EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Physicians, Nurses Reviews on EHRs Improving Care Quality

Physicians, Nurses Reviews on EHRs Improving Care Quality | EHR and Health IT Consulting | Scoop.it

Slightly more physicians said that electronic health record (EHR) systems have decreased quality of care (44 percent) in their primary workplace than increased it (40 percent), according to a recent poll from Medscape.

 

The survey included 273 respondents—207 physicians and 66 nurses/APRN (advanced practice registered nurses)—and did find that nurses and APRNs, unlike their physician colleagues, saw more benefit than detriment in EHRs. Forty-two percent said they had increased quality of care versus 35 percent who said they had decreased care quality.

 

When asked what aspects of EHRs increased quality of care, the top answer among physicians was the ability to locate and review patient information more easily (59 percent), followed by the ability to electronically subscribe (49 percent), and portability/access to patient records by all members of the care team (44 percent). The same three aspects were ranked by nurses/APRNs as the top reasons EHRs have increased care quality, just in different order.

 

And when physicians and nurses/APRNs were asked what aspects of EHRs decrease quality of care, they gave similar weight to these four reasons: added paperwork/charting; entering data during the patient encounter; lack of interoperability with other systems; and system failures or problems.

 

When asked how they would like to improve these systems, physicians' top answer was to make the systems more intuitive/user-friendly (44 percent), followed by allowing greater interoperability and record sharing (30 percent). Nurses/APRNs said they would most like to see more interoperability and better record sharing (33 percent), followed by making the systems more user-friendly (30 percent).

 

The poll also revealed that few physicians or nurses were involved in the decision of which EHR to use in their primary workplace. Among physicians, 66 percent had no input, 28 percent had input, and 7 percent did not use an EHR system. Far fewer nurses were part of the decision making: 80 percent had no input, 18 percent had input, and 2 percent did not use an EHR.

 

There has been no shortage of studies over the years that have measured physician satisfaction with EHRs and how they impact the quality of care. Most have generated mixed results. For instance, Stanford Medicine’s 2018 National Physician Poll found that about two-thirds of the more than 500 primary care physicians surveyed think EHRs have generally led to improved care (63 percent) and are at least somewhat satisfied with their current EHR systems (66 percent). These same survey respondents did also continue to report problems with these systems, however, and many (59 percent) said that EHRs need a “complete overhaul.”

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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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How to Choose the Right EHR Vendor for your Practice

How to Choose the Right EHR Vendor for your Practice | EHR and Health IT Consulting | Scoop.it

Electronic Health Records (EHR) Software has gained considerable attention from practices worldwide due to its innumerable advantages. EHR’s are built to provide an organized, accurate, and cost-effective documentation process. Using one saves time and reduces paper work drastically, thereby enhancing productivity. But, finding the EHR system that best suits your practice and also installing it correctly are two major challenges that you are likely to face before reaping the real benefits of an EHR. So, before you go further with your EHR planning, let’s first have a look at some important pointers to keep in mind while looking for the best EHR vendor.

 

There are so many EHR vendors waiting for a chance to gain your business. They all offer attractive service packages and discounts to make their product seem the most attractive. But, they can’t all be the best in actuality, so it’s important that you consider some critical questions. These questions will equip you with sufficient information about the vendor and will help you make an informed decision. Below are the primary items we’d recommend you think through before going forward:

Tips for Choosing the Right EHR Vendors for your Practice

  • Compatibility and Reliability

If you are used to evaluating vendors on a regular basis, then you would be aware of the requisites of the vendor selection process. But for those not accustomed to this, the first step is to determine that the EHR system in question is compatible with your company’s infrastructure. For that, a trusted and reliable vendor should be chosen who has a solid history, including an impeccable service record. Customer reviews say a lot about a product or a service and are worth looking into.

  • Meaningful Use (MU) Criteria

There are certain criteria that’ll help you shortlist a vendor. The EHR incentive program has set the meaningful use criteria specifically for the EHR systems, so look to this as a priority. It is a common feature found in EHR systems, but the latest one is the MU3 category.  We would recommend that you make sure your new one has this.

  • Aligned Core Values

You want an EHR system made specifically for the management of healthcare-related information and organized for proper documentation. But, it should also align with the needs and values of your practice (a.k.a. customization options). The vendor should be willing to design a unique service package that suits your core operations, too.

  • Impressive User Experience

Although this is not the number one priority list, it’s still important to keep in mind when picking the right EHR system. A system with a confusing workflow that isn’t intuitive won’t work. Ignoring this would be a mistake. Make sure you and some team members of your practice try it first to confirm whether it’s the right fit from a usability perspective.

 

These are some of the key characteristics to think through. Before stepping into the market, do some homework and shortlist all the potential EHR vendors that seem to carry potential. Then, conduct some research on each one of them to narrow down your list. These steps will save you time while guaranteeing, to a great extent, the trustworthiness of your vendor and effectiveness of your decision.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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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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Population Health, EHR, Analytics Needs Drive Orgs to Consultants

Population Health, EHR, Analytics Needs Drive Orgs to Consultants | EHR and Health IT Consulting | Scoop.it

 

August 15, 2018 - Health IT consultants are reaping significant financial rewards as provider organizations seek to bulk up their population health management technologies and big data analytics toolkits, according to a new survey from Black Book Market Research.

 

As pressure to engage in data-driven value-based care initiatives increases, healthcare organizations are likely to spend close to $53 billion in 2018 on consultants who can provide specialized project management expertise and technical aid for health IT optimization.

 

Around 64 percent of that market opportunity, or just under $30 billion, will center on the implementation, optimization, and integration of health IT systems that can support cost reductions and quality improvements, the survey of more than 1500 respondents indicated.

 

Hospitals, health systems, payers, pharmaceutical developers, and physician groups are all turning to consultants in droves due to widespread organizational challenges.

 

Eighty-one percent of respondents said that consultant contracts can help them cope with the lack of highly skilled IT professionals, while 74 percent are looking for support as cloud technology becomes more common in the healthcare environment.

 

More than 60 percent of organizations are looking for help optimizing their electronic health records (EHRs) and revenue cycle management (RCM) technologies, while 46 percent plan to supplement their technology training and implementation capabilities in 2019.

 

Value-based care, including population health management tools and strategies, is top of mind of 39 percent of respondents. Thirty-one percent are looking to improve their big data analytics and clinical decision support competencies.

 

A third of organizations are hoping to leverage consultants to help them work through compliance issues, as well, while 37 percent are interested in expanding their cloud infrastructure.

 

Cybersecurity, interoperability, and consumer-facing initiatives were less pressing but still of interest to participating providers.

 

Provider groups, payers, and health systems aren’t the only ones looking to leverage technology to streamline operations and create efficiencies.

 

Consultants, too, are shifting from traditional methods of deploying a specialist for an intensive project to using technology to automate processes and collaborate more efficiently, said Doug Brown, Founder of Black Book.

 

Organizations are also willing to take advice from experts with deep experience in niche problem-solving, and are likely to engage a number of different boutique firms that will be asked to work together to solve business problems.

 

Eighty-four percent of respondents said they will be taking a pick-and-mix approach to contracting with consultants.

 

“There is an accelerating trend away from one large consulting group retained to execute a substantial project for a health system client wherein 2019 we will see more arrangements where healthcare clients press multiple consultants and advisory firms to collaborate on project engagements,” said Brown.

 

“With the expanded network of knowledge, clients can gain their desired insights, and the relationships between the different consultants are mutually beneficial.”

 

For organizations that prefer one-stop shopping, Black Book identified eight comprehensive consulting firms that scored at least 9 out of 10 on all 20 key performance indicators monitored by the group, including technical support, optimization and implementation skills, system selection advice, and planning and analytics.

 

Among 142 comprehensive advisory firms ranked by customers, only Chartis, ECG Management Consultants, Huron Consulting, Impact Advisors, Leidos, KPMG, Optimum Healthcare IT, and The HCI Group received perfect or near-perfect scores from their customers.

 

The survey supports the results of a previous Black Book poll from May of 2018 that also tracked a significant uptick in reliance on outsourcing and consultants among physician groups.

 

At the time, more than two-thirds of physician groups with ten or more members were planning to hire a consultant by the middle of 2019, closely mirroring the interest outlined in the latest assessment.

 

A whopping 93 percent of the physician executives participating in the May survey admitted that they needed external help because their organizations lacked a strategic value-based care transition plan.

 

Less than 7 percent had started the process of choosing the health IT and analytics tools that would equip them for success with population health and revenue cycle improvements.

 

The lackluster preparedness landscape may be worrisome for providers, but it is good news for consultants looking to take advantage of multimillion-dollar opportunities to set organizations on the path to population health management, mature analytics architecture, and financial success with value-based care.

 

Provider, payer, and developer organizations that find themselves behind the value-based care curve will have ample opportunities to take advantage of consultants in a rapidly expanding market for specialist health IT skills.

Technical Dr. Inc.'s insight:
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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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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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A prescription for EHRs and patient engagement 

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

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

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

 

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

 

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

 

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

 

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

  • Shared information
  • Shared engagement
  • Shared accountability.

 

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

 

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

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When Doctors Choose a Job Based on the EHR

When Doctors Choose a Job Based on the EHR | EHR and Health IT Consulting | Scoop.it

I recently had lunch with a young doctor new to our community. The conversation wandered on to how she settled on her new position and the EHR was identified as one of her key selection criteria. She heavily favored positions with institutions running EPIC.

 

Interesting, I thought. Because when I took my first job, the brand of manilla folder used in the patient chart played no role in my decision. Clearly, times have changed. And so have the doctors.

What does this tell us about doctors and technology?

 

Not everybody hates electronic health records. The generation that never felt paper has officially entered the clinical workforce. And despite the popular press and their drive to perpetuate anti-EHR sentiment, not everyone hates EHRs.

 

Our experiences are increasingly defined by our tools. The clinical tools that surround us go a long way in determining our quality of life. So the EHR is likely to shape how we view a position. I’m working on my second EHR system in a decade and my day-to-day life is very different.

 

Technology can draw or repel talent. The technology we use and the systems we choose are likely to impact the docs we recruit and the talent we retain. Hospital systems that use dated and/or dysfunctional EHR systems are likely to feel the impact at some point.

 

An isolated case you might think. But the truth is that millennial physicians see the world and the workplace through a very different lens.

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Pros and Cons of Patient Access to Electronic Medical Records

Pros and Cons of Patient Access to Electronic Medical Records | EHR and Health IT Consulting | Scoop.it

Doesn’t it seem faintly ridiculous that patients have to jump through hoops to get access to information that, since it is in digital format, would be so readily available to them? Today’s patients are quite accustomed to being able to access data on demand, from whatever location on Earth, as long as they have Internet access and a mobile device or laptop computer.

 

They can, for example, log into their financial institution’s website to check their latest details. Parents of school-aged children routinely access a portal developed by their school to get information about upcoming tests, new requirements, and so on.

Furthermore, the advent of email, text messaging, and social media updates has lead to people becoming accustomed to easy communication with one another. But think about how much of an effort it is for patients to communicate with a medical practice (waiting on hold on the phone to leave a message for a nurse practitioner, for example, and then having to wait more for a reply that might not come until the following day).

 

You may have already deployed a patient portal for your organization, but are not quite sure about the protocols for sharing information. Or, you are somewhat familiar with patient portals, but you’re still not sure whether it’s a good idea to even have one and you would like more information before making an investment in this software solution.

 

Familiarizing yourself with the pros and cons of patient access to electronic medical records is essential before you pull the trigger and launch a patient portal at your organization.

Modern medical practices that have forward-thinking leaders will already have electronic health record or EHR software installed or are about to deploy it. An EHR is a database of all the records for your patients. It’s much more efficient than an antiquated, paper-based method for organizing charts in your practice. The EHR lets you keep track of all important information, from medical history, current diagnosis, details of the treatment plan and any medications that have been prescribed.

One feature of Electronic Medical Records software that medical professionals should be aware of is the patient portal, along with its benefits and potential drawbacks.

Pros of Allowing Patients to Have Access to their Electronic Medical Records

A major pro of patient portals is that they improve patient engagement. Engaged patients are more likely to stay loyal to a practice as compared to other organizations that don’t make much of an effort to connect.

Your staff can easily receive messages from patients over the portal, in a process that’s as easy as email. This cuts down on a lot of wasted time on both ends (patients forced to stay on hold to leave a message by phone, and staffers having to write down the message).

 

A patient portal reduces the total amount of time spent on the phone and can cut down on unnecessary visits. What’s more, it has been proven to reduce the number of no-shows.

Patients will be happier, since they can access their medical information using their own electronic devices, even when on the go.

They will also appreciate being able to check prescription information and request refills online. When patients need to schedule an office visit, they simply sign into the portaland make a request. This makes things easier for them as well as for your staff.

 

Finally, a patient portal eliminates one of the great drudgeries of modern medicine: patients having to fill out a big stack of paper intake forms before they have their first meeting with the doctor.

You can let them input their information through the portal (such as at a kiosk in your waiting area, or from the patient’s computer). They won’t have to fill in their address or list of allergies more than once, and your staff won’t have to transcribe information from potentially messily handwritten documents.

Cons of Allowing Patients to Have Access to their Electronic Medical Records

While there are a number of clear benefits to using a patient portal with your EHR or EMR, there are also some drawbacks to be aware of, so you can address them head-on.

For example, when you enable outside access to your EHR information via a portal, data security concerns will naturally come up. The system must use strong passwords and should include the latest encryption and other protections. Otherwise, patient data could be compromised, leading to fraud and identity theft.

A portal can be tough for some patients to comprehend, especially if they have been used to doing things the old-fashioned way. However, you can educate and acclimate patients to the portal when you explain the benefits to them.

There is also the issue of patients being exposed to more medical jargon then they are used to, including acronyms and strange Latin terms for body parts. But they can always look up terms they are unfamiliar with, or simply ask a member of your team for an explanation.

 

Your older patients may not be very tech-savvy, which could hinder their efforts to log in and access data through the portal. But portals interfaces can be easily simplified and a simple training brochure or online video could make a big difference in getting more patients used to the idea of using the system.

It’s natural to have a number of questions about installing an EHR and activating a patient portal for your practice. Once you have a better idea of how patient portals can empower your staff as well as your patients, you’ll be on your way toward deploying one in your organization.

Key Takeaway:

  • Electronic health record or EHR software enables you to activate a special patient portal.
  • A patient portal is a great way to let patients access their own information on demand.
  • One con to keep in mind with patient portals is that some patients may not have much experience with computers, preventing them from getting the most out of it.
  • Another drawback is the potential for data breaches, so you’ll need to work with a vendor that provides robust, secure EHR software.
  • Patients will appreciate being able to check into the system to set an appointment or request a prescription refill.
  • Your staff will waste less time because patients can leave them electronic messages via the portal, instead of having to stop what they are doing to respond to a call.
  • Patients find it liberating to gain more access to their lab test results through the portal, rather than waiting for the report to come by surface mail or a phone call from the physician.
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How EHR is different from EMR?

How EHR is different from EMR? | EHR and Health IT Consulting | Scoop.it

EHR and EMR have been in our vocabulary for nearly 20 years. Since the 1990’s, clinical environments have increasingly relied on technology to function and improve patient care. Today, our methods are becoming incredibly sophisticated, particularly following the application of Stage 3 of Meaningful Use in 2016. Because of this, it’s important to take a look at a commonly misunderstood distinction: EHR (electronic health records) and EMR (electronic medical records).

 

The Basics of EHR vs EMR

Back in 1995, one could arguably use EHR or EMR interchangeably. This is because electronic medical records systems were just that: an electronic version of the medical chart. But as the years have gone by, our technological functionality became more robust, stretching far beyond the exam room or even the clinical setting. In fact, it’s very common now for the patient to have access to their own records, physician communication, and more all from within their home.

It is for this reason that the Office of the National Coordinator for Health Information Technology (ONC) has made a detailed study on EHR vs EMR.

 

How Records Systems Affect Different Parties

One way to better understand records systems in healthcare is to consider how those systems affect different parties. Let’s take a look at EHR vs EMR systems in terms of three different major parties in healthcare.

 

Patients  Improving patient outcomes is one of the largest and most important objectives of healthcare records systems. Patients rarely cross paths with EMRs. However, they are affected by them through follow-up exams, regular checkups, and other indicators over time. EHR systems, on the other hand, enable the patient to view their health reports, contact their healthcare providers, view referrals, pay their bills, and much more.

 

Providers  For providers, records systems not only help to improve patient care through improved data accuracy and alerts such as medication contradictions, but they also help to close gaps in communication and improve clinical workflow efficiency. This is true for both EHRs and EMRs, but the advantage an EHR has over an EMR for physicians is its ability to communicate information beyond the practice to patients, specialists, hospitals, and more. EHRs “move with the patient,” as explained by the ONC, as opposed to staying solely inside the walls of one practice.

 

Vendors  While vendors are responsible for providing a health records system, requirements for those systems can change over time, especially for certified EHR technology. EMRs are no longer sufficient to support a medical practice and its patients. Instead, EHR systems enable vendors to offer comprehensive, customizable services to medical practices that include everything from billing, to charting, to scheduling, and more, all while staying abreast of federal requirements like HIPAA and Meaningful Use regulations.

 

In the end, EHR systems are a direct reflection of how far technological advancements have taken the industry of records systems in healthcare. What once was simply an electronic version of a chart has become a real-time reflection of a patient and their health. This makes an EHR more powerful to the benefit of all parties involved, but in particular, to the patient.

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Practice EHR to Attend Midwest Podiatry Conference

Practice EHR to Attend Midwest Podiatry Conference | EHR and Health IT Consulting | Scoop.it

Calling all Midwest podiatrists! Are you looking for an opportunity to collect your continued education credits and collaborate with fellow podiatrists, while having some fun? Well then, we hope to see you at the Midwest Podiatry Conference (MPC) at the Hyatt Regency Chicago on April 19-22.

We are very excited to support the podiatry profession at MPC18, and have some fun activities planned that we hope you'll join us for. Mark your calendars!

  • Stop by our booth - First and for most, we'd like to invite you to come by our booth (Booth #1019) to learn more about Practice EHR and what we do. Meet our team and experience our EHR and practice management solution that's designed for podiatry. 
  • Attend our presentation - Our very own, Natasha Patel, Clinical Sales Director will be leading a fun and informative session on the EHR features you can use to better streamline your practice. She'll also give you an inside look at Practice EHR and how those features work in our software. Details: Saturday, April 21 at noon in the exhibit hall theatre.
  • Hear from one of our clients - This year we're very excited to have one of our clients with us at MPC, who will be leading a presentation session. Dr. Barbara Aung will discuss running a practice from a business state of mind. She'll dive into the numbers of your practice, the cost of treating a patient and how your EHR can help you keep track of your financials. Details: Friday, April 20 at 5pm in Grand AB.

 

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5 Secret Ways for Physicians to Use Your EHR More Efficiently

5 Secret Ways for Physicians to Use Your EHR More Efficiently | EHR and Health IT Consulting | Scoop.it

Implementing an Electronic Health Records system does not in and of itself guarantee a boost in productivity or revenue. However, it would be reasonable to assume that these will happen as a result of putting in the effort to learn how to best use an EHR. We would like to reveal 5 secret ways you can use an electronic health record system (EHR) to boost the output of your practice.

Secret Ways for Physicians to Use Your EHR More Efficiently

Use Medical Voice Assistant

If you are sick and tired of the effort required to complete the documentation aspect of your EHR, then it might be time to start using an intelligent medical-based voice assistant to do it for you. There are many AI-based medical dictation and clinical documentation software options out there that seamlessly integrate with and enable your voice commands to operate your electronic health record software. That said, talkEHR is the only electronic health record software available on the market that comes with an interactive voice assistant named Alison. This next generation technology empowers you to naturally interact with your EHR. You can use voice commands to enable features instantly, and it can also type for you.

 

Shortcuts Save Time

Just like you would save your favorite websites on a browser like IE or Chrome, we recommend that you think through the most useful features of your electronic health records software and then assign them shortcut keys so you can reach them with a single click. Generally speaking, there are a variety of other customization and shortcut options available with regard to setting up your dashboard or tabs as well. Investing the time upfront to customize such elements will ultimately save you time in the long run, thereby making it more manageable to run your practice.

 

Consider Useful Add-ons

Contact your EHR vendor to find out which add-ons are available. For instance, “Smart Pen” is an input device add-on that you use like an ordinary pen to put data into your EHR. These kinds of add-ons will improve the workflow of your practice and are worth your time and investment.

 

Explore your EHR

Electronic health record software is a complex system that is equipped with a range of features that you may or may not be aware of. Many features are built to reduce the hassle of practice management, but as is usually the case with new tools, you need to first know about them before you can explore them. So, we would suggest you fully explore your EHR and make note of the best ones available. You can also schedule a technical meeting with your vendor’s support team to fully understand the capacity of your electronic health record software.

 

Stay Updated

EHR suppliers frequently update the advanced features and bug fixes. We suggest that you ensure your practice is fully aware of this fact and stays updated with all the ongoing improvements that vendor makes to the system. This way, you can utilize your electronic health record software in the best possible way. Using your EHR more efficiently will save time so your practice can see and treat more patients, thereby increasing revenue. And don’t forget, if you have suggestions for your vendor, don’t hesitate to offer them feedback so they can improve their system to meet your expectations and needs.

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How talkEHR's Virtual Assistant “Allison” is Helping Doctors Improve Patient Care 

How talkEHR's Virtual Assistant “Allison” is Helping Doctors Improve Patient Care  | EHR and Health IT Consulting | Scoop.it

MTBC has managed to successfully innovate and serve a large customer base with quality and consistency over the years,  facilitating patients and providers by making the billing process more manageable. Along the way, MTBC has offered various feature-filled PMs and EHR systems with amenities that cut costs and reduce the time spent on data entry, while allowing the providers to dedicate their time and attention fully to their patients’ care.

 

Most recently, MTBC launched talkEHR, which includes a virtual assistant named “Allison.” While the concept of having a virtual assistant is not new technology, the use of voice recognition is. Allison comprehends voice commands and also performs specific functions with increased efficiency.

 

In today’s world, providers are obligated to keep their productivity and efficiency up, and also conform to the latest healthcare policies and standards, which can be challenging. So many of them are focusing on keeping their clerical staff lean and are employing AI-based virtual assistants and EHRs to handle lengthy, repetitive tasks. We’ve built Allison to be ready to assist you so you can competently balance all the tasks mentioned above. Here are some more details about the ways in which Allison is making the lives of doctors simpler than ever:

  • Allison is programmed to manage all incoming phone calls and notify the doctors about them in a timely manner. This smooths out the influx of calls and messages, and also prevents the providers from having to deal with the distraction of any unwanted calls.
  • Allison helps to develop a smart schedule and encourages the provider to stick to it by informing them about any upcoming or missed appointments through timely prompts. Doctors have the ability to set their working days and hours in the system which automatically guides Allison on how and when to best inform the patients about their availability.
  • Allison even follows-up with the patients. This wonderful feature reminds patients of their upcoming or missed appointment through a message or phone call. Despite the automation, this makes the patients feel valued and cared for.
  • If you have any prescriptions, Allison can handle those requests by making a command to the pharmacy. This way, patients get the right medication at the right time.
  • Allison does a wonderful job of getting all the necessary patient information required for making the transcription and billing process a seamless one. She ensures that all the insurance claims created are spot-on so they are accepted by the insurance companies in one-go.
  • You can command Allison to take notes for you. The voice recognition feature will simply convert your voice input into a word file and you will have your notes ready without any hassle.
  • To save you precious time, Allison helps you locate the ICD and CPT codes based on the disease you are diagnosing. This step is crucial as it maintains the medical standards and makes sure that patients receive the correct treatment the very first time. It also helps ensure the accuracy of the claim being generated.

Allison comes with various features that make it an added bonus for your practice and offer far more efficiency than any normal virtual assistant would. And, you don’t have to allot any office space or other resources for Allison. She works seamlessly from within your talkEHR module.  Serving as a bridge between patients, practices, and the insurance companies, Allison takes your commands, understands and translates them, and then delivers results driven by the instructions she’s given. You’re left with an uninterrupted stream of operations built to enhance your productivity, and offer you some much needed convenience along the way.

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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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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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Medical Billing and Coding Trends for 2018

Medical Billing and Coding Trends for 2018 | EHR and Health IT Consulting | Scoop.it

According to the New York Times, disease-classification systems originated in 17th-century London to help doctors prevent the bubonic plague from spreading to populations that didn’t speak English.

 

French physician and statistician Jacques Bertillon (the 1890s) introduced the first medical coding system when he developed the Bertillon Classification of Causes of Death. In the 20th century, the codes encompassed not only causes of death but also the incidence of diseases.

 

These days, medical coding translates the content of a patient’s health records into a universal standard medical code so it can be billed properly. Let’s take a closer look at the landscape to see how things stand, and identify the medical billing and coding trends you should look for in 2018.

 

The medical billing and coding landscape

 

Between 2015 and 2020, Deloitte predicts worldwide spending on health care will increase anywhere from 2.4 to 7.5%. Despite this extra spending, many healthcare delivery organizations are facing increased operational costs, which are eating into their returns.

 

One source of increased operational costs is the ever-expanding complexity of medical billing. The same Times piece cites in-office earwax removal and vaccinations as examples; there exist unique codes for the method used as well as each injection. On top of that, not every payer uses the same coding system.

 

Administrative costs account for a full quarter of U.S. hospital spending; for comparison, those costs sit at 16% and 12% in England and Canada, respectively.

 

While medical billing and coding are ever-changing, there is the general movement toward efficiency. Here are three medical billing and coding trends you should be watching in the coming year; they’ll only get more important as 2018 gets underway

.

Three trends to look for in 2018

 

1. Computer Assisted Coding (CAC)

 

  • Uses natural language processing (NLP) to read and interpret text-based clinical documentation from patient charts.
  • Identifies potentially relevant ICD-10-CM diagnoses, ICD-10-PCS and CPT procedures, and present on admission (POA) indicators to provide suggested codes and corresponding documentation for coders or CDI specialists to review and approve.

 

CAC software is proliferating, particularly for coding inpatient claims. According to a report available through Research and Markets, the global market for computer-assisted coding software is projected to reach $4.75 billion by 2022.

 

According to CareCloud, coding specialists are afraid that the CAC built into EHRs could replace their jobs within a decade. This concern, however, is likely overblown. CAC is a huge help to human coders. According to one study, CAC increased coder productivity by over 20% and reduced coding time by 22% relative to their peers who didn’t use CAC, all without reducing accuracy.

 

2. EHR alignment


Poor record keeping—from not capturing the chart data you need to code correctly to capturing the data but making it hard for a coder to find later—can lead to a variety of problems for reimbursement. Already, most providers spend too much time searching for the right diagnostic codes for their patients rather than looking at and listening to them.

 

If your EHR and medical billing software are integrated, especially if your medical billing offers CAC, the process can go much faster. For example, your software can offer coding suggestions at the point of documentation, making codes more accurate from the get-go.

 

When your EHR has integrated CAC, it can automatically populate patient demographic data into a bill instead of wasting time by requiring staff to re-enter it and introducing the opportunity for errors. Fewer errors increase your first-pass claim acceptance rate, can improve data abstraction, and offer more robust reporting than standalone EHR and billing and coding software.

 

This reporting can include a robust set of financial data, such as units billed per visit, days sales outstanding (DSO) to accounts receivable, net revenue per visit (NRV), staff productivity, referral numbers, appointment cancels, and no-shows.

 

3. Blockchain
In 2016 ONC called for white papers on how the blockchain can improve healthcare. Researchers submitted more than 70 papers, and ONC awarded 15 papers covering everything from precision medicine clinical trials and research to a decentralized blockchain-based record management prototype for EHRs.

 

“Blockchain is booming in clinical trials right now; it is a big favorite of the pharmaceutical sector,” Maria Palombini, director of emerging communities and initiatives development at the IEEE Standards Association, said. Palombini predicts that blockchain has an especially intriguing promise in EHRs.

 

In early 2017. EHR Intelligence’s Kate Monica wrote: “Blockchain is becoming increasingly common as a way to improve the standardization and security of health data.”

 

In September, HealthcareITNews published “Why blockchain could transform the very nature of EHRs.” And Bruce Broussard, CEO of Humana, described blockchain as the next big healthcare technology innovation.

 

There are three primary reasons EHRs should consider adopting blockchain data storage:

 

  • It can offer better privacy protections
  • It can make information exchange easier and more efficient
  • It can increase patient control over their data

 

With blockchain, it could be as simple as a patient giving their doctor a token to access their records. “Using blockchain technology to reconfigure EHRs makes sense,” Elizabeth G. Litten, partner and HIPAA privacy and security officer at Fox Rothschild, recently wrote.

 

Dave Watson, a chief operating officer at SSI Group (an RCM and analytics company), sees tremendous potential for the blockchain to improve revenue cycle management and claims processing.

 

By recording tests, results, medical billing, and payments in an immutable ledger, the blockchain could reduce fraud and even save money by decreasing the time and labor currently used to track that information through various systems.

 

On Medium, strategy, design, and development consultancy Sidebench wrote that the three areas where the blockchain could impact healthcare with the clearest path forward to providing significant ROI through cost savings are developing better health exchanges, protecting patients and practitioners through supply chain accountability, and reducing fraud in billing and claims.

 

Palombini’s “Holy Grail” is when patients own and control their own complete health histories, from the hospital, stays to outpatient visits to data from wearables. A blockchain is a tool that could help get us there. But it’s not the only way.

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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 the Failure to Communicate

EHR and the Failure to Communicate | EHR and Health IT Consulting | Scoop.it

Clinical workflow in my early career included the ritual of phone messages. Every day, at least once and usually in the afternoon, I would sit with my clinic nurse and a pile of manila folders to discuss phone calls. Details were discussed, recommendations were made, triage assessments were cosigned and I would hold the charts of those patients needing a callback. The ritual began with the daily call to action, “Let’s do calls.”

EHR and the disruption of the nurse-doctor interaction

About 15 years ago when our first EHR, Logician (evolved as Centricity), came along the process of handling calls changed. It was Texas Children’s first venture into EHR and with it we began the long calculation of how electronic records fit our clinical flow.

My nurse at the time was a pediatric nurse with years of experience. Seasoned and crusty, her capacity for laser-sharp phone triage was impeccable. She was a stickler for tight documentation.

 

As we grew comfortable with Logician, the ritual of call review evolved. While we began doing calls around the screen, my nurse began to insist that our daily rendezvous was no longer necessary. “It's’ all in the message. Just read the message, Dr V,” she would crow from her cramped desk. “And the documentation is better. Trust me.” Despite my insistence, she ultimately became an unwilling partner in a clinical dance for two.

 

Our digital phone messages involved a back and forth of queries and replies through the EHR. Documentation was tight. But something was missing.

Not all media are created equal

When it comes to communication not all media are created equal. The assumption on the part of my nurse was that communication through the EHR was the same independent of how it was transmitted. A message, in the end, was just a message.

As it turns out, there are different ways for patients and health professionals to exchange information with one another. All bring different affordances to a human encounter.

 

  • In person (mano y mano)
  • Asynchronous text (Epic MyChart, email)
  • Synchronous text (Live texting)
  • video stream (Skype)
  • audio transmission (phone)
  • And there are lots more.

 

All represent ways for us to exchange health information. As I have written, different problems call for different media depending on the type of problem at hand. Text works well for simple problems. But the text isn’t always enough. A video is an overkill for simple issues. And as inconvenient as it may be for both the patient and the doctor, sometimes a patient needs to be seen, heard or touched in person.

The EHR and the subtle dimensions of the human experience

So when my nurse stopped talking to me about my understanding of what was happening with my kids fell off significantly. The notes were impeccable and the transmission instant. But something was missing.

 

So what was missing from the EHR? As it turns out in human exchange there are subtle elements that get lost in the type. There are critical bits of information during a phone exchange that get picked up by an experienced pediatric nurse. Often there are subtle contextual elements of a social situation that are never properly documented. Some of these things can’t be documented.

 

Sometimes these details only come to my attention when face-to-face with my staff. And there are things that come from the gut that we don’t share in the record.

 

Paper charts didn’t solve this problem with the EHR. Written messages are exactly the same. They just forced us to sit at a table because there was no way to send a paper message across the office and easily back again.

 

Humans are messy. They rarely fit the constraints of the technology we create. The dimensions of the human experience are rarely felt through typewritten messages. Consequently, the accurate exchange of information and documentation of human interaction is potentially more challenging than we think.

 

Communication through and around the electronic health record is an inevitable part of medical practice. But we have a long way to go with regard to capturing the subtle elements of human engagement.

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Trends in EHR Software, 2017 and Beyond

Trends in EHR Software, 2017 and Beyond | EHR and Health IT Consulting | Scoop.it

As the transition to electronic health records continues, we’re beginning to see how the use of EHR software can transform the ways that care is provided, as well as the quality of that care. With increased adoption, EHR software is becoming an integral part of the healthcare experience for both providers and patients.

In the U.S., changes to HIPAA regulations and incentives for providers have had tremendous impact on the landscape of electronic health records. As EHR software matures, interoperability and ease of access, improved patient portals, and a move toward cloud-based solutions are going to be some of the biggest trends in electronic health records.

One of the key features of electronic health records is ease of access. Ideally, both providers and patients will be able to utilize EHR software in ways that maximize access to information and create smoother workflows. That also extends to full interoperability between systems.

 

Ideally, practitioners will be able to quickly share information with other healthcare providers inside and outside their organizations, streamlining care for patients, and making sure that practitioners have full access to health records at all times. Improved interoperability also has long-term benefits outside of individual patient interactions. For example, researchers could use pools of patient records to identify trends, or use of the large datasets that improved EHR software interoperability would provide for large scale real-world studies of treatment outcomes.

Along with interoperability comes the need for improved patient access to their own electronic health records. The United States Congress enacted regulations in 2009 to provide financial incentives to encourage adoption of EHR software, and HIPAA regulations also require that electronic health records also allow for patient access to stored data. According to a 2015 report, the number of people accessing their electronic health records via a patient portal is on the rise. In 2014, 38 percent of Americans had access to their health information, an increase of more than 33 percent over the previous year. Of those patients who had access, more than half—55 percent—had accessed information contained in their medical record. Clearly, the trend is toward improving and increasing patient access to personal medical information via continued development and improvement of EHR software.

 

Like most other modern technologies, the shift toward mobile devices is also playing a key role in shaping EHR software. Consumers are more comfortable using mobile devices, which makes cloud or mobile EHR more important for practitioners and EHR software providers.

But there are also many upsides to cloud EHR solutions for healthcare providers, including reduced costs, better scalability and improved data security. Without the need for large onsite IT departments to manage software and hardware, cloud EHR software allows healthcare providers of all sizes to focus resources on patient care, which is in the best interests of providers and patients alike.

 

Healthcare is changing, and electronic health records will continue to be a driving force in the evolution of the industry. We’ve already seen some of the tremendous benefits that EHR can provide, and look forward to the innovations in EHR software that will empower healthcare providers to offer better, more streamlined care to their patients.

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Benefits of EHR Systems - Benefits of Using EHR

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

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

 

Meaningful Use

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

Scalability

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

Accessibility

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

Support

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

Interoperability

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

Customization

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

Security

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

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

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