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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Successful EHR interoperability starts locally

Successful EHR interoperability starts locally | EHR and Health IT Consulting | Scoop.it

Interoperability is one of the most difficult challenges with electronic health record optimization: The ability to share clinical data across health systems and respective EHRs. Sometimes it takes a personal experience to drive home the meaning of interoperability, not only to the healthcare professionals who regularly interface with the EHR, but the patients.

When EHR interoperability hits home

For those that read my last post, you know that I lost my 40-year-old brother to a heart attack in 2015.  I had a physical about two months after my brother died, but due to my family history of heart disease, I also made a long-overdue appointment to see a cardiologist. Both my primary care physician and cardiologist work within the same system and use the same ‘integrated’ EHR. And yet the scheduler for the cardiologist requested I fax my EKG and history, including labs, to the office prior to my appointment.

Needless to say, we know interoperability will doubtlessly improve patient care and experience. But it can often feel like a mammoth, unachievable task. Some staff are accustomed to jumping through hoops to access data, but it doesn’t have to be that way. The secret is to approach interoperability on a smaller scale and address the changes you can make more locally to move the needle forward. Interoperability is a spectrum, and the right answer for one health system may not be the same for another. 

Small steps toward interoperability

Every health system executive has interoperability on their priority list these days, with exciting strides in personalized medicine, the day-to-day demands of care management and reducing unwarranted care variation.

So where should you start?

First, as leaders in this industry, we need to recognize interoperability isn’t just a technology problem. Opening up access to clinical data across different care settings must be a strategic priority that starts with an honest assessment of a health system’s technical capabilities against the imperative to deliver better patient care. Health systems can’t afford to be left behind here, but can’t do it alone. In an industry rife with mergers and acquisitions, health systems should work from the inside out. While that might seem obvious, many systems struggle to make sure internal stakeholders have access to data on the system in some way or another. 

Second, there’s more than one right technique to achieve some level of interoperability. While a truly integrated EHR is the ultimate goal, it’s typically more costly, time-intensive and organizationally disruptive than other options. There is a myriad of interface engines/brokers, health information exchange tools, APIs and custom-built options that can be implemented much more quickly and provide real value, at the point-of-care, now.

Most health system executives assume that to achieve interoperability, they need to implement or migrate every provider in their system onto the same EHR. And often this course of action is advised. However, I’ve seen clients use some innovative methods to tackle interoperability.

One of my favorite examples is a large health system in the northeast that explored different methods to standardize access to data without moving to the same EHR platform.

As the health system acquired new physician practices, it faced limitations that made an integrated EHR financially and operationally prohibitive. After exploring its options, the health system opted to create an HIE, a safe way to send and standardize patient records between EHRs. While the data are not truly in one single place, HIEs give clinicians access to data across separate systems within a couple clicks.

Achieving interoperability will be a long journey that will only grow in importance as healthcare shifts from a volume to value mindset. When possible, health systems should move to an enterprise EHR architecture and go beyond minimally meeting regulations. There’s no such thing as true, complete interoperability: There will always be a new source of data with a different set of access issues. But in the interim, work with community partners to craft solutions to affect patient care now.

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Physician resistance to EHR systems and how to overcome it

Hospitals face a number of challenges when they implement a new electronic health records (EHR) system. One of them is often getting doctors on board with the new system. Due to this and other issues, facilities may struggle to maintain productivity at first. 

The key to overcoming these obstacles is communication.

The benefits of an EHR system need to be stressed by the folks in charge from the initial planning stages on. Organizations need to be honest about what the system will achieve so that doctors aren’t disappointed in the actual results.

Effectively communicating the benefits of electronic records, training everyone properly and providing strong technical support can help organizations overcome doctors’ three most common complaints about EHR systems:

Productivity drops

Implementing an EHR system is a huge undertaking, and as with any new tech system, it will take some time for an organization to adapt to it. That means doctors might not see any productivity gains for a while. In fact a survey conducted by American EHR Partners found that in many cases, productivity drops dramatically right after a new system is installed.

Physicians may also become frustrated that they’re no more productive with their documentation than they were before the EHR system implementation. That’s why it’s important to stress the benefits of EHRs to doctors in terms of what they’ll allow docs to do for their patients and not so much in terms of saving time.

So if physicians start feeling like data entry clerks, you may need to take a look at the system and make sure it is working properly or get providers more training so they can use the EHR system more effectively.

The bottom line is: Hospital administrators need to make sure doctors still have time to focus on what they’re best at — treating patients – to keep physicians happy.

Overreliance on EHR systems

EHR systems have a lot of features to help doctors make better decisions — and some doctors will interpret that to mean the system will be making decisions for them. Facilities, however, need to emphasize during EHR training how doctors can combine the information they get from the system with their own expertise to give patients the best possible care.

Another benefit to emphasize is the fact that EHRs can greatly increase efficiency for administrative staff through patient self-service tools.

Hospitals can save a lot of staff time by having patients enter data into the system themselves. For example, many patient forms can be filled out beforehand through online portals or at a computer kiosk in the waiting room.

Interfere with patient communication

Little changes that are caused by EHR adoption can have a big impact — for example, facing a computer instead of holding a chart can make it more difficult to make eye contact with a patient and make it clear the doctor is listening.

To help, hospitals might want to consider using tablets instead of laptops to access records. This makes it feel more like providers are holding paper charts and are still able to focus on the patient, rather than sitting with their backs to patients typing away.

What’s extremely important to getting physician buy-in for an EHR system is to find one that’s easy for doctors to use and has all the features the hospital needs. Just remember, there’s no such thing as a perfect system. In a hospital with numerous physicians, there will always be some gripes about any given EHR system.

That’s why finding a system that’s flexible enough to meet the greatest number of end users’ needs is the best bet.

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The Pros and Cons of Customizing Your EHR

The Pros and Cons of Customizing Your EHR | EHR and Health IT Consulting | Scoop.it

Customizing an EHR can offer incredible benefits to a medical practice, but it is critical to understand the cost-benefit analysis of customization before implementation for the benefit of the practice and the health of its patients.

Customization is a common path for modern practices; research from Medical Economics reveals that in a 2-year survey, over 50 percent of practices were starting to customize generic EHR templates. Analyzing both the pros and the cons of customizing an EHR system can help a practice best plan for the future.

 

To Customize of Not to Customize

One of the first questions to ask before deciding to move towards a customized EHR is about the health or the efficiency of an existing system. Are there currently bottlenecks in flow? Would EHR customization better support “meaningful use” and best practices? Do providers and staff find themselves frustrated on a routine basis with data entry or records management? If so, it may be time to consider a tailored records system.

Despite the benefits of customization,there are associated costs which must also be weighed in the decision-making process. Resource consideration is important when deciding if customization is appropriate, for example. Are the resources (both time and financial) available? Creating a cost-benefit analysis can help to determine whether or not to adopt a customized EHR system.

 

Pros of Customization

Designing and implementing a customized EHR system has many incredible benefits. Custom modules lead to better capturing of data and improved accuracy of that data. SuchEHR system impact affects not only practice flow, but also health outcomes.

Another important benefit of a customized records system is utilization by providers and staff. With a system carefully tailored to the needs of the practice (and in-turn its staff), practice-wide adoption can become much easier. It is no coincidence that staff will be eager to use an EHR system that’s more functional; when appropriate screens and modules appear when and where they are needed, and the system is tailored to the flow providers desire and follow, staff is more invested.

 

Cons of Customization

Despite its advantages, practices need to be aware of the cost of implementing a customized EHR system, both in terms of time and financial investment. The cost of implementation can by high, which is a common barrierto EHR customization for practices. This cost comes in the form of financial investment, but also the investment of time.

Adaptation and training take commitment on the part of providers, staff, and administrators, and customization management requires thoughtful and careful leadership. Other points of consideration include long-term system changes such as updates, as vendor updates down the line may create rifts with interfacing custom systems. Careful communication with a vendor before customization about future changes is key to best prepare for such events.

Understanding the advantages and costs of implementing a custom EHR system is an important step in deciding if customization is right for your practice.

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Improve Patient Care with EHR

Improve Patient Care with EHR | EHR and Health IT Consulting | Scoop.it

EHR systems did not appear overnight. Since the Institute of Medicine’s strong endorsement of computerized medical records in 1991, developers and providers have worked closely to employ the use of information technology to improve patient care. Modern applications like today’s integrated and robust EHR systems is simply an extension of this idea that technology can help us better serve patients. Nonetheless, it’s not uncommon for administrators and providers to find themselves frustrated at the perceived distance between the realities of EHRs and their goals for practice workflow and patient care.

Patient Record Software and the Roots of Best Practices

It is easy to lose sight of the purpose of an EHR system. For example, a common complaint is feeling like EHR implementation means staring at a computer and not at patients.

But, it’s important to remember both the end-goal of EHRs (excellent patient care)as well as effective implementation strategies to maintain the best practices of accurate documentation methods and good bedside manner while still adhering.

EHRs have demonstrated incredible strides in patient safety and continuity of care and have proven themselves worth the investment for even the smallest medical practice.

Patient Care By the Numbers

It’s an exciting time for the electronic records industry. Part of this is due to the years of valuable data to which we now have access – data which has shaped HIPAA, Meaningful Use, and ultimately, the quality of patient care. EHR systems have contributed to increased data accuracy such as patient history, medications, CPOE processes, and more. And for chart access and patient report maintenance, research shows that not only do EHR systems support the accuracy of these activities, but also the speed of completion in a clinical environment.

In addition, patient record software systems’ ability to interface with clinical tools have generated huge improvements in health outcomes, for example,drug interaction alerts via data sharing between an EHR system and an electronic prescription system. And patients are responding positively, too. In fact, patients are beginning to associate EMR use with higher-quality healthcare and perceived increased value with the use of electronic records systems.

Buy-In and the Importance of Practice Investment

It may seem obvious, but an EHR system can only be a useful tool for improving patient care if all of its users are invested. Success requires the commitment of physicians, nurses, technicians, billing and front desk staff, administrators, and everyone in between. This can take patience. Research indicates that it can take up to a year for physicians in primary care to report increased efficiency, communication, and overall clinical quality as a result of the implementation of an electronic health records system. But commitment throughout the stages of implementation and optimization can help ensure the very best functionality of a health records system, provide the best ROI for the organization, and result in the best possible patient care.

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The Changing Healthcare IT Consulting Landscape

The Changing Healthcare IT Consulting Landscape | EHR and Health IT Consulting | Scoop.it

The last several years of healthcare IT consulting, specifically around EHR implementations, has been busy and fruitful. For a period of time there, it seemed that anyone who could both breathe and type would be hired on, trained, and thrown into the fire, working at a feverous pace to digitize our Nation’s medical records. Largely, this onslaught was driven by the financial incentives of Meaningful Use – get up on an approved medical record system, hit specific targets, by specific dates, and reap large financial rewards. The incentives were highly effective and as a result the vast majority of US hospitals are now utilizing some form of electronic health record solution. But there is a murmur out there: “what’s next?”

To begin, two significant dates come to mind. The first date was May 25, 1961, when President Kennedy committed to having a man on the moon by end of the decade. To many it was an impossible goal. Something that seemed so absurd considering we had only just witnessed the first American to orbit the Earth some 20 days prior. The next 8 years were filled with collaboration, heavy investments, long hours, and much ingenuity, which all culminated to the first human to walk on the moon on July 20, 1969.

 

The second date was January 20, 2004, when President Bush, during his State of the Union address, announced his vision for the majority of American enjoying the benefits of computerized medical records within 10 years. Here we are, 10 years later, and the majority of Americans are provided care at a facility that utilizes an Electronic Health Record. The parallels between the two announcements and efforts are apparent – unbelievable amounts of money were invested and an innumerable number of people were involved in realizing the vision, similar amounts of time were allotted, and both meant accomplishing something that seemed impossible. In both cases we were successful. We successfully landed on the moon by the end of the 60’s and today the majority of Americans are provided care at a facility that utilizes an EHR.

 

We’ve accomplished what we’ve set out to do. Sure, not all facilities are utilizing an EHR yet, and not all that are using an EHR are yet meeting “meaningful use guidelines”, but for the most part, the big push is complete. The big question that looms is: what’s next? And this question is one that riles many who were involved in this great undertaking. It’s alarming and concerning to know that what you’ve become accustomed to will be changing – demands of great effort and great ingenuity working tirelessly to discuss, plan, build, configure, test, train, implement, and support, and then repeat and repeat again – this will be changing. But this is the nature of IT. Without successfully completing our mission, would be akin to Neil Armstrong not taking the first step onto the Moon. But as with NASA, that first step wasn’t the last one either, but the beginning of what would become its greatest era with the likes of the Hubble Space Telescope, Space Shuttle, and Rover programs.

 

I believe that this is just the beginning of a more exciting time for healthcare IT. That the real bread and butter, the real pleasure from the work we do, and the real benefit to patients is just beginning. Now that the majority are utilizing an EHR, we can now leverage the efforts and investments through optimization, integration, and interoperability. Through optimization, we can make the experience more effective for both the clinician and the patient. Through integration with other health software, we can extend the capabilities of the EHR further using the EHR as the jumping off point. And through interoperability it’s easier to share patient information when it’s needed the most; no more burning CDs with images or faxing results.

 

About the only tangible benefit of utilizing an EHR over a paper based documentation system is legibility; it’s not having an EHR that matters, rather it’s how the digital bits of information are used and leveraged that makes the difference. Walking on the moon did very little for us, it’s what it took to get there, what it represented, and its ability to make us realize our potential that mattered most.

It’s important that we never stop progressing, that we never settle down and accept status quo. We must continue to innovate.

 

Moving to an EHR from a paper based documentation system should never be the end goal but rather the means to getting there. As a healthcare IT professional, your continued success will be in driving this progress forward. Continuing to look for opportunities – by recognizing issues when they present themselves and developing solutions, continuing to develop yourself through continuing education and certifications, and networking with other professionals. The possibilities are endless really, and now is the time when we get to see the real benefit of this investment. Now is the time for leverage.

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Most doctors with EHRs still not taking advantage of their benefits

Most doctors with EHRs still not taking advantage of their benefits | EHR and Health IT Consulting | Scoop.it

Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control.

About 8 in 10 U.S. physicians had an electronic health records system in 2015. One-third of these doctors electronically sent, received, integrated or searched for patient health information — indicating that most physicians still aren’t using EHRs to their fullest extent. These findings come from the NCHS Data Brief from the CDC, State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015.. Only 9 percent of physicians took advantage of all four functions.

 

Full use of EHRs varies by state:

  • The percent of doctors who electronically sent patient health information to other providers ranged from a high of 56.3 percent in Arizona to a low of 19.4 percent in Idaho.
  • The percent of doctors who electronically received patient health data from other providers ranged from a high of 65.5 percent in Wisconsin to a low of 23.6 percent in Louisiana and Mississippi.
  • The percent of doctors who electronically integrated patient health information from other providers ranged from a high in 49.3 percent in Delaware to a low of 18.4 percet in Alaska.
  • The proportion of doctors who electronically searched for patient information from other providers ranged from a high or 61.2 percent in Oregon to a low of 15.1 percent in Washington, DC (the District of Columbia).

These data come from the 2015 National Electronic Health Records Survey which polled a national sample of nonfederal office-based patient care physicians between August and December 2015.

 

Health Populi’s Hot Points:  Most U.S. physicians have purchased, installed and are using electronic health records systems, driven primarily by financial incentives they’ve derived from the HITECH Act — part of the Stimulus Bill (more formally, the American Recovery and Reinvestment Act of 2009). Why was this part of the Stimulus package? The policy thinking was that health care costs in America were a key driver of the long-term deficit and so the U.S. health system had invest in the means to measure health spending and outcomes and then manage what we measure.

Without interoperability — that is, the ability to move data where it needs to go throughout the continuum of care and shared across providers who all serve the patient — we can’t fully measure, and thus manage, costs and quality for that N of 1 patient.

U.S. taxpayers have made the investment into EHRs for their doctors. But we’ve still miles to go before we see and benefit from the ROI from fully interoperable digital health records systems. There are promising technologies and standards beginning to be adopted by pioneering informaticists and healthcare systems — FHIR standards for innovating within the EHR environment, and APIs bringing patient-generated data to their personal health records. May 2017 be a new year for health data liquidity and sense-making out of EHRs

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Building the right IT team for a successful EHR go-live

Building the right IT team for a successful EHR go-live | EHR and Health IT Consulting | Scoop.it

In the world of healthcare IT rarely is one person or small group of individuals able to complete the entire value chain of delivering IT solutions that properly define operational requirements and workflows and translate these needs into technical programs or application builds. A variety of backgrounds are needed including input from people with diverse and unique expertise that lie in different areas of the organization. As a result, comprehensive teamwork is essentially required to successfully launch and deploy projects that result in ongoing improvement in patient care, advancements in research and overall operational efficiency. 

So what are some of the specific essential components of building the right team to ensure success in an environment that requires absolute preciseness and accuracy? 

 

Based upon my healthcare organization’s successful deployment of an integrated electronic medical record throughout the ambulatory, inpatient and homecare environments, the following are some elements that delivered optimal results via an integrated teamwork approach:

People: Recruiting the right people into the right roles is the number one starting point to begin an initiative. Clearly communicating each person’s role on a project accents the defined contribution expected from each participant. In our organization, we focus heavily on selecting people who exude energy, have a positive attitude and demonstrate a proven record of aptitude in their specific area of expertise.

Chemistry: Blending operational and information services personnel together is a critical component needed to collaborate and most effectively evaluate all required application functionality for delivery.

Project Leadership: Guiding the project and removing barriers from issues ensures that staff level employees can be successful in their role.

Process: Using a tried and proven methodology with agreed upon milestones binds the various teams together and aligns goals and tasks for execution.

Culture: Building an environment to foster recognition that we are all in this together results in developing respect for one another. This aspect is paramount to gaining positive momentum in working as a highly functioning team. No “drama” is tolerated.

Enterprise Leadership: Working with other leaders throughout the organization ensures proper staffing, goal setting and achievement of set objectives.

In a healthcare environment — which is characterized by continuous change, increased transparency and a wide variety of diverse accountabilities — the need for a solid, mission oriented team has never been greater. Organizations that have invested in using the integrated team approach are recognizing the benefits of their investment by more readily enabling their business objectives. And these organizations are better prepared for the next wave of challenges.

 

The journey on the road to achieve the many benefits of healthcare IT is long and winding, but the need for comprehensive teamwork along the way will always be vital to achieving success.

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EHR vs EMR - The Key Differences

EHR vs EMR - The Key Differences | EHR and Health IT Consulting | Scoop.it

Many think that electronic health records (EHR) and electronic medical records (EMR) are the same, but there are important differences. Electronic medical records have been around longer and are focused on the diagnosis and treatment of medical conditions carried out by a single provider. Meanwhile, electronic health records are specifically designed to be shared or transferred.

Compare EMR and EHR features with your most important requirements by using a EMR/EHR Software Requirements Template

What are Electronic Medical Records?

Electronic medical records are the digital equivalent of old-fashioned paper medical records. They allow doctors to track data on patients associated with their practice. Some major applications of EMRs include identifying which patients are due for preventative screenings, vaccinations or check-ups. They are a useful tool for tracking quality of care–making them useful business intelligence tools–but they don’t easily allow information to be transferred to other health care organizations.

What are Electronic Health Records?

Electronic health records fulfill many of the same purposes as EMRs, but they have a much stronger focus on the individual patient. Electronic records are designed to transfer easily between health care organizations when the patient moves or starts seeing a new provider. Health care providers can easily share information using this type of record. Further, providers can benefit from implementing an EHR system from the EHR incentive program. As a result, EHRs build up a much broader picture of a patient’s overall health, whereas EMRs held by single providers often focus on particular medical conditions.

Read more on EHR system requirements.

The Basic Difference Between EHR vs EMR Software

EMR software allows you to enter information about a patient’s medical care, including test results and prescription medications. You can use this kind of software to issue repeat prescriptions, schedule appointments, and bill patients. EHR software also allow e-prescribing, but also provide communication features to allow health care providers from different organizations to collaborate in patient care.

Should You Use EHRs or EMRs?

If your health care organization regularly needs to share information with other health care providers, then using a certified EHR technology is an excellent decision. For example, if your health care practice regularly refers patients for tests or consultations with specialists outside of your practice, then it is highly beneficial for each patient to have an electronic health record. However, if your practice is self-contained and focused on treating a particular medical condition, then an EMR system may be a simple and adequate addition to the suite of business intelligence tools you use to run your health care business.

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Benefits of EHR Systems - Benefits of Using EHR

Benefits of EHR Systems - Benefits of Using EHR | EHR and Health IT Consulting | Scoop.it

The Affordable Care Act (ACA) radically changed the healthcare landscape, and the rise of electronic health records (EHRs) as critical tools for delivery and continuity of care is one of its more involved outcomes. There are significant benefits of EHR systems for healthcare providers from small private practices to large hospitals and provider groups. To find the best EHR software for your business, make sure it provides these seven key benefits:

 

Meaningful Use

The ACA’s Meaningful Use mandates began to go into effect last year, and providers who aren’t caught up are losing money. The best EHR software is designed to help your practice meet Meaningful Use guidelines and prepare you for upcoming mandates in future stages. There are a number of EHR Incentive Programs that optimal EHR software will help you take advantage of so that you aren’t leaving money on the table.

Scalability

Third party EHR software can grow with your practice and be scaled up rapidly to include larger patient bases. And cloud-based EHRs can quickly integrate patient populations in the event that your practice chooses to join an accountable care organization or group practice.

Accessibility

Online EHRs are always accessible. Unlike EHRs stored on a single server in your office, you can access EHRs managed by a third party vendor from any location with an Internet connection. This allows you to improve collaboration with other health care providers, involve patients in management of their care and respond to patients’ concerns from anywhere.

Support

An EHR vendor who provides customer support around the clock can make your IT concerns disappear. They can also provide on site support that will significantly reduce your IT costs. Data migration, updates and patches are handled automatically so that you don’t even have to think about IT support.

Interoperability

EHRs that can interface with other systems allow your practice to optimize continuity of care. If your patients need to see specialists, manage chronic conditions such as diabetes or plan on transitioning to a home health care environment for recuperation or hospice, an EHR system that offers interoperability is critical.

Customization

Every practice is somewhat different, and EHR systems can be customized to meet your practice’s individual needs so that you get the best possible package. An EHR package that can be tailored to fit your practice’s workflow will make the transition virtually seamless.

Security

Protecting electronic health information is critical. One of the benefits of EHR systems is that they can make sure your practice is HIPAA-compliant and that your health records are protected. EHR companies that are compliant with IDC9/10, CPT and other EHR standards offer the highest security.

Adopting a robust EHR software platform isn’t just about maintaining compliance with Meaningful Use or even about ensuring the best delivery of care to your patients. It’s also about optimizing your practice’s ability to make smart business decisions based on patient data. This kind of business intelligence is critical to growing your practice and optimizing your bottom line.

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The Promise of Tomorrow’s EHR 

The Promise of Tomorrow’s EHR  | EHR and Health IT Consulting | Scoop.it

Advances in technology have fundamentally altered and inarguably improved the way we drive, shop and travel. Just ask anybody who uses Google Maps, Foodler or Uber.

Sadly, however, information technology has failed to deliver so far in the most crucial service of all – healthcare.  This is at least partly because electronic health records (EHR) systems grew out of the computer systems that run the hospital’s inner workings — patient scheduling, admission and discharge, staff payroll and accounts receivable. For system designers, physicians’ needs were an afterthought, which is problematic because physicians are, after all, the linchpin of the healthcare delivery system.

To begin pulling healthcare IT out of the past, we must first take a look at how it supports physicians. The short answer today is “not well.” In fact, EHRs are creating as much frustration as benefit.  Problems include poor presentation of patient data, fragmented information sources and unwieldy user interfaces that require dozens of mouse clicks or screen taps. It’s no wonder more than half of physicians who responded to a recent survey claimed their EHR system had negative impacts on costs, efficiency and productivity – three things IT should help, not hinder. These issues not only affect physicians’ professional satisfaction, they contribute to the phenomenon of physician burnout, which is a growing concern across healthcare. Studies show some 30 percent of primary-care physicians age 35 to 49 plan to leave medicine, and there’s an expected shortage of 25,000 surgeons by 2025. A Mayo Clinic study released earlier this year directly connected the burnout problem to physicians’ use of EHRs.

Today’s EHRs have done little more than “pave the cow paths.” We’ve gotten rid of paper in the hospital and made processes electronic, which is why EHRs can legitimately claim to have reduced transcription errors. But eliminating paper is just table stakes; the critical next phase is to do for healthcare what Uber has done for transportation: Reinvent the process so it’s optimized for and native to the technology that enables it.

Patients and physicians can and should advocate for such change. Today, patients have access to a vast body of information—the notes a doctor took, quality of care rankings, the level of personalization provided—and it’s only going to increase.  As Lygeia Ricciardi, former director of the Office of Consumer eHealth at ONC said, “Getting access to personal health information is the start of engaging patients to be full partners in their care.”

Patients of the (near) future are going to choose alternate care if they experience poor administrative practices, or if they don’t feel a connection with their doctor. And patients will know when technology inefficiency negatively impacts their quality of care, whether it’s due to admin issues or diagnosis.

In the coming decade we will begin to realize the benefits of computing and genomics in determining patient care. For example, modern medicine delivers anesthesia based on a number of factors, such as height, weight and age.  But people metabolize it very differently, and you can’t know how an individual will react unless you look at the genome. For the 20 percent of people for whom drugs do not work, it’s usually because of their specific DNA. But since this is something we’re currently not tracking, physicians are left to trial and error. Doctors should know what works for each type of person—perhaps based on what has worked for similar people in similar situations in the real world in the past.

On the technology side, EHR vendors aren’t going to get us to the next step. We must look to data, data scientists and innovative start-ups. Medical research and development is poised to move from a traditional molecular “hypothesis/proof” model to a data-centric “observation/analysis” model, in which it’s possible to do a trial without a (clinical) trial. Upwards of 90 percent of Americans are willing to share their medical data to benefit care and treatment research. We currently have enough institutions with enough data to build algorithms and apply them to other populations in such a way that we can change—and dramatically improve—healthcare.

It’s time to make healthcare work better for both patients and providers. Leveraging the innovative, ground-breaking tools we have at our disposal will propel healthcare quality and efficiency forward. Making EHRs and other healthcare IT as intuitive to use as Uber, Foodler or Google Maps will not only improve the quality of care, it will help to enhance the overall healthcare experience for everyone involved in it.

 

 

 
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Few Ways How EHR Can Stop Physician Burnout In Its Tracks

Few Ways How EHR Can Stop Physician Burnout In Its Tracks | EHR and Health IT Consulting | Scoop.it

Physician burnout isn’t fun. It can lead to increased errors and lower-quality care for patients – and in some cases, consequences for patients are irreversible. Some physicians equate EHR use with more homework, believing the common misconception that spending extra hours each night, finishing up notes, addressing inboxes, and catching up on messages and emails, is inevitable. It’s not. While many physicians feel that technology, along with government regulation and the tremendous change in the healthcare industry, adds to today’s main burdens contributing to burnout – optimizing the right EHR software will actually greatly increase a physician’s efficiency.

 

A good EHR will serve your workflow, not hinder it; a sophisticated, integrated EMR system will function as a useful physician tool. When all of the components of your software speak to each other seamlessly, the stream of your practice as a whole improves.

 

Part of making sure your EHR helps you evade burnout (rather than cause it) is learning how to utilize the entire system optimally. You should strategize your EMR use and need to document. Your EHR needs to do everything from allow you to flow efficiently through a chart to improve your revenue cycle time. Optimize all of these functions and you’ll increase your profits and overall quality of patient care. That way, you can enjoy all of the reasons you really became a physician – and go home at a reasonable hour.

 

Choose your practice’s EHR champion: Figure out who on your team is an EHR power user – this is your technology leader. Just watching his or her process will help you by giving you a plethora of tips and shortcuts to dramatically speed up your process.

 

Delegate: Allocate duties and tasks in your EHR that don’t require your specific talents or skills to other members of your team, or explore the option of hiring a trained scribe. Use your team; don’t try to do everything on your own. Sharing your workload within your EHR is one of the easiest ways to start alleviating burnout. Begin conversations with your team members on how you can work together to share documentation duties.

 

Choose a cloud-based EHR with full functionality on an iPad: You shouldn’t have to chart from home – or record the same notes twice.  When your EHR is designed for an iPad, you can chart at the bedside or exam room while maintaining eye contact with your patients. Perform a complete SOAP note and chart from anywhere you can connect to the Internet, from your iPad or iPad mini (in addition to any mobile device, tablet, laptop or desktop platform). You can choose to touch, talk or type, depending on what method will be fastest and more efficient for you. Dictation functionality is built in and can be used to replace typing for faster data entry and you can prescribe and check your schedule from your smart phone. Mobile medicine is paramount to efficiency in your practice.

 

Make sure the system you choose is truly integrated: Piecing together a patchwork structure of tools that don’t speak to each other well will only make for a clunky, inefficient and frustrating process. When your system is seamless across the EHR, Practice Management, Clearinghouse and Patient Portal, you will cut down on errors and a lot of redundant manual data entry.

 

Use and optimize your integrated patient portal: Correct use of a sophisticated patient portal will undoubtedly reduce clutter and save time. When patients check in well before their visit, and enter their histories and current medications themselves, your staff members can spend their time on other duties – and the patient’s information will be organized before their visit. Having easy access to their lab results and the ability to electronically communicate with your practice will also save time you or your staff spends on phone calls.

 

Blueprints: Software is meant to be automated. While templates are helpful in the automation process, blueprints take the level of sophistication and flexibility steps beyond templates. Your system should provide the blueprints and customization you need. You should be able to repurpose old encounters as favorite blueprints, making them easily accessible.

 

Coding: Using an EHR with advanced ICD-10 coding features and enhancements will save you time by guiding you to the most precise code appropriate for the clinical presentation of your patients. An efficient ICD-10 code search and conversion tool will eliminate many hours you would otherwise spend manually looking up codes, especially when the coding requirements become much more stringent late in 2016.

 

e-Prescribe: Most EHR systems have an e-Prescribing module, but did you know that over 200 EHRs borrow their interface from a third party? Working on an EHR that has a fully integrated e-Prescibing interface will enhance workflows and save time. In addition, providers should only work with e-Prescribing modules that have been awarded the Surescripts White Coat Quality “seal of approval.” Remember, high quality electronic scripts reduce the time providers spend managing rejections or phone calls from their local pharmacist.

 

Alerts: Alert overload kills productivity. Alerts should only be disruptive to a workflow in the case of a serious patient health risk, like a drug to allergy alert. Less critical alerts should be subtle, enough to notice but not disruptive to workflows. MediTouch Health Maintenance alerts are a good example, they are obvious enough to have prevented a case of colon cancer (see our blog post about how our Health Maintenance Alert helped a patient receive the care he needed) but not disruptive to the typical SOAP charting workflow.

 

Don’t employ a dinosaur-era EMR system. When you choose state-of-the-art software, your EHR should cut the effects of burnout for every member of your practice. MediTouch is cloud based, truly integrated, with mobile-friendly interfaces; optimizing all of MediTouch’s features will help your practice run smoother so that you can get home on time.

 

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How Health IT Enables Safer Medical Travel & Tourism 

How Health IT Enables Safer Medical Travel & Tourism  | EHR and Health IT Consulting | Scoop.it

IT innovation, global medicine and frustrated medical patients drive the demand for medical travel. But telemedicine also improves patient care and the customer experience of medical travelers. Once again, we welcome medical IT entrepreneur, Agha Ahmed, Managing Partner of GHIMBA, as we explore how IT innovations help patients get high-quality healthcare outside of the USA.

 

How do IT innovations help provide services that medical travelers can benefit from?

 

IT helps deliver safe medical care and a pleasant trip to facilities overseas. For more than 20 years, IT innovations have improved patient care worldwide. Now, these innovations are helping medical travelers, too.

 

How so?

 

In telemedicine and m-health, telecommunications, mobile devices and information technologies provide clinical health care at a distance. (M-health is the practice of using mobile technology in healthcare.) There are three important devices and software capabilities that help deliver the promise of medical travel:

 

  • First, there are electronic media records. With an EMR system, it’s easy to gather patient clinical notes, diagnostic scans, medical administrator records, and discharge summaries in digital form. By automating and streamlining clinical workflow, IT cuts the time and effort needed to maintain information and create the data trail needed for medical audits and QA procedures.

 

  • Then, there are smartphones. Our familiar hand-held computers are becoming an important enabler in the cloud-based healthcare infrastructure. An EMR system deployed in the cloud can make a smartphone a virtual healthcare wallet. Patients can access their medical records from a smartphone and share the information with overseas healthcare providers.

 

  • Finally, data mining and analytics. Data mining and analytics technologies combine, prepare and search massive data stores gathered from many sources. Combined with analytics software, a cloud-based EMR system provides easy access to the knowledge and insight that overseas doctors can use to identify medical problems. And, patients can learn about cost-effective treatment for specific diseases and conditions without leaving home.

 

These innovations work with participants in the medical travel industry to deliver value to patients and business opportunities to entrepreneurs.

 

What’s the most important thing that IT provides patients and entrepreneurs?

 

Powerful data sharing and analysis, anywhere in the world. Cloud computing and modern IT devices make it easy to transfer, analyze and share massive amounts of medical data, quickly and safely. IT contributes medical services that patients and overseas healthcare providers can be confident in. There are three notable capabilities.

 

  • IT makes comprehensive medical information accessible. All patient-related data is stored in a single, authoritative source in a cloud computing center. Centralized data management makes it easier for qualified medical travel solution providers to identify gaps in information and synchronize the data and people involved at each step in patient care.

 

  • IT helps patients get the best care available. By hosting medical records, cloud computing centers become part of an ecosystem, which includes globally accredited hospitals and clinics. Healthcare providers anywhere in the world get easy access to medical information before patients arrive. Or, patients can use their smartphones to download information when they arrive. When highly qualified practitioners analyze and share medical information, patients benefit.

 

  • IT provides patients with a smoother, more pleasant trip. Internet data searches and medical travel solution facilitators reduce the time, effort and worry of finding, traveling to and engaging medical facilities overseas.

 

Cloud computing and other IT innovations can help make offshore treatment a safe, cost-effective alternatives to U.S. healthcare. These innovations can be used with medical travel facilitators and solution providers to deliver world-class medical services.

 

Where can we find out more about IT and medical travel?

 

Telemedicine is a major topic in an upcoming conference, the Medical Travel and Global Healthcare Business Summit in Tampa, Florida. If you’re wondering about medical travel business opportunities, you’ll want to check out the conference, which will be held on June 14th through 17th. The summit is designed for healthcare and wellness providers, IT services business leaders, and hospital and clinic administrators.

 

The conference discusses business and technical aspects of medical travel, including how IT, telemedicine and m-health support travel logistics and patient care. The emphasis is on finding and making the most of the many business opportunities available to entrepreneurs and healthcare industry professionals.

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Richard Stern's curator insight, July 8, 2016 9:15 AM

Safety and Health are priority issues when travelers have business travel needs on a regular basis. Technology innovations contribute to the likelihood of a better outcome. 

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Should You Test Your EHR Data Backup and Restore Process?

Should You Test Your EHR Data Backup and Restore Process? | EHR and Health IT Consulting | Scoop.it

It’s common knowledge that backing up data for your medical practice is critical forprotecting against devastating losses of patient data in the event of a natural disaster, system glitch, or hardware failure. But practices should go further than simply backing their data up; testing these backup and restoration processes is just as important for ensuring data safety as the initial backup itself.

 

Why Backups are Important

 

For practices that utilize EHRs, having backups is critical for a number of reasons. While the first scenario that many imagine is a catastrophic loss of data resulting from a server malfunction or local event, this is not the only reason to have a data backup.

Experts recommend backups to protect againstsecurity breaches or viruses, to provide continuity of care across multiple providers or in the event of an outage, andthe protection ofvaluable assets for research and analytics.

Medical practices should establish scheduled, automatic backups as well as perform manual backups after making any system changes.

 

Your Backup is Only as Good as its Restore

 

When preparing an EHR data backup procedure, it’s important to remember that the value of your backup is congruous to the quality of the restore. A backup is no good if the restore is incompatible with current hardware or software, which is just one example of what can go wrong.

 

Particularly for practices using an EHR vendor, it’s essential to confirm compatibility of the restore with current systems. This restore must also be promptly accessible, and establishing synchronization with an EHR vendor is importantfor this timeliness. Checking post-restore integrity as a routine part of testing can ensure that once your restore is complete, your data will be accessible and useable.

 

How Will You Know if Your Backup is Good?

 

One of the most effective ways to know if your backup is good is to run a test. The test should exercise the system using common work processes that access multiple types of data.  The worst case is when a practice believes they have beensuccessfully backing up their data, only to find out that the backups are incomplete.

 

Other restore fail scenarios include practices that have discovered that theyhave only been backing up their software (URL: http://www.americanehr.com/blog/2011/12/data-backup-information-protection/), not their data. This kind of loss can be devastating for patients and providers alike, and regularly running tests can protect against these situations.

 

Scheduling Your Backups

 

Aside from testing the functionality of backups,strategically determining the times that these systems will run will prevent interference with staff or clinic activities. Frequency also depends on how much data the practice can afford to lose. If a backup runs weekly, this means that a worst-case scenario could result in the loss of six days’ worth of data.

 

Depending on practice volume, agenda, and other factors, setting goals and quantifiable standards for backups ensures alignment with best practices.

 

Conclusion

 

Protection against disaster-borne data loss, along with the convenience of external management,has led many practices to choose third parties or their EHR vendor to administrate backups.  Don’t rely on external entities to validate your backups.  Internally test and verify your systems restore process too.

 

At ZH Healthcare, our BlueEHS services offer complete peace of mind with multiple layers of protection, including automated backups and “snapshot” components which can be used to restore your systems quickly. In addition, we offer on-demand download access from the cloud, and in-house data storage. 

 

 

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Your nurses may hate your hospital’s EHR: Here’s why

Your nurses may hate your hospital’s EHR: Here’s why | EHR and Health IT Consulting | Scoop.it

While most talk about electronic health record (EHR) systems has centered on doctors’ troubles with adapting to them, hospital nurses are also having major difficulties with EHRs.

 

A new survey highlights just how frustrated nurses are with most hospitals’ EHR systems. Ninety-two percent of nurses are currently dissatisfied with their hospital’s EHR, according to the Q3 2014 Black Book EHR Loyalty survey.

The survey polled almost 14,000 RNs from across the country who all used hospital EHRs in the past six months, and participants had mostly negative things to say about their facility’s systems.

Most nurses said their hospitals’ EHR systems contributed to lower productivity and workflow disruptions affecting the quality of patient care. And 85% of nurses said they continually struggle with their facility’s flawed EHR.

Reasons for frustration

Communication issues are a major contributor to why nurses aren’t happy with hospital EHRs. Ninety percent of nurses surveyed said their hospital’s EHR negatively affects communication between nurses and patients, and 94% thought it hurt communication between nurses and other clinical staff, including doctors and pharmacists.

Some of the communication problems between nurses and other medical staff come from a lack of consistency when it comes to documentation in the system. Only about half the nurses working in large hospitals with more than 100 beds said that all clinical staff access and document patient info on the same EHR screens.

Because everyone accesses patient info differently, there’s more room for confusion and miscommunication when it comes to patient care.

Another big problem for nurses is a lack of IT resources, which can cause delays in entering information in a patient’s EHR. In fact, 91% of nurses in for-profit facilities said they had difficulty even locating an available EHR workstation during their shift.

The survey also showed many hospitals are lacking when it comes to troubleshooting EHR problems. Less than a third of nurses said that their IT departments or administrators responded quickly when nurses pointed out EHR vulnerabilities in documentation.

Rather than solve their problems, many nurses are just given temporary workarounds, and that makes them more frustrated with the system. Almost 70% of nurses surveyed have been told to use workarounds with their facility’s EHR.

Heading off problems

Not only can these issues compromise the quality of care your hospital provides, they can also cause issues with retention and recruitment for nurses. Several nurses surveyed indicated they were currently looking for new jobs, and for close to 80% of these nurses, the reputation of a specific hospital’s EHR is one of the top three factors that determine whether they’d accept a position at a facility.

So it’s clear: Your nurses’ needs should be considered when selecting or upgrading an EHR. This is why it’s key to include representation from your nursing staff throughout the process.

Nurses spend most of their time directly interacting with patients – possibly even more than your doctors. So it’s important for nurses to be able to accurately and effectively document vital signs and other key medical info in patients’ health records. Getting their feedback about what should be included in an EHR system will improve their efficiency and the quality of care they provide.

Besides getting input from nurses about your EHR – and implementing their suggestions – it’s also important to make sure they have easy access to the technology required to use the system.

One suggestion: Instead of limiting nurses to a few EHR workstations, consider allowing them to access the system using secure handheld electronic devices, such as tablets. This could help them enter clinical information into patients’ records faster, boosting productivity and reducing frustration.

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What does practice leadership have to do with an EHR system?

What does practice leadership have to do with an EHR system? | EHR and Health IT Consulting | Scoop.it

Like any practice-wide implementation, a successful electronic health system relies on leadership and coordination. Because an EHR system impacts an entire practice, an effective leadership team should comprise a number of individuals from practice administration to physicians, to nurses or technicians, to billing, and more, depending on the size of the practice.

This leadership team is key for a successful EHR implementation, along with one critical decision-making individual who is capable of leading that team.

 

Who makes the EHR Decisions?

Determining the configuration of an EHR system is no small task.While effective leadership in EHR design requires confident decision making from a focused individual, EHR decisions should be influenced by other players in the practice and their workflow needs, highlighting the importance of a leadership team as described above. Individual doctors, for example, are a critical source of valuable information for the EHR decision-making process, as their needs and challenges in an electronic system impact the entire practice.

 

Leadership in EHR Systems

The transition to electronic records in healthcare has witnessed challenges of adoption and usability, many of which are still common today. Whether implementing a new EHR system for a small practice or a large group, common complaints from providers or staff include feeling mandated to use a system that perhaps they do not enjoy using, or that they themselves would have configured differently.

Other common complaints include the concept that EHR operations are not part of a physician’s job, for instance, and that data management tasks should be allocated to specific data specialists or data entry clerks. These sentiments may lead providers to disperse EHR system tasks down to nurses, technicians, and other staff, leading to productivity bottlenecks and increased frustration.

EHR leadership helps to address these and many other challenges. Consolidating decision making to this team can minimize time and costs, and also improve the overall quality of data captured in the electronic records with standardized use.

 

Ways to Calm the Storm

Fortunately, there are methods of EHR implementation that create fair and realistic expectations for providers and staff in a medical practice.

  • Customization

One of the best ways to prevent issues stemming from frustration is to configure a custom EHR tailored to the specific needs of an individual practice. Customization can improve reception and adoption of a records system, leading to effective use.

  • Training

Training is critical for a successful EHR system implementation. Some of the many decisions for the EHR leadership team are training providers and staff on the new system, deciding who will provide this training, and assigning individuals as points of contact for questions.

  • Leadership

While an EHR leadership team should be equipped to address individual challenges as they arise, it is critical for this team and the leading individual to keep in mind “big picture” goals and management. Patient outcomes, best practices, “meaningful use,” and other practice-wide goals should always be part of the leadership team’s considerations throughout a new system implementation.

Designing a consolidated EHR takes leadership. Keeping the goals, challenges, and needs of the practice as a whole in mind, while also addressing the concerns of individuals throughout the practice’s workflow, requires thoughtful management and guidance.

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5 Signs You Need EMR Consulting Services

5 Signs You Need EMR Consulting Services | EHR and Health IT Consulting | Scoop.it

Let’s face it, medical records can be frustrating. Between keeping up with new information and making sure that things are orderly, it’s a tough task.

Thankfully, you can get some help. EMR consulting can make your medical facility run smoother than ever!

Ready to learn more? Keep reading for some telltale signs that it’s time to look into an EMR service.

1. It Takes Too Long to Find a Patient’s Medical Records

Let’s face it, the old pen and paper format just isn’t as effective as it once was. These days we have the cloud and all sorts of EMR consulting services that make finding records easy.

And in the medical field, time is of the essence. Every second you waste looking for a patient’s records is a second that could be spent with the patient.

You’ll also lose money due to basic logistics and time management issues. Using an EMR service is just more cost efficient.

2. You’re Looking to Boost Your HIPAA Compliance

You already know that it’s critical that your medical facility complies with HIPAA. But by switching to an EMR system, you’ll make things far easier on yourself.

Under HIPAA, each and every patient is afforded a few things:

  • A copy of their medical records
  • The correction of any mistakes on their form
  • Specific information on how and with whom their medical history is shared

Take a moment to think about how difficult all of that could be with paper correspondence. By contracting an EMR consulting service, your patient will have easy access to their pertinent info.

Best of all, you’ll have backups of your files in case something goes wrong.

3. Your Current Records System Is Uncoordinated and Messy

Of course, there’s always a chance that your current MR system is a bit of a bust. Whether you’re using paper or electronic services, you’ll want to make sure that organization is a priority.

With the right product, there’s little to no room for error. Best of all, you’ll have access to all sorts of analytics.

So when the patient comes in for a visit, you’ll have tons of hard data that you can use to better inform your care.

Give yourself and your staff a break. Get in touch with EMR consulting services and watch productivity go through the roof.

4. You’ll Have Support When Things go Wrong

One of the best reasons to invest in EMR consulting is the support it offers. Most companies, such as ourselves, offer a robust support service. With more than 25 years’ experience in the health informatics industry, CIS understands that a system is only as good as the efforts lifting it to success.

Leave the technical details to someone else, you and your team already have enough on your plates. When something goes wrong, don’t hesitate to seek support.

In the case of an emergency, our staff is ready to help at a moment’s notice.

5. You Need an Easier Way to Access Medical Records

Perhaps the biggest reason to invest in an EMR service is due to the sheer convenience it offers. No more clipboards and shuffled papers; today’s technology allows for a more streamlined and organized system, with information available at the touch of a button.

Believe it or not, all you really need is your phone, a tablet, or a smartwatch.

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What is Certified EHR and Why is it Important?

What is Certified EHR and Why is it Important? | EHR and Health IT Consulting | Scoop.it

The advent of electronic health records (EHR) systems was built on a foundation of improving patient care. Establishing infrastructures that support highly accurate patient data, closing gaps in communication between healthcare providers, and securely storing records are all among the goals of a certified EHR system. To standardize this, certified EHR systems were conceived and built.

Why is Certified EHR Technology Necessary?

Certified EHR technology is simply a method of taking the ideas of improving patient outcomes through technology forward in a standardized, regulated fashion.

But what does this mean for providers?

Not only does adopting a certified EHR system ensure that your records adhere to requirements for HIPAA and Meaningful Use through CMS and the ONC, but they also can qualify medical practices for federal incentive programs, which can greatly reduce the cost of EHR implementation.

Who Certifies EHR Technology?

The requirements for certified EHR technology are generated and regulated by the federal government. Both the Centers for Medicare & Medicaid Services (CMS) as well as the Office of the National Coordinator for Health Information Technology (ONC) determine the regulatory requirements for certified EHR systems.

Overview of Requirements

In order to adhere to Medicare and Medicaid requirements (and to qualify for incentive programs), an EHR system must meet a set of requirements, and then further, a medical practice or organization must put those features appropriately to use. Meaningful Use was broken down into three stages, and while details on all the requirements for the three stages can be found here, below is a brief overview of requirements to demonstrate Meaningful Use.

• Data capture and sharing

Stage 1 of Meaningful Use focuses on essentially capturing and tracking KPIs (key performance indicators) within a clinical setting. Coordinating care with this new information includes both in-office communication, and communication with patients and their families.

• Advance clinical processes

Stage 2, advance clinical processes, focuses on honing electronic processes such as e-prescriptions, online laboratory reports, electronic delivery of patient care summaries such as after visit reports, and a new focus on Health Information Exchange (HIE).

• Improved outcomes

Finally, Stage 3 focuses on demonstrating improved health outcomes, decision making on high-priority conditions, and patient portal access and utility, including access to laboratory results, provider communication, and more.

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5 must-have traits to require from your EHR and infrastructure vendors

5 must-have traits to require from your EHR and infrastructure vendors | EHR and Health IT Consulting | Scoop.it

You are past the big go live. You and your team are focused on optimization, enhancements, ongoing support issues and upgrades. So, what should you expect from your vendor in this ongoing relationship?

I have worked with all the major EHR players and many other IT application and infrastructure vendors over the years. I have worked with three of the major EHR vendors just in the last 18 months given my interim CIO engagements.

My post “Keys to successful vendor management” covered the importance of the product roadmap, service, total cost of ownership, reputation, contract, implementation, and escalation.

It’s time to look at the ongoing vendor relationship that clients should expect. Vendors, take note. I assume most of your clients would share this view. There’s a reason that the KLAS Research reports carry a lot of weight for CIOs, they are vendor evaluations from their peers.

Whether it is a large, proven vendor or a small start-up, here’s what you should expect:

  1. Excellent customer service: this means being highly responsive, providing quick resolution to issues without escalation, and well-trained, expert support staff. All in the context of a service culture.
  2. Effective account management: every client needs a primary point person who is the face of the vendor, who effectively and expeditiously navigates the vendor’s organization regardless of its complexity on behalf of the client, tracks and reports on all open issues and ensures overall excellent customer service.
  3. Executive level relationship: vendor executives who regularly meet with client executives to ensure an effective, ongoing win-win partnership and who understand and support the client’s strategic plans.
  4. Long term value for the investment: vendors should work with their clients to help them fully leverage and utilize current products they have already licensed, have deep knowledge and transparency around the product roadmap, and sell new add-on products only when there is a clear client need.
  5. Support mergers and acquisitions: provide pricing, licensing and maintenance models that enable and support continued mergers and acquisitions; not create burdens and roadblocks that hinder growing integrated delivery systems.

No vendor or product is perfect. As clients, we must make tradeoffs. But we invest big dollars in long term relationships with our vendors. There is a reason that the Gartner magic quadrant has two dimensions – “ability to execute” and “completeness of vision.” We need robust products that work reliably today and that will evolve in the future to meet changing needs.

How does your vendor stack up against these expectations? Yes, “awesome” is a very high bar. But if you gave them a low grade, it may be time for some face to face discussions.

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Top 5 ways to bring doctors to the EHR optimization table

Top 5 ways to bring doctors to the EHR optimization table | EHR and Health IT Consulting | Scoop.it

While some speak optimistically about the "post-EHR era," electronic health records are still very much a going concern – and will be of great interest to many of the 45,000 or so attendees at the 2017 HIMSS Annual Conference & Exhibition later this month.

There will be education sessions on topics ranging from enabling EHR analytics to resolving usability issues that could impact patient safety to better integrating genomics data into clinical workflows. There's even a half-day User Experience Forum at HIMSS17 –  a major theme of which will be the ways UX can be improved for care teams to create a more transparent, intuitive way of care delivery.

Long story short: For all their ubiquity, EHRs still have a lot of improving to do.

 

As a physician informaticist, I'm fortunate to be invited to many meetings about electronic health record optimization: big meetings, small meetings, fantastic meetings … YUUUGE meetings.

 

But there is always one thing, or rather, person, missing: Inevitably, I'm usually the only doctor in the room … and I haven't seen an actual patient in more than five years!

With only 34 percent of physicians reporting that they are "satisfied" or "very satisfied" with their EHR according to a 2015 survey conducted by the American Medical Association, this is a definite problem. Not only that, but as the AMA's Vice President of Professional Satisfaction Christine Sinsky, MD, and colleagues reported, physicians spend another 1-2 hours on computer and other clerical work during their personal time each day, contributing to the increasing rate of professional burnout.

Nearly every hospital and health system has an EHR in place, and are hard at work optimizing their investment in a system that typically cost millions or even billions to implement. EHR optimization, for those unfamiliar, is the continuous improvement of the primary technical tool that provides care to the patient through the clinician. Healthcare organizations are simply not going to get the results they want if practicing physicians aren't at the table.

 

To a layman reading this, this sounds laughable that they are not at the table. Just having guys and gals like me – "the geek doc," "the techie nurse," or "the ex-clinician turned 'suit'" – is not enough. While we haven't forgotten the years we spent providing care for patients at the bedside, you must include the current bedside providers into the decision-making processes.

I understand this is easier said than done – doctors are among the busiest people on the planet, and most do not show up or speak up if it means leaving their patients or taking a significant productivity hit (code word for "financial"). Many clinicians will remember the days of pharma reps bringing in catered lunches in exchange for some of their time. I think the question you need to ask yourself is: "What is the new drug rep luncheon that we can offer busy physicians in order to get a bit of their time to get feedback, versus make a sales pitch?"

In my 15 years of expertise, most physicians and nurses care about "buttons, clicks and lists," which translates to usability, configurations, and technical workflows that match their real-world workflows. So the next question you should have is "How do we get this level of input without needing them to leave the bedside and join a meeting?" I'm glad you asked. I will put on my technical and organizational 'chef hat' to share with you a few recipes for getting the docs and nurses to the table!

 

Here are the top five ways to bring doctors to the EHR optimization table:

1. Email. I know what you're thinking: Did he really open No. 1 with email? Don't doctors get enough messages already? Keep reading: They do, but in my experience in leading EHR efforts at healthcare organizations across the country, it still works. Be sure to leverage the account they use most—for many docs, this is not their hospital-issued account and may be the Gmail account they check every evening instead. If you're unsure, ask them which address they prefer to communicate about EHR matters, which is their new "black bag." Asynchronous (non-real time) communication allows physicians to respond on their schedule. It might take a while to get a reply, but if you include a clear call to action and it's formatted properly, you'll get it eventually. Which leads me to my next point…

2. Images. As I mentioned above, most of the time when you're seeking physicians' opinions for EHR optimization, it centers on how something looks or feels to them: Which design for a particular screen do they prefer, or which workflow diagram makes more sense for their reality? When you can use images—a screen capture or mockup, a Visio, a chart—you're much more likely to get a response. Try to avoid the tyranny of choice by giving no more than three options per question, and always remind them what the current state looks like alongside the future state options: Physicians are typically visual learners, and they also may not realize what the current state looks like. You'll get a much better response when presenting the status quo and three redesigned options under consideration versus a "Here's the new design for this alert, what do you think?"-type question. Minimum 'free-thinking' allowed: Provide focused and well vetted choices.

3. Screencasts. If a picture is worth a thousand words, how much are short videos worth? Screen recording technology tools such as Camtasia and Snagit are inexpensive and user-friendly ways to showcase and explain EHR changes or proposed changes. Other industries have used this method for years, and it often can replace an in-person meeting. EHR builders and analysts can record themselves actually going through a new screen or workflow in the EHR, as they explain what they are doing and why it was designed this way. Doctors can easily watch the video on any device; the small .mp4 files can be sent via email, and email replies or comments on the video itself (preferably web hosted, but follow the guidelines of your health system and vendor) make it easy and efficient to collect physician feedback. Your technical teams will love it as well.

4. Surveys and polls. I've used tools like Surveymonkey for over a decade to survey physicians across organizations. They can be accessed inside or outside of organization firewalls and can be incredibly effective. For example, you may have an EHR developer or analyst create various options for the physician home screen. By embedding images with clearly written captions in the survey, you can get a clear indicator for which one is preferred. This method also gives you objective feedback, which can often be better than random anecdotal feedback—which is the most common thing heard in meetings with many docs. You can use the survey results as support for critical decisions. I once had a doctor voice concern about the new format of an order set, but when I was able to point out that more than 80 percent of her peers selected it as their top choice, she was more amenable to the decision given that so many of her peers had weighed in favorably, and objectively. I've coined this "evidence based optimization!"

5. Meeting etiquette. If you've tried all of the above, and you just really need an in-person meeting, follow these simple etiquette tips to make doctors more inclined to participate. Depending on the group(s) you're targeting, you may have different optimal meeting times. For example, you'll have the best luck with primary care docs around the lunch hour, but hospital-based docs are usually more available in the early mornings or evenings. No matter when you schedule it, be sure to use the best virtual meeting tools you can afford, so docs have no problem logging on and viewing the deck if they're remote. You can also record the meeting to share with those who couldn't attend. If you can't schedule an exclusive meeting, try to negotiate a bit of time during a meeting already on their calendar, such as a recurring "med exec" (hospital meetings that docs typically attend) or "monthly ambulatory practice management" meeting. Design meetings to cater to "WIIFM" (what's in it for me): Before gathering their input on EHR changes and the like, provide a few tips and tricks that can help streamline their current EHR workflow right now. Once you have the "oohs and ahs," the door will be open for gathering their feedback and their suggestions will be more candid and focused. By continuously showing them the results your EHR optimization efforts are achieving, the more invested they will be in the ongoing process.

Nothing is foolproof, but I'm confident that using a combination of these methods will help you bring doctors to the EHR optimization table at your hospital. The pharma reps may bring the food, but effective EHR optimization efforts using the above methods can engage clinicians and garner candid feedback–and that's a pill that's not hard to swallow.

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Tips to help prepare for EMRs, even before you choose your software

Tips to help prepare for EMRs, even before you choose your software | EHR and Health IT Consulting | Scoop.it

The reason to purchase EMR or any medical software is to make your practice work better for you, your staff, and your patients. Keeping this at the forefront of your medical software decision will put the brakes on foolish purchases that may offer glitter but don’t offer your practice enhanced functionality and don’t offer your patients improvements in the quality of care they receive.

Though there is no need to leap  blindly into an EMR no matter how many incentives are offered to you,  you can be quite sure than an EMR is in your future. There are certainly preparatory steps to take for a transition to EMR. Even if you are a year or two away from making your EMR / EHR software buying decision, there are many things you can do now to make the eventual medical software implementation easier. Though the purchase should not be rushed, the transition is going to happen, so get ready now.

As the marines say, “semper preparatus” always  be prepared.  Here are ways to begin your implementation even before you know which EMR system you will choose:

  1. Make sure that everyone in your organization is extremely comfortable with using his or her computer. Not just your desktop computer, but your laptop and tablet PC need to be easily managed by all hands on board.  Support staff – administrators, receptionists, sonographers, and x-ray technicians, and nurses who already use many electronic instruments for tests and for administrative tasks  – are perfectly comfortable with using different types of computers, but many doctors are not.  If your physicians  will not be comfortable using your EMR and its associated technology, the war is lost before it has begun. Which brings us to the next readiness step:
  2. Your medical practice requires what the marketing people call “buy-in”!  Everyone has to be on board with the plan to move to an EMR. If they are not, discuss their reasons for opposing the move.   Often, it is because of lack of comfort with the technology.  Some vendors will offer preliminary seminars on EMR in order to interest prospective clients.  Offer one to your employees, so that they can see the types of change their use of EMR will bring.
  3. Talk to colleagues who have already made the move to EMR or other medical software. Find out which features they like, and which they don’t. Find out how difficult it is to maintain HIPAA compliance with different systems. Find out which vendors offered good support and training.
  4. Read medical software reviews. There is a tremendous amount of valuable software information available at no cost to you online.   You can learn about different features, and think about how they might be used in your practice.
  5. Consider which parts of your practice are most amenable to going electronic and which are least amenable.EMR and medical software is not an all or nothing proposition.  It could be that your practice should not be moving all of its functions to electronic media just yet. And it almost surely should not be moving all modular functions at once. Discuss this question with key people in your organization: your medical billing specialists, your nurses, and your doctors.
  6. Consider whether your might want an in-house client-server solution, or a web based Software-As-A-Service solution that you lease and log into from any location. EMR and medical software solutions like this are becoming more feasible and are often more affordable than having your own in-house server and having to manage security and backup of your data.

  7. If your medical billing is not yet electronic, this may well be the way to begin your transition to medical software. Your medical billing must become electronic almost before anything else. Medical billing presents the quickest ROI of all EMR modules, because it allows for quick turnaround on claims denials, code lookup, and an opportunity to be more easily HIPAA compliant than your paper files allow.  Prepare your staff and data to migrate to a medical billing module as quickly as possible. Otherwise,  because of reporting requirements and claims processing alone, your bottom line will be compromised.
  8. Identify an in-house leader and liaison. If you already have an IT person on board, and he has the people skills as well as the technical skills to act as a liaison when you are planning your purchase, ask her to read up different EMR configurations, on implementation schemes, and EMR priorities in relation to your practice. If you are a large enough practice, identify a physician who you think can be the physician liaison for the implementation.  Give these people time and space to do some  research – talking to colleagues, attending free or low cost seminars, reading, etc.
  9. Make use of your scanner today! If you haven’t already, buy a good quality scanner that is easy to use, and make sure everyone know how to use it. Start scanning your newer patient documents now so that when you actually get to implementation stage, you do not have to re-invent the wheel scan every piece of material within  your archives and records.

These preparatory steps will make your move to an EMR simpler, and should give you some insight into criteria for choosing the right EMR.  Never buy into an all-or-nothing strategy for implementation. You cannot expect to change the entire workflow of your practice when you implement an EMR – and you do not want to.  You need to follow the demands of your practice, when reasonable.  And most of all, you need to work with your staff as a teamso that when you find the right EMR you can begin with a full complement of invested, able people who want your investment of money, time and effort to make sense.

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7 Types of Healthcare Information Technology

7 Types of Healthcare Information Technology | EHR and Health IT Consulting | Scoop.it

The 3 Main Categories of Healthcare Information Technology

There are three main categories of healthcare information technology that you’ll find in both hospitals and physician offices:

Practice Management

Practice management is pretty much exactly what it sounds like: it helps you manage the different aspects of your practice.  This category centralizes your practice’s various systems so you can run it more efficiently.  Practice management software automates just about every task that fits under the “health information management” umbrella.  They take away the stress and give you back the time spent on time-consuming tasks.  The overall goal is to help you provide better short- and long-term care.  To achieve this goal, most practices integrate other systems to truly centralize the platform (more on that later).

EMR

Electronic medical records software, or EMR, is one of the most popular medical software categories.  EMRs replaced paper records by making digital versions of charts and patient histories.  They have similar features to business intelligence, in that they can track data over time.  This alerts you when patients are due for preventive procedures and screenings.  In addition, EMRs help diagnose and treat patients by looking at their history and comparing their health data.  All these features allow you to provide consistently better long-term care.

EHR

Electronic health records software, or EHR, is another extremely popular category.  As you may have guessed by the name, they have similar functionality to EMRs.  An EHR provides health information management in the form of digital health records.  The differences from EMR begin, however, by providing a broader view.  EHRs include a patient’s history, diagnoses, treatments, medications, allergies, X-rays, test results and more.  Another advantage is the ability to share information.  While EMRs give a healthcare provider a great overview of a patient, they can only do so for that provider.  EHRs, on the other hand, can share patient data with other EHRs.  This allows a healthcare provider other than the patient’s primary provider to access the same information.  So when a patient moves or goes to an emergency room, they can still be properly treated.

The 4 Smaller Categories of Healthcare Information Technology

There are also smaller categories of healthcare information technology that aren’t as common.  These systems are often integrated with practice management software to provide robust functionality and better patient care.

Patient Portal

Today’s consumer expects more transparency and accessibility than ever before.  This is certainly true for the healthcare industry, where patients want access to their medical records.  You certainly can’t blame them, so patient portals were developed.  They’ve increased in popularity among hospitals and medical practices in recent years, and appear to become an industry standard.  Patient portals allow access to just about everything in an EMR and EHR, including their history, treatments, medications, etc.

Scheduling

Scheduling software oftentimes goes hand-in-hand with a patient portal.  This allows patients to login to the portal, view their previous treatments, receive an alert that it’s time for a check up and then schedule it.  Possibly the biggest advantage of scheduling software is reducing your phone traffic.  Rather than having to call every time they want to make an appointment, patients can just go online and do it.  Plus, in today’s digital age, they prefer to do it on their device of choice anyway.

Medical Billing

One of the more time-consuming tasks for practices is managing patient billing.  Writing up, sending and processing payments takes a lot of time, especially for busy hospitals and practices.  That’s where medical billing software steps in.  A medical billing system automates all of this, so you don’t have to think about billing at all.  If there’s an issue such as a late payment, the system alerts you so you can act accordingly.

ePrescribing

One of the last parts of an appointment is sending the patient’s prescription to their pharmacy.  In order to expedite the process, physician offices began using ePrescribing software.  In just a few clicks, a prescription is sent, filled and waiting for the patient when they get there.  This saves not only your time, but your patients’ as well.  Additionally, ePrescribing systems ensure that there’s never a prescription mix up due to, say, poor handwriting (no offense doctors).  The system displays the prescription to the pharmacy so they can ensure patient safety by giving the patient the right one.  A study by Decision Resources found that using ePrescribing software has increased the prescribing of generic drugs.  This furthers your mission of patient care by providing them with cost-effective medicine.

Although there are lots of different medical software categories, hopefully this list has helped clear up any questions you had.  If you haven’t used any of these systems yet, you might want to start looking into some options.  Just think of how much better you can run your hospital or practice with some or all of these systems.

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Tips for Changing EHRs and Transferring Patient Data

Tips for Changing EHRs and Transferring Patient Data | EHR and Health IT Consulting | Scoop.it

One of the challenges of choosing a new EHR is considering the long-term investment.

Implementing any new system into a medical clinic is a potential short-term disruption, so there needs to be an assurance that your decision to change EHR services will serve you well moving forward.

The rapid pace of technological ensures that most doctors will switch their electronic records system throughout their career.

Some doctors start building a medical practice with a budget, and then become ready to pay more for a full service EHR. Others are simply dissatisfied with their current system and want to move to something more suited to their needs.

Very often the big issues that arises is with data continuity. Changing EHR systems should ideally mean that you retain access to your previous patient records. But this is not always the case. The fear of transferring data and losing vital information is a real threat.

With the recent growth in cloud-based EHRs, your patient data is no longer stored on a local server in-house, rather it is under the care of the EHR vendor.

The good news is that the ease of transferring medical records has been steadily improving over the last several years. The recent wave of federal regulations relating to Meaningful Use includes a set of standards developed to enable electronic referrals and cross-provider communication.

These standards describe the specific structure and elements of a patient record, so that any two EHR applications which adhere to the standards, should be readily able to exchange patient data from one to the other.


The creation of these standards makes it easier to transfer patient care data from one provider to another. This technology process is also used to import all patient records from one EHR to another.

For any two EHR applications, it is unlikely that all data will transfer over seamlessly. You need to check with your new vendor which information is essential.

Start with Structured Data.

This includes ICD9 Diagnosis codes, medication lists, procedure lists, allergies, and immunizations. Detailed chart notes and SOAP-type templates can prove to be difficult because the data is unstructured, and free text format may not transfer easily from one EHR technology to another.

In order to meet Meaningful Use certification, EHR vendors are required to be able to produce this data in a standardized, structured format for any given patient. However, they are NOT required to be able to automatically export all data for all patients.

With some EHR vendors, they may charge a processing fee for creating an export file of all of your patient data. A new EHR vendor may also charge you a fee for importing previous data.

This fee will vary based on the volume and complexity of your previous record set.

 

Testing the new System

Once the data transfer has been the second step is testing. Anyone familiar with the process will tell you the the transfers are rarely executed perfectly on the first round. So be patient and persistent.

It is necessary to perform careful quality testing to validate that your data in the new environment is accurate, just like in the old environment.

The simplest way to do this is to select a small test group of your patient population and manually verify that everything is exactly correct for those people. Check both systems to see that everything is correct and orderly. Ensure that you check more than contact information, also review medication lists, procedure lists, allergy lists, and immunization lists. Detailed chart notes and SOAP-type templates can also show if the data has transferred effectively.

If you find an error in the record of one individual, chances are that it is a systemic problem that is affecting many other patient records in your population.

If you identify any problems, you will then need to work with both EHR vendors to determine the origin of the issue and correct it. This can be time consuming, but also worth fixing early.

Even with cloud based date, and modern EHR systems, data transfer can still be a challenging process for any provider to undertake.

 

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5 EHR Benefits We Seem to Have Forgotten About

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

Here are a few of the guaranteed EHR benefits:

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

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

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

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Electronic Health Record Solutions Don’t Make Errors, People Do It

Electronic Health Record Solutions Don’t Make Errors, People Do It | EHR and Health IT Consulting | Scoop.it

HealthITNews reports that the Centers for Disease Control and Prevention is expressing increased alarm about patient care errors that are being introduced as a result of poorly designed or poorly implemented electronic health record solutions. The US Food and Drug Administration has also be weighing in lately on whether Health IT solutions should be more tightly regulated.

 

Whether or not more regulatory oversight of Health IT is needed, I suspect many of us have experienced instances where health information about us is found to be in error. I recall when my mother was hospitalized for chest pain that doctors were treating her as though she had been a life-long smoker. In fact she had never, ever been a smoker. At some point in time, information about smoking history had been erroneously entered into the electronic record. Now, the doctors treating her for chest pain were making decisions about the likelihood of heart disease based in part on that information about smoking history. In my own medical records I have also found, and had to correct, occasional errors in medication history, allergies, and immunizations over the years.

 

Despite this, I would tend to put the blame not on the computer or the software. It is not generally these systems making the errors, but rather the people using them. Sometimes the wrong information has been entered into the system, as in the case of my mother. Sometimes, errors are made because the information being displayed is in the wrong chronological order or is buried in a user interface that is out of synch with real-world, clinical workflow. In both instances, the problem is with people—those who designed the software and those who use it, but not with the software itself or the machines running it. How can we improve on this situation? Here are four ideas:

 

 

Involve the Patient Right from the Start

 

In gathering the information that becomes the foundation of our medical records, we are putting too much burden on caregivers. How much of the complete medical history or SOAP note is information that comes directly from the patient? Chief complaint, history of present illness, past medical history, social, family and occupational history, medications, allergies, review of systems? All of this information is retrieved by “interviewing” the patient. Perhaps it would be more efficient and more accurate if the patient himself entered all that information into a kiosk, or some other kind of fully automated, information intake solution. Surely with today’s technology we could design systems that would do a more consistent and comprehensive patient interview and subsequent documentation of information without taking even a minute of clinical staff time. Patients could then review the information captured about them for accuracy before it was officially entered into their record. 

 

 

Ease the Documentation Burden on Clinicians 

 

We need to ease up on documentation requirements for clinical staff. The patient-centered machine capture solution mentioned above would help remove a lot of the documentation burden. The remaining documentation of the exam, differential diagnosis, and treatment plan could be better facilitated by free text, medical dictation solutions with natural language processing and coding technology on the back end. Nothing is more important that freeing our clinicians of the time currently being spent doing data entry.

 

 

Prohibit Templates, Cut and Paste

 

Templates simply don’t work because it is impossible to template the “patient story” and all of the other nuances of a good clinical exam. Likewise, cut and paste solutions are probably responsible for more medical misinformation and errors than anything else. EHRs should ban “cut and paste” capabilities altogether.

 

 

Share Information with Patients

 

At the end of the day, I believe all information in the medical record should be shared with the patient. The patient is an extra set of eyes, an extra check point if you will, against medical errors. Giving patients complete and full access to the information about them is not only a better way to engage patients in their care, but also a way to help make sure everyone is on the same page about their care. As eHealth advocates proclaim, “Nothing about me, without me!” I think this is sage advice for preventing misinformation and the introduction of errors in our medical records.

 

I would also be the first to admit that many, if not most of today’s electronic health record solutions are still too hard to use. They have been poorly designed in our attempt to replicate a clinical workflow previously based on paper records. As I have stated many times before, there is a unique opportunity to design solutions that really take full advantage of today’s technology

 

 

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Techniques For Matching Patient Record Data Across Disparate EHRs & Other Systems 

Techniques For Matching Patient Record Data Across Disparate EHRs & Other Systems  | EHR and Health IT Consulting | Scoop.it

Some of the most frequent questions I receive these days surround data interoperability and integrating multiple health IT systems. One of the biggest problems in connectivity is matching patient record data and ensuring that the same patient data in different systems is linked properly. Given how many times this topic comes up, I reached out to Cameron Thompson, Acxiom Healthcare Group Managing Director. Acxiom has an interesting method of patient data matching, called persistent links, and when I saw what they were doing for matching consumer records in non-healthcare settings (e.g. marketing) I thought some of you might want to learn about it. Here’s what Cameron had to say about the various techniques for matching patient data:

 

The promise of secure and seamless exchange of patient healthcare information is powerful. As payers, providers, Health Information Exchanges (HIXs) and Accountable Care Organizations (ACOs) move rapidly toward the full deployment of electronic medical records, healthcare IT professionals are grappling with a fragmented network of systems and data silos. These disparate systems and databases often house redundant copies of patient medical data in multiple formats, which limits the ability to see a true 360-degree view of the patient. The benefits from connected patient data are many, including:

 

  • Reductions in inaccurate coverage determinations.
  • Intelligent information sharing for clinical decision making.
  • Honoring patient consents and preferences consistently and accurately.
  • Minimizing risks of data breach with a unique health identifier that allows the transfer of patient information but NOT personally identifiable information such as name and address.
  • Reduction in time and effort in administrative processes including billing or claims inaccuracies.
  • Avoiding costly duplication or unnecessary testing.

 

To reduce these inefficiencies and solve the underlying problem, the new healthcare ecosystem needs an accurate means of identifying and matching patient record data to the correct individual across internal and external healthcare systems, including collaborative care delivery models.

 

Multiple systems across the healthcare enterprise produce duplicate patient records that are not easily recognizable as matches. Recognizing that Mary Jane Smith at 123 Elm Road in the 2009 clinical laboratory system is also Mary Collins of 78 Oak Street in the 2011 patient registration system is a challenge for any organization. Identifying a solid method for distinguishing patient information across multiple data systems and combining the data accurately will be pivotal to the effective adoption of Electronic Health Records (EHRs) and successful implementation of Health Information Exchange (HIE).

 

As organizations take on this challenge, several methods have been identified and considered to recognize an individual. Three leading methods can to be explored to achieve your business goals of continuity and cost reduction. These are:

 

1. Algorithm or String-Based Matching

 

An organization can develop an algorithm with string-based matching using identifiers in the existing data to uniquely identify individuals. The benefits of string-based matching include:

  • Recognizable practice – This is a well-known practice and resources capable of creating these programs are plentiful.
  • Options for processing – Algorithms can be created internally and run without sending data outside the organization or an external organization can be identified to conduct the match on the organization’s behalf.

Some of the challenges with this strategy include:

  • Inherent challenges in string-based matching – String-based matching relies on consistencies in reported names and addresses, which tend to change often.
  • Ensuring the accuracy of the data used in the algorithm – Manually entered names and addresses are often laden with inexactness. This makes string-based matching more difficult.
  • Absorbing the costs to develop and enable this identifier across systems – Costs would need to be incurred to develop, maintain and put the identifier into use across systems.

 

2. State-Issued Number

An organization can use another state-Issued number such as a state of issuance and birth certificate number. Benefits of this method include:

 

  • Development cost savings – using existing assigned identifiers would save costs on development of a new identifier.
  • Availability – an organization could select an identifier that is already available in many systems.

Some challenges with this strategy include:

  • Inconsistent data fields and record lengths – if state issued numbers are of different lengths this could create difficulty for the programmer creating the data field.
  • Protecting personal information from fraudsters – using a state-issued number could raise concern over identity theft with the proliferation of stolen Social Security numbers. Whether real or perceived, this information being made available opens the door for fraudsters to invade an individual’s privacy.

 

3. Persistent Links

Healthcare organizations should consider the use of highly accurate match technology that delivers knowledge-based persistent linking. This match technology delivers a set of persistent links a company uses to recognize their patients across a fragmented network of systems and data silos. Persistent Link match technology is regarded as the most precise match technology available to accurately resolve patient identity (such as AbiliTec, the linking technology offered by my company, Acxiom). The link provides a consistent, client-specific ID, across data variations, and it can be applied at all touch points and databases within an organization.

 

The use of persistent links, created from knowledge-based match technology, can provide:

 

  • More accurate patient recognition and identity resolution.
  • Greater control and governance around the patient data because each healthcare entity receives a dedicated set of encoded links, specific to their enterprise. This facilitates link transactions, minimizing the amount of personal identifiable information exchanged, aligning with the need for HIPAA compliance. Further, when multiple entities interact (e.g. an Accountable Care Organization between provider and payer) a unique link reconciliation can be processed by the provider in batch or real time.
  • A minimized amount of personal information that a healthcare entity needs to store as they use encoded links to integrate data and recognize patients.
  • Eliminate an upfront investment to develop and maintain identifiers. The first two options I mentioned – algorithms/string-based matching and state-issued numbers – require healthcare entities to develop and maintain the identifiers.
  • · Creation of a refresh cadence based on specific business needs, say monthly or quarterly, reducing non-matching exposure to the cadence latency.

 

There are also some challenges related to using persistent links:

  • Persistent link application and maintenance will be more costly and an organization needs to be willing to look at the investment in higher quality.
  • The healthcare organization needs to be willing and able to transmit records with personally identifiable information in a privacy compliant manner, such as encryption.

 

As healthcare organizations move forward by adopting technology to improve patient experience they will find that the accuracy of the data will drive their success. Organizations should consider each of these methods for recognizing patients, each have their benefits and select the method that best meets specific organizations needs.

 

 

Technical Dr. Inc.'s insight:

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

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