Healthcare Information Technology (HIT) has the potential to transform global healthcare systems ensuring safer and more effective treatments while increasing the productivity, profitability and efficiency of practices.

 

IT companies have integrated path breaking medical research with ingenious information technology, giving us medical tools, data systems, applications and devices that can change the way healthcare is practiced. Not only has it enabled doctors to connect with patients and other doctors in different parts of the world, HIT makes it possible for them to access a global database of precious medical information.


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The digital transition to EHR - is it worth it?

The digital transition to EHR - is it worth it? | EHR and Health IT Consulting | Scoop.it

When it comes to using electronic health record (EHR) software, whether in a traditional practice or a multidisciplinary office, it usually comes down to just one question: Is it worth it?

 

For the vast majority of cases, the answer is Yes.

 

Why?

Great efficiency, lower expense;Increased collections;Improved third-party audit results;

 

Worth the effort?

 

Not all software is created equal, so choose your system wisely, accounting not only for what you need in your clinic now but also for how you see your clinic down the road.

 

For a limited time, the government is prompting you to adopt EHR software in your practice through funds provided by the HITECH Act (part of the American Recovery and Reinvestment Act). You can collect up to $44,000 over the next five years by adopting certified EHR, depending on your Medicare-allowed charges submitted each calendar year.

 

No doctor should implement EHR software solely for the incentive. But if you’re already considering it, the incentive is icing on the cake.

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The Social Business of Fighting Disease

The Social Business of Fighting Disease | EHR and Health IT Consulting | Scoop.it

Whilst social media tools have primarily been used for commercial ends, there is a growing stream of evidence showing that it has scientific and social benefits as well. Nowhere is this more so than in the tracking and prevention of diseases.

 

For instance Google Flu Trends tracks search queries and applies its trending algorithm to gain an understanding of where flu outbreaks are occuring. A 21 month study by John Hopkins University found that the app was exceptionally good at predicting when hospitals would start to see people coming in with flu symptoms.

 

Primary investigator of the study, Dr. Richard Rothman, said that the results were promising for “eventually developing a standard regional or national early warning system for frontline health care workers.”

 

Social media context

 

It could be argued however that social media is a better method of tracking the spread of infection because it provides you with better context. Back in January the American Journal of Tropical Medicine and Hygiene reported that tweets and other public ‘status updates’ were a better way of determining the spread of cholera in post-earthquake Haiti than official channels. The research was conducted by scientists at Children’s Hospital Boston and Harvard Medical School and with over 6,000 people having died from the disease in Haiti, it has serious implications in terms of disaster prevention.

 

“When we analyzed news and Twitter feeds from the early days of the epidemic in 2010, we found they could be mined for valuable information on the cholera outbreak that was available up to two weeks ahead of surveillance reports issued by the government health ministry,” said Rumi Chunara, PhD, of the Informatics Program at Children’s Hospital Boston, Research Fellow at Harvard Medical School, and the lead author of the study. “The techniques we employed eventually could be used around the world as an affordable and efficient way to quickly detect the onset of an epidemic and then intervene with such things as vaccines and antibiotics.”


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Luca M. Sergio's curator insight, December 20, 2012 10:26 AM
so much potential from the social space to identify disease trends and act at an early stage ....
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E-prescribing continues rapid growth

E-prescribing continues rapid growth | EHR and Health IT Consulting | Scoop.it

ONC examined changes in rates of physician e-prescribing, pharmacy capability to accept e-prescriptions and the volume of e-prescriptions,   at the national and state level between December 2008 and June 2012.

 

Some of the findings include:

In December 2008, 7% of physicians in the U.S. were e-prescribing using an EHR; by June 2012, almost half (48%) of physicians were e-prescribing using an EHR on the Surescripts network. As of June 2012, twenty-three states had more than half of their physicians e-prescribing. States that had the highest growth in percent of physicians e-prescribing using an EHR include New Hampshire, North Dakota, Wisconsin, Iowa, and Minnesota from December 2008-June 2012. Massachusetts (77%), New Hampshire (74%), and Iowa (73%) had the highest rate of physicians e-prescribing through an EHR. From December 2008 to June 2012, nineteen states increased the percent of physicians e- prescribing through an EHR by 50% or more. The growth in e-prescribing has not been limited to physicians. In the same period, the percent of community pharmacies enabled to accept e-prescriptions grew from 76% to 94%. Wyoming, Nebraska, and Kansas had the largest increases in community pharmacies enabled to accept e- prescriptions. The vast majority of pharmacies are enabled to accept e-prescriptions in Rhode Island (97%), Delaware (98%), and Nevada (96%).

 

 

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Why EMR is a dirty word to most physicians

Why EMR is a dirty word to most physicians | EHR and Health IT Consulting | Scoop.it
EMRs do not improve productivity and it is highly questionable that EMRs lead to better patient outcomes.

 

Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and the healthcare industry.

 

However, their origin and the ulterior motives currently driving their adoption is sowing the seeds of their failure. First, what is actually happening out there? The most recent CDC data would seem to be encouraging for EMR adoption, with EMR use (finally) passing 50%.

Too bad there is more to the story.

 

If you look at adoption rates for so called “fully functional EMRs,” the adoption rate remains in the low teens (full data for 2011 is not yet available). So why is there an almost 4-fold discrepancy between “any EMR” and “fully functional EMR”? If EMRs are so great, why does the government have to essentially “bribe” physicians to adopt them through incentives such as the meaningful use incentive program? Why is this so important to them that they didn’t even wait for the healthcare affordability act to implement this “incentive”? (They put it in the stimulus package after Obama had only been in office a few months.)

 

The 50% adoption rates seen in the first link reflect the presence of any type of an EMR-like technology. While it is a great headline for sure, the second link shows that this is an overly broad declaration. When we look at “fully functional systems,” meaning they are being used for a full work-flow solution, we get numbers in the low teens instead. (When you subtract out unique situations such as Kaiser, the VA, and a few large independent doctor networks, I suspect the actual number is much lower.)

 

One reason that incentives and threats of decreased payment are necessary for EMR adoption is that the industry and physicians have known for years that EMRs do not improve productivity and that it is highly questionable that EMRs lead to better patient outcomes. So why is all this taxpayer debt being accrued by throwing borrowed money at the healthcare industry to drive EMR adoption, if the end users are so disenchanted? As Jonathan Bush, the Founder-CEO of AthenaHealth (a major EMR supplier) famously said, “It’s healthcare information technology’s version of cash-for-clunkers,” and because it is actually all about control.

 

The goal of EMRs is to wrestle control of healthcare away from the doctor-patient relationship into the hands of third parties who can then implement their policies by simply removing a button or an option in the EMR. If you can’t select a particular treatment option, for all intents and purposes the option doesn’t exist or the red tape to choose it is so painful that there is little incentive to “fight the system.”

 

For patients, this means that they will only be able to consume the healthcare that they “qualify” for or be forced to find another way to obtain the care that they want and need. It is the second outcome that is the most intriguing, because as “shoppers,” patients will want to be informed and have choices as they take on more responsibility for the cost and quality of their own care. This approach works very well with Health Savings Accounts, which were conveniently de-emphasized in the healthcare reform effort. Like the lightning going to ground, this is the inevitable future for healthcare in this country (assuming the other alternative, an acceleration to a single-payer system does not occur first).

 

For physicians … well, it isn’t hard to figure out where this is all heading. EMRs are quickly becoming the instrument by which we are controlled and managed. As an example, many organizations are already starting to restrict diagnostic testing and therapies via EMR.

 

What’s next? Patient referrals? It will be the final step in subjugating physicians.

 

So why is genuine EMR adoption struggling so much? After all, one may argue that the accessibility of instant data that technology now enables is the greatest single advance in patient care so far this century. With so much money being thrown at the problem, one might expect a much greater adoption. Why hasn’t it played out in a much more positive way?

 

This comes back to the origin and ulterior motives of EMRs. First, EMRs have been largely a top down effort. Rather than working with physicians to design the technologies and drive adoption, the experience (and almost universally the perception) is that the technology has been thrust upon physicians by administrators. Compounding this is the unintended consequences of the meaningful use government incentives (or cash-for-clunkers program to use Jonathan Bush’s, more colorful language). Having left the guidelines vague and largely written by a small group of industry insiders, most products have become a Tower of Babel with atrocious user interfaces and user experiences that … well, I don’t blame my fellow physicians for not wanting to use them. In addition to being expensive, they are complex, inefficient, and do not make physicians or their staff more productive.

 

Widespread adoption of an EMR (or multiple compatible EMRs) that is intuitive and easy to use, that empowers the end user and patients, and that actually helps to make the healthcare system more efficient would be a good thing for doctors, patients, and the industry. However, unless we recognize what the ultimate goals are and better involve the people most critical to their effective use (physicians), I believe Jonathan’s prediction will be true and cash-for-clunkers applied to the healthcare sector will turn out about as successful as that other government program — TARP.

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Survey: MU incentives top motivator for EMR adoption at small practices | PhysBizTech

Survey: MU incentives top motivator for EMR adoption at small practices | PhysBizTech | EHR and Health IT Consulting | Scoop.it

Federal incentives appear to be having the desired effect at the small-practice level, ramping up meaningful use of certified EHR/EMR technology, according to results of a survey released Jan. 9 by Practice Fusion, a company that offers a free web-based EMR to physicians. The report indicated that the incentives, administered by the Centers for Medicare & Medicaid Services, were the strongest motivator for adopting EMR technology among surveyed medical professionals.

 

The desire to use technology to improve patient care ranked second among motivators for EMR adoption among survey respondents.



Practice Fusion conducted the State of the Small Practice study via Internet survey with a national sample of more than 1,000 practices gathered through the company’s platform. Medical providers were asked to provide responses to a series of multiple choice survey questions based on the previous year’s data.

Sixty-three (63) percent of survey respondents said new technologies like EMR made things easier in their practices. However, those doctors also reported feeling more confusion around the meaningful use incentives than in years prior -- possibly due to heightened Stage 2 requirements.

 

Forty-five (45) percent of surveyed doctors reported that their practice fared better in Practice Fusion's 2013 report than in 2012, possibly reflecting an improving economy and the influence of EMR incentives. While the majority of remaining doctors reported no change, 16 percent reported that their practice is doing worse – about a 2 percent increase from the 2012 survey.

Here's a synopsis of additional key findings from the 2013 survey:

Doctors reported more confusion about meaningful use this year, with 46 percent of doctors claiming “moderate expertise” in 2013 (a 16 percent drop from 2012) and 50 percent (a 6.5 percent increase from last year) claiming “little” or “no” understanding.Meeting meaningful use deadlines was the main motivation for EMR adoption (55 percent), followed by improving care through new technologies (45 percent) and excitement around adopting a new technology (39 percent).Most computers used today in doctors’ offices are 1-2 years old (41 percent), but some practices continue to hold on to older machines -- 4 percent of doctors’ computers are 6 years or older, compared to 3 percent in 2012.Among doctors’ chief complaints, insurance and reimbursement were ranked highest, followed by practice management costs and administrative burdens.

“Small medical practices are critical as the first line of care,” said Ryan Howard, CEO of Practice Fusion, in a press release accompanying release of the survey findings. “As these practices struggle for survival in a turbulent time, we see it as Practice Fusion’s duty to do everything we can to empower them to adopt and utilize new, lifesaving technologies. With an estimated $100 million paid to our doctors so far, it’s clear we’re on the right track."

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ONC map lets users track EHR incentive payments nationwide

ONC map lets users track EHR incentive payments nationwide | EHR and Health IT Consulting | Scoop.it

HHS' Office of the National Coordinator for Health Information Technology at HHS, working in cooperation with the CMS, has posted a set of data-rich interactive maps to track the country's progress on health IT adoption, as spurred by programs created by the American Recovery and Reinvestment Act of 2009.

 

The main page of the dashboard now includes links to U.S. maps showing provider payment levels under the Medicare and Medicaid electronic health-record system incentive payment programs. On the incentive payment map, visitors can click on a state and see a map speckled by dots of payment recipients.

 

Each dot produces a pop-up box giving basic information about that recipient. The maps can be layered to show recipients of only Medicare or Medicaid EHR incentive payments, or both.

 

In addition to EHR incentive recipients, map layers are posted for locations of health IT regional extension centers, state health information exchanges, Beacon Communities, Strategic Health IT Advanced Research Projects, community colleges and universities participating in the ONC Health IT Workforce Program and the workforce curriculum development centers, as well as dozens of other regional health information organizations.

 

See your tax dollars at work in health information technology: http://dashboard.healthit.gov/meaningfuluse/ ;

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Engaging Health Care Consumers Through Information Technologies

Engaging Health Care Consumers Through Information Technologies | EHR and Health IT Consulting | Scoop.it

Despite being heavy users of technology in everyday activities such as online shopping and banking, consumers tend to make less use of technology to support their health care decisions. Nevertheless, they are enthusiastic about a technologically enabled health care system that enhances its accessibility, reduces paperwork, increases access to their personal health information, and improves its overall performance.

 

Effective use of information technologies represents both an unmet need and an opportunity for the health care system to better engage consumers.


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Why Don't Patients Report Medical Errors?

Why Don't Patients Report Medical Errors? | EHR and Health IT Consulting | Scoop.it
Why Don't Patients Report Medical Errors? - The Huffington Post

 

I was recently browsing through the nearly 200 stories we've compiled with our Patient Harm Questionnaire, when I was reminded again of a troubling truth. Many of the people who suffer harm while undergoing medical care do not file formal complaints with regulators. The reasons are numerous: They're often traumatized, disabled, unaware they've been a victim of a medical error or  don't understand the bureaucracy.

 

That's a problem for those individual patients and for the rest of us. There are many places to complain: a state licensing agency; a professional licensing board that monitors doctors or nurses; the Joint Commission, which accredits hospitals or a Medicare Quality Improvement Organization. But if there are no complaints, there are no independent investigations, and that means no outside accountability for providers who may have made mistakes, and no public inspection reports that documents the case -- assuming an agency makes reports public, which is not always the case. It's a collective problem because patient safety flaws that remain hidden, if they are not corrected, may be repeated.

 

We have staggering estimates of the number of people harmed while undergoing medical treatment. A review of medical records by the U.S. Health and Human Services Department's inspector general found that in a single month one in seven Medicare patients was harmed in the hospital, or roughly 134,000 people. "An estimated 1.5 percent of Medicare beneficiaries experienced an event that contributed to their deaths," the IG found, "which projects to 15,000 patients in a single month."

 

But there's no central system in place to tally and track these events. There's no way to know when and where patients are being harmed or to tell if the problem is worse in one place than another.

 

It's not like keeping track of patient harm is a new idea. More than a decade ago the Institute of Medicine's landmark "To Err Is Human" report called for a national system to capture cases of serious harm to patients or death. The report said accurate reporting provides accountability and knowledge that leads to learning. That's information that could save lives.

 

"You really can't improve what you don't measure," said Dr. Julia Hallisy, president of the Empowered Patient Coalition. "How do you know where to focus your improvement efforts if you haven't measured what's happening in the first place?"

 

Efforts at the state level appear to be falling short, according to federal inspectors. In many states, hospital are required by law to file a report every time a patient suffers unexpected harm -- often called  "sentinel" or "adverse" events. But a July report by the HHS inspector general's office found that only 12 percent of harmful events identified by the office even met state requirements for reporting them. Compounding the problem: Hospitals themselves only reported 1 percent of the harmful events.

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Patient Experience vs. Patient Engagement

Patient Experience vs. Patient Engagement | EHR and Health IT Consulting | Scoop.it
The patient experience is about perceptions and patient engagement is about actions and behaviors.

 

The Beryl Institute, a global community of practice and premier thought leader on improving the patient experience in healthcare, defines the patient experience as “the sum of all interactions, shaped by an organizations culture, that influence patient perceptions across the continuum of care.”

Similarly, the Robert Wood Johnson Foundation describes the patient experience as “comprised of research reports and administrative information that reflect quality from the perspective of patients by capturing observations and opinions about what happened during the process of health care delivery. Patient experience encompasses various indicators of patient-centered care, including access (whether patients are obtaining appropriate care in a timely manner), communication skills, customer service, helpfulness of office staff and information resources.”

 

How is the patience experience measured?


Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).  The HCAHPS Survey is the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.  HCAHPS is a 27-item survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience.

CMS publishes HCAHPS results on the Hospital Compare Website four times a year, rolling the oldest quarter of patient surveys off and the newest quarter on each time. Since 2008, HCAHPS has allowed valid comparisons to be made across hospitals locally, regionally and nationally.

 

What is the driving force behind improving the patient experience?


Value Based Purchasing (VBP) incentive payments.  The Hospital Value-Based Purchasing Program is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide to people with Medicare.

Hospital VBP incentive payments to hospitals will come from the regular fees Medicare pays hospitals through its Diagnosis-Related Group (DRG) system. Hospitals participating in Hospital VBP will have their base operating DRG payments for each patient discharge across all hospitals reduced by a small percentage each year.

Taking into account the reduction in base Diagnosis-Related Group operating payments to hospitals (1 percent for Fiscal Year 2013), CMS estimates that roughly half of participating hospitals will receive a net increase in payments as a result of this rule, while the rest will receive a net decrease in payments.

The Fiscal Year 2013 Hospital VBP Program consists of two domains including 1) Clinical Process of Care and 2) Patient Experience of Care.  For FY 2013, these weighted values are 70 percent for Clinical Process of Care and 30 percent for Patient Experience of Care.

The Patient Experience of Care score is the sum of a hospital’s Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) base score and that hospital’s HCAHPS Consistency score.  The Experience of Care domain is broken out into eight equally-weighted dimensions:

Communication with NursesCommunication about MedicinesCommunication with DoctorsPain ManagementCleanliness and Quietness of Hospital EnvironmentResponsiveness of Hospital StaffDischarge InformationOverall Rating of Hospital

What is patient engagement?


To my knowledge, there is no common definition of patient engagement.  I believe patient engagement can be defined as a person’s active participation in managing their health in a way that creates the necessary self-efficacy to achieve physical, mental and social well-being.  This means that healthcare delivery must entice a person to actively participateover the long-term while fostering health related self-efficacy which yields meaningful physical, mental or social benefit.  In only this way can healthcare organizations depend on the active and sustained participation required to improve clinical outcomes.

This definition clearly differentiates the patient experience from patient engagement.  Whereas the patient experience is based on the patient’s perception of quality, patient engagement is based on the patient’s active and sustained participation in managing their health.  The patient experience is about perceptions and patient engagement is about actions and behaviors.  A patient can conceivably be satisfied with their healthcare experience while  having minimal engagement.

 

How is patience  engagement measured?


Medicare and Medicaid EHR Incentive Programs Proposed Stage 2 Meaningful Use Criteria.  CMS published in the Federal Register the proposed rule which would specify the Stage 2 criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet in order to qualify for Medicare and/or Medicaid electronic health record incentive payments.  Among the many topics addressed in the proposed rule are patient and family engagement measures.

The proposed Stage 2 patient and family engagement measures focus providers and/or hospitals on:

Making visit/inpatient information available to patients timely and onlinePresenting visit/inpatient information in a manner that leads to patients viewing, downloading or transmitting the informationProviding patient-specific education resourcesPromoting patient and provider interactions that lead to patients sending secure messages to their provider

Providing the ability for patients to access and exchange information online seems like a basic, reasonable and early step towards engaging patients.  However, I believe it falls woefully short as an overall measurement of patient engagement.  The proposed patient information access and exchange in and of itself does not create patient engagement, rather,  it creates a channel where patients can engage in some aspects of managing their health. Even when providers meet the proposed Stage 2 measures they will still be saddled with the more complex task of actuallyfostering patient engagement.  So, the really hard work lies ahead for providers and hospitals.

 

What is the driving force behind improving patient engagement?


The Patient Protection and Affordable Care Act (PPACA) Payment Reform.  The PPACA has many provisions related to payment reform.  These reforms include Medicaid & Medicare payment adjustments, payment reductions, incentive payments, bonus payments, bundled payments and shared savings programs.  Payment reform is increasingly shifting away from fee-for-service to performance based payments.  As such, improved healthcare delivery models have significant dependence on the active and sustained participation of patients post their hospital or provider visits in order to achieve financial targets.  Higher levels of patient engagement will be essential to achieving targeted health outcomes that trigger additional reimbursement.

 

For example, let’s look at Accountable Care Organizations (ACO).  The CMS.gov website describes ACO’s as groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.  The key to this payment structure is to generate healthcare savings through better healthcare delivery which then can be shared between the ACO and the government.  Generating these savings will be significantly dependent on patients actively participating in the management of their health as a means of driving down cost through reduced utilization of services.

 

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How to budget for a cloud-based EMR system - American Medical News

How to budget for a cloud-based EMR system - American Medical News | EHR and Health IT Consulting | Scoop.it

Health information technology consultant Matthew Grob likes to compare implementing an EMR to buying a car. The sticker price might be $15,999, but once tags, insurance, warranties and other incidentals are added, it'll take at least $20,000 to get it out of the lot. And it will take more than $40,000 over the next five years to keep it on the road.

 

Similarly, many practices think the price quoted to them by their electronic medical records vendor is the total amount that EMR implementation is going to cost the practice. "And then reality sets in," said Grob, a solution partner with the health care consulting arm of EMC. But careful planning and budgeting can keep practices from sending their bank accounts into the red as the result of EMR adoption.

 

Many practices are discovering that cloud-based systems -- which eliminate the substantial cost of installing and maintaining servers in the office -- can be less expensive. But analysts said that even those require careful consideration based on cost and necessitate that a practice set a budget before signing a contract. With cloud-based systems, the budgeting is not just about what's spent up front -- it's what spent to keep it on the road.

 

Click headline to read more--


Via Chuck Sherwood, Senior Associate, TeleDimensions, Inc
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MPCIRHC.ORG's curator insight, July 26, 2014 6:39 PM

Cloud based personal Health Care Administration is the wave of the future. As long as it can be made secure and in the hands of the consumer.

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Half of docs nationwide e-prescribe via EHRs | EMR Industry

Half of docs nationwide e-prescribe via EHRs | EMR Industry | EHR and Health IT Consulting | Scoop.it

Just about one half of physicians nationwide are now performing electronic prescribing using an electronic health record on the Surescripts network, with all states producing double-digit increases.

 

The percent of physicians e-prescribing using EHRs swelled from 7 percent in December 2008 to 48 percent in June 2012, according to a report released Nov. 27 from the Office of the National Coordinator for Health IT.

Surescripts is a leading e-prescribing network, which is used by 95 percent of pharmacies for routing prescriptions, excluding closed systems such as Kaiser Permanente.

 

Twenty-three states had more than half of their physicians e-prescribing using an EHR, with New Hampshire, Minnesota, Iowa, North Dakota, and Wisconsin experiencing the largest increases since December 2008, according to the report.

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Digital diagnosis – The Future of Telemedicine

Digital diagnosis – The Future of Telemedicine | EHR and Health IT Consulting | Scoop.it
Speaking to a doctor via a webcam might sound like something out of The Jetsons, but it could be a reality sooner than you think. Sir Bruce Keogh, the medical director of the NHS, has called for doctors to offer remote consultations to patients via video link within the next year. But is this a service people want from their family doctor?

 

In order to find out more, YouGov polled over 2,000 people and found that almost 29 per cent in the UK would like to see GPs start offering remote consultations via video link in the next decade. Less than a third may not sound like much, but if you take into account how many millions of appointments NHS doctors conduct each year, there is clearly a huge demand from patients for ‘virtual’ consultations. Experts have also suggested that telemedicine could generate savings of £1bn a year for the NHS and a massive reduction in the number of hospital admissions.

Via nrip
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Africa's mHealth breakthroughs to pave way for U.S.

Africa's mHealth breakthroughs to pave way for U.S. | EHR and Health IT Consulting | Scoop.it

The United States will look to Africa to gain knowledge about advances in mobile health technologies because Tanzania, among other countries, already has maternal child health and community health worker programs that rely on smart phones.

 

While it’s still the early days of mHealth and the digital revolution, “we will see huge breakthroughs in Africa and South Asia,” said Jeffrey Sachs, director of the Earth Institute at Columbia University, speaking at a Monday afternoon mHealth Summit 'Super Session' on global implications for mHealth technologies.

 

“Those breakthroughs will eventually become breakthroughs in the U.S. when it addresses the high costs of its healthcare system and frees up $750 billion a year in waste,” Sachs said.

 

Mobile phones have been used to deliver messages about maternal and child health to mothers who live in areas that are remote or lack communications and other services. Mobile technology can make a difference, getting critical [pregnancy] stage-based information to expectant moms


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5 steps to protect patient privacy

5 steps to protect patient privacy | EHR and Health IT Consulting | Scoop.it

The newly released Third Annual Benchmark Study on Patient Privacy & Data Security, by Ponemon Institute reveals that 94 percent of healthcare organizations surveyed suffered at least one data breach during the past two years.

 

The findings highlight the need for organizations to act now to secure PHI and protect patient privacy.

 

Organizations are not breach-proof. They require an ongoing approach to minimize their frequency, size, and impact.

We recommend that healthcare organizations:

 

1. Operationalize pre-breach and post-breach processes, including incident assessment and incident response procedures. Embedding breach-related processes into everyday business demonstrates what we call a culture of compliance—something regulators love to see.

 

2. Restructure the information security function to report directly to the board. This move symbolizes a commitment to patient data privacy and security.

 

3. Conduct combined privacy and security compliance assessments annually. These assessments identify the gaps between an organization’s privacy and security profiles and what the law requires.

 

4. Update policies and procedures to include mobile devices and BYOD. This is especially critical since, as we discussed, the vast majority of organizations permit employees and medical staff to use their own mobile devices to connect to their networks or enterprise systems such as email.

 

5. Ensure the Incident Response Plan (IRP) covers business associates, partners, and cyber insurance. An effective IRP encompasses third-party contingencies and the role of cyber insurance in managing a security or privacy incident.

 

Organizations need to commit to this problem and make significant changes. These five steps are a good beginning.

 

Read More at: http://www2.idexpertscorp.com/ponemon2012/

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EHR vendor selection checklist for small providers

EHR vendor selection checklist for small providers | EHR and Health IT Consulting | Scoop.it

Selecting a quality EHR vendor is important, but just as crucial is the vendor’s ability to tailor its system to your needs.

 

There are literally hundreds of EHR systems out there for you to choose from, all with different pros and cons. Selecting a quality EHR vendor is important, but just as crucial is the vendor’s ability to tailor its system to your needs.

 

Here are some points to consider before making a final selection:

 

1. How much experience does the vendor have with EHR implementation? What type of stability and track record do they have?

 

2. Assess your physical environment and document it in a detailed list and rank those in order of importance to your organization.

 

3. Is the EHR system software designed to fit your organization’s needs?

 

4. Identify the hardware needs of your office and EHR.

 

5. Does the vendor offer a Software as a Service (SaaS) solution, sometimes called Application Service Provider (ASP)? Or do they require you to use client-server systems, which require a staff member to manage the entire process of updates, upgrades and backups.

 

6. How much can the vendor prepare for and help you get selected by CMS for Meaningful Use Stage 1 under the Medicare EHR Incentive Program?

 

7. Will the system be able to scale up if needed for Stage 2?

 

8. Will their system be relevant beyond meaningful use?

 

9. Will there be any trouble converting to IDC-10? Are they compliant in all other areas?

 

10. Can they help you avoid productivity losses and EHR transition issues?

 

Remember, you can reach out to Regional Extension Centers (RECs) for guidance and resources.

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Tech worker opportunity with new health-care laws

Tech worker opportunity with new health-care laws | EHR and Health IT Consulting | Scoop.it

With President Barack Obama’s re-election ensuring that his 2010 law will be implemented, companies are scouting for workers to fill hundreds of thousands of jobs in everything from running records systems to creating and servicing new insurance exchanges and entering thousands of additional codes for health-care treatments.

 

The federal government projects that under the law, 30 million more Americans will start getting coverage in 2014 through expanded state Medicaid programs or private insurers, or pay a penalty.

 

A study published this month in the Annals of Family Medicine found that the newly insured will contribute to rising demand for medical services, requiring an estimated 8,000 more doctors over 12 years.

 

They also will create jobs for workers in support fields such as IT, already in short supply. On the IT front, health-care systems, data companies and other industries in need of talent all are competing for the same workers.

 

The U.S. economy may create as many as 758,800 new computer and IT jobs, a 22 percent increase, from 2010 to 2020, the Bureau of Labor Statistics said in its outlook on job growth.

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