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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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How To Choose the Right EHR for Your Practice

How To Choose the Right EHR for Your Practice | EHR and Health IT Consulting | Scoop.it

It takes time, dedication and the right technology to run a successful medical practice in today’s healthcare industry. Implementing an electronic health record (EHR) has become essential in order for medical practices to grow their practice and provide a better care experience for their patients.

 

EHRs are given a bad reputation, but not all EHRs are created equal. With the right platform, medical practices can offer better, more efficient, patient-centered care and run a successful practice.

 

It takes time to research and compare what each platform brings to the table. However, there are ways to narrow down your selection to ensure you find one that is the right fit. Here are a few things to consider when selecting the right EHR for your practice.

 

Cost

There’s a variety of price points for EHRs that vary based on what features you choose to include, the vendor you select, and how many providers are in your practice. Not all vendors are transparent about fees, so it’s important to get specific about what’s included in the price and what’s an additional cost. It’s ok if you don’t have a huge budget, there are EHRs on the market that provide a comprehensive platform for an affordable price.

 

Meaningful Use Certification

Ensure that your EHR is Meaningful Use (MU) 2015 edition certified so that you can qualify to participate in the MU Incentive program. Ask vendors about their certification and how the software supports your practice in meeting program requirements. You can also check certification status here.

 

Cloud-Based Accessibility

Your EHR should be cloud-based and provide access to an iPad friendly application. Unlike server-based systems, cloud-based EHRs do not require any hardware installation, maintenance, software licensing or IT staff, making them much more affordable and easily scalable for practice growth.

 

Workflow

Perhaps one of the most important aspects of an EHR is workflow; a good workflow is key to practice efficiency. Look for an EHR with a simple workflow that your entire staff finds easy to use and clinical content created specifically for your specialty.

 

Patient Engagement Tools

An EHR should provide you tools to help you easily engage and interact with patients to improve the patient experience. A good EHR will include tools like a user-friendly patient portal and a kiosk, where patients can check in and fill out forms from an iPad.

 

Automation

A platform with built in automation will help your practice save time on tasks, such as appointment reminders, medication refills, and more. For instance, with voice recognition physicians can complete notes by voice. In addition, your front desk staff will love automated eligibility verification, which pulls a patient’s insurance status 24 hours before an appointment.

 

Selecting an electronic health record (EHR) platform is an important decision for your practice that can impact patient care, practice operations and practice financials. Practices should take the time to review the software in detail to find one that’s the right fit. Cost, meaningful use, mobile accessibility, workflow, patient engagement and automation are all important factors to consider. In addition, make sure to evaluate the EHR based on factors that are specifically important to your practice. By taking these steps, you’ll be sure to find an EHR that meets (or hopefully exceeds) your expectations.

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6 Advantages of Using a Cloud-Based EHR

6 Advantages of Using a Cloud-Based EHR | EHR and Health IT Consulting | Scoop.it

Healthcare has shifted certain operations to be cloud-based so that patients can be provided with both the best and most convenient delivery of healthcare services. One prominent advancement is the advent of cloud-based EHRs (Electronic Health Records). With cloud-based Electronic Health Records, practices have boosted their operational efficiency while patients have increased confidence about the accuracy and safety of their clinical information. These records offer a wide array of features that facilitate the handling of clinical data and ease the lengthy and cumbersome documentation process, which improves the patient management process. The following six points summarize the advantages of cloud-based EHRs:

Cloud-Based EHR Software Advantages

  1. Enhanced Accuracy and Accessibility of Data

Cloud-based EHRs have the primary objective of making patient medical data available to the patient and providers 24-7. These records can be accessed on-the-go by way of any smart device. And, all of the information contained in these records is accurate, complete, and all-encompassing, which enables providers to determine the most appropriate diagnosis for future ailments and prescribe effective medication with a reduced chance of error.

 

  1. Networking Opportunities

Cloud-based EHRs have features that allow patients and providers to have a constant and uninterrupted stream of contact between them. Providers can view their scheduled appointments in there and they will also be updated about the date and time of upcoming appointments. If providers want more information about the patient, it can be obtained by simply clicking over the patient’s name. Additionally, patients can be reminded automatically by phone or email about their appointments with their doctors as well. With cloud-based EHRs software, as a provider, you can stay connected to all the pharmacies, labs, and clinics your practice might be affiliated with, thereby enhancing your network, too.

 

  1. Cost-Efficient Data Management

Cloud-based EHRs make thorough and accurate documentation possible. You get to avoid stacks of papers yet have the ability to create useful formal reports out of the data stored in the EHR. You will also notice a reduction in the number of redundant or duplicate tests once you adopt these cloud-based EHRs. They have all the ICD and CPT codes integrated to help the providers reach the most suitable diagnosis and treatment in the quickest amount of time possible. These codes make the insurance claims more specific and clear, hence easing the billing process. And, with comprehensive and carefully filed insurance claims, you’ll lessen the chances of denial or rejection. With that, cloud-based EHRs considerably reduce the associated costs of data management.

 

  1. Increased Efficiency and Productivity

Prior to the introduction of cloud-based EHRs, providers worldwide spent a lot of time sifting through documents and finding relevant data for delivering quality patient care. There used to be room for unexpected errors which negatively impacted the quality of medical services and also caused delays. Cloud-based EHRs have helped to increase efficiency, and make it easier for providers to achieve maximum productivity throughout the workday.

 

  1. Information Security

Cloud-based EHRs software store data on external servers which makes it accessible by way of any internet-enabled device. The software as a service (SAAS) provider maintains the system so the provider does not have to worry about the installation cost or ongoing maintenance hassles. Patient’s data security on cloud-based EHRs is a shared responsibility of both the SAAS provider and the physician. All the patient information in cloud-based EHRs is considered electronic protected health information (ePHI) and it is fully covered under strict regulations of the HIPAA act. Cloud-based EHRs heavily safeguard this sensitive information while ensuring easy access for authorized persons.

 

  1. Participation in Quality Programs

Most of the cloud-based EHRs nowadays are put together with strict adherence to quality standards. These and other features make cloud-based EHRs part of the Meaningful Use Program and other quality programs ensuring that patients and providers get the optimum healthcare experience. These programs enable the electronic prompts that make sure all the required information is entered into the EHR, and when required. These records can also help the data analysts figure out the population-related trends from the dataset and improve the healthcare policies, especially for different social segments.

Tagged Cloud-based EHR
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4 Key Considerations for Analysts When Implementing an EHR 

4 Key Considerations for Analysts When Implementing an EHR  | EHR and Health IT Consulting | Scoop.it

Implementing a new EHR system requires a great deal of collaboration between clinical and technical teams. Analyzing the legacy system and operational workflows, then successfully recreating—or better yet, improving—this experience in a new EHR takes finesse.

 

The foundation of every successful EHR and other large-scale implementation is a team of analysts who are knowledgeable, engaged and passionate about their work. From groundwork and discovery to build, acceptance testing and go-live support, analysts do it all. Here are four key considerations for analysts to keep in mind to help ensure their projects go well and they continue to thrive in their roles.

 

1 – Start with the end goal in mind.

When gathering requirements, project teams will often start by walking through every workflow in the legacy system with end users. This can be a long process, and can lead to a lot of information gathering that is ultimately unnecessary. A better approach is to start at the end and work backwards. Ask users why they complete these workflows and what the expected outcome is. This will help get to the root of the requirements, and allow analysts to immediately begin thinking in terms of the new EHR.

 

Here are several questions analysts can ask when gathering requirements:

  • What is the end goal or objective?
  • Why have you traditionally done it this way?
  • What would improve the process?
  • What is the clinical rationale for this workflow?

 

By starting at the end and asking users why they do what they do and what outcome they are hoping to achieve, analysts can more effectively and efficiently build a system that meets the needs of users.

 

2 – Be aware of the functional limitations of legacy systems.

A key point that is sometimes overlooked is that EHR workflows are often defined by—and limited by—the functionality of the EHR itself. Users will default to what they are familiar with, so if a certain workflow is used frequently in the legacy system, they will assume it is required in the new one. Some workflows may not be needed, however, because the new EHR is designed to achieve the objective in a different, more efficient way. If analysts do not understand this, they risk building in features that are counterproductive, or not needed at all in the new system.

 

For example, in her current workflow, a clinic manager needs to generate and print a report of all the assessments completed in the office each day. During requirements gathering, she may feel this is an important step to replicate in the new EHR. As it turns out, this workflow is a result of poor auditing functionality in the legacy system – to keep proper records, the clinic manager is required to generate and print these reports. Improved auditing functionality in the new EHR eliminates the need for the daily assessment report and makes this workflow unnecessary.

 

3 – Communication is key.

One of the most important things an analyst can do is to effectively translate the clinical and business needs of end users into technical requirements for the new EHR system. They must also communicate future-state workflows in a way end users can understand and relate to. Communicating effectively is vital to project success.

 

EHR transitions are often intimidating and frightening for users who have established a comfort level with the legacy system, and likely had little input in the decision to change platforms. Analysts can begin to alleviate concerns and increase user adoption by putting together a few “quick wins.” A quick win is when an analyst identifies a piece of functionality that is very important to users, but is also easy to build and demonstrate in the new EHR. Quick wins communicate to users the team is not only listening to their needs, but can also deliver solutions quickly and effectively. This also increases confidence, workgroup participation, and communication response time with users and stakeholders, all of which contribute to project success.

 

4 – Strike a balance between functionality and maintainability.

Enterprise EHR systems are complex and, depending on the size and diversity of the user base, may require a team of several hundred application analysts to maintain. In addition, it’s important to remember that every clinical user in a health system is depending on the EHR to complete their documentation and deliver the highest quality of care to patients. Because of this, it is important to strike a balance between functionality and maintainability.

 

If the project team attempts to build in every piece of functionality requested by end users, including things that are nice to have but not critical for the system to function, the EHR will become unwieldy and difficult to maintain. Future updates by the EHR vendor will likely break any customizations, cause unnecessary downtime, and push the volume of help desk requests beyond what the business can support.

 

In contrast, if the project team oversimplifies and standardizes too much, they risk building a system that does not meet the core requirements of end users. When users can’t leverage the system the way they need, they find “creative” approaches that don’t always work, or simply don’t document everything needed. This can lead to a host of problems such as violating operational policy, regulatory reporting issues, loss of revenue due to incorrect documentation, HIPAA violations and, ultimately, lower quality of care for patients. A well-balanced system will keep the support team busy but not overwhelmed, include all required functionality as well as some quality of life features and allow clinicians to be at their best with patients.

 

In summary, by keeping workflow objectives in mind, understanding legacy system limitations, communicating effectively and balancing functionality and maintainability, analysts demonstrate the value of their critical role in EHR implementation success.

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Making the Case for Patient-Generated EHR Data - Healthcare IT Consulting

Making the Case for Patient-Generated EHR Data - Healthcare IT Consulting | EHR and Health IT Consulting | Scoop.it

The proliferation of wearable and mobile health devices from Fitbit, Apple Health, Google Fit, Nokia Health/Withings and others is bringing patient-generated data into the digital health fold. Health-savvy patients amassing this information are increasingly looking for ways to share the data with their providers.

 

Epic is one Electronic Health Record (EHR) vendor looking to bridge the gap between patients’ device app data and the patient health record. Patients can integrate data tracked on Apple iPhone devices into Epic’s MyChart patient portal; with an active MyChart account, patients can sync data such as weight, steps, pulse, blood pressure, and more back to the EHR for providers to review.

 

For example, let’s say I am a patient with hypertension and I’m on a new medication. I’m interested in monitoring how that medication impacts my health over the next month. Epic’s Apple integration enables me to track my vital signs daily for a month and share that information with my provider without the requirement of an in-office visit or sending the information via fax or postal mail. The data captured via my smartphone will already be with my provider by the time I have my next follow-up visit.

 

The Benefits of a Patient-Generated Data Strategy

Technology that supports bringing patient-sourced data into healthcare assessments poses benefits to both providers and patients. Providers can more easily track and monitor patients between visits. This offers clinicians a fuller picture of a patient’s health beyond lab results, problem lists, allergies, and medications. Patient lifestyle data beyond the walls of institutionalized care can reveal where patients are doing well and where there is room for improvement.

 

Patient involvement in personal health monitoring between visits promotes patient accountability in reaching health goals. If I’m an overweight patient with a weight reduction goal, for example, my doctor can recommend I use a Fitbit that allows me to track step data. I can routinely review that data and provide feedback to my provider with real-time updates on whether I’m reaching my daily goals or not.

 

Wearables and personal tracking devices drive patient accountability with empirical data that is captured automatically. Patients become more active participants in their health and in the creation of their health record.

 

Both patients and providers benefit from improved access to quantifiable health information. Shared visibility into patient health trends over time improves patient access and engagement, mitigates trust issues, and strengthens the patient/provider relationship.

 

Considerations When Integrating Patient-Generated Data

hile the integration of patient-sourced data into EHRs poses clear patient engagement and accountability wins, implementing this exchange of information does come with unique challenges. Here are a few key considerations healthcare organizations need to address along their journey.

 

Patient awareness. Promoting the availability of device data integration is key to usage. To build awareness some healthcare organizations may set up “health bars” in waiting rooms or lobbies to offer patients a tangible experience of offerings. These health bars typically feature devices like iPads, iPhones, and Fitbits with information on the various integration points available to patients.

 

Patient technical aptitude. Another hurdle healthcare organizations may face when rolling out device data integration is patient technical aptitude. Support teams dedicated to helping less tech-savvy patients successfully sync devices can help drive adoption.

 

Provider adoption. Driving provider awareness and adoption of device data integration is another challenge healthcare organizations may need to tackle. Clinicians need to be aware of the offering, how to make it available to their patients, and how to use the information when received. Educating providers on the how, what and why through tip sheets, medical staff meetings, and other venues is essential.

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Physician viewpoint on How to remove 'stupid stuff' from EHRs 

Physician viewpoint on How to remove 'stupid stuff' from EHRs  | EHR and Health IT Consulting | Scoop.it

It's time to cut unnecessary work from the EHR, according to a perspective in The New England Journal of Medicine by Melinda Ashton, MD, a physician with Hawaii Pacific Health in Honolulu.

 

In the article, Dr. Ashton describes a program she and her colleagues launched in October 2017, called "Getting Rid of Stupid Stuff." In an effort to engage clinicians and reduce burnout, the program team asked all employees at the healthcare network to review their daily documentation practices and nominate aspects of the EHR they thought were "poorly designed, unnecessary or just plain stupid."

 

Along with fielding nominations from physicians and nurses, the team also conducted its own review of documentation practices, and removed 10 of the 12 most frequently ignored alerts the EHR pushed to physicians. The team also removed order sets that had not been used recently.

 

Dr. Ashton acknowledged the specific changes likely aren't relevant for other hospitals, but she advocated for the shift in mentality the "Getting Rid of Stupid Stuff" program initiated. "It appears that there is stupid stuff all around us, and although many of the nominations we receive aren't for big changes, the small wins that come from acknowledging and improving our daily work do matter," she wrote.

 

Here are four of the categories Dr. Ashton and her colleagues deleted from the EHR as part of the program:

 

1. One nurse who worked with adolescent patients asked to remove a physical assessment row labeled "cord," meant to reflect care of the umbilical cord remnant in newborns. The row, which was supposed to be suppressed for those older than 30 days of age, had still been present for other ages.

 

2. A nurse who cared for newborns said she had to click three times whenever she changed a diaper, as a result of EHR documentation for incontinence requiring the clinician to indicate whether the patient is incontinent of urine, stool or both. The team created a single-click option for children in diapers.

 

3. Multiple nurses highlighted the frequency of "head-to-toe" nursing assessments, which they are expected to complete upon assuming care of each patient. However, in some units, the EHR prompted nurses to document several of these assessments during a 12-hour shift.

 

"We sought to identify standards in the literature and found that some of our practices were in keeping with those standards," Dr. Ashton wrote. "In other units, we reduced the frequency of required evaluation and documentation."

 

4. An emergency medicine physician questioned why the EHR prompts employees to print an after-visit summary before scanning it back into the system. He hadn't noticed the patient was expected to sign the summary, which was stored in the record.

 

"His question led us to query other health systems and our legal team about the value of the signature, and we were able to remove this requirement," Dr. Ashton wrote. "The physician was delighted that he had been able to influence a practice that he believed was a waste of support-staff time."

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Kareo Integrates EHR with GoodRx to Reduce Prescription Drug Costs

Kareo Integrates EHR with GoodRx to Reduce Prescription Drug Costs | EHR and Health IT Consulting | Scoop.it

Kareo, a cloud-based EHR provider for independent medical practices has launched Kareo Rx Saver, an integrated solution with GoodRx that seamlessly delivers prescription cost savings to patients of physicians.

 

Prescription drug prices often vary significantly across pharmacies, making it difficult for a patient to select the least costly option. To address this problem, Kareo has integrated its clinical EHR with with prescription and drug savings provider GoodRx to present real-time cost comparisons between local pharmacies during e-prescribing while also delivering money-saving coupons. With KaroRx Saver, independent physicians can directly and instantly help lower the cost of care for their patients when prescribing medication.

 

Kareo, a cloud-based EHR provider for independent medical practices has launched Kareo Rx Saver, an integrated solution with GoodRx that seamlessly delivers prescription cost savings to patients of physicians.

 

Prescription drug prices often vary significantly across pharmacies, making it difficult for a patient to select the least costly option. To address this problem, Kareo has integrated its clinical EHR with with prescription and drug savings provider GoodRx to present real-time cost comparisons between local pharmacies during e-prescribing while also delivering money-saving coupons. With KaroRx Saver, independent physicians can directly and instantly help lower the cost of care for their patients when prescribing medication.

 

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The EHR Journey – Selecting an EHR Vendor

The EHR Journey – Selecting an EHR Vendor | EHR and Health IT Consulting | Scoop.it

As a healthcare organization, innovation and change can be a challenge. And while many changes are forced, either by government mandate, financial incentive, or patient care necessity, each organization must make a series of decisions that will dictate their technological, financial and cultural future. Though the EHR journey, from selection and implementation to maintenance and upgrades, is not easy, it is necessary. In this series, we reached out to Terri Couts, VP of Epic Application Programs at Guthrie Clinic, for her thoughts on the end-to-end EHR journey.

 

EHR Vendor Selection
The easiest part about selecting an EHR vendor is making the decision that you need one. The selection itself can be, and in my opinion, should be a challenging task. No matter what vendor you choose, you can be sure that it will be a large financial investment. In the past, organizations would tend to steer towards the “best of breed” approach. This approach can lead an organization down the path of silo systems and disjointed processes creating additional work and costs.

 

There are many vendors who deliver an excellent product, but do you understand what your requirements are of the system? Defining the scope, requirements, and the desired outcomes are all part of the first step. Many users look to the technology to address a need and ask questions like “what can Epic do for me?” However, I would challenge our users to understand their requirements ahead of time and use those requirements to drive your selection process. List out the requirements and make sure to have a rating scale for each when you meet with vendors.

 

I have found that attending several vendor demos can help you identify the requirements that you ultimately want to have in your EHR. If they are good vendors, they have already done a great deal of research for their development. Use their investment to your advantage. Participate in as many demo sessions as you need to come up with a robust and complete RFP.

 

Also, make sure you have the right stakeholders at the table when defining the requirements. Be careful not to get sidetracked by the shiny new object and focus on how it can align with the organization’s goals, value, and mission. Vendors are good at showing the functionality around the new buzzwords such as big data, population health, and the newest artificial intelligence features. However, if they cannot meet the organization’s core function needs, none of that will matter.

 

Every organization’s needs are different based on their type of patients, variation in care, location, and finances. Therefore, there is not a single checklist that all organizations can use. However, I have found that the more integration the system offers, the better. Taking away silos within departments allows for the highest level of transparency driving an increase in patient safety and outcomes.

 

Again, I believe the hardest part of selecting a new EHR is identifying what you want out of the system. Once you know that, you can make the system work for you and instead of you working for the system. The decision to implement a new EHR is one you will have to live with for a long time. It’s an investment in your organization’s future. Put the effort and work in ahead of time to be sure the investment is something you can live with and scale.

 

The EHR journey can span years and effectively dictates, at least in part, the healthcare organization’s path and culture. This series examines the experiences of healthcare leaders that have been through it. Whether you’re selecting an EHR for the first time or replacing an existing system, the EHR journey is a daunting one. These lessons learned could be priceless to you and your organization.

 

Check back soon as the next post in this series will cover workflows and their importance throughout your EHR Journey.

 

Make sure to subscribe to our blog for the latest thought leadership in healthcare IT delivered directly to your inbox. You can also follow us on LinkedIn, Twitter, and Facebook to join the conversation. Check back for our next Center Stage feature in the coming weeks.

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Here we go again ... EHR Reset, Refuel, Optimize

Here we go again ... EHR Reset, Refuel, Optimize | EHR and Health IT Consulting | Scoop.it

At some point, we all thought the Electronic Health Record (EHR) implementation lifecycle would stabilize and transition into the ever elusive “maintenance mode”. Costs would go down, patient quality and care would improve, physicians would be more efficient and effective in the care of their patients, physicians would actually “like” the system, and the world would go back to normal. Right? Well, that is partially right. And now it would seem that it’s time for an EHR reset.

 

The introduction of the integrated EHR did accomplish many of these goals. We can quote statistics of a positive move towards gaining all of these benefits. However, we can also bring to light many frustrations with physicians, clinical teams, operations teams and even patients.

 

Pro-Active EHR Optimization is a Necessity
Why is this? For one, we forgot that the expectations, the functionality, and the potential are always moving farther to the right. These expectations are supported by advancing capabilities within EHRs but are also driven by the need for data science capabilities that provide innovative, real-time solutions to deliver patient care when, where and how it is needed.

 

Vendor sponsored EHR capabilities advance on a regular basis by introducing new functionality and capabilities, by expanding their capabilities for integration, analytics, and other critical functions and by offering alternative solutions to support the changing needs of the market (e.g., Community based solutions, organization acquisitions and organic growth, lower cost solutions with rapid implementation timelines, etc.)


The healthcare market is ever changing as is the expectations of those who work in the healthcare field. Introducing an integrated EHR is the first taste that required healthcare providers and operators to open their minds about “how it could be”. Now that we have asked them to think this way, the door is open. EHR vendor capabilities and their integration with other third-party systems that support integration, analytics and even data science are now the “norm” to operate in a more global healthcare market. Users of these systems are now asking, “what if the system could do this?”


Organizations of all types and sizes are reevaluating the current structure and use of their Electronic Health Record (EHR) and deciding to not just optimize, but also completely re-implement the system. With an eye towards market growth, transformation and innovation, healthcare leaders are initiating a major program effort to re-implement their EHR focusing on leading-practice standardization, leveraged capabilities, cost-efficient support structure, decision-focused analytics and most importantly, the patient experience.

 

There are many reasons healthcare organizations are considering a complete reimplementation of their current system.

 

Function-specific EHR implementation where multiple activities may still be supported by many, disparate and/or non-integrated systems


Rapid installation timeline with minimal use of the potential system capabilities


Continuation of technology “isolation” where decisions are not driven by clinical and operational stakeholders and technology teams are still focused on the singular activities of taking care of their world


An installation that is on an outdated version with a highly customized build and non-standardized workflow components
Need for a foundation to support an organization’s market expansion through acquisitions, connect alternatives or other market growth


Whatever the reason, organizations and their leaders now understand that the initial implementation was not the end. Rather, it was only the first step in creating a technological foundation that supports the organization’s vision and strategy for continued excellence in care, growth, innovation, and viability in the market.

 

The encouraging side to all of this is:

 

You have already gone through an implementation so completing an “EHR reset” requires a similar structure, effort, and rigor, and
You get a “do-over”, or said differently, an EHR reset provides a new chance to transform your organization and establish a foundation for moving forward in the organization’s vision and strategy.
If your organization is considering an EHR reset, Optimum’s team of experts can help. Optimum Healthcare IT has a dedicated Advisory Services solution line that brings years of healthcare clinical, operational, and IT knowledge.

 

Our team brings years of healthcare clinical, operational, and IT knowledge. Using our experience and expertise, we design project plans that turn your goals from vision to reality. Working with your staff, we refine the approach, the methodology, and define the resources needed to execute on time and on budget. We work with you to make sure you are leveraging your technology to increase the safety and quality of care you provide to your patients throughout the continuum of care.

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Pediatric EHRs Must be Treated Differently

Pediatric EHRs Must be Treated Differently | EHR and Health IT Consulting | Scoop.it

When it comes to healthcare, there are many different types of facilities and settings. There are acute care hospitals, specialty care hospitals, nursing homes, long-term care facilities, ambulatory care centers, surgical centers, outpatient clients, physicians’ offices, rehabilitation centers, pediatric care hospitals, and many more. What all of these different care settings have in common is that they most certainly benefit from some form of electronic health record (EHR) software, each with their own specific needs. What they do not have in common, is the type of patients or type of care they provide. Pediatric patients and healthcare facilities require the right approach to install their Pediatric EHR.

 

An acute care hospital’s primary task is to provide short-term care for people with varying degrees of health issues. These usually stem from injury, disease, or genetics. They are open 24/7/365 and bring together physicians from varied specialties, a skilled nursing staff, technicians, and specialized equipment. Most hospitals offer a wide range of services including emergency room, labor and birth, scheduled surgeries, and lab work. Acute care hospitals utilize standard EHR software where each department has a specific module with tailored functionality to meet their needs.

 

The difference between the standard acute care hospital and pediatric care hospitals is, of course, the patients. Though it may seem obvious, teams in pediatric facilities must recognize that infants, children and those with special needs are not merely small adults and they cannot be treated as such. Caregivers must pay additional attention to how they interact with pediatric patients and their families. Bedside manner, psycho-social considerations, and family dynamics have to be considered during the course of care.  In many respects, the Pediatric EHR must be treated the same.

 

Pediatric facilities have unique requirements that dictate many aspects of their EHR software adoption.  Hardware and device placement have unique needs to facilitate documentation where the patient is – many times patients aren’t located in their bed or assigned room.  Specific attention and adherence to isolation requirements are vital. Also, close attention should be given to screen visibility to include parents or other approved family members engaged in care planning, patient teaching, and patient education.  Consideration is also given to the multi-disciplinary care team engaged with a pediatric patient – case management, social work, therapies, child life services, etc.

 

Hospitalizations are essential for both adults and children. How a healthcare organization chooses to treat them is even more critical. Pediatric organizations require special machines, special tests, special nurses, special doctors, and more importantly SPECIALIZED Pediatric EHR software systems. While the primary objective for healthcare organizations is to provide high-quality patient care, they must also make money.  Reimbursement rates continue to decrease which calls for consistent best practices for both hospitalized adults and child to ultimately reduce the length of stays.  Effective and efficient use of the EHR coupled with the power of the data it provides is crucial to patient satisfaction and improved care.  Additionally, healthcare organizations can save money and improve patient care by partnering with healthcare IT consulting companies who have the knowledge and methodologies to ensure that when an EHR is implemented, no matter the setting or patient type, it will be done correctly.

 

Whether it is a standard acute care hospital or a specialized pediatric hospital, Optimum’s expert resources recognize these needs and facilitate incorporation of the “triangle of care” – meaning patient, family and caregiver/device.  In the majority of our activations, we have provided expert support for pediatric inpatient settings, PICU settings, Leve 2, 3 and 4 NICU’s, Pediatric Trauma and Emergency Room settings while implementing their Pediatric EHR.

 

While preparation is undoubtedly a key ingredient for success, all the planning in the world can yield minimal results if you don’t have the right people in place to execute the plan. In addition to the years of experience Optimum brings to the table, we also specialize in allocating the right resources – the right people – for your project at the right time. Optimum Healthcare IT uses its SkillMarket portal to not only manage your go-live resources, but to optimize resources based on your needs, their skillset, and geo-location.

 

Our commitment to your needs ensures that your implementation will be successful throughout your planning, go-live, stabilization, and optimization. And once you make it through the arduous task of implementing an electronic health record, the challenge then becomes sustaining it and meaningfully using it. Optimum Healthcare IT has the best team in the business.

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Become an EHR Super User

Become an EHR Super User | EHR and Health IT Consulting | Scoop.it

When I visit clinics to help them optimize EHR use, there is a clear difference between the super users and other users. While the super users may still have complaints about the system, they are nowhere near as frustrated as the other users. This is because they have invested the time in understanding how to leverage the EHR to significantly speed up their everyday workflow.

 

Most EHRs have built-in "accelerators," tools and shortcuts similar to what you find in Microsoft Word or Excel, for greater efficiency. The problem is most physicians don't bother to learn them because they've either exhausted many systems in their career or there is not ample time in the day to do anything other than "survive" in the clinic. But taking the time to learn to use something you use for hours a day every day pays off, and investing as little as an hour each week learning to better use your EHR has been shown to increase physician satisfaction.

 

Three tips to get you started


1. Make sure you understand and spend some time loading your system's "macros." You want to make checking off boxes or typing a rare, unique action, not a routine one. One rule of thinking is that if you are doing the same thing the third time, you should spend a moment to save it, memorize it, macro it or whatever your system calls it.

 

2. Get a good tool for finding diagnosis codes. I recommend Problem IT Plus. Try it and you'll thank me if you are doing this now without it.


3. Make sure you understand how your system enables team-based care. Allowing everyone to practice at the top of their license and contribute to the delivery of care is crucial. Empower the care team to create notes and use automated tasking and messaging within the EHR whenever possible.


It is an exciting time for healthcare IT: leverage tools such as the EHR and allows them to help you refocus on the business of medicine instead of the business of administration. It takes an extra hour or so a month, but allows you to focus on the three things that matter most: your patients, your practice, and yourself.

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Are Medical Practices Taking Advantage of Cloud-Based EHR?  

Are Medical Practices Taking Advantage of Cloud-Based EHR?   | EHR and Health IT Consulting | Scoop.it

In today’s medical field, technology is a big player. With regulations dictating that even independent practices attempt to make the jump to a dedicated EMR/EHR. An EMR/EHR, or electronic medical record/electronic health record interface, provides physicians and patients a way to connect to promote efficient healthcare delivery and organizational profitability. Today, we will look at how smaller healthcare providers are utilizing EMR/EHR solutions that are hosted in the cloud, bucking the trend of hosting their patient information locally.

 

EMR/EHR


For the modern healthcare provider, the EMR/EHR is a major piece of software. The EMR/EHR is an interface that physicians, healthcare providers, and insurers use to update the information on each patient. As the patient has access to their own EMR/EHR file as well, it makes it a very useful guide for all parties involved to manage an individual patient’s care.

 

Major Considerations
With the massive cost of health care, it isn’t much of a stretch to say that there are some very serious considerations that have to be made to the way that doctors and health organizations utilize cloud-hosted technologies. Many providers, however, are reluctant to do just that as there are serious questions about the viability of cloud computing for regulation-covered information such as electronic protected health information (ePHI). One such consideration is the massive incentives offered to organizations who implement “meaningful use” EMR/EHR technology. In order to meet the “meaningful use” criteria, however, many separate variables have to be met, including:

  • Engaging patients in their own care
  • Improving quality, efficiency, safety, and reducing health disparities
  • Improving care coordination
  • Improving public health and health education
  • Meet HIPAA regulations for the privacy of health records

 

So while many of these variables seem to be common sense, there are additional costs that go along with this kind of comprehensive use of EMR/EHR functionality, which, for smaller medical practices, can be enough of an impetus to not meet those qualifications. Cost usually supersedes most other qualifications, even in a high-stakes, results-based business model like healthcare. That means that even though utilizing cloud technology will cut costs, there is no guarantee that a practice will meet the necessary criteria for “meaningful use”.

 

That said, cloud computing has more resources available to maintain data security than ever before, and organizations can still move to an EMR/EHR solution that will benefit their users, and their staff. If you are looking for a solution to help your medical practice cut costs, get dynamic web-based functionality, or get your technology in a position to meet industry regulations, contact the experts

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Getting the Most Out of Your EHR - Healthcare IT Consulting

Getting the Most Out of Your EHR - Healthcare IT Consulting | EHR and Health IT Consulting | Scoop.it

No matter how much your organization has invested in an EHR, there will always be opportunities to improve its performance—especially when considering the ways individuals interact with and are impacted by it. If you are interested in learning how to ensure your implementation goes well or to better leverage your current EHR, check out four popular blog posts about getting the most out of your system.

 

8 Best Practices for Building Better Relationships During EHR Implementation and Training
EHR implementations and training can be highly stressful for end-users, especially those in patient-facing roles. Minimizing that stress can result in more engaged training sessions and better long-term retention, which is why in this article an experienced principal trainer shares how to streamline these processes through relationship building.

 

EHR Training: How to Help Users End Frustration, Overcome Fear and Engage
EHR training should include more than technical skills instruction—it should instill in end-users confidence that they will be able to adapt to a new system (even if they forget a few details post-training). In this blog post, an experienced training consultant explains how to create an environment of positivity conducive to learning.

 

EHR Optimization as a Bridge to Population Management
Healthcare organizations already analyze patient data to identify savings opportunities, but what often goes overlooked is how the configuration and use of the EHR can make a significant impact on cost and care. This article examines how organizations maturing their population health and value-based care programs can use their existing technology to meet their goals.

 

Quality Reporting: What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration
For healthcare organizations with limited resources, participation in pay-for-performance plans like MACRA’s Quality Payment Program (QPP) is challenging. They often lack the time and expertise to retool their EHR implementation to document new metrics and recognize when a measure has been met. In this post, we discuss important data management issues and the repercussions of waiting to address them.

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EHR and Challenges of the Modern Medical Note

EHR and Challenges of the Modern Medical Note | EHR and Health IT Consulting | Scoop.it

There was a time when documentation was an almost inconsequential process. After seeing a patient, the doctor would scratch a note, close the folder, and file it on a shelf until the next visit.

 

Things are different and the medical note has evolved. As it’s evolved, electronic health records (EHR) have brought efficiencies to the medical note while introducing new challenges. And like the cognitive biases that impact patient care, the problems inherent in documentation need attention.

 

Thinking about these challenges becomes important in documenting care and training the next generation of health professionals. Here are a few that I think about

Auto Documentation

One of the powers of the EHR is that it allows users to auto-populate the medical record with chunks of pre-fabricated text known as smart phrases. But these personally created building blocks of the medical note create the potential for one-clip-fits-all documentation. As I’ve said in the past, the smart phrase is not new technology.

 

I work to keep smart phrases out of my history of present illness and impression where individualized narratives show what’s unique about a case. Free text keeps me real.

Replicability

While smart phrases represent the dropping of self-created language, we have the ability to clip and paste information from other parts of the chart. This may include bits and pieces from notes penned by another medical professional.

 

While we all lift bits of language from places like CT and biopsy reports, issues arise when the origination of our language is that of another health professional. Epic now allows visualization of a phrase’s origin when not created by the author.

 

I’m careful about what I copy. I’m twice as careful with what I paste as a representation of my own thinking.

Size and absence of constraint

While smart phrases are limited only by our imagination, a digital note with no constraints predisposes to note bloat, one of the looming threats to modern medicine. Pre-digital notes were constrained by writer’s cramp.

 

I’ve laboured through notes where every single lab drawn on a complicated patient is dumped into the note. Pages and pages of marginally abnormal CBC and metabolic panels create a scenario where it’s difficult, if not impossible, to discern what data is relevant to the decisions made.

 

I try to consider the needs of the end user of the note. Of course, this is challenging when our opinion of what constitutes a ‘good note’ varies from that of the note read.

Ambiguity of purpose

This is the most remarkable phenomenon of the modern medical note. Medical notes have traditionally had pet purposes. Medical students learn early on that ‘the right way to write a note’ varies not only by speciality but by the whim of the individual physician responsible for the note. Physicians with firm views regarding what constitutes the purpose of a note may even morph their perspective depending upon the nature of an individual case.

So if you ask 3 physicians the purpose of a medical note and you’ll get 5 answers ranging from billing and quality documentation to legal coverage and professional communication. Over time the medical note has morphed into all of these things at once.

 

The problem with an ambiguity of purpose is how to manage the expectations of the end user. A physician who feels compelled to paste three months worth of blood results into the data portion of a note will be at odds with someone like myself who believes that a note serves to offer nothing other than concise support for what I’m thinking and planning.

 

As notes become more visible to more folks we can expect ambiguity of purpose to become more pronounced. Digital notes and their capacity for customization amplify this divergence of purpose.

Scaling visibility of the EHR

Once restricted to the shelves of offices in big buildings, medical documentation has traditionally been siloed. This was fine because notes existed for the doctors who occupied those individual offices.  The medical note is now enjoying new freedom in its electronic shape. More notes are more visible to more professionals. This is evident within consolidated health systems where networks of offices connect to big hospitals.

 

Beyond professionals, patients are watching and, in some cases, editing their own notes. OpenNotes is a related program based in Boston’s Beth Israel hospital. Regular patient review and revision represent a revolutionary move in medical documentation.

This scaling visibility of the modern note brings greater scrutiny for what we do or don’t do.

 

This idea of the medical note and its evolution gets little attention yet it represents the core medium of all documentation by medical professionals. It deserves more thorough attention and study.

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5 Essential Benefits of Using Artificial Intelligence (AI) Technology in EHR's

5 Essential Benefits of Using Artificial Intelligence (AI) Technology in EHR's | EHR and Health IT Consulting | Scoop.it

Machine learning is a promising domain that has positively impacted many industries and now healthcare is witnessing its powerful emergence. The progress of Artificial Intelligence-based technology, along with other advances in EHRs is bringing a new wave of interest in how this latest technology is going to change the shape of health and healthcare. EHR platforms are at the forefront of using artificial intelligence within the healthcare arena. This is because of the widespread use of EHR software and the capability of EHR software to categorically store real-time patient data. These data sets can be used by artificial intelligence to make predictions and suggestions for the future.

 

This fast-growing digitalization has created major opportunities for the use of artificial intelligence. Industry experts and innovators see the potential and continue to gradually improve AI-based features within updated EHR systems. The widespread use of this digital health data advances health outcomes and there is no doubt it will eventually reshape the healthcare industry. Let’s have a look at some more unique benefits.

Benefits of Using AI Technology in EHR Software

  1. Better Diagnosis & Treatment

Newly developed AI diagnostic systems can help providers diagnose and treat different diseases. This advanced system uses the historical data and patient symptoms to predict future illness. EHRs are more intelligent now and can suggest the high paying CPT codes for the identified disease so providers can maximize their earning potential as well. In the future, this AI-based diagnostics system could possibly even lead to self-diagnosis tools and treatment facilities for common diseases.

  1. Reduces Human Error

talkEHR is a good example of a self-learning electronic health record system that comes with an integrated medical voice assistant named “Allison”. This intelligent voice assistant lets you talk with your EHR, and performs the requested functions you tell her to. This saves charting time and reduces human errors. Also, the longer you use the system, the more this self-learning software is able to provide you with an improved, personalized experience.

  1. Cost-Efficient

Artificial intelligence based EHR software automate the normal workflow of medical practices and, to some extent, eliminate the need for additional support staff. Auto reminder calls, appointment scheduling, and other task automations are improving the workflow of medical practices, as well as reducing overhead expenses.

  1. Better Medical Imaging Analysis

Artificial intelligence-assisted medical imaging analysis is much better than a manual one. It analyzes and compares the cell structures and also tissue segmentation to identify disease and suggest treatment.    

  1. Improves Productivity

AI-based EHRs improve the productivity of medical practices as they significantly reduce the administrative complexity, clinical waste, malpractice likelihood, and help to save the staff time they would otherwise spend on repetitive tasks.

Healthcare facilities are making necessary investments in AI-based EHR development, and over time, the AI algorithms will continue to improve and fully transform the healthcare industry. How closely will this transformation resemble the vision of medical futurists? We look forward to seeing how it takes shape. Feel free to share your thoughts in the comment box below!

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EHR Optimization as a Bridge to Population Health Management 

EHR Optimization as a Bridge to Population Health Management  | EHR and Health IT Consulting | Scoop.it

In the quest to meet value-based care, population health and quality reporting goals, healthcare leaders face an array of avenues and tactics. While the strategies differ, one constant in virtually all efforts to bring structure to new care delivery models is the improved use of technology and systems, and the troves of data they store and transmit.

 

Analytics has a pivotal role in meeting healthcare’s triple aim of reducing the per capita cost of care, improving patient experience (including quality and satisfaction) and improving population health. Without the support of the clinicians using these technologies and the information they hold, however, it is difficult to succeed. This has prompted some healthcare organizations to champion a quadruple aim that also seeks to improve the work life of healthcare providers.

 

To develop and execute on a quadruple – or even triple aim – healthcare leadership teams must answer the question:

 

How can our organization capture the information needed to deliver effective, data-driven care in a manner that benefits patient outcomes and compliments provider workflows?

 

Through a disciplined EHR optimization methodology, a structured plan, and input from providers and clinicians on goals and practical ways to meet those goals, it is possible to adopt a data-capture care strategy that minimizes impact on provider workflow while maximizing return on reimbursement.

 

Optimization in Action
Consider how EHR Optimization can aid population health management efforts.

 

Many healthcare organizations are analyzing patient data to identify high-risk and/or high-utilization patient populations that could pose savings opportunities if their care interventions are migrated from high-cost emergency department and inpatient settings to preventive and primary care, but how many are truly looking up-stream at how the configuration and use of the EHR impacts their success?

 

When developing and deploying an organization’s population health goals and identifying target patient populations, consider how your organization can engage and support your clinicians in this evolution. What clinical workflow supportive functionality is available in your EHR to aid and prompt care team members to ask the right patients the right questions, proactively screen, and implement low-cost interventions to quickly put population health management into action? How can these opportunities be implemented without disruption of patient care flow?

 

Here are specific strategies for building an EHR Optimization plan targeted toward enabling population health while supporting your providers:

 

  • Engage your clinicians early on. Including your providers and allowing them to tell you how they work and what will work for them to support your effort makes a successful initiative.
  • Integrate with established workflows when possible. Data entered correctly into your EHR supports your analytics needs. You will depend upon your providers to capture this for you.
  • Prioritize your target patient populations. Which initiatives will yield the highest return? Start with a single impactful goal and fine tune processes, measurement and engagement around it.
  • Ensure consistency in design. Provide consistency in data standards and naming conventions. This can go a long way to eliminate redundancy in documentation for clinicians. This is particularly important when planning to expand your program

 

EHRs and supporting technologies are an incredible data source and the key to value-based care and population health management success. EHR implementation and optimization strategies that keep the quadruple-aim top-of-mind can support organizational initiatives while enhancing, or at very least not burdening, clinical workflows of your EHR users. Engaging your end users in the process inspires a collaborative, supportive environment while encouraging a successful outcome to organizational directives.

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Getting the Most Out of Your EHR  

Getting the Most Out of Your EHR   | EHR and Health IT Consulting | Scoop.it

No matter how much your organization has invested in an EHR, there will always be opportunities to improve its performance—especially when considering the ways individuals interact with and are impacted by it. If you are interested in learning how to ensure your implementation goes well or to better leverage your current EHR, check out four popular blog posts about getting the most out of your system.

 

8 Best Practices for Building Better Relationships During EHR Implementation and Training
EHR implementations and trainings can be highly stressful for end-users, especially those in patient-facing roles. Minimizing that stress can result in more engaged training sessions and better long-term retention, which is why in this article an experienced principal trainer shares how to streamline these processes through relationship building.

 

EHR Training: How to Help Users End Frustration, Overcome Fear and Engage
EHR training should include more than technical skills instruction—it should instill in end-users confidence that they will be able to adapt to a new system (even if they forget a few details post-training). In this blog post, an experienced training consultant explains how to create an environment of positivity conducive to learning.

 

EHR Optimization as a Bridge to Population Management
Healthcare organizations already analyze patient data to identify savings opportunities, but what often goes overlooked is how the configuration and use of the EHR can make a significant impact on cost and care. This article examines how organizations maturing their population health and value-based care programs can use their existing technology to meet their goals.

 

Quality Reporting: What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration
For healthcare organizations with limited resources, participation in pay-for-performance plans like MACRA’s Quality Payment Program (QPP) is challenging. They often lack the time and expertise to retool their EHR implementation to document new metrics and recognize when a measure has been met. In this post, we discuss important data management issues and the repercussions of waiting to address them.

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VA's EHR project is 'yellow trending towards red,' says report obtained by ProPublica

VA's EHR project is 'yellow trending towards red,' says report obtained by ProPublica | EHR and Health IT Consulting | Scoop.it

The Department of Veterans Affairs' EHR contract with Cerner has been plagued by multiple roadblocks during the past year, including personnel issues and changing expectations, according to a ProPublica investigation.

 

Former VA Secretary David Shulkin, MD, released the agency's plan to scrap its homegrown EHR VistA for a Cerner system during a news briefing in June 2017. Almost one year later, the VA finalized a $10 billion no-bid contract with Cerner to implement its EHR systemwide over a 10-year period, beginning with a set of test sites in March 2020.

 

However, a recent progress report by Cerner rated its EHR project with the VA at alert level "yellow trending towards red," according to ProPublica. To investigate the underlying factors that have contributed to the EHR project's problems, the publication reviewed internal documents and conducted interviews with current and former VA officials, congressional staff and outside experts.

 

Here are five details from ProPublica's investigation:

1. When Dr. Shulkin initially announced his plan to implement Cerner at the VA, he emphasized the EHR would provide "seamless care" to veterans, since the Department of Defense had also recently signed a contract with Cerner. However, in September 2017, the VA convened a panel of industry experts who objected to this claim, noting two health systems using Cerner doesn't mean they will be able to share all data with one another.

 

2. At another meeting, Cerner representatives gave a presentation on how their software would be able to share data with private providers, three people present told ProPublica. However, Dr. Shulkin noticed the representatives were only talking about prescription data, rather than the full record of health data, lab reports and medical images that the VA would need. Dr. Shulkin reportedly cut the meeting short and told Cerner to come back with a better solution.

 

3. Cerner's off-the-shelf product didn't match the VA's EHR needs, according to ProPublica. While Cerner's software successfully helps private hospitals bill insurers, the VA doesn't need these same functionalities, since the agency serves as the sole payer for its patient population. Cerner's product also didn't have features for some of the VA's core specialties, such as post-traumatic stress disorder, since these conditions aren't as common in the general population.

 

4. Dr. Shulkin, who left the VA in March, reportedly wanted to find a CIO with a background in healthcare and experience leading major software transitions to helm the EHR project. The VA enlisted two search firms, which identified several qualified candidates, according to sources who spoke with ProPublica. However, the Presidential Personnel Office rejected them, and the White House instead proposed candidates who had worked on the Trump campaign but didn't have a background in health IT.

 

5. At a recent subcommittee hearing, some lawmakers questioned the VA's work on the Cerner project and asked whether the DOD should head up its implementation. Instead, the VA and DOD secretaries opted to sign a joint statement Sept. 26 pledging to align their EHR strategies. However, industry experts warned ProPublica that the agencies have different medical priorities, as the DOD treats young people with acute injuries while the VA provides long-term care to those with complex illnesses.

 

VA spokesman Curt Cashour declined to answer specific questions from ProPublica, saying that "efforts thus far have been successful and we are confident they will continue to be successful." The White House didn't provide answers to a list of questions ProPublica sent, and Cerner also declined to comment.

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Stanford Launches App That Connects to Epic EHR & Healthkit

Stanford Launches App That Connects to Epic EHR & Healthkit | EHR and Health IT Consulting | Scoop.it

tanford Health Care today announced its new iOS 8 MyHealth mobile health app for patients. Developed in-house by Stanford Health Care (SHC) engineers, MyHealth connects directly with Epic’s EHR, Apple’s HealthKit and cloud services for consumer health data monitoring.

The SHC MyHealth mobile app is designed to make it quick and simple for patients to manage their care right from their iPhones, including:

• Make appointments

• Get test results – your lab results are automatically made available in the palm of your hand

 

Communicate with your care team through a secure messaging system where your information is always kept confidential

• Have a video visit with your doctor through the new ClickWell Care clinic which gives you the convenient option of a “virtual” appointment

 

• Manage your prescriptions and medications

• View your health summary

• Access and pay your bills

• Share your vitals with your doctor via HealthKit integration

Secure Messaging


With the new MyHealth app, patients can communicate directly with their care team through a confidential and secure messaging system. In addition, the app automatically syncs with wearable and wireless products, allowing patients to take vital signs at home or on the go. That data is automatically and securely added to the patient’s chart in Epic for their physician to review remotely.

“The SHC MyHealth app allows patients to connect their lives with their health care,” said Pravene Nath, MD, Chief Information Officer, Stanford Health Care. “By integrating with companies like Withings, our physicians have access to meaningful patient data right in Epic, without having to ask the patient come in for an appointment. We believe this is the future of how care will be delivered for many types of chronic conditions.”

 

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Don't Overlook EHR Communication

Don't Overlook EHR Communication | EHR and Health IT Consulting | Scoop.it

Through all of the planning and preparation that goes into an Electronic Health Record (EHR) implementation, EHR communication is often overlooked and undervalued. With everyone focused on delivering the system, building applications, testing hardware and validating workflows, end user preparedness, outside of training, can be overlooked.

 

Sure, they’re going to be trained on the system, but it’s important to remain engaged with end users in the months and weeks leading to go-live, but also beyond go-live. In many aspects, post-live communication is more vital to day-to-day operations throughout the organization.

 

In this post, we’ll discuss the primary types of communication that must be considered, carefully planned for and thoughtfully executed to serve end users best as they prepare for and live in the new world of the EHR.

 

Types of EHR Communication

 

Internal Marketing, pre- go-live
Transitioning to an EHR is daunting for everyone. It’s exciting and new, but it is scary. It’s a daunting task for leadership and project teams, but for end users, this new technology will completely disrupt their professional lives – especially those that have never used the technology.


The merits of the new system, how it will help them in the long run, and how it will benefit patients must all be sold to end users who, in most cases, have always worked a certain way – without technology. The system must be sold to them because there will be resistance, some kicking and screaming, all the way through go-live.


Change Communications
Don’t listen to anyone that tells you that you’ll be able to relax once the system goes live. If anything, the importance of clear, concise communication escalates exponentially after go-live.


Technology, by its nature, evolves. And electronic health records are not exempt. One of the primary features of the technological age we live in is that the systems we use can, and will, be updated.
When changes are made to the system, there must be a coordinated Change Management procedure featuring robust communication to all impacted employees.


System Updates/Downtime Messaging
EHR’s and the infrastructure they run on are fallible. No matter how well the system is designed and built, there will be issues and downtimes that negatively impact end users, and if not planned for accordingly, patients.


System Update (SU) and Downtime procedures must be carefully developed and communicated throughout the organization to ensure that employees know the protocols that are in place in the event of a system outage.


Additionally, communications processes and protocols must be installed throughout the organization to ensure that vital information can be delivered to end users crisis situations – and that end users can communicate what’s happening on the ground with leadership and IT.


Ultimately the goal here is to ensure that clinicians can continue to care for their patients in the event of a system outage and proper communication is key.


Targeted Messaging
This comes down to a simple realization – clinicians are extremely busy people that don’t have time to wade through waves of content to find what pertains to them.
Messaging designed with a specific user group in mind that includes a concise, actionable message works best. Think providers or nurses.


This audience also benefits from a well-known or trusted sender. They don’t pay attention to mass emails from generic inboxes. Their bosses, Chief Medical Officers, Chief Nursing Officers, or a department head usually garner the most respect, and the most attention, in clinical circles.


Patient Communication
This change is disruptive for patients as well, especially during go-live. Taking the time to thoughtfully communicate the change to patients will help ease the transition for them as well.
They’ll have questions. Why is my doctor on that computer so much? Is my medical information online? Is it secure?
Without going into the minutia around the EHR, device integration, real-time data, secure servers, firewalls, data centers, etc. – take the time to explain the change to patients, at least at a high level. They will appreciate it.


myChart & Meaningful Use
On the surface, Meaningful Use and MyChart communication don’t immediately come to mind when thinking of the EHR communications plan. They should, though. Soon after go-live, the focus shifts to stabilization and optimization, which includes myChart and Meaningful Use.


While they’re paired together here because they’re add-ons that don’t necessarily fall under the initial communications scope, these two are very different and need their own comprehensive communications plans and delivery methods as the content, audience, and implications are drastically different.


While not explicitly responsible for building or activating the EHR system that will revolutionize your organization, it’s important to have a person or team dedicated to communicating with your end users – at all stages of the system’s life cycle. Uninformed end users are disgruntled end users, and it pays to have communications people that have experience with IT and EHR delivery as it is a world unto itself.

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Workflow Analysis, Ease of Use & Best Practices

Workflow Analysis, Ease of Use & Best Practices | EHR and Health IT Consulting | Scoop.it

As a healthcare organization, innovation and change can be a challenge. And while many changes are forced, either by government mandate, financial incentive, or patient care necessity, each organization must make a series of decisions that will dictate their technological, financial and cultural future. Though the EHR journey, from selection and implementation to maintenance and upgrades, is not easy. It is necessary. In this series, we reached out to Terri Couts, VP of Epic Application Programs at Guthrie Clinic, for her thoughts on the end-to-end EHR journey.

 

Workflow Analysis, Ease of Use & Best Practices
A major part of any EHR installation is workflow analysis. Every organization practices, functions, and cares for patients a little differently largely due to training, culture, and patient demographics that they serve. Knowing all of this, there is still an unrealistic expectation that healthcare technology is plug-and-play. Being trapped in this misconception can lead to end-user frustration, delays in care for patients, delayed revenue or revenue loss, and an overall mistrust of the product and the IT implementation team.

 

Workflow analysis should start the day you sign your vendor contract. Of course, during the implementation, each vendor will have suggested workflows but most only consider the technological use of their product. They do not address any policies or procedures established by your institution. They do not include any State or local regulatory requirements that your organization is bound to. Finally, they do not consider the culture of your organization including the providers’ independence of practice. When I state providers’ independence of practice, I am not suggesting that standard tools and workflows should not be implemented and encouraged. What I am suggesting is that identifying workflows at your organization and having the tools to support those workflows is the first step to a successful go live and sustainability.

 

To accurately collect and document workflows, your IT team will need to heavily engage the subject matter experts. These include registration staff, transporters, nursing, physicians, surgeons, back office staff, medical records, pharmacists, radiologists, and the list goes on. Once the analyst understands how each of the users practice within the organization, they can start to configure the technology to support the workflow.

 

Technology should never define the workflow. But it should support and enhance the work, drive patient outcomes, and increase patient safety.


While performing workflow analysis, ease of use and best practices should always be considered. Most electronic health record (EHR) early adopters implemented their systems with the driving desire to fill the Meaningful Use agenda to ultimately receive incentives and avoiding penalties. Thankfully, those days are behind us and there have been many lessons learned. Physician burnout is one effect stated to be caused by EHR requirements and we have all heard the complaint about “too many clicks”. The role of the provider should not be defined by the number of clicks in the EHR. Be careful to design technology for ease of use, clean and intuitive workspaces, and to not take away from the patient experience.

 

In my opinion, users should not only be involved in the definition of the workflows and design of the product, but also the testing of the design. Usability testing is just as important as the initial workflow analysis. This gives us the chance to identify gaps in the design and user adoption before implementation.

 

The product and documentation that comes from the workflow analysis should also serve as the foundation of training for the system. I have found that EHR training cannot just be about the technical aspects of the system. It should also include relevant scenario-based training to include policies, and procedures held at the organization. End users want to know how this affects them personally. They also need to know the effect of not completing or performing a particular workflow. For example, if the system is built to drop a high dollar charge only if a particular box is clicked, how would the clinician know the downstream impact of revenue loss if they are not educated on the entire workflow. Finally, build the scenario training to include scenarios that the providers can relate to. If something does not seem realistic to a provider, he or she will be lost in that concept and not focused on learning the system.

 

The EHR journey can span years and effectively dictates, at least in part, the healthcare organization’s path and culture. This series examines the experiences of healthcare leaders that have been through it. Whether you’re selecting an EHR for the first time or replacing an existing system, the EHR journey is a daunting one. These lessons learned could be priceless to you and your organization.

 

Check back soon as the next post in this series will cover change management and governance and their importance throughout your EHR Journey.

 

Make sure to subscribe to our blog for the latest thought leadership in healthcare IT delivered directly to your inbox. You can also follow us on LinkedIn, Twitter, and Facebook to join the conversation. Check back for our next Center Stage feature in the coming weeks.

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Epic Launches Sonnet with Rhyme and Reason

Epic Launches Sonnet with Rhyme and Reason | EHR and Health IT Consulting | Scoop.it

The long-anticipated launch of Epic’s new scaled-down Electronic Health Record (EHR), known as Sonnet, took place in March at HIMSS18 with tremendous excitement. Sonnet is intended for smaller to mid-sized hospitals, critical access hospitals, post-acute care facilities, long-term care facilities, and physician practices, who either do not require all of the functionality of a full version EHR or don’t have the budget or the resources needed to implement the full version of Epic. Through the use of Sonnet, these smaller systems will have access to a scaled-down version of Epic which falls at a more competitive price point and with a significantly quicker implementation timeline.  “It’s still the same Epic, it has a fully integrated inpatient-outpatient, rev cycle, and patient portal,” Adam Whitlatch, Epic’s research and development team lead, told Healthcare Dive in February. Additionally, Sonnet will allow smaller hospitals a clear and attainable add-on/upgrade path with the ability to adopt different features of Epic as they expand.

 

It’s an exciting move for Epic on the heels of Epic CEO Judy Faulkner’s call for a shift in collective thought when she announced she would now refer to the EHR as CHR.  To Judy, and I believe many of us, the letter change represents the bigger picture. “Healthcare is now focusing on keeping people well rather than reacting to illness. We are now focusing on factors outside the traditional walls,” Faulkner told Healthcare IT News.  In the future, the CHR will include more types of data, such as social determinants, sleeping patterns, diet, access to fresh foods, exercise, and whether they are lonely or depressed because all of those factors can have an enormous impact on an individual’s health.

 

Epic continues to increase its footprint with the addition of Sonnet; aiming to capture a market segment which KLAS research identified in 2016 as the most significant buyers of EHRs in the U.S. accounting for nearly 80% of all sales. This portion of the market has historically been dominated by Athena Health, e-Clinical works, NextGen and the like.

 

It will be interesting to watch how Sonnet is received in the market and if Epic can successfully move into the community hospital space. It can be argued that Epic is the undisputed leader in the healthcare IT market with Cerner a close second as it pertains to healthcare organizations over 300 beds. The ultimate question is if a scaled-down Epic EHR can garner the same level of success in this space? If Epic can balance the functionality needs to support the complexity of healthcare, while maintaining a light-version of Epic that is easy to maintain and satisfactory to providers, then they will be successful.

 

Still, with an implementation of this size, there is a lot of complexity. As with all implementations, it is vital to have a structured plan in place that includes how to most efficiently manage the retirement of legacy systems, an effective communication and change management strategy, resource allocation, and the proper training of your current staff. Getting it right the first time is the differentiator of a successful install.  Engaging with the right advisory partner can be the key to managing costs. The right partner can aide in making decisions regarding how to best approach an installation from a best practices/”lessons learned” perspective. Often, a new install is the largest investment many hospitals of this size will make in a fiscal year. Doing it right can have great reward, but missing the mark, can have costly implications.

 

As a community hospital, if the implementation of your EHR isn’t correct, the future care of your patients and the financial stability of your organization could be in jeopardy. Optimum Healthcare IT has the people, the expertise, and the experience to ensure that your EHR is implemented correctly and smoothly.

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Alen Smith's comment, October 26, 2018 7:49 AM
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Sharing What You Know for EHR Consultants

Sharing What You Know for EHR Consultants | EHR and Health IT Consulting | Scoop.it

In the world of Healthcare IT consulting, it is important to share what you know. HIT Consultants work long hours to get the job not only done but won.  They know how to put their thinking to work.  These rock stars stay focused longer than others to push the success needle forward for their clients.  But, before their work is done, there is one more win that can add tremendous value – knowledge sharing.  It’s the next best step that can lift the lid of consulting services to higher levels.  Here’s how.

 

Four questions that EHR Consultants can ask themselves:

 

What do I know?
There are a plethora of skills that consultants bring to the table that range from core functional skills to having a good knack for people, talent development, and team building.  A general thought among consultants is that their knowledge is common knowledge.  Everybody knows this, right?  Think again. What’s common to them may not be so common to their peers or their clients.  Plus, their experience and knowledge may have paved a different road from other consultants so knowledge sharing is a definite gain.

 

Who can benefit from my knowledge?
Without question, consultants add value to the clients by knowledge sharing.  They can also add value to their peers by passing on their proven record of how to’s, quick wins, best practice solutions and lessons learned.  Their peers can share their added value with their clients.

 

What do I need to know?
It’s always a good rule of thumb to place ourselves between teaching and learning.  And even the most knowledgeable consultant can benefit from learning. In addition to sharing your knowledge, ask your peers what they have learned.  A proactive approach to knowledge sharing will ensure success for everyone.

 

Who do I need to know?
Get to know peer consultants who know more and whose experience has exceeded yours.  It’s great to be able to have this person handy for quick huddles to field any questions you have.

Creating intentional opportunities for high performers to collaborate is a big deal.  It gives consultants with all levels of skills and experiences a forum and space to both learn and share the sharpest innovative tools in the market with their clients.  Everybody wins.

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Smaller Practices are Choosing Cloud-Based EHR 

Smaller Practices are Choosing Cloud-Based EHR  | EHR and Health IT Consulting | Scoop.it

The medical field has spawned all kinds of new technology that takes patient care to the next level. Regulations demand that even smaller practices need to make the jump to electronic medical record systems (also known as electronic health records). These EMR/EHR solutions provide an interface that gives providers and patients a way to keep themselves connected to each other--a tool to promote a more efficient delivery method for these services. We’ll take a look at these EMR and EHR solutions that are hosted in the cloud, giving your organization more information to make an educated choice on implementing this software.

 

EMR/EHR


EMR/EHR is a critical piece of software for any modern healthcare provider. EMR/EHR is an interface that gives physicians, healthcare providers, and insurers access to updated information about their patients, all at a glance. Since the patient has access to their own file, it can help to promote transparency and collaboration between healthcare providers and patients to improve the quality of their care.

 

Major Considerations


Healthcare is expensive for both patients and providers, which should prompt them to consider a cloud-hosted solution as a viable strategy to minimize costs associated with this industry. Unfortunately, many providers are somewhat reluctant to implement cloud-hosted solutions, even in the face of regulatory compliance laws. There are many serious questions that need to be considered by any organization hoping to take advantage of electronic records--particularly those who store electronic protected health information (ePHI). One of the many considerations any practice needs to consider is the incredible incentive offered to businesses that implement “meaningful use” EMR/EHR technology. To qualify as “meaningful use,” the following variables need to be met:

 

  • Engaging patients in their own care
  • Improving quality, efficiency, safety, and reducing health disparities
  • Improving care coordination
  • Improving public health and health education
  • Meet HIPAA regulations for the privacy of health records


Some of these might seem like common sense, but the costs associated with meeting all of these requirements might be used as an excuse to not invest in these qualifications. Cost is one of the most important factors to consider, and in a high-risk market like healthcare, industry providers generally don’t want to spend more than they have to. The end result is that an organization might utilize cloud-based technology to cut their costs, but there is no guarantee that they will be able to sustain “meaningful use” as it’s defined above.

 

With that said, cloud computing has really come into its own over the past few years, providing even more great services (including security) than ever before--services that EMR/EHR can really benefit from. If you want to implement a solution that can help your medical practice reduce costs and improve functionality, or if you just want to meet the changes in industry regulations, look no further. SouthBridge Consulting can help your business implement high-quality technology solutions designed to increase profits and efficiency. To learn more, reach out to us at (281) 816-6430.

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EHR Market Needs Competition & Innovation

EHR Market Needs Competition & Innovation | EHR and Health IT Consulting | Scoop.it

I spend a fair amount of my days engaged in conversations with family physicians and policymakers on how to improve our nation's health care system. These conversations and the feedback they generate are the engines that drive the AAFP's advocacy. There are dozens of pertinent issues impacting family physicians and their patients, but there are two themes that emerge in every conversation. The first is the disdain family physicians, really all physicians, have for electronic health records. The second is how the EHR industry, to date, has failed in its core mission.

 

On Jan. 20, 2004, President Bush made the following statement as part of his State of the Union Address: "By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care."

 

On April 26, 2004, the Bush Administration formally launched the Promoting Innovation and Competitiveness campaign(georgewbush-whitehouse.archives.gov), which was aimed at accomplishing the goals outlined in his SOTU address. The campaign made several observations and had several goals, but I would like to highlight three:

 

A patient's vital medical information is scattered across medical records kept by many different caregivers in many different locations – and all of the patient's medical information is often unavailable at the time of care.


Innovations in electronic health records and the secure exchange of medical information will help transform health care in America -- improving health care quality, preventing medical errors, reducing health care costs, improving administrative efficiencies, reducing paperwork, and increasing access to affordable health care.
Within the next 10 years, electronic health records will ensure that complete healthcare information is available for most Americans at the time and place of care, no matter where it originates.
Within the next 10 years?

 

Guess what? Time's up, and none of this happened. It is reasonably safe to say that in the 14 years since President Bush issued his call to action, the promise of EHRs has failed epically to meet the expectations outlined in the SOTU speech -- avoid dangerous medical mistakes, reduce costs and improve care. Some would argue that we have digressed in each of these areas.

 

I struggle to find an articulate and elegant way to describe what is so frustrating about electronic health records, but I think I have found a way to do so succinctly -- they suck. They suck as products, and they suck the life out of everyone that uses them.

 

Ponder this, since President Bush issued his 2004 challenge, the following innovations hit the market -- Facebook (2004), Reddit (2005), Twitter (2006), iPhone (2007), Airbnb (2008), Thumbtack (2008), Rent the Runway (2009), Uber (2009), Instagram (2010), Pinterest (2010), Snapchat (2011), Alexa (2014), Bumble (2014), and dozens of others targeted at specific industries or activities. Each of these platforms changed an industry or changed the way we communicate and share information with each other. They have made positive contributions to our economy and our lives.

 

It is a shame that the efficiencies realized from these platforms have not translated to health care via EHRs. Instead of streamlining the healthcare industry, EHRs have created a plethora of cottage industries and consultants; required physicians to incorporate "workaround;" and, most sadly, the EHR has contributed significantly to the onset of an actual epidemic -- physician burnout.

 

A few weeks ago, I was in San Francisco and had the opportunity to meet Andrew Hines(canvasmedical.com), an engineer who has spent his professional career working in and around the technology industry, including work for a major EHR company. During our conversation, he said something that really stuck with me, both for the boldness of the statement and the fact that, deep down, I think we all know it may be true. He said, "I used to think we could improve the electronic health record from within, but now I realize the only way to truly improve electronic health records is to start over."

 

A Harvard professor known for his work in disruptive innovation, describes this as sustaining versus disruptive innovation. Incumbents focus on incremental improvements in their products whereas new entrants succeed with disruptive innovations. The problem with healthcare and EHRs specifically, is that incumbents have all the market power.

 

Steven Waldren, M.D., director of the AAFP Alliance for eHealth Innovation, summed it up as follows: "The reason EHRs suck is not due to a lack of innovation in technology but rather in a lack of innovation in health care. It seems that the health care industrial-complex, unlike other industries, is insulated from such innovative challenges from new players."

 

Waldren summarized his thoughts in a simple statement, "Without competition, we will not see the technology innovations in health care we have seen in other industries."

 

There are no easy solutions in health care, and improving EHRs is no different. However, we desperately need innovation and meaningful competition in the health information technology and EHR space. The following are three objectives the AAFP is pursuing to increase competition and spur innovation:

 

Make it easier for new companies to enter the health IT marketplace -- The AAFP continues to work on expanding interoperability to allow appropriate access to data stored in EHRs, in a timely manner. The AAFP is aggressively advocating for policies that force EHR vendors and other health IT products to be interoperable based on a defined set of standards. We also believe that all data in the EHR should be available for use by third-party vendors, of course with appropriate privacy.


Make it easier for innovators to design smarter health IT products -- One of the differences between health care and the general IT space is the complexity and fuzziness of the semantics of clinical data. The AAFP is committed to working with others to model clinical data in standard ways that allow developers to make health IT systems that can reason about clinical data and therefore help automate tasks physicians must perform.
Eliminate or reduce administrative requirements placed on health IT products -- The poor usability of EHRs is often due to external requirements established by regulators and payers, such as clinical documentation, which does not add clinical value. The AAFP is actively promoting policies that eliminate or, narrow, those requirements. We believe a reduction in administrative burden will help physicians, and also allow health IT developers to focus on features and functions that add clinical value.
Closing Thought


As you can tell, I am frustrated with the performance of current EHRs and the negative impact they are having on our health care system and each of you personally. The dominant companies in the market have produced products that have largely failed at the core goals established in the early 2000s. As I have noted, technology in every other industry tends to result in rapid improvements to function and efficiencies. Health care simply hasn't seen the same improvements, and the companies that make these products have seen windfalls in the billions, yet their products continue to underperform and fail to meet expectations of patients, physicians, and policymakers.

 

I remain a strong supporter of the broad use of EHRs in our health care system. The EHR still stands to improve the aggregation and distribution of medical information, which would improve our health care system. Without a doubt, the ability to access and transmit medical information among care sites and physicians would improve care and result in efficiencies for patients and the system overall.

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The EHR and Rage Against the Machine

The EHR and Rage Against the Machine | EHR and Health IT Consulting | Scoop.it

The EHR is the latest focus of our rage against the machine. Case in point: Chrissy Farr’s poke at the EHR in today’s Fast Company. Red meat for angry old doctors.

 

What might be interesting is to take a bunch of millennial doctors and make them work for a month with clipboards, fax machines, mailed letters and emulsion films on view boxes? Then we could write a story about the joy and efficiency of manilla folder medicine.

 

I suspect it would put things in perspective.

We fancy ourselves as victims of our technology. But while EHRs have a long way to go, it’s a long way back to paper.

 

I was in an elevator at Texas Children’s Hospital this weekend where there were a number of people looking at their smartphones.  An older gentleman in the elevator remarked shaking his head, “I remember a time when people used to talk.”

 

Actually, no one talked in elevators.  We’ve always stood the same direction and stared at the numbers at the top of the door.

 

It’s easy to blame technology on our human shortcomings.  It’s been suggested that the adoption of EHR has us ignoring patients.  But in the old days, we scribbled on paper.  Irresponsible resident and medical student conduct with social media are blamed on the platform.  But trainees have always done and said stupid things.

Blame it our chauvinistic human bias:  “It’s not me, it’s the machine.”

 

While there are those of us who share a perverse relationship with our tools, it’s important to remember that the world wasn’t necessarily rainbows and unicorns before [insert technology of choice] appeared.

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