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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Points to Consider for EHR Optimization

Points to Consider for EHR Optimization | EHR and Health IT Consulting | Scoop.it

It is often said that implementing a new electronic health record (EHR) is just the beginning of a journey that will lead to better patient care, greater efficiencies and improved return on investment. It is true that the work will continue, so it is worth pondering how you will approach the post go-live world.  It’s not enough to install EHR software.  

 

It could be argued that tailoring the EHR to your organizational needs and implementing new functionality is where the real work lies.  This much is clear though, EHR optimization is vital to your organization’s successful long-term use of the EHR.  Below are some tips to help you think through the challenges ahead.

 

Plan Early


Start planning for how you will approach and manage your IT investments early.  Putting your plan together even before your implementation begins is not too soon.  Your plan should include an outline of what you will undertake during the implementation and what can wait, or should wait, until after the implementation phase is complete.  For example, it may make sense to wait and deploy some population health tools after go-live.

 

Tie Plans and Programs to Organizational Strategy


IT strategies should mirror the strategies of the organization.  For example, many organizations are actively exploring mergers and acquisitions.  IT leaders should understand the outlook for the organization and any challenges that lie ahead and have a plan to grow the IT environment appropriately when the EHR optimization phase begins.

 

Establish Strong Governance


Having a strong governance structure from the beginning is critical, but tweak the structure as needed during both implementation and post go-live phases.  The decisions that need to be made post go-live will likely be different from those made during the implementation phase.  Adjust the membership on the committee when needed to ensure that the proper stakeholders are represented and engaged.

 

Manage Change


Change management is a necessary activity throughout the implementation and as the EHR evolves post go-live.  Not only will the business practices and workflows change but people’s roles will change as well.  It is important to communicate early and often regarding changes so that employees understand the “why” of the change and “how” the change will affect them.

 

Standardize and Innovate


This topic may seem like an oxymoron – it is not.  Standardizing where it makes sense such as standardizing workflows, project management toolsets and methodologies, will allow for a stable environment post go-live. Stability lends itself to innovation because chaos is contained and a certain amount of predictability occurs.

 

This stability will allow creativity and innovation to thrive.  One area to pay close attention to is enterprise reporting.  Resist the temptation to merely recreate your current reports and instead approach report development and distribution as a way to improve operations and show off the power of your new system.

 

Contain Costs


Once the initial, and substantial, cost of implementation is behind you, the CFO and other executives will look for cost containment, even reductions.  Consider strategies to contain costs such as targeted outsourcing. Explore cost reduction strategies as well, such as consolidation and eliminating legacy systems as quickly as possible.

 

IT Shift


The IT staff will be exhausted after many months of intense pressure to get the system up and running smoothly.  The pressure will continue post go-live as EHR optimization becomes the focus.  Be sensitive to your staff’s needs, both inside and outside of IT, as they refresh and regroup.  Have a plan in place to maintain proper staffing as well as give your teams some much needed time away. 

 

HR departments can help with this plan. Also, added skills such as reporting and analytics, will be in higher demand during the EHR optimization phase as greater emphasis is placed on data and its value in improving patient care and operations.

 

Conversion and Archiving


Have a plan for the method and technology needed to convert data from your legacy systems to the new systems early on.  You need to specify the minimum data set that you will convert.  In addition, some departments, for example, Oncology, may have special conversion requirements.  

 

Also, figure out an archiving solution well ahead of time.  The archiving solution should account for easy access to the data that did not convert to the new system.

 

As with all EHR changes, proper guidance and preparation can be the difference between success and failure.  The outline above can get you started, but also consider outside resources such as those at Optimum Healthcare IT. Experts in the art of EHR Optimization bring insights that can only be gained through experience.

 
 

 

 

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

inquiry@technicaldr.com or 877-910-0004
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Speed Up Healthcare Practice Office Management Using an EHR Solution

Speed Up Healthcare Practice Office Management Using an EHR Solution | EHR and Health IT Consulting | Scoop.it

If it hasn’t happened already, your practice will probably be adopting an EHR system soon, due to the mandated HITECH Act of 2009. While this may seem daunting and laborious now, we promise there are many benefits to integrating an EHR-PM system -- it will prove to be a great decision that will boost patient satisfaction and your practice’s overall efficiency and interoperability. Here are 5 ways it will do just that:


          1.  Automatic Appointment Reminders

Office managers have a lot to do, that’s obvious, so placing calls to confirm appointments sometimes falls by the wayside. This tends to result in missed appointments and scheduling errors. EHR systems are the solution to this problem: Practices are now able to send automatic phone calls and auto-messages to patients’ phones. Plus, EHR systems allow you to easily send a text to your patient, enabling you to connect with your patients where they are in 2016: on their cell phones.


          2.  One Screen to Rule Them All

Gone are the days when office managers and doctors were inundated with organizing and systematizing thousands of patients’ confidential records. Today, EHR systems allow for all of a patient’s historical medical records to be easily navigable from one screen. Worried about form field restrictions? No problem -- User-friendly EHRs offer progress notes and freehand fields throughout, so you will always have the most prudent information right at your fingertips.


           3.  Automatic Claim Management

If there’s one vexation we’ve heard from doctors over and over again, it’s the constant headaches and lost revenue associated with poor claim management. The reality is, insurance companies don’t always make it easy to settle their claims. An integrated EHR system will speed up this process by leveraging Revenue Cycle Management to automatically scrub claims clean, so there’s less chasing down records and insurance policies for doctors and staff.


          4.  Integrated Clearinghouses

Once these claims are scrubbed clean, 99% of them can then be submitted to clearinghouses. Some EHR software comes standard with a fully integrated clearinghouse, making the claims process easier and faster than it’s ever been. According to the Centers for Medicare and Medicaid Services, 30% of claims are denied/ignored on the first submission to insurers and 60% of those are never resubmitted. An EHR system is a solution to this problem. The right one can increase your practice’s revenue, decrease time spent on resubmissions and save you countless headaches!


           5.  Patient Portal

The best EHR systems save office managers time by enabling patients to pay bills and securely communicate with their doctors from the comfort of their own homes, on the train or even from the waiting room. These cloud-based features will directly affect the patient-doctor relationship, resulting in more organized communication, higher retention rates, and happier patients! Thanks to this intuitive patient portal, patients will love the new accessibility of their doctors.

 

Of course, not every integrated EHR-PM system supports all of these features because not all EHR software is created equal. Practice EHR is perfectly priced and cost-efficient for practices of 1-3 doctors. It’s built by doctors for doctors, which makes it uniquely positioned to address all of the doctors and office manager’s day-to-day concerns.

 

Technical Dr. Inc.'s insight:
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Fix the EHR!

Fix the EHR! | EHR and Health IT Consulting | Scoop.it

After a blizzard of hype surrounding the electronic health record (EHR), health professionals are now in full backlash mode against this complex new tool. They are rightly seen as a major cause of professional burnout among physicians and nurses: Clinicians are spending almost half their professional time typing, clicking, and checking boxes on electronic records. They can and must be made into useful, easy-to-use tools that liberate, rather than oppress, clinicians.

 

Performing several tasks, badly. The EHR is a lot more than merely an electronic version of the patient’s chart. It has also become the control panel for managing the clinical encounter through clinician order entry. Moreover, through billing and regulatory compliance, it has also become a focal point of quality-improvement efforts. While some of these efforts actually have improved quality and patient safety, many others served merely to “buff up the note” to make the clinician look good on “process” measures, and simply maximize billing.

 

Mashing up all these functions — charting, clinical ordering, billing/compliance and quality improvement — inside the EHR has been a disaster for the clinical user, in large part because the billing/compliance function has dominated. The pressure from angry physician users has produced a medieval solution: Hospital and clinics have hired tens of thousands of scribes literally to follow clinicians around and record their notes and orders into the EHR. Only in health care, it seems, could we find a way to “automate” that ended up adding staff and costs!

 

As bad as the regulatory and documentation requirements are, they are not the largest problem. The electronic system's hospitals have adopted at huge expense are fronted by user interfaces out of the mid-1990s: Windows 95-style screens and drop-down menus, data input by typing and navigation by point and click. These antiquated user interfaces are astonishingly difficult to navigate. Clinical information vital for care decisions is sometimes entombed dozens of clicks beneath the user-facing pages of the patient’s chart.

 

Paint a picture of the patient. For EHRs to become truly useful tools and liberate clinicians from the busywork, a revolution in usability is required. Care of the patient must become the EHR’s central function. At its center should be a portrait of the patient’s medical situation at the moment, including the diagnosis, major clinical risks and trajectory, and the specific problems the clinical team must resolve. This “uber-assessment” should be written in plain English and have a discrete character limit like those imposed by Twitter, forcing clinicians to tighten their assessment.

 

The patient portrait should be updated frequently, such as at a change in clinical shifts. Decision rules determining precisely who has responsibility for painting this portrait will be essential. In the inpatient setting, the main author may be a hospitalist, primary surgeon, or senior resident. In the outpatient setting, it’s likely to be the primary care physician or non-physician provider. While one individual should take the lead, this assessment should be curated collaboratively, a la Wikipedia.

 

This clinical portrait must become the rallying point of the team caring for the patient. To accomplish this, the EHR needs to become “groupware” for the clinical team, enabling continuous communication among team members. The patient portrait should function as the “wall” on which team members add their own observations of changes in the patient’s condition, actions they have taken, and questions they are trying to address. This group effort should convey an accurate picture (portrait plus updates) for new clinicians starting their shifts or joining the team as consultants.

 

The tests, medications or procedures ordered, and test results and monitoring system readings should all be added (automatically) to the patient’s chart. But here, too, a major redesign is needed. In reimagining the patient’s chart, we need to modify today’s importing function, which encourages users indiscriminately to overwhelm the clinical narrative with mountains of extraneous data. The minute-by-minute team comments on the wall should erase within a day or two, like images in SnapChat, and not enter and complicate the permanent record.

 

Typing and point and click must go. Voice and gesture-based interfaces must replace the unsanitary and clunky keyboard and mouse as the method of building and be interacting with the record. Both documenting the clinical encounter and ordering should be done by voice command, confirmed by screen touch. Orders should display both the major risks and cost of the tests or procedures ordered before the order can be confirmed. Several companies, including Google and Microsoft, are already piloting “digital” scribes that convert the core conversation between doctor and patient into a digital clinical note.

 

Moreover, interactive data visualization must replace the time-wasting click storm presently required to unearth patient data. Results of voice searches of the patient’s record should be available for display in the nursing station and the physicians’ ready room. It should also be presentable to patients on interactive whiteboards in patient rooms. Physicians should be able to say things like: “Show me Jeff’s glucose and creatinine values graphed back to the beginning of this hospital stay” or “Show me all of Bob’s abdominal CT scans performed pre- and postoperatively.” The physician should also be able to prescribe by voice command everything from a new medication to a programmed reminder to be delivered to the patient’s iPhone at regular intervals.

 

Population health data and research findings should also be available by voice command. For example, a doctor should be able to say: “Show me all the published data on the side-effect risks associated with use of pembrolizumab in lung cancer patients, ranked from highest to lowest,” or “Show me the prevalence of postoperative complications by type of complication in the past thousand patients who have had knee replacements in our health system, stratified by patient age.”

 

AI must make the clinical system smarter. EHRs already have rudimentary artificial intelligence (AI) systems to help with billing, coding, and regulatory compliance. But the primitive state of AI in EHRs is a major barrier to effective care. Clinical record systems must become a lot smarter if clinical care is to predominate, in particular by reducing needless and duplicative documentation requirements. Revisiting Medicare payment policy, beginning with the absurdly detailed data requirements for Evaluation and Management visits (E&M), would be a great place to start.

 

The patient’s role should also be enhanced by the EHR and associated tools. Patients should be able to enter their history, medications, and family history remotely, reducing demands on the care team and its supporting cast. Patient data should also flow automatically from clinical laboratories, as well as data from instrumentation attached to the patient, directly to the record, without the need for human data entry.

 

Of course, a new clinical workflow will be needed to curate all of this patient-generated data and respond accordingly. It cannot be permitted to clutter the wall or be “mainlined” to the primary clinical team; rather, it must be prioritized according to patient risk/benefit and delivered via a workflow designed expressly for this purpose. AI algorithms must also be used to scrape from the EHR the information needed to assign acuity scores and suggest diagnoses that accurately reflect the patient’s current state.

 

Given how today’s clinical alert systems inundate frontline caregivers, it is unsurprising that most alerts are ignored. It is crucial that the EHR be able to prioritize alerts that address only immediate threats to the patient’s health in real time. Health care can learn a lot from the sensible rigor and discipline of the alert process in the airline cockpit. Clinical alerts should be presented in an easy-to-read, hard-to-ignore color-coded format. Similarly, hard stops — system-driven halts in medication or other therapies — must be intelligent; that is, they must be related to the present reality of the patient’s condition and limited to clinical actions that truly threaten the health or life of the patient.

 

From prisoners to advocates. The failure of EHRs thus far to achieve the goals of improving healthcare productivity, outcomes, and clinician satisfaction is the result both of immature technology and the failure of their architects to fully respect the complexity of converting the massive health care system from one way of doing work to another. Today, one can see a path to turning the EHR into a well-designed and useful partner to clinicians and patients in the care process. To do this, we must use AI, vastly improved data visualization, and modern interface design to improve usability. When this has been accomplished, we believe that clinicians will be converted from surly prisoners of poorly realized technology to advocates of the systems themselves and enthusiastic leaders of efforts to further improve them.

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

Electronic Health Records Consulting  | EHR and Health IT Consulting | Scoop.it

For most health systems, investment in an electronic health record (EHR) is inevitable—and possibly one of the largest expenditures they will make. To achieve the clinical, financial, and operational return on investment, you need to be strategic in your selection, implementation, and utilization.

 

Why the EHR life cycle is just like raising a child 

 

No matter where you are in your journey, our services are designed to produce results that improve efficiency, effectiveness, and quality of health care for patients.

 

Our clinically-experienced IT consultants can support you through the entire EHR lifecycle, including:

 

  • Implementation strategy and planning: We guide clients through everything that goes on behind the scenes before the “go-live,” including a full assessment of current capabilities and workflows to determine what functionalities to look for in an EHR. From there, we lead the selection process for new EHR platforms by vetting qualified vendor options, identifying the initial vendor selection pool, orchestrating product demonstrations, and assisting in the negotiation process.

 

  • Go-live: To increase the usability of the EHR, we give clinicians the ability to learn about and personalize the technology before the go-live date, with items such as common procedures or prescriptions. Once we launch, we provide around-the-clock project management at every level and work to address any challenges that may come up during the process. 

 

  • Optimization: Whether after the “go-live” or as a standalone engagement, we work to develop strategies that optimize the EHR’s capabilities and produce results that drive value and profitability in the healthcare delivery model. We often optimize EHR platforms for:
    • HCC Capture
    • Medicare Annual Wellness Visit
    • Evidence-Based Guidance

 

  • Meaningful use attestation: Attesting meaningful use requires effort from many directions—from navigating regulatory changes to overcoming operational challenges. We take some of these tasks off clients’ plates by tracking federal updates, sending actionable alerts, and validating every aspect of the attestation plan. 

 

  • Life sciences support: To support customers and grow health system partnerships, life sciences firms are leveraging EHR strategies that align with industry trends and consumer priorities. Our experts help these firms determine high-yield, value-add strategy for implementing health IT resources into the EHR. 

 

And while we use these processes to guide our clients through the EHR lifecycle, we also support any IT platform using similar methodologies.

Technical Dr. Inc.'s insight:
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Reduce the Pain of Switching EHR Software with These Four Steps

Reduce the Pain of Switching EHR Software with These Four Steps | EHR and Health IT Consulting | Scoop.it

There are days when you have to face that monster behind the screen. EHR replacement can be a significant challenge for any healthcare executive or IT administrator. The reasons vary—from performance issues to software being discontinued by the vendor.

 

Seeking the right EMR software solution to overcome these problems is becoming more difficult as companies innovate and evolve to meet the demands of an increasingly complex healthcare environment. The whirlwind of options can be confusing as you seek the best EHR software to improve physician productivity, financial outcomes, and patient satisfaction.The following tips will help you find the solution you need to achieve your organization’s goals.

Start your search for a new EHR vendor with these steps

Here are the top recommendations for choosing an EHR vendor to make this change something you only have to do once.

Step 1: Develop a Request for Proposal (RFP)

An RFP allows you to compare potential partners. It provides a framework for providing detailed information about your practice and listing specific requirements. It’s well worth the effort in making sure prospective vendors have guidelines to prepare a proposal that clearly addresses your needs.

Step 2: Give them a wish list

A wish list of key features, functions, and reporting needs gives prospective vendors a full picture of what you expect from a partner. When they respond, you’ll have a better understanding of how their services will fulfill your goals.

Step 3: Research, research, and more research

Go online to read blogs, customer comments, and third-party review sites. Talk with your clinicians and staff to get more details about what works and doesn’t work with the current EHR system. Reach out to peers in professional organizations to learn more from their experiences.

Step 4: Go beyond the sales pitch and get to know the vendor

An EHR solution goes beyond the software. EHR replacement involves the personalities that you’ll be working with on a regular basis. You need to take time to get to know the vendors and make sure they’ll be a good fit for your practice.

Have questions ready

Similar to how a business develops interview questions for to ask a candidate for an important position, your practice needs to prepare a list of specific questions for your potential EHR partner. Here are a few questions to consider:

  • Does the EHR provide robust, specialty content out of the box?
  • Will the partner be able to meet the demands as my practice grows?
  • Does the EHR vendor offer the full end-to-end solution from when the patient arrives to when the payment is collected?
  • Does the EHR vendor ensure a true continuum of care?

A partnership built on trust every step of the way

Switching to the right EHR software to yield better results requires a partner you can trust. Managing the complexity and difficulty in keeping up with workflow demand is possible with a partner who will be there every step of the way. It’s essential that they share the same amount of passion and commitment you have in serving your clinicians, staff, and patients.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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5 EHR Features For Optimizing Efficiency In Your Urgent Care Clinic

5 EHR Features For Optimizing Efficiency In Your Urgent Care Clinic | EHR and Health IT Consulting | Scoop.it

The urgent care market is booming. There’s a steady increase in demand for convenient healthcare, and as a result, more patients are turning to urgent care clinics (UCCs) for their needs. With an increasing demand for care, it’s important for UCCs to operate efficiently to meet the needs of their patients and stay competitive.

 

Taking a look at your electronic health record (EHR) is a simple step in understanding how to optimize efficiency in your urgent care clinic. Does your EHR possess a simple and intuitive workflow? Above all, your EHR should support care delivery, not hinder the process. In addition, your EHR can help you uncover inefficiencies within your clinic and how to improve them.

 

Here are five EHR features every urgent care clinic can leverage to improve efficiency:

 

  1. Patient Kiosk

A strong check-in process is vital to running a successful urgent care clinic. A patient kiosk is a great tool for urgent care clinics and patients, ensuring efficient and streamlined check-in processes as well as improved patient experience. Instead of filling out paperwork upon arrival, patients can enjoy a self-service check-in system to provide important information, like demographics, family history and more. All of the information collected is integrated into the EHR and readily available for the physician’s review. The kiosk eliminates the need for paper forms and inefficiencies that come with it, improving check-in processes that result in benefits for patients, physicians, and staff.

 

  1. Electronic ID Scanning

Electronic ID scanning is another great EHR feature that improves the patient check-in process, by capturing insurance and driver's license information quickly and accurately. A patient’s card is placed in the scanner for front and back extraction of information. The collected data is then integrated into the EHR, eliminating the need for multiple data entries and potential errors that impact efficiency in UCCs.

 

  1. Document Management

An organized EHR is vital to running an urgent care clinic like a well-oiled machine. Your EHR should provide comprehensive document management capabilities to help you keep patient files secure, organized and easily accessible. A good EHR will have a simple document management system designed to make it easy for healthcare providers to find the information they need, at the right time. Unlimited cloud storage, as well as the ability to integrate and extract scans, faxes and other paperwork electronically, will help save your clinic valuable time and money.

 

  1. E-Prescribing

Given the competitive nature of the urgent care market, it is highly important for the entire patient visit to run as smoothly as possible, including prescribing medications. With electronic prescribing (e-prescribing), physicians can prescribe and send a prescription from within their EHR, maximizing efficiency, security and patient safety. E-prescribing also makes it easier for patients to receive their medications, improving patient experience and medication adherence.

 

  1. Integrated Billing

An integrated billing system is essential to optimizing your urgent care clinic and your bottom line. A good billing system should: automate administratively and claim management tasks; simplify insurance verification and eligibility checks; allow you to bill directly from your EHR. A billing system including all of these features will promote better billing processes, allowing UCCs to get reimbursed accurately and quickly for the care provided.

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From EHR to Paper to EHR .. to Paper??

From EHR to Paper to EHR .. to Paper?? | EHR and Health IT Consulting | Scoop.it

I can’t help myself from telling patients how things really work in health care. But I feel they have a right to know.

When I see new patients their jaw usually drops when I sit down with them next to the computer with a stack of papers held together with a rubber band or a gigantic clamp and with yellow sticky notes protruding here and there with words like a LAB, ER, and X-RAY.

 

Patients always assume that medical records transfer seamlessly between practices. They don’t, even between clinics that use the same EMR vendor. The stack of papers gets scanned in, as images or PDFs, but they don’t appear in the searchable, tabular or report-compatible form. Often, they don’t each get labeled, but are clumped together under headings like “Radiology 2010-2017”.

 

In one of the clinics I work in, a Registered Nurse enters patients’ medical history in the EMR before each new patient’s first appointment. In the other, it is my job. In both cases, only a fraction of he information is usually carried over from one EMR to the other, and the patient’s life story risks getting diluted, even distorted.

 

It doesn’t take much imagination to understand why things work this way:

 

Once upon a time, the Rulers of a great country handed out money to all the medicine men so they could start using computers to document what they did (and what they charged for, which was the real reason the Rulers handed out money the way they did).

 

This was a gift, not only to the medicine men but also to a lot of computer companies, who quickly geared up and made EMRs that the medicine men needed to buy before the deadline the Rulers had imposed.

 

Soon the medicine men gave all their newfound money to the computer makers. One of the things they thought they remembered hearing about was “interoperability”, but the computer makers were no fools. By making it just about impossible to transfer data between EMRs, the computer companies figured they could keep their respective customer's hostage because no matter how much they hated the slapped-together systems, it would be too costly to start over with another system.

 

Eventually, each vendor secretly hoped they would end up with the most users and thereby becoming the industry standard when the medicine men and the Rulers caught on to the lack of interoperability.

 

That, I explain to those of my patients who were around for it, is like the early days of VCRs – Betamax or VHS – more than 100 times over or, think about it, 100 times worse.

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