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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75% of Hospitals Had a Basic EHR System in 2014, ONC Data Show

75% of Hospitals Had a Basic EHR System in 2014, ONC Data Show | EHR and Health IT Consulting | Scoop.it

The percentage of hospitals with electronic health record systems increased eightfold between 2008 and 2014, according a data brief from the Office of the National Coordinator for Health IT, FierceHealthIT reports.

The report was based on an American Hospital Association survey of non-federal acute-care hospitals.

Findings

Overall, the data show 97% of hospitals in 2014 had certified EHR technology, an increase of 35% since 2011

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Meanwhile, 75.5% of hospitals in 2014 had a basic EHR system, up from 59.4% in 2013 and 9.4% in 2008.

The report showed that in every state at least half of hospitals had adopted a basic EHR in 2014.

The states with the highest adoption rates of basic EHR systems included:

  • Delaware, with 100% of hospitals;
  • South Dakota, with 95.1% of hospitals; and
  • Virginia, with 93.2% of hospitals.

Those with the lowest adoption rates included:

  • West Virginia, with 49.6% of hospitals;
  • Hawaii, with 54.8% of hospitals; and
  • Kansas, with 60% of hospitals.

Meanwhile, 34.4% of hospitals in 2014 had adopted comprehensive EHR systems.

In a blog post, Matthew Swain -- a program analyst in ONC's Office of Planning, Evaluation and Analysis -- and ONC Interoperability and Exchange Portfolio Manager Erica Galvez wrote that that about 60% of hospitals in 2014 exchanged data electronically, marking a 55% increase from 2013.

However, Swain and Galvez said, "While these survey results are promising, there is plenty of room for progress." They added, "These results capture exchange activity among hospitals; however, these results do not assess exchange volume, whether the exchange is interoperable, and if information is available to providers at the point of care".

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Epic Systems’ Open Platform Will Bring U.S. Health Care Delivery Into the 21st Century | The Health Care Blog

Epic Systems’ Open Platform Will Bring U.S. Health Care Delivery Into the 21st Century | The Health Care Blog | EHR and Health IT Consulting | Scoop.it

Epic Systems, the market leader in electronic health record software (EHR), recently made a quiet but potentially transformative announcement that may finally shake the healthcare industry out of its technological doldrums.


Epic said it is prepared to support the creation of a more open interoperability platform for integration with other diversified healthcare applications. This will attract substantial investment to create software that operates, hopefully seamlessly, within the Epic EHR infrastructure.  Expect Epic’s competitors to follow suit, eventually opening up the marketplace of installed EHRs to third-party software developers and the efficiencies of modern, post-EHR technology ecosystem.

Epic’s critics have often denounced the company for selling a mostly closed technology, dampening hopes for the creation of an ecosystem of best-of-breed applications that work together with the EHR to automate much of the care delivery infrastructure beyond patient intake and billing.  The value of such an infrastructure is extremely compelling and so the company is under enormous pressure from its customers to become more open.


An open-architecture environment, with published Application Programming Interfaces (APIs) and open standards, will improve the functionality of EHRs in myriad ways.  Consider innovations such as full-service, secure, HIPAA compliant mobile care networks within and around hospitals, integrated delivery systems and ambulatory care providers. These networks would facilitate powerful point-of-care mobile automation, such as the delivery of interactive care checklists to doctors, nurses and patients; the sharing of patient medical histories to create a comprehensive care record; and automating the patient hospital discharge process with care plans developed digitally by physicians and nurses for their individual patients.  These networks integrated to the data available through the EHR will also enable advanced workflow applications.  Imagine providers interacting with one another and their patients in real-time, independent of care settings when care considerations and treatments get logged as part of a living patient record and, ultimately, when real-time software and cognitive analytics can aid in the development of patient care options.


The move toward open-standards, cloud-based, mobile-enabled EHR applications will be the biggest development in the healthcare software industry in many years.  The passage in 2009 of the Health Information Technology for Economic and Clinical Health Act (HITECH Act) stimulated the adoption of EHRs, but these systems were largely built on older technology and struggle to incorporate the benefits of internet-based architectures, enabling cloud and mobile computing, and as such, today the EHR value proposition still remains uncertain.  However, open standards for interoperability is the key to opening up the EHR infrastructure to all facets of the provider value chain.

One of Psilos’ investments, PatientSafe Solutions, developer of a smart point-of-care mobile communications network, is already working on adapting their product for to Epic’s open source standards.  As the CEO of PatientSafe Solutions, Joe Condurso, recently mentioned, “All of our customers are now seeking to optimize their EHR investments through interoperability in order to liberate and activate data with mobile tools for clinicians and patients. It’s an important part of our operations today. Being able to leverage OpenEpic to interoperate and connect with the Epic allows us to deliver more capabilities for our customers to prepare for quality and value-based reimbursement.”

Open architecture EHR as the standard, rather than the exception, should set the stage for a much brighter future for participants at all levels in the healthcare arena. Let’s hope it meets its promise and makes the delivery of U.S. healthcare — not just our medical technology — the envy of the world.


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EHR Systems Lack Adequate Lab Data Graphing Functions

EHR Systems Lack Adequate Lab Data Graphing Functions | EHR and Health IT Consulting | Scoop.it

Current electronic health record systems lack adequate laboratory data graphing capabilities, according to a study published in the Journal of the American Medical Informatics Association, Modern Healthcare reports.

Study Details

For the study -- which sought to determine the abilities of various EHR systems to display test results -- researchers analyzed eight EHR systems based on 11 criteria.

Of the eight EHR systems included in the study, six had been certified by the Office of the National Coordinator for Health IT, including those from:

  • Allscripts;
  • Cerner;
  • eClinicalWorks;
  • Epic;
  • Meditech; and
  • Partners Longitudinal Medical Record.

The other systems were the Department of Veterans Affairs' Computerized Patient Record System and Glassomics, an EHR prototype designed to work with Google Glass.

The study did not rate the EHR systems by name.

Findings

Overall, the researchers found none of the systems met all 11 criteria.

According to the study, the highest-rated system achieved 10 of 11 criteria, while the lowest-rated system achieved five.

The most common problem among EHR systems was the failure to label the vertical, or Y-axis.

Other flaws included:

  • An EHR system that labeled data in reverse order with the most recent data on left instead of the right;
  • An EHR system that did not equally space out data points on graphs, which could result in an erroneous slope when measuring rates; and
  • Three systems that did not include patient identification directly on the graphs.

According to EHR Intelligence, the results showed a lack of standardized workflows among EHR systems, which could lead to an increase in medical errors and a decline in patient safety.


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Connecting Behavioral Health EHR to HIT Community at Large

Connecting Behavioral Health EHR to HIT Community at Large | EHR and Health IT Consulting | Scoop.it

Behavioral health EHR adoption is on the radar of health IT developers already well position in acute and ambulatory settings. For behavioral health organizations and providers, the challenge of EHR integration centers of the difference in provider workflows and their use of health IT to document a patient’s care.

As value-based care programs extend the range of the care continuum, the ability to move a patient’s health data between primary and specialty providers becomes a necessity. The rise of accountable care, however, may be responsible for eroding differences between care settings and providers.

“As accountable care and the new healthcare environment that move forward in evolves, there will be less difference because one of the big things in behavioral health is that it is very much a team environment so that you have folks from all different specialties participating along with the patient,” says Melinda Wagner, General Manager of Behavioral Health for Cerner.

That being said, primary care and behavioral health are currently distinctly different animals. As health IT developers from traditional care settings to behavior health environments, they must come to appreciate what makes the two distinct.

“As we integrate mental and physical health together, there will be a lot of great lessons more learned by the physical side,” Wagner explains. “Your workflows are perhaps a little bit different, and the care planning coordination are definitely much different.”

For Cerner, this learning process has relied heavily on feedback from providers from both environments. ” We acquired a community solution a couple years back and that really thrust us into the environment quickly, so we have been gleaning information from the community clients as well as existing Cerner clientele who were primarily acute clients with behavioral health access about what was missing,” Wagner reveals.

As a result of the EHR selection of Cerner by Hazelden Betty Ford Foundation, the EHR developer also faced a unique challenge in the form of moving the behavioral health organization from its own homegrown system onto an EHR platform capable of performing the same functions.

“They did have their own system,” continues Wagner, “so they had been automated for some time and mature in their thinking about how IT supports their overall workflows and patient care. We have worked with them for a couple years in looking at how our Cerner functionality would fit their needs as well as our overall vision for where we’re taking our solution.”

While the transition from one electronic documentation platform to another presents challenges, the greatest test for behavioral health EHR adoption remains interoperability with the EHR technology of other providers involved in a patient’s healthcare experience.

“It is the patient’s right to be able to expect that from healthcare and IT providers — that we will find ways to interoperate, that there won’t be one single system ever,” says Wagner. “That’s a driving force behind why Cerner got into behavioral health. Between interoperability and population health, we recognize to provide care for the whole person that behavioral health is integral to that.”

And the mental health environment likewise brings with it privacy concerns.

“We’re now trying to figure out how to make that compliant but still be able to share information,” Wagner observes. “We need to make sure that we protect the rights of those folks on the mental health side while also protecting their right to full and safe care by sharing information that needs to be given to other providers responsible for coordinating overall care.”

With patient’s road to recovery now taking a variety of routes, his health data must demonstrate the capacity for moving where it is needed.


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RNs are Choosing Where to Work Based on Hospital EHR

RNs are Choosing Where to Work Based on Hospital EHR | EHR and Health IT Consulting | Scoop.it

I came across this tweet and it made me stop and realize how important the selection and more important the implementation of your EHR will be for your organization. In many areas there’s already a nurse shortage, so it would become even more of an issue if your hospital comes to be known as the hospital with the cumbersome EHR.

Here’s some insight into the survey results from the article linked above:

79% of job seeking registered nurses reported that the reputation of the hospital’s EHR system is a top three consideration in their choice of where they will work. Nurses in the 22 largest metropolitan statistical areas are most satisfied with the usability of Cerner, McKesson, NextGen and Epic Systems. Those EHRs receiving the lowest satisfaction scores by nurses include Meditech, Allscripts, eClinicalWorks and HCare.

The article did also quote someone as saying that a well done EHR implementation can be a recruiting benefit. So, like most things it’s a double edge sword. A great EHR can be a benefit to you when recruiting nurses to your organization, but a poorly done, complex EHR could drive nurses away.

I’m pretty sure this side affect wasn’t discussed when evaluating how to implement the EHR and what kind of resources to commit to ensuring a successful and well done EHR implementation. They’re paying the price now.

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Epic Systems Squeaks to Top of Physician EHR Adoption List

Epic Systems Squeaks to Top of Physician EHR Adoption List | EHR and Health IT Consulting | Scoop.it

Epic Systems is the number one vendor when it comes to physician EHR adoption, but it only barely beats out some of its close competitors for the top spot, according to a report from SK&A.  While the mega-vendor is a frequent choice for large hospitals and health systems, taking best-in-show honors from KLAS Research for nine out of the past ten years, Epic has not yet secured total dominance on the physician side.  The highly fragmented market has left a number of other vendors nipping at Epic’s heels, including eClinicalworks, Allscripts, and Practice Fusion, which have secured similar shares of the top 35% of physician customers.

In contrast to last year’s report, where the top ten vendors made up 53% of the physician EHR adoption market, this year’s research shows that just eight vendors have now scooped up the same proportion of providers.  Epic, now at 11.6 percent of the overall market, has grown by more than 1 percent over last year’s numbers, while eClinicalworks has stayed steady at 10.2 percent, and Allscripts follows at 8.7 percent.

The next few vendors, including Practice Fusion, NextGen, GE, and Cerner, drop off from 6.7 percent to 3.5 percent, while other companies, including athenahealth, McKesson, Greenway, and MEDITECH, hover between one and two percent of market share.  Overall adoption has increased from 61 percent to 62.8 percent of all responding providers, the report shows.

Quite notably, the top twenty vendors make up less than three-quarters of the physician EHR market.  Twenty-seven percent of providers are using close to 500 different products that may be proprietary, specialty-specific, or small newcomers in the industry.  Providers with one to three physicians were significantly more likely to be using one of these unknowns than larger organizations, with close to 30% of these small organizations adopting a product outside of the mainstream.

The fragmentation of the EHR landscape is a boon for startup developers and smaller companies looking to cash in on the few remaining paperbound providers, or those seeking to become an unhappy organization’s choice for a replacement EHR.  But it is also bad news for health IT interoperability, as small vendors who may or may not be certified by the ONC for meaningful use attestation, are built upon a wide array of proprietary technologies that do not foster data exchange.


While a 2013 survey found that small EHR vendors were more likely than larger ones to produce happy customers, likely due to better customer support and more individualized attention for training and technical glitches, these vendors may also be more likely to fold suddenly under financial pressures, leaving physician organizations in the lurch.

But financial disasters are not the provenance of small vendors alone.  Epic has made more headlines than most other vendors for its role in several spectacular EHR implementation failures, though it is most frequently cited for its success in larger hospitals, and continues to expand its footprint into major health systems.  The Mayo Clinic recently announced that the vendor would be replacing Mayo’s trio of EHR systems with a single, integrated platform, while Epic remains in contention for the $11 billion Department of Defense EHR modernization contract.  The company’s suite of offerings, including business intelligence software, ambulatory practice management, health information exchange, and patient portals provides physician practices with an attractive toolkit to fuel expansion into the physician EHR world.

Other companies are seeking a similar crossover between the ambulatory and hospital markets as adoption reaches its saturation point.  athenahealth, ranked eighth in physician EHR market share by SK&A, is moving into the hospital sphere by offering its cloud-based services to the rural and critical access hospital (CAH) market.

“Rural and CAH organizations may not receive the same attention as academic medical centers and large, clinically-integrated health systems, but they make up approximately 1/3 of the hospital market,” explained Jeremy Delinsky, Chief Technology Officer at athenahealth.  “They’re also innovative, important pillars of their communities, providing tremendous value and quality at generally lower costs. These providers have been unable to afford the steep price tags of legacy software installations. Our revenue model is closely tied to that of our customers; we don’t make money unless they succeed.  We think this message will gain a lot of traction in the CAH market.  From there, we will have room to climb upmarket.”

EHR vendors looking to achieve a foothold in both worlds will need to tailor their offerings appropriately for customers no longer satisfied with basic data entry interfaces.  While some companies tout the standardization of their user experiences as a selling point, products that will continue to gain traction in either segment of the marketplace will need to meet the specific needs of choosy providers looking to make the most of their costly EHR investments.


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Google on board for DoD contract bid

Google on board for DoD contract bid | EHR and Health IT Consulting | Scoop.it

Google is a key contender – part of the PwC team – bidding on the massive 10-year federal contract to build an electronic health record system for the Department of Defense. PwC announced the collaboration with Google Thursday.

Google had been part of the team from the start, Dan Garrett, PwC's health IT leader, told Healthcare IT News.

"They were part of our submission in our original proposal," he said. "Since the proposal, we've also cemented a broader relationship between the two firms. And, we thought it was appropriate now to make the rest of the world aware of the submission that we had made."

"Google provides us with another whole layer of options from an infrastructure perspective." Garrett said. "You have everything from work management, storage, search engines, security, cloud – a whole level of infrastructure that we can pick from as the industry changes and innovation continues to come into the space."

Besides Google, the main players on the PwC team include General Dynamics Information Technology, DSS Inc. and Medsphere, whose commercial OpenVista EHR, an open source offering, was derived from the VistA-EHR, built by the Department of Veterans Affairs.

The other three teams that submitted bids are:

  • IBM and Epic
  • Computer Sciences Corp., partnered with HP and Allscripts
  • Cerner, Leidos, Accenture Federal and Intermountain Healthcare

Formally named the Department of Defense Healthcare Management Systems Modernization Electronic Health Record contract – DHMSM, for short, the DoD award could pay as much as $11.3 billion over 10 years. DoD is expected to award the contact this June.

As the clock ticks toward the anticipated verdict, the contenders have released more information on their bids. Epic, typically silent about any of its doings, last week joined its partner, IBM, to reveal it had assembled a team of advisors from some of the most recognizable health system names in healthcare, among them Kaiser Permanente and Partners HealthCare.


The PwC proposal is called the Defense Operational Readiness Health System. Garrett refers to it as DORHS.

PwC's interest in Google is not limited to the DoD contract. PWC and Google also recently forged a business relationship in which they will team up to help companies use the cloud and build trust in it.

“Google is known for its expertise in innovative, secure and open technologies, and the power of Internet scale, Scott McIntyre, PwC’s clobal and U.S. public sector leader, said in a statement. “Google can assist us in delivering a cost-effective and efficient solution to serve the healthcare needs of our military.”

“Our solution is engineered to provide flexibility, cost effectiveness and a platform that will stand the test of time, and does not rely on unproven technologies or proprietary computing platforms,” said Garrett. "Consistent quality is what we were looking for, true open systems, true interoperability and true open source systems."

DORHS’ flexibility, he added, would  help prevent the federal government from being locked into a single technology, avoiding “vendor lock” and “innovation lag” which can occur with proprietary EHR and technology companies.

"Google is a great example of how we're going to prevent that," Garrett said. "With Google on our team, the DoD will be able to tap in to the latest and greatest infrastructure innovation for the duration of those 10 years,."

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Epic Systems Wins Big in “Best of KLAS” EHR Rankings

Epic Systems Wins Big in “Best of KLAS” EHR Rankings | EHR and Health IT Consulting | Scoop.it

Epic Systems Wins Big in “Best of KLAS” EHR Rankings

A number of Epic Systems products have achieved top marks in the annual Best of KLAS health IT and EHR rankings, including best overall physician practice vendor and best overall software suite in addition to other awards for acute care, ambulatory care, health information exchange (HIE) and patient portals.  The recognition signals a return to dominance for the health IT giant, which temporarily lost its top title to athenahealth in 2013.

“We are honored to be able to continue to work with talented healthcare providers to create the annual Best in KLAS report. Their feedback is beneficial as vendors strive for excellence,” said Adam Gale, CEO and president of KLAS Research in a news release announcing another winner, Phytel, which was named the top population heath management vendor. “We also look forward to expanding our global research initiative to evaluate additional products/services that impact both provider and vendor success.”

Other familiar names featured frequently in the latest report, including Impact Advisors, winner of the overall IT services firm category, Cerner Corporation for best small ambulatory EHR, and athenahealth for small and mid-sized practice management.  Epic, however, snagged the ribbon for large ambulatory practice management.

Accenture Health may be getting a few more phone calls in the next few months after being named best ICD-10 consulting firm, while Optum’s computer assisted coding (CAC) expertise won the category for the in-demand technology.  For clinical documentation improvement (CDI), another critical ICD-10 competency, KLAS awarded first prize to Navigant.

Overall, Epic received eleven recognitions from the independent research company, which indicates how deeply and widely the company has been able to integrate itself into the healthcare industry’s IT needs.  In contrast, Cerner received three nods and athenahealth bagged two, while McKesson and MEDITECH had one apiece.  Last year, athenahealth had five honors to its name, with Chairman and CEO Jonathan Bush claiming that his company’s victory over Epic for ultimate prize was a triumph of “nimble, innovative models” over the “old guard of HIT leaders.”

Putting aside Epic’s runaway dominance – and athenahealth’s slip from the spotlight this year – Bush may have been correct in saying that new contenders are challenging the big names that seemed so solidified in the early days of the EHR Incentive Programs.  The large number and diversity of winners shows that the marketplace continues to be fragmented, giving new companies a chance to offer the intuitive, user-friendly, feature-rich EHRs that healthcare organizations are clambering for.

With EHR replacement still a very strong force in the marketplace, vendors have a strong incentive to claw their way past their competitors onto EHR ranking lists that give them visibility and credibility in an environment of weary mistrust.

“We are all part of a community of care,” Gale said of the 2013 winners list. “From the vendors that provide services and advance healthcare technology, to KLAS, who produces insights on vendor performance, to the providers who administer care, our joint efforts can make a difference in the lives of the patients.”

“To the healthcare providers, your effort to be heard and counted is critical. It is your voice, amplified by KLAS, that can drive improvements to healthcare technology and services. To the healthcare vendors who diligently seek to align with provider needs, we thank you for your unwavering determination to deliver excellence with passion. We commend your efforts to truly be Best in KLAS.”


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HIMSS Analytics Announces eClinicalWorks as Certified Educator of the EMR Adoption Model

HIMSS Analytics Announces eClinicalWorks as Certified Educator of the EMR Adoption Model | EHR and Health IT Consulting | Scoop.it

EMRAM is an eight-step process that allows healthcare provider organizations to analyze their level of EMR adoption, chart accomplishments, and benchmark progress against other healthcare organizations across the country. Each of the stages is measured by cumulative capabilities and all capabilities within each stage must be reached before progressing.

“We’re happy to be able to confirm eClinicalWorks as an EMRAM Certified Educator,” said Blain Newton, COO, HIMSS Analytics. “EMRAM allows organizations to align IT initiatives and overall business strategy, which is essential to shaping future direction and moving the industry forward.”

Vendors achieving HIMSS Analytics Certified Educator status must pass an annual certification exam and commit to an annual educator program. This ensures they stay current with trends within the model and are equipped with the necessary knowledge to help their clients advance through the various stages.

“A major goal is having our customers utilizing the EMR the most beneficial way possible for both providers and patients,” said Girish Navani, CEO and co-founder of eClinicalWorks. “This certification will benefit organizations looking to analyze their adoption of EMR technology. We welcome being part of the program.”


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Lessons learned from an award-winning EHR system replacement | Healthcare IT News

Lessons learned from an award-winning EHR system replacement | Healthcare IT News | EHR and Health IT Consulting | Scoop.it

In 2012, ARcare undertook a fast-paced transition to a next-generation electronic health record system. Less than two years later, ARcare was nationally recognized, receiving HIMSS Analytics' Stage 7 Ambulatory Award, the highest HIMSS honor for EHR adoption.


ARcare, a private, non-profit corporation providing primary care in rural Arkansas and Kentucky through a network of clinics, pharmacies and wellness centers, is the first Federally Qualified Health Center – and was one of only two ambulatory practices not connected with a hospital – to receive a Stage 7 ambulatory award.

On the way to a successful implementation, ARcare learned a great deal about the relationship between ongoing physician involvement and final clinical training – information that may help our peers who are moving forward with similarly ambitious systems replacements.

Managing change during the transition

ARcare’s system replacement involved moving from comparatively basic EHR use to a more comprehensive system with clinical event functionality that would enable us to better manage patient conditions across multiple care venues. A primary goal was to have the system drive orders and events rather than merely document clinical activity.

Migrating to next-generation technology across an enterprise requires significant IT resources, training, management support and workflow changes. Our strategy was to tie these elements together with a carefully constructed change-management plan, in which a highly experienced, multi-disciplinary team with C-level support facilitated all aspects of system adoption. The change-management team was tasked with creating a continuum of sustained change with a primary focus on improved patient care, stripping away governance of information silos. In this spirit of change management, each identified issue was relevant to the team – rather than individual roles – without regard to reporting structures.

The importance of keeping physicians in the change-management loop

Although ARcare achieved significant success in the arena of change management from an IT perspective, and within an aggressive timeframe, we also found in hindsight that keeping physicians in the loop throughout the transition can simplify clinical training during the final stages of implementation.

While ARcare actively sought input and buy-in from physicians on the front end of the transition, our sensitivity to the demands on physicians’ available time led us to remove most of them from the actual transition process, preserving involvement to a select few clinical staff members as physician representatives. While physicians remained involved to provide input to the new standardized workflows required by the new system, most of them had minimal exposure to the new system prior to clinical training.


The scheduled training sessions involved the clinical staff who were part of the change-management team performing training duty: nurse practitioners training other nurse practitioners and physicians training other physicians. We had anticipated this to be one of the easier tasks of implementation, and hadn’t fully accounted for the learning needs of clinical staff.

Although our physician leadership group requested they be the trainers, it soon became apparent that many healthcare professionals are simply uncomfortable voicing the need for additional help, especially to their peers. We also learned that having select clinical staff involved in the overall process didn’t necessarily translate directly to building teaching skills; the ability to understand complex technology and to teach its use are quite different. We decided to revisit training with the assistance of our own KMS – knowledge management systems – education team.

Getting clinical training back on track

Together with the KMS education team and led by four top instructors, we created a new, three-day program that integrated training for physicians, nurses and physician assistants.

Working in small groups, clinical staff participated in the training program, which was rolled out across facilities in series. Feedback gathered at the end of each training session helped to improve each subsequent session. Satisfaction increased quickly and steadily, and ARcare has continued to provide training updates on a regular basis to ensure continued optimal performance.

Well worth the effort

Five months after going live with our new system, ARcare became the first ambulatory practice that was not part of a hospital to achieve Stage 6 on the HIMSS Analytics EMR Adoption Model. One year later, we became the first FQHC to achieve the highest level of EHR usage, Stage 7.

The overall experience helped the organization recognize and develop an appreciation for the fact that change can and should be a positive experience. ARcare has developed a level of confidence across the organization where employees are less reluctant or fearful of change, and where learning from failure produced valuable outcome – not just in successful training, but in the successful adoption of a new Greenway Health EHR that brought with it substantial benefits, including:

  • Improved patient management with better information access for providers and clinical event management that drives events and orders, computerized provider order entry and closed-loop medication administration, and other advanced functions that improve patient care
  • The ability to exchange data directly with the state health department
  • Streamlined access to patient records across the network of primary care clinics, dental clinics, pharmacies and wellness centers

During the transition to the new system, ARcare successfully converted more than 17.2 million records, including clinical notes, images and test results. Now, when ARcare identifies and secures a new clinic site, the new site can be completely operational from an IT perspective in 30 days or less thanks to advanced system capabilities for scalability and extremely fast implementations. As of today, the system provides paperless charting and order entry for 37 ARcare clinics.

In all, it’s been a very satisfying transition in which the gains were well worth the pain – pain that can be avoided by following the lessons learned in ARcare’s approach and re-working of clinical training. In short: It’s all about identifying an effective training team.



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How Large-Scale EHR Adoption Is Transforming the Pharmacy | EHRintelligence.com

How Large-Scale EHR Adoption Is Transforming the Pharmacy | EHRintelligence.com | EHR and Health IT Consulting | Scoop.it
With the addition of onsite clinics and EHR technology to support practitioners, pharmacies are fast becoming producers of large amounts of health data and innovators in using this information to guide consumers toward positive health outcomes.
“We have a phenomenal platform to improve health and delivery value to the marketplace,” Walgreens CMO and Group Vice President Harry Leider, MD, MBA, tells EHRIntelligence.com. “The big idea is using our physical and digital footprint to support patients to get well, stay well, or to help manage chronic illness.”
This ecosystem of opportunity is the subject of Leider’s keynote during next week’s mHealth Summit in Washington, DC. It represents the culmination of his organization’s efforts to implement a health IT infrastructure capable of capturing large stores of health data.
“We’re now accumulating large amounts of data every month from consumers who are logging their steps, weight, and things such as blood pressure or glucose — either automatically through devices or manually,” he reveals. “In return, our consumers receive reward points for these activities. We’re on the cusp of proving the effectiveness this program, called Balance Rewards for health choices, to improve health outcomes.”
Driving this increase in health data is large-scale EHR adoption across the company’s many retail locations which were originally using an in-house EHR technology better suited to the needs of pharmacists than clinicians:
Our IT system was homegrown, Intercom Plus, and designed and enhanced over many years to support the prescription fulfillment process, but it really wasn’t configured to capture robust clinical information. The EHR that we’re now using in our pharmacies enables our pharmacists to record data about the important services they are providing: like blood pressure tests and immunizations. They can capture much more clinical information that is of value to clinicians in the community or to our own pharmacists and nurse practitioners. This also enables us to do more outcomes studies to evaluate the the effectiveness and value of our clinical programs.
Concomitant with this widespread EHR adoption is the need for health information exchange (HIE) health information with other clinician EHR users outside of the Walgreens ecosystem and the challenge of interoperability.
The decision to add a clinical arm to its traditionally pharmacy-only setup appears novel, but according to Leider it actually recalls a time when pharmacists played a more direct role in the lives of individuals.
“In the late nineteenth and early twentieth centuries, your pharmacist was oftentimes more critical than your doctor, unless you needed surgery, because they he or she could make a tincture of something to suppress a cough or compound a prescription to provide a salve for a rash,” he explains. “Surveys demonstrate that this trusted relationship between patients and pharmacists continues to this day and is very strong.”
In many ways, recent decision-making at Walgreens indicates a plan to emulate that former setup which can now be enhanced with new and emerging technologies and approaches to care delivery.
Technology is definitely enabling Walgreens to share data across the healthcare continuum,” Leider maintains. “In many of our stores, we’ve moved pharmacists from out behind the counter, making them more accessible, and providing them with tools and supports to counsel patients not only about medications, and medication adherence, but also about healthy behaviors such as smoking cessation.”



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Surescripts' New Tool Aims To Improve Interoperability, EHR Access

Surescripts' New Tool Aims To Improve Interoperability, EHR Access | EHR and Health IT Consulting | Scoop.it

On Monday, health information network Surescripts launched a new tool that aims to expand providers' access to electronic health records and simplify the data-sharing process, EHR Intelligence reports.

Details of Tool

According to EHR Intelligence, the National Record Locator Service will allow more than 480,000 providers to share EHRs housed in any medical center across the U.S.


Specifically, the tool implements a query and response system into providers' workflows. Providers using the tool will be able to access more than 230 million patient EHRs.


The NRLS tool will be integrated with the EHR systems of:

  • eClinicalWorks;
  • Epic; and
  • Greenway Health.


According to EHR Intelligence, the service will be implemented in accordance with legal agreements under CareQuality, which governs collaborations between health information exchanges.


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Can Apple, Others Bring PGHD to the EMR?

Can Apple, Others Bring PGHD to the EMR? | EHR and Health IT Consulting | Scoop.it

Not settled with simply being the dominant device on which clinical data applications are hosted, Apple made another step towards becoming an even more ubiquitous presence at healthcare organizations last week when it launched ResearchKit.


ResearchKit is a platform that allows healthcare organizations to host apps that will get people to participate in clinical trials. During an event for the press, the company announced a few initial partnerships with major healthcare provider organizations to use ResearchKit, including Icahn School of Medicine at Mount Sinai, Penn Medicine, Dana-Farber Cancer Institute, Massachusetts General Hospital, Stanford Hospital, and more.


ResearchKit builds off HealthKit, which was a health platform Apple launched last year that aimed to connect personally-generated health data and clinical data. Since HealthKit’s launch, many notable healthcare organizations, including Stanford Medicine, Cleveland Clinic, and EHR vendors like Epic, have all partnered with Apple to work in their own patient-generated data applications.


The Cupertino, Calif.-based company is part of a wider movement in the industry to bring patient-generated health data (PGHD), from various portals and monitoring devices, into clinical data applications like the electronic medical record (EMR). The Office of the National Coordinator for Health IT (ONC), in its proposed rule for Stage 3 of meaningful use, made integrating PGHD into the EHR a requirement for eligible hospitals and providers.


Of course, this integration is easier said than done. Healthcare Informatics Senior Editor Gabriel Perna spoke with Rob Faix, principal advisor at the Naperville, Ill.-based consulting firm, Impact Advisors on the most recent edition of the Healthcare Informatics podcast. Faix discusses the challenges of bringing together patient and clinical data; why Apple has taken the lead in this category with many prominent healthcare organizations; and how ResearchKit can be a game changer.


“Integrating this data will be a significant challenge but I think it’s one that hardware device vendors, software developers, and EMR vendors are up for…it’s the next big opportunity,” Faix says. “


Faix talks about how this integration may happen. He predicts there will be a staging process, where PGHD is graded and reviewed. “Context will be important. The software and EMR vendors and the clinical community are really going have to think about that as we integrate PGHD into the EMR,” he says.


Sifting through a potential avalanche of data will present itself as a challenge, as will having to deal with potential issues of liability. “I have information in front of me that I chose to accept or discard, and therefore, it could be tied back to an adverse event,” Faix says.


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Epic Trails in Black Book Ranking of Inpatient EHR Vendors

Epic Trails in Black Book Ranking of Inpatient EHR Vendors | EHR and Health IT Consulting | Scoop.it

Between system replacements, EHR interoperability issues, and ICD-10 implementation delays, the health IT landscape has been as complex as ever over the last year. In an effort to get the industry ready for coming challenges, Black Book Market Research conducted an inpatient EHR user survey to find out the top inpatient EHR vendors for 2015.

The survey focused on identifying EHR vendors that score highly in certification-required EHR capabilities, clinical workflow applications, documentation functionalities, connectivity, and accountable care data mandates.

Black Book polled 14,000 nurses and 5,000 hospital staff using EHR technology among 702 hospitals. The survey was taken from August 2014 to February 2015. One interesting finding from the poll shows that 74 percent of hospital CIOs and medical technology leaders claimed their selection of EHR systems consisted of “significant nursing input.”

“Black Book survey findings included a substantial improvement in reducing the gap between hospital nursing, physician, administrative, financial and technology stakeholder satisfaction, although there’s still a long way to go,” Doug Brown, Managing Partner of Black Book, said in a company press release.

Out of all nurses responding, 14 percent felt that clinicians’ perspectives were considered highly when selecting healthcare technology to improve workflow and care. About one in five hospital IT managers – 19 percent – state that the current EHR system used in their practice is not the best technology to operate in their facility.

Many find that their EHR systems are not meeting the needs of their facility including their EHR interoperability goals and cost-cutting strategies through expensive add-ons. The survey also illustrated that 69 percent of hospital technology leaders feel that nursing satisfaction has risen due to EHR system updates that occurred after implementation because of nurses’ concerns.

Only 10 percent find that the improvements in nursing satisfaction is due to training and adjustment in EHR use while 20 percent of respondents attribute it to enhancements in EHR functionalities and updates.

The Black Book survey uncovered the top three EHR vendors to be CPSI, Cerner, and Allscripts. Epic Systems was right behind Allscripts among hospitals with 250 beds or more. For the past three years, Epic had earned top client bestowed honors among academic teaching facilities and large hospitals.

CPSI received a nursing and clinician satisfaction rating of 90.2 percent and a technology and financial administrative satisfaction rating of 95.4 percent. Cerner’s satisfaction rating among nurses and clinicians hit 91 percent while the technology and financial administrative satisfaction rating was at 94.1 percent.

Allscripts had its nursing and clinician satisfaction at 83.2 percent with the technology and financial administrative satisfaction hitting 92 percent. Hospital CIOs and IT managers selected Cerner as their first choice for an EHR system suitable within the hospital setting. Other vendors that scored well include Epic Systems, GE Healthcare, Meditech, McKesson, and Siemens.

In order to ensure high physician and nursing satisfaction within the healthcare system, providers will need to implement top EHR systems capable of meeting the demands of the industry and being customized to fit physician practice needs.


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UCLA Health to integrate genomic data into EHR in pilot

UCLA Health to integrate genomic data into EHR in pilot | EHR and Health IT Consulting | Scoop.it

UCLA Health will soon begin a pilot project with Seattle-based startup ActX that will integrate genomic patient data into its Epic EHR system, with the eventual intent of applying precision medicineto a large-scale patient base.

ActX, founded in 2012 and just out of stealth mode six months ago, collects a patient’s genetic information by way of a saliva sample, and then analyzes the information in real time. The data is integrated into an EHR – already, ActX is working with Allscripts and Greenway Health – and physicians will receive an alert about a medication and possible side effects, or warn of potentially serious risks for cancer.

Think of it as a 23andMe that is integrated into an EHR and available to the patient.

Molly Coye, chief innovation officer at UCLA Health, which operates four hospitals, said that’s precisely what intrigued the academic health system.

“Our goal is to try to bring precision medicine to a much larger proportion of patients,” she told MedCity News. “Right now it tends to be focused particularly on people with cancer, and even then on a low number of patients.”

She added that genomic data combined with an EHR could have “real clinical meaning for a larger number of patients than we could have known about five or 10 years ago.”

The pilot will begin in the coming weeks on 50 patients that the health system thinks will be a good fit, Coye said. Depending on initial success, it will be expanded to a greater number.

“If successful, and our physicians are enthusiastic about it, we’ll rapidly make it available more widely,” she said, adding that most UCLA Health pilots range from three-to-six months.

ActX co-founder and CEO Andrew Ury, a physician who has worked extensively in the EHR space, said up until now, few if any genomic data collectors have been integrated into an EHR. Dr. Ury previously worked for Practice Partner, which was acquired by McKesson in 2007.

As he sees it, EHR integration is the only way to harness genomic data on a large scale while at the same time providing the results for patient.

“We believe the way to do that is to build it into the everyday tool, the EHR,” he said. “The consumer factor is because we have to get the patient’s genomic data in order to make it work, so we offer access to affordable DNA sequencing. In order to that, we involve the patient.”

Given that UCLA Health uses an Epic system, which dominates the hospital market, Coye said the potential to reach a mass of patients is significant, and that such an EHR add-on could someday be a standard feature if it proves successful.

“They’re actually working with Epic, so decision support means a lot more if it pops up in the EHR,” Coye said. “This is going to be a game changer, I think. That’s the real promise that everyone recognizes about genetic testing,  that this will become a standard. It’s just a question of how you do it early on.”

Importantly, Coye cited the autonomous nature of ActX in how it’s available to both patient and physician.

Dr. Ury elaborated on the potential of precision medicine and EHR integration from a clinical standpoint.

“What this means is that if a patient’s genetic data is on file, because we’ve analyzed it, each time the physician writes a prescription in the EHR, it’s going to see if a drug is going to work, or if there’s an adverse reaction,” he said. “If there is an issue, the physician will get an alert.”

The data, and its use within an EHR, can also help physicians better determine if a patient is at higher risk of a genetic disease or a certain type of cancer. With that knowledge, more effective medications and treatments can be determined far earlier than before.

Coye said UCLA Health hopes the pilot can bring precision medicine to primary care and a further breadth of specialists “across a wide variety of clinical conditions.”

ActX is so far privately funded and has about 25 employees and independent contractors, including scientists, pharmacists, genetic counselors, physicians and software developers, according to Dr. Ury.

Dr. Ury noted that it’s “the dawn of precision medicine,” referring to the $235 million initiative championed by President Obama and overseen largely by the NIH.

“While genetics can’t predict everything, genetics can predict more and more and whether a patient has a side effect,” he said. “We think this is the future.”


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Acute Care EMR Purchasing Plans 2015

Acute Care EMR Purchasing Plans 2015 | EHR and Health IT Consulting | Scoop.it

Stiffer competition between key vendors is causing a growing number of providers to be undecided about which EMR to purchase when looking to make a buying decision. In the KLAS acute care EMR purchasing plans report released today, researchers found that even though providers have fewer choices due to market contraction, they are less likely to have made up their minds about which system to buy when evaluating future purchases.

Energy in the market is being driven largely by legacy customers looking to make a purchasing decision. This report shines a light on which companies are under consideration by providers looking to make a decision and what is fueling that consideration.
“The competition between Epic and Cerner is closer than it has been in years past as customers determine their future purchasing plans. This has left twice as many facilities “up for grabs” as there were last year,” said report author Coray Tate. “The lion’s share of the remaining customer mindshare is split between MEDITECH and McKesson, pretty consistently along partisan lines.”


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Stalking the "Perfect" EMR | Hospital EMR and EHR

Stalking the "Perfect" EMR | Hospital EMR and EHR | EHR and Health IT Consulting | Scoop.it

Everyone’s heard about it, but nobody’s seen it — the perfect EMR. You know, the one that satisfies every doctor, integrates easily with every related hospital system, plays well with HIEs and even makes coffee for the CIO.

In all seriousness, virtually every EMR installation seems to involve systems integration problems, workflow requirements, user interface design or a  baker’s dozen of additional problems that hang like a cloud of smoke over even the more successful rollouts.

In theory, you might be able to resolve these disputes by letting the staff choose which EMR they’d like to see in place. But in reality, that doesn’t work either, argues John Halamka, MD, MS, whose many titles include CIO of Beth Israel Deaconess Medical Center and CIO at Harvard Medical School.  “I’ve heard from GE users who want Allscripts, eClinicalWorks users who want Epic, Allscripts users who want AthenaHealth, and NextGen users who want eClinicalWorks,” he notes.

Worse, if you let every department and clinical constituency pick what they want to include in their EMR, you end up with “an unintegrated melange of different products that make care standardization impossible,”  Dr. Halamka suggests.

As nice as it would be to satisfy everyone, there’s really only one approach that works, Dr. Halamka says. IT leaders need to pick an EMR for their enterprise that meets the enterprises overall strategic goals, one “providing the greatest good for the greatest number.”  Then, follow up with substantial training, education, collaboration, user engagement support and healthcare information exchange, he says.

No matter what your EMR turns out to be, it’s going to fix some workflow and process issues while creating others, he suggests. The best thing healthcare CIOs can do is simply go with smart enterprise-wide technology and help providers user it effectively.

This argument makes a lot of sense to me, at least at this stage in the emergence of EMRs. In, say, five years when key features are more standardized, it might be easier to buy “off the shelf” EMRs that please almost everyone. Or will it?  What do you think?


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Can True EHR Customization Help Physician Practices Survive?

Can True EHR Customization Help Physician Practices Survive? | EHR and Health IT Consulting | Scoop.it
In the rapidly-evolving EHR market, one size definitely does not fit all and true EHR customization can make all the difference.

It is a commonly-held belief that the healthcare system in the United States is in need of more than a fairly steep overhaul. In fact, the once highly sought after profession of doctor has shifted to become one of the more embattled jobs nationwide.

Many healthcare professionals are now forced into the impossible situation of navigating exploitation by insurance companies and government regulations, all while grappling with the challenges of providing quality patient care, keeping their practices afloat, earning a living and paying back often-exorbitant medical school loans. If anything, in today’s world it would surprise most people to know how little doctors actually make, relative to the effort and investment in their careers they are required to put in, day in and day out.

This is a critical issue facing the US today, as tens of thousands of physicians are closing their practices every year and either retiring or becoming employees of large healthcare corporations. This is having a significant impact on accessibility and affordability of medical care. With fewer doctors available and many individuals seeking care from “corporatized” healthcare providers, not only is the personal relationship between doctor and patient lost, the cost of medical care at corporate-run medical facilities is substantially higher than ever before.

Capable and cost-effective?

So, the question becomes — how do doctors maximize their healthcare practice and record management processes, cost-efficiently and effectively? Enter the wide variety of EHR and EMR solutions that have flooded the market in recent years, each promising to streamline the process and take the guesswork out of compliance to the government’s evolving mandates that regulate healthcare record-keeping.

In addition to managing healthcare records, doctors also need a secure and HIPAA compliant scheduling system, medical devices integration, practice management system, e-prescription, lab interfaces, patient engagement, and tele-medicine. Of course, these systems must also be equipped with disaster recovery and business continuity safeguards.

And while there are many current solutions on the market which range from open source to a one-stop package that practices implement directly on their end, they miss one crucial element. Each doctor practices his/her profession in their own unique way, and this extends to all aspects of their work, from patient care to record keeping and practice management. Just as Dr. Lawrence ‘Rusty’ Hofmann in The Huffington Post, describes it, EHRs are like Model T Ford: Any Color You Want As Long As It’s Black.” The majority of these solutions hitting the market today just don’t cut the mustard when it comes to really addressing the needs of our country’s doctors and healthcare practices.

Furthermore, while the creators of many of these packaged EHR solutions claim to be “customizable,” they are actually merely “configurable.” Instead of allowing the user the autonomy and flexibility to create a system with parameters that align with their own specific practice and its operational goals, editable functions are typically limited to creating additional fields in the forms — barely paying lip service to the task of meeting the true needs of healthcare professionals in this country.

These solutions also require heavy reliance on a computer screen, which often hinders a doctor’s ability to provide the standard of care and bedside manner that comes with more face-to-face interactions inquiring into pain, ailments, and body language from patients. This seminal aspect of the healthcare field is threatened by one-size-fits-all systems that squelch the nuances between practices and the differing techniques doctors use to treat their patients. This diversity between providers is central to continued advancements in the medical field and breakthroughs in patient care and disease treatment.

Diversity and true EHR customization rule

So then, what is the answer? In my opinion, built from countless conversations with doctors on this issue, it is EHR systems that provide an easy-to-use interface that are truly customized to fit the ways in which each doctor treats patients, approaches his/her field, and manages their practice, in a cost-effective package that does not require a huge up-front investment. Additionally, everyone within the practice should have access to the system, to ensure continuity in an often-volatile EHR market that typically sees 45-50% churn annually.

In short, it is crucial that developers of these software tools accommodate doctors’ needs first, rather than create a framework that expects doctors to squeeze themselves into a pre-defined structure, often asking them to sacrifice their individuality, professional approach, and expertise.

This approach, which represents incredible opportunity in the once thought to be saturated EHR market, is the essential step to rescuing our doctors from their often embattled position, bringing them back to the esteemed position they once held, all while improving our overall patient experiences and outcomes in the process.


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Mayo taps Epic for EHR, revenue cycle management

Mayo taps Epic for EHR, revenue cycle management | EHR and Health IT Consulting | Scoop.it
Dive Brief:
  • Mayo Clinic announced this week that it would be abandoning its three current EHR systems in favor of a new contract with EHR giant Epic, which will now be the healthcare icon's sole EHR provider and strategic partner, according to a Mayo press release.
  • The plan is to deploy a single, integrated Epic EHR and revenue cycle management system at Mayo's main campus. Jilted in the deal are GE and Cerner, who were the providers of Mayo's current systems.
  • "With our staff working together on a common system, we will be able to accelerate innovation, enhance services and provide a better experience for our patients," said Dawn Milliner, MD, Mayo's chief medical information officer, in the release. The current schedule will see the project team assembled by  April of this year, with the actual system being built between then and 2016, and a final implementation target of 2017.
Dive Insight:

If this were any other press release from almost any other provider and vendor, it would not be news. But the words "Mayo" and "Epic" make this an important milestone in an incredibly competitive race.

First, it's a game changer for the Mayo Clinic, as it will completely overhaul its existing system from scratch. Moreover, it's a bodyblow to Cerner, who we predicted had a good shot at swiping the top spot in the EHR biz from Epic earlier this year. We'll be the first to admit this is a big win for Epic, and while it's not big enough to put Cerner down for the count, it's a good way for Epic to start the year (and not so good for Cerner).


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Developing a Specialty-Specific Action Plan for ICD-10

Developing a Specialty-Specific Action Plan for ICD-10 | EHR and Health IT Consulting | Scoop.it

As the calendar turns over to the beginning of a new year, the healthcare industry begins yet another countdown towards an autumn implementation date for ICD-10.  With just under ten months left until the most recent deadline of October 1, 2015 – and that date likely to stick thanks to Congressional support and a growing chorus of healthcare stakeholders endorsing the switch – healthcare providers may not have the luxury of banking on an additional delay.  Organizations can make the most of their remaining time by using CMS resources to develop a specialty-specific action plan that will carry them through their ICD-10 prep for the rest of the year.

The Centers for Medicare and Medicaid Services has provided a number of transition resources to providers who may not be sure what is required for the ICD-10 switch or how to achieve transition benchmarks.  Among these Road to 10 tools is an interactive timeline feature which allows providers to select their practice type, size, progress, and business partners to formulate a personalized plan.

The action plan tool provides common specialties with tailored information, including the clinical documentation changes necessary for the most common ICD-10 codes and sample clinical scenarios for practice.  For cardiologists, for example, the literature reminds practitioners that a myocardial infarction is only considered acute for a period of four weeks after the incident in ICD-10 compared to 8 weeks in ICD-9.  Orthopedists are prompted to remember the specificity requires to accurately code a bone fracture, including the type of fracture, localization, healing status, displacement, and complications, while obstetricians will need to distinguish between pre-existing conditions and pregnancy-related issues when documenting complications.

For the 27% of providers who have not planned to start their ICD-10 testing as of November, and especially the 30% who admitted that a lack of understanding had them stalled, the Road to 10 timeline provides detailed steps to achieve internal and external testing of systems.  From identifying sample cases for testing to coordinating with external business partners and fixing any problems that arise from the process, the resource allows providers to review checklists and suggestions that will set them on their way towards a successful testing period.

CMS suggests that healthcare providers have their internal testing already completed by this point in the process, and is currently seeking volunteers for their end-to-end testing week scheduled for the end of April.  According to the timeline, the external testing process is likely to extend through July as organizations coordinate with their payers and clearinghouses, but the number of providers that are significantly behind these recommended timeframes means that many in the healthcare industry are likely to experience a sharp crunch up against the October deadline.

Providers that are struggling with the sheer volume of tasks associated with the ICD-10 switch may benefit from using the Road to 10 toolset and exploring CMS resources on the transition to identify common pitfalls that may strike their specialty or size of practice.


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EHR Quality Reporting Rewarded through $36.3M in HHS Funding | EHRintelligence.com

EHR Quality Reporting Rewarded through $36.3M in HHS Funding | EHRintelligence.com | EHR and Health IT Consulting | Scoop.it
EHR quality reporting led to $4.9 million in ACA awards to 332 health centers.

The Department of Health & Human Services (HHS) has rewarded the quality improvement efforts of health centers with $36.3 million in Affordable Care Act (ACA) funding.

“This funding rewards health centers that have a proven track record in clinical quality improvement, which translates to better patient care, and it allows them to expand and improve their systems and infrastructure to bring the highest quality primary care services to the communities they serve,” HHS Secretary Sylvia M. Burwell said in an official statement.

The rewards spans four distinct kinds of quality improvement achievements.

The first award went to 361 health centers and totaled $11.2 million for health center quality leaders, those clinical settings scoring in the top 30 percent of all health centers based on best overall clinical outcomes.

The second award of $2.5 million rewarded 57 national quality leaders for surpassing national clinical standards for chronic disease, preventive care, and perinatal/prenatal care.

Clinical quality improvers — demonstrated at least a 10-percent improvement in clinical quality measures between 2012 and 2013 — were recipients of largest sum of awards, $17.7 million. The award goes to 1,058 health centers.

The last category of awards recognized 332 EHR reporters which received $4.9 million for reporting clinical quality measures (CQMs) for their entire patient population.

According to the Health Resources and Services Administration (HRSA), ACA-established Health Center Program comprises close to 1,300 health centers operating in more than 9,200 delivery sites in all 50 states, the District of Columbia, and US territories and treating approximately 21.7 million patients.

The ACA earmarked $11 billion to be disbursed over a five-year period to support the creation, expansion, and operation of health centers.

In the past year alone, 43 Health Center Controlled Networks received $21 million in rewards specifically for EHR adoption and meaningful use with requirements to “include at least 10 Health Center Program grantees and overall will provide support to more 700 health centers nationwide.”

In a recent brief, the Office of the National Coordinator for Health Information Technology (ONC) demonstrated that incentive dollars and looming financial penalties are driving EHR adoption and meaningful use.

The chance to benefit from tens of thousands of dollars from the EHR Incentive Programs was cited as a major influence for 62% of physician providers participating in the 2013 National Ambulatory Medical Care Survey Physician Workflow Survey. Another major factor were the ONC-funded regional extension centers whose availability during Stage 1 Meaningful Use and beyond influenced 35 percent of respondents to adopt a certified EHR technology and demonstrate meaningful use as part of the EHR Incentive Programs.

The major takeaway from the HHS and ONC announcements is the integral role health IT-related funding in the form of incentives or awards plays in transforming the care delivery and coordination through the innovative use of technology.



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