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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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 |

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

Via nrip
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EMR and Practice Management, Is Implementation Actually Difficult?

EMR and Practice Management, Is Implementation Actually Difficult? | EHR and Health IT Consulting |

Electronic Medical Records (EMR) and Practice Management systems are being adopted by almost every physician across the US, thanks to the slogans of quality care provision and the government’s meaningful use incentive funds, there still seems to be a handful of physicians who find it difficult to switch from their conventional methods to automated EMRs and Practice Management. One could possibly list down a couple of reasons behind that. While some find it troublesome to let go of their existing workflows, other consider health IT applications to be intricate and time consuming.


’I agree it is not easy to change your habits. However, given the number of advantages and benefits that comes with certified EMR and practice management, physicians should take the matter seriously. Fortunately, majority physicians have implemented such solutions, however others still look for convincing arguments and answers’, says a North Carolina based health IT consultant.


One of the biggest misconceptions about EMR and Practice Management is that these solutions are complex and time consuming. Whereas today, usability along with maintaining product quality is what most established vendors keep on top of their priority lists. According to research, health IT applications are so easy to use that even amateurs get up to speed with them in no time. Physicians do not have to spend extra dollars or hours to learn such applications, the less time consuming yet effective demonstrations provided by the vendor are sufficient to comprehend the functionality and features of the system.


’It is simple, technology is meant to facilitate physicians and to complicate their working patterns. Certified EMR and practice management are designed keeping in view that physicians are not IT personnel. Hence, keeping the technology easy to use has always been the priority of established vendors’, says a New Jersey based health IT consultant.


Although there isn’t paucity when it comes to the myths about EMR usability, one can identify ample reasons to support the adoption of the technology. However, this requires good research on one’s end. As majority physicians are convinced and are implementing certified EMR and practice management, it is just a matter of time when this handful of physicians would start realizing how easy it is to switch to these solutions.


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Medical EMR Can Simplify Healthcare | EMR NEWS

There are many ways that an integrated medical EMR system can help a practice to save money and become more efficient. But one benefit of EMRs that is often overlooked is the way a good system can simplify healthcare in general. There are benefits to patients as well as clinicians that can help even the most confused patient to get the care they need at a better price, without costing the practice more money.

Billing Advantages

Healthcare providers already know how an integrated medical EMR can make billing more accurate and efficient. If everyone in the practice is using the same system, and all data are available through that system at any time, medical billing staff can pull the data they need and bill on a timely schedule. Coding can also be easier, with a specific set of billable tasks and diagnoses, clinicians can provide medical EMR coding staff with the precise information they need to get the medical coding done more quickly and easily.

The billers can then take the information and file claims with the insurance companies and bill patients for their share of the cost. The improvement in efficiency that medical coding and billing departments are experiencing has been exciting for those practices that have implemented a medical EMR.

So how does this simplify healthcare and understanding the healthcare and insurance system in the United States? First of all, if the billing system requires specific information from patients, the billing department can implement procedures for determining what a patient will owe even before services are provided.

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Inaccurate EHR info can spoil research, public health efforts

Inaccurate EHR info can spoil research, public health efforts | EHR and Health IT Consulting |

Data entered incorrectly in electronic health record systems can render not only that patient's record inaccurate, but also can adversely impact the results of research based on that data, according to a recent blog post by Anna Lembke, M.D., an assistant professor of psychiatry and behavioral sciences at Stanford's School of Medicine.


Lembke, writing on the school's blog Scope, points out that one of the benefits of EHRs is to use their information for "big data" purposes and that EHRs are being data mined to make "important decisions" about clinical care and health policy.


However, "if data-mining is based on inaccurate information, then the whole operation is a house of cards," she points out.


For example, one physician Lembke knows is required by his EHR to identify the ethnicity of all of his patients. Since he believes that this information isn't necessary, he quickly tackles that chore by listing them all as Albanian, since that is the first ethnic group listed on the EHR's pull down chart. As a result, more than 90 percent of his patients are identified as Albanian, even though they aren't, which falsely skews information about the population in his California county.


"Misinformation in electronic medical records, whether accidental or otherwise, has far-reaching consequences for patients and healthcare policy," Lembke warns.


Via nrip
Paul Epping's comment, October 20, 2012 3:32 PM
This problem can be limited if the EHR is based on structured data entry!

Survey: Most U.S. Primary Care Docs Using EMRs – Capsules - The KHN Blog

Survey: Most U.S. Primary Care Docs Using EMRs – Capsules - The KHN Blog | EHR and Health IT Consulting |

U.S. doctors are no longer the laggards when it comes to using health information technology in their practices. But they are still more weighed down by paperwork and health care costs than many of their Western counterparts.


A survey of nearly 8,500 primary care doctors in ten of the world’s wealthiest countries took a new look at health IT adoption, updating a 2009 study conducted by The Commonwealth Fund and Harris Interactive.


Two-thirds of the American physicians in a sample size of 1,012 reported using electronic health records, compared to 46 percent three years ago. More doctors also said their practice included e-mailing patient summaries and test results.


The Netherlands, Norway and New Zealand adopted the technologies earlier, and almost all of their physicians continued to report using EMRs since 2009. All three countries have some form of universal health care.


“Bringing in EMRs only makes sense when standards have been set,” said Cathy Schoen, a lead author of the study and senior vice present of policy, research and evaluation at the Commonwealth Fund.


Schoen said more U.S. physicians were open to transitioning from to paper to electronic records and exchanges after national policies were put into place to regulate the technology. The Centers for Medicare & Medicare Services Incentive Programs govern the “meaningful use” of electronic health records and provide incentives to physicians who adopt systems that meet specific criteria.


Dr. Jeffrey Cain, president of the American Association of Family Physicians, said primary care doctors were the first to implement electronic health records, even though the cost was high for their practices compared with that of specialty practices. He said newer physicians entering the workforce, who are generally more comfortable with technology, have added to the momentum driving EMR use.


While health IT advancements foretell more efficient practice, only 15 percent of American physicians thought the country’s health care system worked well, according to the study. And they blamed insurance coverage restrictions for stymieing access to care and undermining potential for change.

“It’s expensive and fragmented,” Cain said in response to complicated insurance reimbursements. He said family physicians spent an average of eight hours a week filing paperwork, because insurance companies and federal coverage plans each had a different process.


Primary care physicians are hopeful that changes advanced by the health law – including coverage expansions – could prove helpful, according to the Commonwealth Fund’s Schoen. “Right now it’s complexity without value,” she said.

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Digital medicine: Patients are stuck in the precarious middle

Digital medicine: Patients are stuck in the precarious middle | EHR and Health IT Consulting |

The use of computers in everyday medical practice has finally reached the tipping point.


EHRs are secure digital repositories of patient information–doctors’ notes, lab and X-ray reports, and letters from specialist physicians. They are an electronic version of the paper chart. Newer, more advanced EHRs are integrated systems and allow doctors to order tests, generate bills, communicate with patients, and run analyses on aggregate patient data. In hospitals, nurses use EHRs to administer and record medication dosing and document other patient care activities.


Though medical practices have a high burden of proof to claim their bonus–the Department of Health and Human Services is still in the process of fully defining just what constitutes ‘meaningful use’–there is now conclusive evidence that the carrots are working. Recent data demonstrates that solo and two-doctor offices, which still comprise over half of all medical practices in the U.S., have seen the biggest jump in EHR adoption over the last six months. These small shops are reaching the conclusion that they must participate, as they risk being left behind technologically and financially.


As a practicing primary care doctor, I feel I am slowly being pulled into the apostate camp. Our apostasy is not about EHRs; that game is all but over. Rather, there’s a pervasive sense that our use of technology has become a wedge between doctors and just about everyone else: Nurses. Other doctors. Worst of all, our patients.

Via nrip
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MHealth Identified as Major Growth Sector in Healthcare - Especially with Support from FCC

MHealth Identified as Major Growth Sector in Healthcare - Especially with Support from FCC | EHR and Health IT Consulting |

Some well-known companies – as well as lesser known firms – stand to benefit from the growing demand for mobile health technology.

Mobile health (mHealth) involves the monitoring of patients or providing them with various forms of healthcare using mobile technology. There is exchange of data, images and video and the use of mobile networks, devices and applications.

And the sector’s technology is becoming more popular, with growing acceptance by physicians.


Companies like Qualcomm, Intel and Apple, as well as smaller firms like Fitbit Inc., and Entra Health Systems, stand to benefit from this trend.

One example of expansion in this sector is Qualcomm, which invested $100 million in its subsidiary, Qualcomm Life Inc., in 2011, according to a company statement. The division is focused on improving the capabilities of medical devices.

According to a recent report from iData Research, the U.S. patient monitoring market was valued at over $3.1 billion in 2011 and will grow to almost $4.2 billion by 2018.

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The need for long-term digital retention in eHealth

The need for long-term digital retention in eHealth | EHR and Health IT Consulting |

Although the price for storing data may be falling there are additional economic challenges in ensuring digital content remains understandable for future generations. Guaranteeing long term usability for spiralling amounts of data produced or controlled by organisations with commercial interests is quickly becoming a major problem, says Michael Wilson, Secretary, UK e-Infrastructure Leadership Council.


Wilson gave some excellent background on the subject during Thursday's e-health session at eChallenges presenting findings from the ENSURE project which is examining economical solutions for long term digital preservation in user cases (healthcare, clinical trials, and finance).


Digital medical data serves a different purpose depending on the stakeholders. Health records and data can be preserved for the benefit of patients, their families and future medical research. Over time, the reasons for collecting specific data-sets may also change. Medical imaging data takes up to 30% of the digital universe. Each record has it's own formula (e.g. pathology images are saved in DICOM). In a further 10-20 years, software will inevitably have changed but virtual environments can preserve the software to make the data useful (e.g. associated manuals, hardware, operating systems). There are of course risks in preservation associated with different strategies, and this is what ENSURE is researching (i.e looking at cost/value of different strategies, how to automate the lifecycle, as well as scalability options of leveraging new technologies such as cloud technology).


For researchers, a major flaw in social media is its transitory state. Already one project is examining how to preserve and manage weblogs - Blogforever. Recent studies have revealed that blogs on major historical events have already been lost (see another blog post). BlogForever aims to provide a solution to preserve and organise all blogs especially those that have historical significance - one project partner is CERN with the goal of preserving physics-related blogs. GridCast originated at CERN. The ultimate vision of the project is to preserve collections of blogs in a cost efficient manner safeguarding their authenticity and integrity for users/organisations (e.g. a National Library of Medicine would like to preserve a collection of health and medicine blogs). Other aims include enabling full text searching, tagging, sharing and reusing content.

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Can social media help heal healthcare?

Can social media help heal healthcare? | EHR and Health IT Consulting |
For all of the debate, one thing is for sure: social media in medicine is here to stay. But when it comes to the availability of trustworthy information, we still have a ways to go.


How to get more for less? It’s an age-old question and one that is playing out today in our healthcare system. With healthcare reform top of mind these days, everyone is asking how the medical industry can treat patients better for less money. Social media often comes up in these discussions and everyone seems to have an opinion about the risks and rewards.


For all of the debate, one thing is for sure: social media in healthcare is here to stay. But when it comes to the availability of trustworthy health information, research suggests that we still have a ways to go. According to a recent Pew Internet survey, four out of five Internet users have searched for health information online,


making health one of the most searched topics on the Internet. At the same time, the study also revealed that more than 50 percent say the information they find is “of no help at all.” After all, anyone with Internet access can set up a health blog or answer health questions on Google or Yahoo Answers, no credentials required.


As the CEO and founder of, an online legal and health Q&A forum and professional directory, I talk to hospital administrators, doctors and consumers about these issues on a regular basis. When it comes to providing information about health issues and healthcare providers online, I see a massive opportunity for improvement. Ultimately, I think it comes down to two primary actions on the part of the medical community and those providing health-focused social media platforms.

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24% of doctors use social media daily for medical information, study says - - ModernMedicine

24% of doctors use social media daily for medical information, study says - - ModernMedicine | EHR and Health IT Consulting |
Nearly one-fourth of physicians use social media on a daily basis to scan or explore medical information, according to a recently published study in the Journal of Medical Internet Research.


The researchers behind the study set out to examine physicians’ level of social media usage for the purpose of exchanging advice, ideas, reports, and scientific discoveries with other physicians.


The study was based on emailed survey responses from 485 primary care physicians (PCPs) and oncologists, and it had a response rate of 28%.


They found that, whereas just 24% of physicians use social media to “scan or explore” on a daily basis for those reasons, that number jumps to 61% when measured on a weekly basis.

Physicians who use social media to “contribute,” rather than merely scan information, stood at 14% daily and 46% weekly.


In terms of what social media applications physicians are using, “restricted online communities” such as Sermo and Ozmosis were the most popular, at 52%. Somewhat surprisingly, Twitter scored much lower, with a 7% usage rate. Facebook was in the middle at 19%.


“Respondents might see online communities as a less-risky and higher-quality source of medical knowledge than more broadly open social media applications such as Twitter, LinkedIn, or Facebook,” the authors theorized.

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Coming Next: Doctors Prescribing Apps to Patients

Coming Next: Doctors Prescribing Apps to Patients | EHR and Health IT Consulting |

Before long, your doctor may be telling you to download two apps and call her in the morning.

Lee Perlman, left, and Benjamin Chodor of Happtique, developer of a medical app that can facilitate the writing of prescriptions.
Smartphone apps already fill the roles of television remotes, bike speedometers and flashlights. Soon they may also act as medical devices, helping patients monitor their heart rate or manage their diabetes, and be paid for by insurance.


The idea of medically prescribed apps excites some people in the health care industry, who see them as a starting point for even more sophisticated applications that might otherwise never be built. But first, a range of issues — around vetting, paying for and monitoring the proper use of such apps — needs to be worked out.

“It is intuitive to people, the idea of a prescription,” said Lee H. Perlman, managing director of Happtique, a subsidiary of the business arm of the Greater New York Hospital Association.


Happtique is creating a system to allow doctors to prescribe apps, and Mr. Perlman suggested that a change in the way people think about medicine might be required: “We’re basically saying that pills can also be information, that pills can also be connectivity.”

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4 reasons voice recognition and mobile devices are meant to be together | EHR Watch

4 reasons voice recognition and mobile devices are meant to be together | EHR Watch | EHR and Health IT Consulting |

Remember doctors walking down halls, talking into tape recorders like Agent Dale Cooper from Twin Peaks? Now they're holding conversations with their mobile devices, taking a page from David Bowman and Frank Poole's interactions with HAL 9000 in 2001: A Space Odyssey.

Ubiquitous mobile devices such as iPhones and Androids offer both opportunities and challenges for physicians. Critical EHR data is accessible almost anywhere and near instantly, and patient notes can be recalled with a few taps on a screen. But minimized screen real estate is at a premium: What data should be shown? And that's to say nothing of the challenges of entering the data: Typing full notes on a mobile phone can be a carpal-tunnel inducing strain.


Nuance Healthcare's Jonathon Dreyer thinks these strengths could be improved – and the weaknesses could be eradicated – with strong integration of voice recognition, cloud-based applications and natural- or clinical language understanding technology. He says these tools create "better access for the physician," who can have an interactive dialogue with his or her device to access and create medical records on the fly.


Dreyer offers four reasons voice recognition and mobile devices were meant to be together.


1. Speech to text. "There's no question that these mobile devices are great for consumption of information, but when it comes to generation ... they fall flat," says Dreyer, who says he's noticed more and more people attaching external keyboards to their mobile phones, effectively turning them in to mini laptops. That's contrary to the point of a mobile device, he argues, and "even with a keyboard I can't imagine a physician entering data that way."

Speech-to-text services for mobile devices resolve that shortfall. As a majority of doctors are comfortable around dictation already, this enables them to allow patient notes or clinical information directly in to their device, on the fly. Dictating to a service that can automatically convert a doctor's speech to text lets them deliver notes in a conversational style. This is good for several reasons: It frees them up from typing on a small keypad and it means that they may include things they'd forget to type.


2. Custom commands and navigation. "You've got so much information in an EMR, especially within the confines of a four inch screen, it becomes really difficult to present that information," says Dreyer. While software vendors are getting better at choosing what data to display and when, he envisions a better approach. Voice recognition lets physicians "have a free form and flowing conversation" with their devices, "like they were actually talking to a person at their side."

Dreyer references a study that found 81 percent of doctors own a smartphone and that a majority of them use their devices to access reference materials at point of care. "A physician can simply say, 'Show me my patients for the day,' or, 'Show me Mary Smith's info,'" and have that information brought up as he or she is walking in to the room to see the patient, says Dreyer. That level of flexibility can make a physician's workflow much more efficient and can allow them to devote more time to patient care and less to retrieving and looking through records.


3. Clinical language understanding. Natural or clinical language understanding is a process that can pull relevant medical information out of a narrative conversation and convert it in to actionable data that a computer can act upon. A physician "can take speech recognized text, run it through a CLU engine that extracts clinical data and pull structured information out of a patient narrative," says Dreyer. This allows a physician to concentrate more on getting an accurate narrative from the patient, as opposed to asking routine questions. Having a CLU to sort all of the data "allows physicians to document the patient's whole story," says Dreyer. Capturing the entire narrative means the resulting care will be better. "You don't want to force patient narratives in to a template."


4. Future developments. What if a doctor saw a patient and dictated the notes, mentioning the patient showed signs of a certain ailment and that they were prescribing a certain medication, and had a speech recognition and CLU system that was able to send a prescription order to a pharmacy – all in real time? "That scenario is totally feasible," says Dreyer. "For as much as there is unknown [in medicine], there is a lot of known." With actions and protocols centered around so many day-to-day routines, integrating voice recognition and CLU systems with a physician's commands could simplify and streamline workflows

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New analysis of docs on Twitter shows that they are active and connected users

New analysis of docs on Twitter shows that they are active and connected users | EHR and Health IT Consulting |

The use of social media has exploded in the last couple of years, and doctors are also jumping on board.


In an effort to understand how physicians are using social media, WCG, an independent strategic communications firm, created a database of nearly 1,400 doctors on Twitter and linked their profiles to the National Provide Identifier, a unique 10-digit identification number that the Centers for Medicare & Medicaid issues to providers in the U.S.


After tracking more than 400,000 tweets over a five-month period this year, the creators of the database came away with a few conclusions. According to a post written on the website of one such physician tweeterand blogger, the findings were:


1. These are active users. They tweet over 2x per day on average.
2. Twitter is a part of their work-day. More than 50% of tweets are sent between 9am and 5pm (in the physician’s local time zone).
3. They have an audience. 2/3 have at least 150 followers (the median is 306).
4. They connect to each other. More than 1/3 of the doctors are followed by at least 20 other doctors in the database.

The most-followed physician by those in the database was none other thanKevin Pho(the same physician on whose blog, this entry was posted); followed by nearly half of the doctors studied.
The characteristics of the database are not unlike the overall specialty mix and geographic location of the overall physician population in the U.S.


The database creators also wanted to find out what the doctors talk about and decided to analyze a sample of tweets related to diabetes, breast cancer and prostate cancer. A whopping 83 percent of the specialties mentioned the term “diabetes” in tweets.


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EHRs provide good ROI, even in low-income settings

EHRs provide good ROI, even in low-income settings | EHR and Health IT Consulting |

Implementing an EHR provides a good return on investment for hospitals in low-income areas, according to a case study published in the Journal of the American Medical Information Association.


Researchers, led by Julia Driessen, PhD, of the Graduate School of Public Health at the University of Pittsburgh, studied the implementation of a hospital-wide EHR in a tertiary facility in Malawi, a southeast African nation.


The researchers studied three areas of impact: length of stay, transcription time and laboratory use. When comparing the previous paper-based system to the electronic system, they found estimated cost savings in those three areas of $285,000 in U.S. dollars. When compared with the costs of installing and sustaining the EHR system, there is a net financial gain by the third year of operation. Over five years the estimated net benefit was more than $600,000.


Evaluating EHRs in low-income settings is important, the authors wrote, because such hospitals suffer from additional problems, such as staff and supply shortages, which affect how fully the benefits of an EHR are realized.


EMR can have financial, in addition to clinical, benefits in low-income settings," the researchers said. "These results suggest that the dialogue surrounding EMR in low-income settings should focus on how, rather than whether, to make these investments.

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Successfully Managing an EMR Transition in a Practice Shared by a Licensed Physical Therapist

Successfully Managing an EMR Transition in a Practice Shared by a Licensed Physical Therapist | EHR and Health IT Consulting |

Successfully Managing an EMR Transition in a Practice Shared by a Licensed Physical Therapist Since EMR system will be a mandatory for the coming years, Nitin Chhoda, a physical therapist shares some ways how to successfully manage an EMR transition in a practice.


These days it would certainly be an advantage for any healthcare provider to make the transition to electronic medical records. Compared to the traditional file and paper system for archiving and managing medical data, EMRs are faster, more efficient and certainly more convenient for both the provider and the patients that they service. However, transferring or overhauling the entire system is not an easy task as one might think.

Nitin Chhoda, a licensed physical therapist and international private practice marketing expert says that the transition should be gradual and not rush, because there are things that need to be addressed carefully like the migration of data from paperwork into electronic records.

However, there are many advantages that could be enjoyed if data management is turned into the electronic medical records system. A very good management is needed when transitioning from a traditional paperwork-based data archiving into EMR.


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Decoding doctor's handwriting can mean life or death

Decoding doctor's handwriting can mean life or death | EHR and Health IT Consulting |
Physician Brendan Byrne was working his shift at his New Westminster medical clinic when an elderly woman arrived for her first visit after being discharged from the hospital.


The only information Byrne had was a discharge document from the hospital with a crucial line, scribbled in illegible handwriting, giving the dosage for a potent drug prescribed for the patient.


While jokes have abounded for years about doctors' messy handwriting, this was no laughing matter. "Right beside the potassium there was a delta symbol to change from one potassium a day to two twice a day - I couldn't tell if it was the potassium or the medication above that ... an overdose of potassium can kill somebody," he said. "Fortunately we were able to figure out what to do, but it was a bit unnerving to see that."


For Byrne, the experience only served to reinforce the importance of the current shift to eHealth. Outmoded health delivery records are being replaced by digital technology that's improving patient care and transforming our health care system.


"I once had a doc, an older fellow, I was talking to about adopting EMR (electronic medical records)," said Byrne, who is also vice-president physician solutions for Telus Health (part of the Canadian telecom company Telus). "I picked up a chart and I said 'would you take your car to a mechanic who kept records like this?' "He looked at me and said 'No.'" Byrne is among the players on the front line of the digital transformation in health care. He started Wolf Medical Systems, a company that grew to become the largest electronic medical records provider in Canada before it was acquired by Telus earlier this year.


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U.S. Primary Care Physician Adoption of EMRs Increases 50%, Still Lags Other Countries | Healthcare Information Technology

U.S. Primary Care Physician Adoption of EMRs Increases 50%, Still Lags Other Countries | Healthcare Information Technology | EHR and Health IT Consulting |
Primary care physicians in multiple countries have made progress in the use of health information technology in healthcare practices, particularly physicians in the United States, according to a survey published in HealthAffairs.



Physicians from 10 countries completed the survey this year: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the United Kingdom and the United States. The survey consisted of interviews with primary care physicians using a common questionnaire from a 2009 survey. To examine current rates of adoption and the diversity of capacity, the survey asked about basic electronic medical records and included 15 questions about functions that HIT systems potentially provide.


Key findings from the survey include:


• Physician practices in all 10 countries have been investing in HIT to provide information tools and decision support, with Canada and the United States most recently enacting national policies to spur the spread and use of HIT.

• There was a substantial increase in the United States in use and multifunctional capacity compared with 2009. The United States still lags behind countries with near-universal adoption, such as Australia, New Zealand and the United Kingdom, but there has been a 50 percent increase in the rates of use of EMRs.

• Across countries, most physicians with EMRs reported the ability to generate patient and panel information, and they routinely use electronic order entry for lab tests and prescription drugs.

• The share of U.S. practices reporting multifunctional capacity of EHRs is 27 percent.

• The electronic exchange of patient information is not yet the norm in any country. In the United States, the capacity for electronic exchange of patient information is concentrated in larger practices and those in integrated health systems.

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How Has EMR Simplified Prescription?

How Has EMR Simplified Prescription? | EHR and Health IT Consulting |
We are all familiar with the hapless condition of the healthcare system in US. Although a significant percentage of the federal budget was being spent on healthcare, experiencing the expected outcome was barely evident. While there existed several problems which needed to be addressed immediately, medical prescription was certainly a vital one. Over time, be it free EMRs or the ones that charge a monthly subscription fee, became the stepping stone to help in mitigating such problems.


According to research, every year a significant number of complaints were reported against medication prescription errors. On one hand you would come across physicians complaining about the loss of prescription notes on part of the patients, while on the other hand, patients and pharmacies would point fingers towards handwriting errors made on the prescription notes. Since an appropriate remedy was the need of the hour, EMR technology came to rescue, owing to the concept of electronic prescription through EMRs.


It is believed that electronic prescribing has played its role to completely change the dynamics of the healthcare system. Ensuring accountability and storing evidence, which was not possible in paper based practice, has started to settle in the healthcare system ever since the inception of EMR. The science behind electronic prescription is simple; once the physicians is finished with documenting the patient encounter, using the EMR, he can send the prescription details directly to the pharmacy.


Realizing the potential advantages that electronic prescription could bring to the healthcare industry, even the government included it as one of the core objectives of the meaningful use program. Since the government is taking the matter seriously, it expects the physicians to do the same too. This means that if physicians want to get their hands on the incentive funds; sooner or later they would have to start electronic prescription.


Not only have EMRs and the mechanism of electronic prescribing helped save valuable time but also eliminated the loop holes that existed within the system. Today, majority physicians across the US are using electronic prescriptions. According to a leading health IT magazine, approximately 67% physicians across the US are using e-prescriptions. As the technology progresses, experiencing more innovative breakthroughs is just a matter of time.


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Why Your Doctor Doesn’t Want You Using iPhone And iPad Health Apps | Cult of Mac

Why Your Doctor Doesn’t Want You Using iPhone And iPad Health Apps | Cult of Mac | EHR and Health IT Consulting |

Doctors may be fans of the iPad as a clinical tool, but they’re not certain that Apple’s iPad, the 5000+ health and medical apps in the App Store, or other mobile technologies are safe and effective health tools for patients. That’s the gist of a report by PwC Global Healthcare. The report was based on surveys of physicians, healthcare management professionals and payers, and mobile technology users in ten countries around the world.


According to the report, just under two-thirds (64%) of healthcare providers acknowledged that mobile technologies offer potential benefits for patients, but feel that mobile health (also known as mhealth) is virgin and untested territory. As a result, the majority of doctors (73%) don’t suggest iOS or mobile health apps to their patients and some (13%) even discourage patients from using them.


The reasons for not encouraging mobile health apps cover a variety of territory.


There’s the perception of cost, complexity, and scope of change associated with implementing mobile health solutions and an associated lack of technology systems in many healthcare environments. For example, the survey identified that only 40% of private practices and 63% of public sector offices and hospitals worldwide have wireless connectivity.


Concerns about how patients would use mobile health apps was a common reason for discouraging their use. That breaks down into a handful of issues, including patient compliance with health tools, the ability to ensure their proper use, and a concern that patients would become too independent and avoid regular office visits. That last concern appears to be a very valid point since 59% of mobile health users said iOS apps and other mobile technologies have replaced some visits to doctors or nurses.


Beyond patient use of health apps, concern about industry regulations was the biggest drawback to deploying mobile health solutions followed be the sense that healthcare, as an industry, has a particularly conservative culture. Those are areas that PwC’s Global Healthcare’s Christopher Wasden identified as different between as different between industrialized and developing countries.


The adoption of mobile health in emerging markets versus developed markets is a paradox. In developed markets, mHealth is perceived as disrupting the status quo, whereas in emerging countries it is seen as creating a new market, full of opportunity and growth potential. In younger, developing economies, healthcare is less constrained by healthcare infrastructure and entrenched interests. Consumers are more likely to use mobile devices and mHealth applications, and more payers are willing to cover the cost of mHealth services.


Other interesting points from the study include the following:


Health administrators and payers are more encouraging of mobile health solutions – 40% approve of such technologies compared to just 25% of doctors.

Two thirds of people who use health and fitness apps discontinue their use after six months (or earlier).

Roughly half the population expect mobile health options will improve the convenience (46%), cost (52%) and quality (48%) of healthcare.

Nearly half of those surveyed expect mobile apps will change the way they manage chronic conditions (48%), medications (48%) and overall health (49%).

60% of consumers believe doctors are not as interested in mobile health options as patients and technology companies.

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Mobile apps, medical records fuel healthcare's digital transformation - FierceHealthIT

Mobile apps, medical records fuel healthcare's digital transformation - FierceHealthIT | EHR and Health IT Consulting |

It's always interesting when the popular press tackles topics that healthcare industry leaders have been talking about for ages. It brings a different perspective and a fresh voice that's sometimes lacking in board room discussions, conference lectures and trade publication articles.


In a recent series titled "The Digital Doctor," the New York Times offers a glimpse into what the average consumer sees when he or she stands at the intersection of healthcare and technology: how health IT is changing medicine and doctor-patient relationships from the patient's point of view.


The series touches on a number of hot health IT topics--from how younger physicians are embracing technology to how older doctors are trying to catch up to how texting and social media can help pediatricians communicate with teens to the balance between the benefits and the dangers of electronic health records.
In this special report, FierceHealthIT takes a deeper look at some of the subjects in the series. On the following pages, you'll find highlights from and links to the Times' articles as well as links to additional news and information from our own coverage of the topics from the past year.

Via nrip
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9 ways social media is impacting the business of healthcare | Healthcare Finance News

According to a recent report by the Health Research Institute at PwC US, nine distinct uses of social media are helping companies to have an impact on the healthcare business, and to take a more active and engaged role in managing individuals' health.


"Organizations should coordinate internally to effectively integrate information from the social media space and connect with their customers in more meaningful ways that provide value and increase trust," the report read. "Insights from social media also offer instant feedback on products or services, along with new ideas for innovation. Organizations that can incorporate this information into their operations will be better positioned to meet the needs of today’s consumers."


The report outlined nine additional ways social media is impacting the business side of healthcare.


1. Communication is shifting to public, more open forums. Which means less money spent on mailings, websites, and other marketing initiatives. According to the report, four characteristics of social media have altered the nature of interactions among people and organizations: user-generated content, community, rapid distribution, and open, two-way dialogue. "In the past, a company would connect with its customers via mail or a website, but today's dialogue has shifted to open, public forums that reach many more individuals," read the report. "Early adopters of social media in the health sector are not waiting for customers to come to them." Ed Bennett, who oversees social media efforts at the University of Maryland Medical Center, agreed. "If you want to connect with people and be part of their community, you need to go where the community is," he said. "You need to be connecting before you are actually needed."

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How can social media impact treatment, research?

How can social media impact treatment, research? | EHR and Health IT Consulting |
BOSTON--Roger Chafe, PhD, director of pediatric research at the Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada, discussed the intersection of social media and more traditional media at the Medicine 2.0 Congress, and how both are impacting treatments and research.


For example, despite little clinical evidence or support for venoplasty to treat the symptoms of multiple sclerosis (MS), published information about a small trial of 65 patients in 2008 led to significant public debate about the treatment. Thousands of MS patients expressed their dismay on Facebook that the MS Society of Canada was moving too slowly on clinical trials for the potential treatment. Within days, the society reversed its position and requested research proposals.


In another example, Canadian wife and mother Jill Anzarut was diagnosed with HER-2 positive breast cancer with a tumor less than .5cm in size. She was denied coverage for Herceptin because her tumor was too small--Ontario guidelines indicated Herceptin for tumors 1cm or larger in size. Anzarut set up a Twitter account which generated numerous news articles about her plight. Eventually, a clinical trial for Herceptins effect on smaller tumors was set up.


Social media allows patients a greater platform for challenging treatment coverage decisions and research priorities, Chafe said.

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EHR Implementation — Big Bang or Staged? What You Should Know. | EHR Blog | AmericanEHR Partners

EHR Implementation — Big Bang or Staged? What You Should Know. | EHR Blog | AmericanEHR Partners | EHR and Health IT Consulting |

Big Bang describes an implementation where a practice begins using all of the functions at the same time. A staged implementation refers to a practice that gradually starts using a defined subset of EHR functionality before implementing more functionality; this process is then repeated until all of the functions of the EHR system are implemented. The advantages of each approach have been endlessly debated amongst health IT wonks. My view is that the best approach falls somewhere in the middle and may differ for each practice. Before going into the pros and cons of each approach, it is important to elaborate on some of factors that may limit the options your practice considers.

Unfortunately, many EHR vendors are currently suffering from severe resource constraints and may not be able to facilitate staged implementations, especially in smaller practices. If they are able to support staged implementations, the cost for this type of implementation may be higher, as their on-site training staff may be less efficiently deployed. Many EHR vendors are increasingly relying on interactive online training models that allow practices to train on their own schedule. This approach requires less one-on-one interaction, reducing the demand on trainers and how much vendors charge for training. Practices can also reduce the need for vendor training by utilizing a super-user model where a few clinicians and staff receive extensive training on the use of the system and then help train the rest of the practice.


Big Bang:



Theoretically faster as all of the functionality is available at go live.
Onsite training can be completed in a single block of time, reducing the costs of training.
The drop in productivity experienced after all EHR implementations can be shorter, even though it may be more substantial. This is because staff are not continually trying to learn new technologies.
Disruptions caused by the unnatural segmentation of tasks, e.g. the documentation of a patient encounter on paper and then electronically prescribing a medication, are avoided.

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mHealth apps may make chronic disease management easier

mHealth apps may make chronic disease management easier | EHR and Health IT Consulting |
Mobile health (mHealth) applications (apps) for smart phones and tablet computers are proliferating rapidly, ranging in complexity from products as simple as patient scheduling and point-of-care electronic physician note apps to sophisticated remote patient monitoring devices.


“The whole world of mobile health is really expanding very dramatically,” Richard J. Katz, MD, director of the Division of Cardiology at George Washington University Hospital in Washington, DC, told Clinical Advisor.

Smart phone apps are incredibly promising for the field of chronic disease management due to their pervasiveness and increasing attention by designers to things such as user experience and ease-of-use, according to Julie Kientz, PhD, director of the Computing for Healthy Living and Learning Lab at the University of Washington in Seattle.


“More and more frequently, medical professionals and technology researchers are teaming up to deliver best practices from researchers in a mobile format that can be there whenever the patient needs it and serves as a convenient system for tracking data and receiving reminders for medications,” Kientz said in an interview.


There are many apps available in iTunes and the Android marketplace for clinical disease management, as well as patient self-management, for conditions including asthma, diabetes, heart disease, cancer, and even autism and insomnia.

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Will meaningful use help prevent prescription drug abuse? |

Will meaningful use help prevent prescription drug abuse? | | EHR and Health IT Consulting |
Growing national concerns over the rise of prescription drug abuse could lead to future meaningful use requirements the Electronic Health Records Incentive Programs, according one of the Office of the National Coordinator for Health Information Technology (ONC) Federal Advisory Committees (FACs). As its name suggests, the Meaningful Use Workgroup helps the Health IT Policy Committee by defining determine the meaningful use of electronic health records by eligible professionals (EPs) and hospitals (EHs) in future stages of the Centers for Medicare & Medicaid Services (CMS) incentive programs.


During yesterday afternoon’s meeting, the group considered the addition of potential objectives to Stage 3 Meaningful Use order to support the national effort to reduce prescription drug abuse through health IT. In particular, the Meaningful Use Workgroup discussed the value of a state-level program for monitoring prescription drug use, the Prescription Drug Monitoring Program (PDMP).

According to a report from the Centers for Disease Control and Prevention (CDC), drug poisoning has surpassed motor vehicle accidents over the last twenty years as the leading cause of death from injuries. In 2008, poisoning led to 41,000 deaths, with 89% resulting from drug poisoning.


In response to drug-related fatalities, many state lawmakers have embraced the concept of prescription monitoring programs (PMPs) as a means of combating prescription drug abuse as of October 2012. The Alliance of Prescription Monitoring Programs defines PMPs as

an effective tool for improving patient safety and curtailing the abuse and diversion of prescription drugs by enabling a state to monitor the prescribing and dispensing of controlled substances. By accessing this information before they prescribe or dispense, a practitioner can provide better patient care and help protect their practice.

All states with the exception of Missouri have enacted PMP legislation. Whereas Guam has successfully enacted legislation, the District of Columbia is the only territory not having passed legislation. (As of October 2012, this legislation was pending.) Of the states and territories with legislation, nine have yet to begin PMP operations.

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