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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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Hardware Basics for Electronic Health Records

Hardware Basics for Electronic Health Records | EHR and Health IT Consulting | Scoop.it

Basic Terms

  • Workstation - This refers to the hardware that holds everything a physician or office staff worker needs to perform their jobs: word processing, practice management software, EHR software, fax software, etc.

 

  • Desktop - One of three basic types of workstations. This describes a fixed, hard-wired computer that does not move around.
  • The computer can actually sit on the top of the desk (desktop) or on the floor (tower).

 

  • Laptop - One of the three basic types of workstations. This is a portable computer that has a keyboard and either a touchpad, stick, or mouse for moving the cursor around the screen.
  • It is a fully functioning computer that can be carried or placed on a cart and moved around the office.

 

  • Tablet PC - One of the three basic types of workstations. Tablet PCs contain built-in handwriting recognition software that allows the user to "write" on the screen using a stylus, much as they would write on paper attached to a clipboard. Tablet PCs can have add-on keyboards for instances when typing is preferred.

Desktops

The basics:

  • A desktop computer usually has a standard configuration consisting of a CPU, monitor, keyboard, and mouse.
  • It is stationary; it resides in one location and cannot be moved from room to room.
  • It can stand alone or work with any of a variety of network arrangements.

Advantages:

  • Desktops are low-cost and available from a wide variety of vendors.
  • Because desktop PCs are standardized, it is relatively easy and inexpensive to find spare parts and support or to replace a machine.
  • Desktops will run just about any software you need.
  • Additional devices such as microphones, speakers, and headsets are readily available at low cost.

Disadvantages:

  • Because it's stationary, you need to buy a desktop PC for each room in which you need access to your EHR software.
  • Desktops typically take up more space than a laptop or tablet PC. While flat-screen monitors and tower units save actual desktop space, the standard desktop computer requires more room than either a laptop or tablet PC.
  • You must purchase additional equipment to take full advantage of voice recognition and/or handwriting recognition programs.

What your peers have to say:

"Have had wired computers [desktops] in the exam room since 1998 and think it is the best way. I find it less hassle than carrying a computer around all day, worrying about batteries running out or losing wireless connectivity or dropping the computers.

 

The computers are much cheaper both to buy initially and fix if something does happen. I tried a tablet but did not like it all.

 

Never had a problem with children or adults interfering with the computer in the examining room and if you log out when you leave, HIPAA is not an issue."

Laptops

 The basics:

A laptop is a fully functioning computer that is small enough to be portable. Laptops can take advantage of wireless as well as traditional networks. A laptop can easily serve as a desktop machine and can connect via a docking station to a larger monitor and a standard keyboard.

Advantages:

  • A laptop has a smaller footprint and can easily be turned to allow patients to view information on the screen.
  • A laptop is less obtrusive during patient interviews.
  • Most have fairly long battery life and/or an A/C adaptor.
  • Laptops use standard PC inputs such as keyboard and mouse and/or touchpad.

Disadvantages:

  • Although laptops are portable, they can be heavy to carry, typically weighing five to eight pounds.
  • Repairs and maintenance tend to be more expensive because laptops use non-standard or proprietary parts. You may have to send a laptop off-site for diagnosis and repair.

What your peers have to say:

"We work wirelessly with laptops. All [prescriptions] print from one central printer right outside the exam rooms. Benefits of the laptop:

  1. Can open the note and chart before entering the room and bring up appropriate templates. Can enter the room already knowing what HM is late and what the purpose of the visit is.
  2. Can close the note right outside the room if you want to go ahead and have the patient leave before finishing a note.
  3. Can see with bifocals; no neck strain.
  4. Can have all my personal settings and programs handy all the time - PDR, links, hospital links, etc.
  5. Can look at patient easily over the top of the laptop and can easily show patients what I'm doing.
  6. Touchpad is always in the same place in relation to keys; easy to switch from it to typing or tabbing without looking. I like having a full-size keyboard.

Tablet PCs

 The basics:

There are two main types of tablet PCs: a slate tablet PC, which is a tablet with no attached keyboard (although one can be added), and a convertible tablet PC, which is basically a laptop computer with a screen that can swivel and fold onto the keyboard to create the tablet.

 

Advantages:

  • Tablets are truly portable and lightweight, typically weighing three to four pounds.
  • It is as powerful as a PC, but it doesn't require a keyboard. Instead, you add information by writing on the screen with a digital pen or stylus, much like you do in a paper chart.
  • Handwriting recognition software developed for tablet PCs is excellent, even for very poor handwriting.
  • Tablet PCs have integrated dictation capability with voice recognition software that transcribes directly into the patient record.

Disadvantages:

  • Writing with a stylus takes getting used to; there is a longer learning curve in adapting to a new way of using a computer.
  • Handwriting recognition dictionaries have not yet fully integrated medical terminology and acronyms, requiring more correction.
  • There is not as much standardized software yet available for tablets.
  • Screens are easily scratched and can become unusable without screen protectors purchased at additional cost.
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Selecting the Right EHR 

Selecting the Right EHR  | EHR and Health IT Consulting | Scoop.it

Developing an EHR Evaluation Matrix

An evaluation matrix is a simple grid. Across the top are the criteria you want in your EHR and down the side are the EHRs you're considering.

 

You can enter the information about how each EHR meets your criteria and easily compare products. You can also send the empty matrix to each vendor you are considering and ask them complete it.

When EHR certification standards become a reality in the not-too-distant future, it will be easier to evaluate products based on their functionality.

 

Then the evaluation matrix becomes easier and criteria such as vendor stability, compatibility, and interoperability will move to the forefront of the evaluation process.

Understanding EHR Demonstrations

Several options are available to see an EHR demonstrated. Each method has its pros and cons, and you may choose to use more than one in your evaluation process.

Non-interactive video: This requires the fewest resources from the practice, but it is also offers the least benefit.

 

This type of video can give you clues into the complexity of the user-interface and a glimpse into the functionality.

 

Keep in mind that the video was produced by the vendor to showcase the best of the product and what the vendor thinks is important. This type of demonstration is useful when your EHR list of contenders is long.

Interactive trial demo: This requires more time compared with non-interactive video. Your goal during the demonstration should be to gauge the ease of use. The questions you want answered are:

  • Is the product intuitive? 
  • Is it easy and quick to perform repetitive tasks (e.g., writing a prescription)? 
  • Is it easy to find specific patient information?

 

Vendor directed demo: This will require more time than an interactive trial demo and you will need to schedule it with the vendor. Your goal during the demonstration should be to understand the true functionality available in the system. (If you have not already had an interactive demo, you will need to answer those questions as well.) Come prepared with your list of criteria from your evaluation matrix.

 

You want to see how the functions you require are accomplished. Also bring any issues you uncovered during the interactive trial demo.

 

Besides the functionality, you want to see the workflow. The easiest way to accomplish this is to bring some clinical scenarios that mirror what you see in practice (e.g., acute visit for URI; chronic disease care for new and follow-up patients; routine visits such as annual or well child exam).

 

Study how these mock patients flow through the system and how the data is entered and viewed by front desk, nurse, physician, billing, etc.

Live site demo: This requires the most resources from the practice, but offers the largest reward in terms of getting data about an EHR. Because of the time, travel, and money involved in this type of demonstration, many physicians limit these to their final few contenders.

 

To set up a live site demo, you first need to find peers like yourself that are using the EHR in their practice. You can ask the vendor to give you a list of family physicians using their EHR in your region. By asking a vendor for a list, however, you accept the likelihood that these users are happy with their EHR– since it is in the vendor's best interest. You can mitigate this by doing two things:

 

  1. Ask for a list of ten to 20 users
  2. Briefly interview the users by telephone before scheduling a site visit

 

Asking for such a large list and interviewing users can help you find some who may have had a problem with the EHR.

 

You want to ask questions about how they deal with negatives of the system and how well they can explain the functions of the system. This demonstration should build on the previous demonstrations. If you have the resources, doing more than one site visit for a particular EHR is beneficial.

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3 Roles to Support EHR Optimization

3 Roles to Support EHR Optimization | EHR and Health IT Consulting | Scoop.it

Technology should make it easier for Physicians to get their work done, right?  I mean, it seems to work in all other industries and most other aspects of our lives. So, why should healthcare be any different? Well, the fact remains that healthcare is very different. Physicians are trained to be independent thinkers using all available data. Each patient looks for a personalized decision to improve their health and wellbeing.

 

This autonomy of clinical practice is generally not compatible with most of today’s electronic health record (EHR) systems, which has led to a decrease in clinical efficiency and growing frustration for all care team members. While this individualized approach may seem beneficial, advances in medicine and surgery have identified uniform diagnostic and treatment protocols that lead to better patient outcomes in all disease categories.

 

Further, regulatory and payor data collection requirements have added layers of additional burdens to health systems that require the use of standardized technology systems. Optimization is making the best or most effective use of a situation or resource. Within healthcare, this means EHR Optimization.

 

As healthcare systems look to optimize Physician workflows, they should invest in three key supporting roles to help ensure success.

 

1. Process Improvement Specialists - In general, to reliably achieve results, you need a standard approach. A variation in approach leads to a variation of results; this applies to clinical practice as well. Before any new tool, whether it’s a scalpel or an order set, is given to a Physician, all care team members, especially the Physicians, need to understand how that tool will make them more efficient and why it’s effective in driving a particular outcome.

 

If that tool does not enable both tasks, it will likely not be adopted. High performing healthcare organizations understand that concept and intentionally leverage Process Improvement Specialists to focus their efforts on the process before implementing a transformation initiative.

 

They carefully map out the steps for each standardized process and look to understand how technology and insights can provide value along the way. Once a new process is defined, a change management education plan is formulated based on the gap between current and future state.

 

This is an absolute requirement before considering implementing new IT functionality. Otherwise, end-user adoption and optimization will be much more challenging.

 

2. Application Solutions Analysts - As successful organizations design standardized processes, they look to technologists to help them work smarter and not harder.  Typically, Application Solutions Analysts serve in that capacity.

 

These individuals are not only well versed in the functional capabilities of the core EHR system but are also in tune with the industry's best practices for a given process. The “out of the box” functionality promoted by EHR vendors rarely fit ideal workflows and almost always require some amount of configuration to meet the organization’s best practice process.

 

Furthermore, there is often decision support logic or machine learning algorithms that Physicians can leverage to enhance the diagnosis and treatment of patients. To drive innovation, healthcare teams must understand the “art of the possible” from their core systems and incorporate new capabilities into their workflows.

 

3. Insight Engineers - The third leg of the optimization stool is the measurement.  If you can’t measure it, you can’t manage it. Many health systems fall short with the adoption of change simply because they lack the data needed to measure the on-going success (or failure) of their initiatives. Insight Engineers, skilled in measuring lead and lag key performance indicators (KPIs), are valuable participants to the change management process as they bridge the divide between the care delivery teams and the IT analytics/informatics teams.

 

They work with subject matter experts, Applications Solution Analysts, and Process Improvement Specialists to define actionable KPIs that care teams will use to achieve their goals and work with the IT teams to deliver them before go-live.

 

Clinicians and operators need to understand compliance and variation to process in real-time or near-real-time to achieve sustainable clinical outcomes.

 

For example, knowing which Physician is deviating from a specific component of sepsis protocol at the moment is much more impactful to course-correcting behavior than finding out 45 days later in an aggregated report. Without actionable dashboards, leadership will struggle to hold all teams accountable for the care delivered.

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5 Common Misconceptions About Implementing an EHR Platform

5 Common Misconceptions About Implementing an EHR Platform | EHR and Health IT Consulting | Scoop.it

As manager of the front office of a small healthcare practice, it’s your responsibility to do your research. Since 2009, when the HITECH Act mandated the adoption of EHR and supporting technology, administrators have been tasked with finding the best EHR solution for their practice. It’s important to note that if you have formed preconceived opinions about EHR features and functionality, you may end up with a platform that doesn’t actually meet your needs as well as one could.


In an effort to avoid patient record errors and keep costs down, here are five common misconceptions about implementing an EHR, which will help your small practice remain as efficient as possible.


1. EHRs aren’t easy for an entire practice to adopt.

A common pushback of implementing an EHR solution is that it will be too complicated, time-consuming, and counterproductive for all of the practice staff to adopt a new technology and process.

The good news is, you’ve got options. There are flexible EHR platforms that will actually make your job a lot easier, fast. Furthermore, specialty specific EHRs will automatically adapt to your practice specialty and ensure an accurate workflow.


2. An EHR solution will be myopic.

While people may think that whichever EHR you choose will serve one function, comprehensiveness is actually a major benefit that you can take advantage of.

Comprehensive EHR platforms will enable you to perform a number of activities — like scheduling, charting, and E-prescribing — from one central location. Not only will this allow you to fulfill all of your practice’s needs from a single place, but it’ll help you avoid using disparate systems and keep costs down.


3. Your process will not improve.

If you think that implementing an EHR platform will decrease the efficiency of your workflow and your practice’s profitability, think again. Using a comprehensive, closed-loop system will actually enhance communication and transparency among your staff, boost productivity, minimize risk for error, and ultimately ensure better patient outcomes. The right EHR solution will simplify and streamline your process.


4. You will see no ROI.

If you’re hesitant to adopt an EHR because you don’t think you’ll see a return, know that this route can actually save you significant time and money. Improving your workflow efficiency with an adaptable EHR will allow you to optimize your resources and run a much more productive practice.

Remember that a cost-efficient EHR is an option. Also, some platforms even include practice management, which can help enhance transparency in your practice and measure ROI instantly.


5. EHR implementation will take away from the patient experience.

Your patients require your utmost attention — and an EHR can help you ensure your patient relationships are strong. Flexible, cloud-based, specialty-specific EHRs will help you uphold the level of personalization and comprehensiveness that your patients expect, and also minimize errors and improve patient satisfaction.

Understanding that an EHR solution with these capabilities is step one; opening the door to a brand new solution is step two. If you’re ready and willing to see how an EHR platform can benefit your practice, start your free trial of Practice EHR by clicking below!

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Vignard Sophia's curator insight, August 23, 2019 9:36 AM
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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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9 Best Practices For Choosing EMR Software 

9 Best Practices For Choosing EMR Software  | EHR and Health IT Consulting | Scoop.it

Selecting an electronic medical record (EMR) or electronic health record (EHR) for your medical practice is a challenging, but very important task. Purchasing and installing a new EMR system require a lot of research and time. The best EMR software for your practice will fit in with your practice’s workflow and increase efficiency, but a bad EMR will halt your workflow and cause frustrations.

The following best practices should be considered before selecting and implementing a new system, to ensure you select the best EMR for your practice. 

1. Create a list of requirements.

Make a list of EMR software requirements based on the needs of your practice. This list may include the need for e-Prescribing software, automatic billing, scheduling features, and others. Also map out your ideal practice workflow and usual patient visit flow to determine how potential EMR software could complement your workflow instead of hindering it.

It is important to involve all the physicians and staff in your office in the development of this list, ensuring that all aspects of the practice have been considered. However, a physician should be in charge of the decision, not the back-office or IT staff. This decision requires leadership and an understanding of the medical requirements.

2. Analyze your budget.

Purchasing and integrating an EMR system into your practice workflow can be costly. However, the benefits of EMR systems can be worth the financial investment and may even help your practice save money in the long run. Besides the initial EHR / EMR costs, there are hardware, implementation, training, and maintenance costs to consider when purchasing a new system. Find our more about what EMR costs you can expect with a new EMR system.

3. Only consider specialty-specific EMR systems.

EMR software that is designed for your particular specialty is customized to deal with the unique characteristics associated with your specialty. The customization includes specialty-specific features and templates. It is crucial that you only consider software that is designed for your specialty, not software that you need to make adjustments to in order to use. This will help your practice workflow tremendously.

4. Systems architecture.

There are many factors of the EMR system to consider, including the system architecture of the software: web-based or client/server. One type of system architecture is not better than the other, however, one may be better for your particular practice. When choosing EMR software, you will need to decide which type of system architecture is best suited for the needs of your practice and will complement your workflow. Read more about web-based vs client/server EMR.

5. Ensure the EMR System has been certified

Any EMR system you are considering for your practice should be tested and certified by an ONC-Authorized Testing and Certification Body (“ONC-ATCB”). The ONC (Office of the National Coordinator for Health Information Technology) is the responsible agency for establishing EMR certification standards and certifying vendor EMR products. ONC-ATCB certification assures that your EMR has met required Meaningful Use (“MU”) objectives and measures. This is a prerequisite to obtaining MU Medicaid (up to $63,750) and Medicare (up to $44,000) incentives for adopting an EMR, and avoiding penalties for not adopting one.

6. Get advice from other physicians and staff.

The best way to understand how an EMR system will fit in with a practice’s workflow is to witness it first hand. You may want to visit a practice that currently using the EMR software you are considering implementing. Talk to physicians and the staff about the EMR software to find out if the software would be suited to your practice and what issues you may face with usage or installation.

7. Decide how much support you will require.

Most vendors will offer 24/7 support, but you need to make sure you understand what sort of support you will be receiving. You may need nighttime or weekend support if your practice is open beyond normal office hours. You may also need on-site help instead of help from a call center. Lastly, understand the extent of the support you will be receiving. Instead of just technical assistance, you may want additional assistance installing new features and upgrades, and fixing bugs. Be sure to ask these questions before purchasing from a particular EMR vendors.

8. Have a lawyer review the purchase agreement.

Since purchasing an EMR software is a big commitment, have an attorney review the purchase agreement to make sure the software is what was promised and includes the right features. Also be sure you understand all the costs and additional fees associated with the EMR software purchase.

9.  Spend time installing the EMR system.

Transitioning to electronic medical records takes a lot of time, so do not underestimate the time and effort you will need to put in. Apart from installing new hardware and software, you will also need to manually scan or input existing paper records into the system. Be prepared to hire additional help during this process, as it can be time-consuming and disruptive to your workflow. It is also recommended that physicians schedule fewer appointments during the transition time.

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What Features Should You Look For In EHR Software?

What Features Should You Look For In EHR Software? | EHR and Health IT Consulting | Scoop.it

The dental EHR market is an exciting area of study since dental providers have not adopted EHR at the same rate as other medical professionals.

 

The main reason for the low adoption rates of dental EHR is the underdevelopment of the market, which is evidenced by the existence of very few EHR applications and modules appropriate for dentists.

 

What features should dental providers look for in dental EHR?

 

1. INTEROPERABILITY

 

Interoperability connotes the ability of a dental EHR to exchange and share information with other EHR platforms.

 

Interoperability is a function of all EHRs and is not specific to dentistry. However, dental EHRs should consider interoperability to take advantage of incentive programs.

 

2. DECISION SUPPORT

 

Decision support is an important application of dental EHR that captures, displays, analyzes, and stores digital images and consequently proposes treatment options.

 

Dentistry practices that utilize a mapping system can benefit from decision support applications by analyzing images such as an X-ray to generate a course of treatment that is evidence-based.

 

3. TREATMENT PLANNER

 

Planning of treatment in dentistry is vital in supporting care transitions, quality improvement, population health management, and coordination of care.

 

Dental EHR can generate valuable data based on factors such as a patient’s fluoride exposure, intake of sugar, frequency of treatment, and most recent restorations to allow for planning of treatment.

 

4. E-PRESCRIBING

 

E-prescribing allows dentists to experience numerous benefits such as reduced prescription errors, and reduced amount of time spent prescribing, adjusting, and refilling medication orders.

 

Incorporating an e-prescribing module in dental EHR is a way of coordinating care, enhancing the quality of care, and avoiding medical errors.

 

E-prescribing allows dental EHRs to alert dentists to the risks associated with the prescription of certain medications to their patients.

 

Although the risk of adverse effects is minimal in dental practices, there is still a risk of adverse drug events from prescribing the two main types of drugs – painkillers and antibiotics.

 

The dental EHR market does not have the range of choice present in other markets in EHR. The features outlined above can offer benefits to dentists seeking to adopt dental EHR.

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How Small Practices Can Use Software

How Small Practices Can Use Software | EHR and Health IT Consulting | Scoop.it

Dental practices are using EHR systems to organize patient records digitally and improve patient visits.

 

However, smaller dental practices may have a harder time taking advantage of EHR systems, but they can still benefit from EHR by understanding the best systems for their practice.

 

Smaller practices can still transform their health care by leveraging systems that improve key areas.

 

WHAT IS EHR?

 

Before a small practice can utilize an EHR system, they must first understand what EHRs are and how they can improve patient care. Basically, EHRs are digital copies of patient records that can be shared easily with other certified healthcare professionals to provide quick and accurate care to patients.

 

These systems provide up to date information which is easily accessible at the point of care to ensure other doctors and practices have the necessary information to diagnose and treat patients effectively.

 

EHR FOR SMALL PRACTICES

 

Smaller practices can still take advantage of EHR systems by using them to improve certain areas of their operations. Mobile EHR systems are in high demand and can improve prescribing medicine, reviewing medical notes, communication between the doctor & patients, and customizing patients’ charts on mobile devices for quick access.

 

They can use cloud-based EHRs for both long-term and short-term benefits by aligning it with management strategies. Portals enable patients to provide information from outside the clinic saving time and improving patient satisfaction.

 

BENEFITS OF ELECTRONIC HEALTH RECORDS

 

Cloud-based EHR systems remove the burden of maintaining a personal data server and save costs. Software catches mistakes by flagging them, making digital systems less affected by human error. They also help with finding the right treatment plan for each patient, improving engagement with patients.

 

To determine which EHR systems to implement, review the business data to determine which areas need improvement. Make a plan to help meet important goals such as improving patient satisfaction.

 

The bottom line is that small practices can still benefit from EHR systems by implementing mobile systems, cloud-based systems, and patient portals. With these simple systems, smaller practices benefit from improved communication, patient satisfaction, and better information sharing during emergencies.

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morganadwards asd's curator insight, April 24, 3:49 AM

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Reduce the Pain of Switching EHR Software with These Four Steps

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

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

 

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

Start your search for a new EHR vendor with these steps

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

Step 1: Develop a Request for Proposal (RFP)

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

Step 2: Give them a wish list

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

Step 3: Research, research, and more research

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

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

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

Have questions ready

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

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

A partnership built on trust every step of the way

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

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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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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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Essential Questions for Picking EHR Patient Portal Software 

Essential Questions for Picking EHR Patient Portal Software  | EHR and Health IT Consulting | Scoop.it

It’s time to revisit the much undervalued, if much maligned, patient portal. To date, patient portals remain an underutilized resource. But a convergence of trends may change your thinking about their value — especially when selecting or upgrading EHR software. To help with that process, we offer a 10-point checklist for evaluating a patient portal’s usability and functionality. 

Patient Portals: A Mixed Bag

Most of us have used a patient portal, and the reviews are mixed at best. A product of meaningful use requirements, they were mandated as a way to provide patients with timely access to their healthcare.

At their most basic, they’re used to retrieve lab results, ask a question or update patient profiles and insurance providers. Some allow patients to schedule appointments and pay bills. For providers, they represent an opportunity to increase patient engagement, promote loyalty, manage costs and streamline workflows.

In reality, their potential has yet to be harnessed. Hard to access, patient portals are often badly designed, cumbersome to navigate and limited in utility. It’s sometimes easier for patients to pick up the phone and call their provider than to look up their user name or create a new password. For staff and physicians, they require time and resources that aren’t usually billable.

Emerging Trends Impacting Patient Portal Usage and Importance

So beyond next-stage meaningful use requirements, why should the patient portal receive greater consideration in the EHR selection process?

Value-Based Care

First and foremost, as healthcare moves from fee-for-service to value-based care, providers will have further incentive to improve the patient experience, track compliance and manage costs.

In a medical research paper — Patient portals and health apps: Pitfalls, promises, and what one might learn from the other — issued last year, the authors asserted that “the push for reimbursement that relates to value-based care creates an opportunity to develop high-quality patient portals.”

In addition to improving patient health and facilitating wellness, patient portals have the potential to free up staff time, lower call volume (including call backs and phone tag), increase accuracy, reduce duplication and cut down on time spent on patient records, payments and prescription refills.

Data

The future of health and medicine points to the primacy of data. Patient portals can yield a trove of information not captured in a doctor’s visit or clinical interaction — resulting in better population health management and a better ability to track patient engagement and improve adherence to treatment plans.

Patient as Consumer

Patient portals will grow in popularity as patients evolve into healthcare consumers. Increasingly, they want better, faster access to their health information, and to be involved in the medical decision-making process. Patient portals are a natural extension of the trend to go online to select a provider or research medical conditions and treatments. They’re going to expect a positive user experience, rewarding those who do with their loyalty.

Mobile Apps/mHealth

The growing use of mobile apps, smartphones and wearable devices to monitor and upload information about their health and physical activity facilitates more patient self-management and data exchange with their patient portal.

10 Point EHR Checklist for Evaluating Patient Portal Usability

Given the patient portal’s potential and growing importance, how should you evaluate the best portal for your practice or facility?

As a healthcare provider, you can select a standalone patient portal that oftentimes is hosted by a third-party vendor. This approach can result in compatibility issues with your EHR system, requiring your EHR vendor’s cooperation — often at a price.

Alternatively, you can select a patient portal as part of an EHR bundle of services. The good news is that most EHR systems provide a patient portal component. When evaluating their product, you need to remember that patient portals are not all created equal, and can vary in functionality and usability. As such, you need to take into consideration:

  1. Cost – What is the cost to design and activate the portal? Do they provide training, maintenance, troubleshooting and upgrades?
  2. Customization – Do you have flexibility to customize the interface to take into account your practice, specialty and patient profile?  Is it white-labeled to allow for branding?  Do providers have the ability to make refinements?
  3. Patient Management – Does it provide the ability to refill prescriptions, monitor compliance, track patient progress, schedule/cancel appointments, pay bills, upload documents and download practice forms? If they don’t provide all these services, which ones are most important to you?
  4. Communication – How easy is it for patients to send and receive emails and messages? Can patients upload documents? And does it easily and securely integrate with mobile health apps, in a format that providers can use?
  5. Patient Access – How complicated is it for patients to set up an account?  Is it a multi-step process?  Does it incorporate “responsive design” so that it’s accessible and easily readable on a computer screen, mobile device and a smartphone?  
  6. Usability and Navigation – Is the user experience intuitive, consumer-friendly and easy to navigate? Does the portal present information such as test results in a way that patients can understand and interpret? Can it account for sight-impaired patients and patients who don’t speak English?
  7. Content – Can patients view laboratory results and track immunizations, medications and allergies? Can they access personal health data, notes from physicians and medical histories?  Can they renew medications; update their information (insurance, address changes, etc); view discharge and medication instructions; and access an online healthcare library of educational resources?
  8. Security – Is the site HIPAA-compliant to ensure privacy? How secure is the connection in protecting stored data and guarding against data breaches? Does it meet confidentiality and legal requirements for minors? What is the process for setting and resetting passwords?
  9. Workflow automation – Once patient information has been reviewed and approved, can it be uploaded into your EHR (including care plans, clinical visits, insurance coverage, billing) without additional keying or extra work that can result in errors? Can this process be customized to meet your current and future requirements as procedures and policies change? Can it send alerts?
  10. You: The patient portal is evolving, gaining wider acceptance and growing in importance. Not every EHR can address all of these considerations in a manner that meets your needs. Its components are only part of the equation. The other part is you and your commitment.

For starters, do you have a physician champion or super-user who’ll advocate for your patient portal?  Can you ensure that staff are properly trained, and that it’s maintained and regularly upgraded? Are you willing to commit the resources to ensure it’s routinely monitored and being used properly? Do you have the resources to create awareness and educate patients on how to use and maximize its benefits? And do your internal policies and procedures encourage usage?

Ultimately, you can’t guarantee patient compliance or participation. However, you can select a portal that helps you achieve your business goals and meets your patients’ needs.

Technical Dr. Inc.'s insight:
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