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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A prescription for EHRs and patient engagement 

A prescription for EHRs and patient engagement  | EHR and Health IT Consulting | Scoop.it

Most physician practices and hospitals in the U.S. have installed electronic health records. In a classic Field of Dreams scenario, we have made patients’ medical records digital, but people aren’t asking for them or accessing them en masse.

 

“How do we make it easier for patients to request and manage their own data?” asks a report from the Office of the National Coordinator for Healthcare IT-Improving the Health Records Request Process for Patients – Highlights from User Experience Research.

 

The ONC has been responsible for implementing the HITECH Act’s provisions, ensuring that healthcare providers have met meaningful use criteria for implementing EHRs, and then receiving the financial incentives embedded in the Act for meeting those provisions.

 

Now that the majority of healthcare providers in the U.S. have indeed purchased and implemented EHRs, it remains for patients, health consumers, and caregivers to take advantage of them. In my post on the EHR Field of Dreams effect, I highlighted research from the U.S. General Accountability Office that explored the question of how the Department of Health and Human Services should assess the effectiveness of efforts to enhance patient access to EHRs.

 

The ONC team conducted in-depth interviews with 17 patients to understand their health IT personae and personal workflows for accessing their personal medical records. The research also considered medical record release forms and information for 50 large U.S. health systems and hospitals, and interviewed “insiders” – healthcare stakeholders inside and outside of ONC – to assess how patients request access to medical records data and look for solutions to improve that process.

 

Why is it so important for people to access their medical records? By doing so, patients and caregivers can better manage and control their health and well-being, ONC notes, by preventing repeat tests, managing clinical numbers (like blood pressure for heart or glucose for diabetes), and sharing decision-making with doctors and other clinicians – together, the process of patient and health engagement, which boosts health outcomes for individuals and populations.

 

The general process of a patient requesting their health data works like this, illustrated by the patient journey of Melissa and Ava Crawford, a mother and toddler daughter portrayed in the ONC report:

  • A patient/consumer makes an initial inquiry
  • The consumer requests the records, which can be done via a paper authorization form (that is then completed and either mailed or faxed to a provider) or sent online via the portal. Sometimes a consumer must write a letter to request the provider.
  • The consumer waits for a response, which ONC calls “a bit of a black hole for consumers.” This can be as long as 30 days under the HIPAA law.
  • The health system receives and verifies the request, then verifies the patient identify and address.
  • Health systems then fulfill the records request, often a printed copy of the medical record that can be faxed or mailed, PDF files, or a computer disk – CD.

 

ONC conducted research into the consumer journey through this process to identify opportunities to improve the patient experience of requesting and receiving personal health information.

 

Health Populi’s Hot Points: Most Americans see their doctors entering medical information electronically, and most people say accessing all kinds of medical information is important, the Kaiser Family Foundation learned in a health tracking poll conducted in August 2016. However, there are big gaps in the information available to U.S. patients online, such as prescription drug histories and lab results – two very popularly demanded information categories. And through the consumer-patient demand lens, 1 in 2 U.S. adults said they had no need to access their health information online, as the chart from the KFF poll attests.

 

How to bridge the chasm between self-health IT, providers, and patients? The most effective patient engagement technologies are biometric measurement devices like WiFi scales and glucometers, apps, texting, and wearables – with portals ranking last – according to physicians and clinical leaders polled in a New England Journal of Medicine (NEJM) survey published earlier this month.

 

The top benefit of engaging patients with these technologies is to support people in their efforts to be healthy and to provide input to providers on how patients are doing when not in the clinic, this research found.

 

My friend and collaborator Michael Millenson wrote in the BMJ in July about patient-centered care no longer being “enough.” In this era of technology-enabled healthcare, and rising consumerism among patients, three core principles must underpin the relationship between patient and provider:

  • Shared information
  • Shared engagement
  • Shared accountability.

 

Michael quotes Jay Katz from his book, The Silent World of Doctor and Patient, who talked 35 years ago about the concept of “caring custody.” Jay explained this as, “the idea of physicians’ Aesculapian authority over patients'” being replaced with “mutual trust.”

 

It is not enough to build and offer a technology “meant” for patients and people to use for their health and healthcare. Trust underpins all health engagement and must be designed and “baked” into the offering. Today, that trust is built as much on consumer retail experience (the last-best experience someone has had in their daily life, exemplified at this moment by Amazon) as in a new social health contract between providers and patients.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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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.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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Why does EHR customization Matter?

Why does EHR customization Matter? | EHR and Health IT Consulting | Scoop.it

Electronic health records shouldn’t be frustrating. However, many providers are finding themselves disappointed or aggravated by EHR systems that don’t provide the tools they need to support the very best care for their patients.

In fact, the American Academy of Family Physicians has noted a 30 percent decrease in physician satisfaction with EHRs within the past five years. Reasons for this dissatisfaction include inefficient systems, deluges of tools that don’t apply to their practice or even generic modules that lead to inaccurate documentation.

Fortunately, customization presents a key solution to these issues and much more.

 

Your Practice, Your EHR

Every practice is unique, and this should be reflected in each health records system. An EHR system for a small practice will need to operate differently than that of a large practice. Layouts, prescriptions, scheduling, patient education, and countless other EHR tools should reflect the needs of providers and their patients. Customized EHR systems impact not only the efficiency of providers and their staff but also the experiences and health outcomes of patients.

 

The Impact of EHR Customization

Tailoring electronic health records to the unique needs of an individual medical practice impacts all parties involved, from the physicians and their staff, to administrators, to patients. For physicians, EHR customization can result in improved specificity and accuracy of data, whether with a patient or reviewing records outside the exam room.

EHR customization examples can include setting dosage parameters, accommodating in-house test results, or even modifications to make the system mimic familiar and intuitive paper charts.

A system that is carefully tuned to the needs of a specific practice is far more efficient for users, and saves time for both providers and patients alike. And those specific needs are naturally different across varying specialities. An ophthalmology practice, for example, would likely benefit from a very different EHR layout than a physical therapy practice or an urgent care clinic.

Not only can the speed and ease of utility improve with the adoption of a customized EHR, but also the quality of that data and accuracy of the information. A 2006 study illustrated that after customizing EHRs, more than 50% of surveyed practices reported improved accuracy and quality of records. More accurate records and data means better patient care and ultimately better health outcomes.

 

Configuring the Best EHR

Determining the configuration of a system to maximize its usefulness and alignment with best practices requires careful planning. Resources who can help a medical practice ideally customize their systems include EHR vendors and third-party consulting firms, and of course, in-house experts such as providers and administrators who understand the practice’s needs and challenges best.

Customization of an EHR system is an effective method of improving practice efficiency, accuracy, and communication for a medical practice.

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

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

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