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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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Cloud-based EHR vs Server-based EHR

Cloud-based EHR vs Server-based EHR | EHR and Health IT Consulting | Scoop.it

Choosing an EHR for your practice is a major decision. It requires thorough research and consideration before you make that selection and pay for setup.

 

You’ll also need to align your staff to get them on board with the new system, including training them so they can adapt and use it once it’s in place.

 

One step in the decision-making process is to determine whether a cloud-based EHR or a server-based EHR will be the system best suited to accommodate your needs.

 

To help you make that election, we have highlighted their differences below.

Cloud-Based EHR

This EHR system is also recognized as a web-based EMR system and owes all of its functionality to a third-party server. That server stores all of the data coming through the EHR.

 

Generally, the software for this EHR has to be purchased separately from the vendor, but its accessibility may vary depending on the package you opt for.

 

Some vendors load this software partially onto the computers of their client practices, while others have unique web portals that allow complete access to the software according to the plan selected.

 

The cloud-based EHR has its pluses and minuses, though. It is highly suitable for small practices that opt for complete outsourcing of medical billing services.

 

It also makes the deal a cost-efficient one for the smaller practices because they get the functionality of sophisticated software, as well as a comprehensive EHR without having to purchase the complete setup, expand to a larger office space, or employ IT staff for EHR management.

 

Secondly, the cloud-based EHR can be accessed from any location in the world using any of the smart devices you have. It always has the real-time data available to you, which adds to workflow efficiency.

 

As the entire setup is web-based, all your data is absolutely safe from being influenced by any environmental changes, natural disasters, etc. Even if the data is lost somehow, you can retrieve it from the cloud-based backups in no time.

 

However, on the downside, the cloud-based EHR depends solely on an Internet connection for its performance and functionality. If you have a stable Internet connection and high bandwidth available, then you are good to go with this option. Otherwise, this system can delay your operations and cause you more harm than good. Practices located in rural areas might find it difficult to access the Internet.

 

So the cloud-based services are simply a no-go for them. Another important factor here is the reliability of the EHR vendor because you’ll be reliant on them for uninterrupted access to the data. So before choosing one, consider their credibility.

Server-Based EHR

As the name indicates, this EHR system is based on a server or a group of servers, depending on the size of your practice, for storing all the data.

 

These servers have to be installed within the practice and are managed by specialized staff. Also, the software required to make the system function has to be purchased and installed separately.

 

The biggest advantage of this EHR system is that it gives you greater control over your data. If you have efficient servers and a secure internal network, then your server-based EHR will work wonders. You won’t have to depend on an Internet connection for the speed and accessibility, or on the vendor for the data access. You can smoothly upload/download files of any size whenever you want as there is no limit of speed or bandwidth.

 

Moreover, the data security is ensured as long as the data remains within the premises of the practice.

 

However, an in-house server-based EHR will cost you much more than a cloud-based EHR. This is because it requires sophisticated hardware and software, dedicated office space, and specialized staff for its management, all of which incurs huge costs. The story doesn’t end there.

 

There are other expenses, including hardware and software maintenance and updates that have to happen on a regular basis. Also, the staff has to be trained regularly regarding EHR updates.

 

Depending on your needs, either of these types of systems could offer you the right solution. While one is readily adoptable by small practices, the other seems more relevant to the bigger, more established practices.

 

That being said, the decision depends on the particular requirements of your practice. So, it would be best to evaluate your practice needs before opting for a cloud-based or a server-based EHR system.

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Larger Physician Groups Eye Cloud-Based EHRs

Larger Physician Groups Eye Cloud-Based EHRs | EHR and Health IT Consulting | Scoop.it

In January, the federal Centers for Medicare & Medicaid Services (CMS) rolled out a new fee schedule for providers taking care of patients with two or more chronic conditions. Within weeks, Privia Medical Group, a 310-provider multispecialty medical group based in Arlington, Va., had electronic health record (EHR) templates for the documentation and coding requirements as well as a 20-page tutorial with screen shots.


To Andrew Aronson, M.D., Privia’s chief medical officer, that responsiveness is one of the key reasons the group chose to work with the Watertown, Mass.-based athenahealth for its health information technology needs. “Any update or rollout of new information goes on behind the scenes and is pushed out to all our offices,” Aronson says. “It is released quickly and we are off to the races in implementing the new revenue stream. We are not driving a 4-year-old model car anymore. We are constantly driving the newest and coolest as far as technology goes.” He adds that having each physician office purchase and support its own hardware and EHR software is an “antiquated approach.”


Privia is not alone among midsize and large physician groups and independent practice associations in taking a second look at either an application service provider (ASP) remotely hosted EHR from a vendor such as eClinicalworks or a software-as-a-service (SaaS) model from vendors such as athenahealth or Practice Fusion. (The SaaS model involves a single, integrated database that is delivered as a service to multiple customers simultaneously via the Internet. In an ASP model, the EHR is delivered over a secure Internet connection but involves multiple separate instances of an application, and customers could be on different versions of the software.)


The Orem, Ut.-based KLAS Enterprises has done ambulatory EHR perception reports for almost 10 years, and has seen the pendulum gradually swing from almost no cloud adoption to much stronger interest, notes Erik Bermudez, a KLAS research director. “Ten years ago they would say if they got angry at their EHR, they felt better if they could kick a server in the basement,” he says. “They were at peace knowing it was all behind their four walls.” But that perception has gradually changed. Although many doctors may not understand the distinction between ASP and SaaS models, when KLAS has asked physicians about the umbrella term of remotely hosted EHRs, practices ranging up to 100 physicians are now open to it, he said, “although name recognition and a vendor’s size and reach continue to be important criteria for large practices. Practices with hundreds of physicians that have a CIO tend to have an interest in keeping data in-house,” he adds.


Concerns about data security might be misplaced, Kosiorek added. People tend to correlate moving records to another company as a point of fear. But security in the cloud provider’s environment is most likely better than in your own office, he says. Cloud-based systems have a vested interest in keeping things secure. If they have a breach, it will impact their reputation forever. “Small to medium-size practices have limited means to invest in security, so they are trusting their IT staff to have all the bases covered with security,” he said, “and the smaller the staff, the tougher that is to take on.”


Rodger Prong, executive director of Oakland Physician Network Services (OPNS) Inc., a 425-member Michigan independent physician organization, notes that many of its members are adopting the free (with advertising) or low-cost cloud-based Practice Fusion EHR.

“I had a lot of suspicion of this platform at first,” Prong admits. “I ignored it for two to three years. The old saying is you get what you pay for. But then I saw several positive independent surveys of doctors. What creates traction is what interferes with physicians the least,” he said. Prong said the process of migrating data to Practice Fusion from other EHRs has gone well.


The OPNS doctors using Practice Fusion have interfaces to an organization-wide registry and data warehouse. “We like the fact that they do enterprise-wide changes. It helps us not have downstream problems with interfaces,” he says.


Prong said that with some EHR vendors, interface costs are exorbitant. “If they don’t make enterprise-wide changes, then we have different versions out there and every time they change something for a doctor we wind up incurring additional cost to get the interface operational,” he says. “Practice Fusion gave us one price per interface for our entire group. We only pay them once and it works for everybody.”

You don’t see software in other industries developed in this client/server manner anymore. The mentality that the cloud is a new thing is curiously specific to healthcare. Derek Kosiorek

Some provider organizations decide to subscribe to remotely hosted EHRs to avoid costly hardware upgrades and IT personnel costs.  East Georgia HealthCare Center Inc., a federally qualified health center with nine facilities and 23 physicians, had been a customer of eClinicalWorks (eCW) for several years as part of the Georgia Primary Healthcare Association, which managed the software from an Atlanta data center. “As EHRs became more robust, and contained more information than we originally used them for, we started running out of resources,” says Herb Taylor, East Georgia’s IT director.


“Computing and processing speed started getting slow. So we could either spend a bunch of money on hardware upgrades or evaluate cloud-based options. We went with eCW in the cloud. It was a smart decision for us financially and with the IT staff we have.”


Taylor says that performance has improved dramatically.  “At the time we moved, a year ago, with 130 employees, we were averaging about 20-40 tickets a week about people experiencing slowness,” he says. “Now we get only a few tickets a month, and those are in the more rural sites and have more to do with latency with the Internet service provider.”


Taylor says the cloud offers him better disaster recovery protection than he previously had. “You as an individual provider won’t have funds to truly be redundant in a disaster situation,” he says. eCW is so big on a national scale it has sites in multiple locations, he added. The data is encrypted at rest and in transit. You gain the benefit of a larger-scale organization. He also keeps a storage-area network on site, so if there is a disruption, users could keep working and then upload data to eCW’s site later.


For Taylor, it all comes back to financial security. “You may be able to spend that $300,00 to $400,000 to get where you need to be this year, but where are you going to be in five or six years when it is time to upgrade all that hardware again? That was the big factor for me. No matter what happens, I am paying x amount of dollars to eCW. It was a no-brainer for us with 23 providers to pay the monthly fee,” he says.

Another physician group that recently signed a contract with athenahealth is Healthcare Network of Southwest Florida, which has 25 physicians and 250 staff members. In the next six months it will migrate from a GE Centricity system it has been using for the last several years.


Larry Allen, the organization’s chief information officer and vice president of information technology, was attracted by the fact that athenahealth can do 12 software upgrades a year. Like Privia’s Aronson, Allen talks about some of the advantages of the economies of scale a SaaS vendor can offer on the business side. “Let’s say an insurance carrier requires a modifier on an ICD-9 code. When they make that change, you see claims denied, and you have to go back in and reconcile and resubmit it,” he explains. “With athena, the first time any provider in their cloud has that denial, they flag it and put a business rule in the system so that the next time we code that, we would see an alert that this claim will likely be denied and a modifier code is required. And the claim gets successfully processed the first time.”


Allen said there are pros and cons to consider. “One of the advantages of having your own database is that you can make modifications to it that are unique to your group,” he says. On the other hand, with a cloud-based solution, the vendor can study EHR usability issues across all its practices and then make changes that impact all the practices at once, instead of single install of Epic, for example.


Privia’s Aronson says another advantage is that by studying keystroke click variations among Privia’s providers, athena can help its practices with work flow and train them how to become more efficient in terms of keystrokes. “We have 100 separate practices in our medical group. If they were all on disparate EHRs, we would have no idea what our benchmark was, or be able to compare one to another.”


Users also perceive a mobility benefit because they can access the EHR over the web, whether at home or working away from the office. “I can log onto athenanet anywhere I have web access, Aronson said. I don’t have to be in the office. That is huge for our providers. They want to get out of the office at the end of the day and finish their notes at home at night, and not have to go through virtual private networks,” he said.


MGMA’s Kosiorek says that one key challenge is working through contract language with the cloud service providers. “That is the biggest issue groups are going to have with cloud-based systems,” he says. “Who owns the data and what format you get it back in if the relationship ends? The contract has to be rock-solid about what happens to the data.”

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How the Cloud Targets Meaningful Use Requirements

How the Cloud Targets Meaningful Use Requirements | EHR and Health IT Consulting | Scoop.it

The medical sector is geared toward adopting EHR systems and enhancing data exchange among hospitals and physician practices in order to improve care, lower costs, and increase positive population health outcomes. One health information exchange system called Healthcare Access San Antonio (HASA) has recently adopted a cloud platform to better engage patients and more effectively meet meaningful use requirements.

One common concern with HIE organizations is the potential for data breaches and violation of patient privacy and security measures. Chief Executive Officer of Healthcare Access San Antonio Gijs van Oort spoke with EHRIntelligence.com and mentioned the typical protocols the HIE follows to ensure data security standards are met.Cloud Platform and Meaningful Use Requirements

“We’re following protocols and standards federally as well as state-wide. We have a whole series of those in place that we’re checking on a regular basis,” Van Oort said. “We capture security not only in our processes and the way we operate but also in contractual agreements with the customers. That’s probably where we see most of the likelihood [of data breaches] if a physician is using the HIE and does not necessarily use the appropriate protocols or security levels. That’s where we see most of the risk with us. In general, we are working very cautiously and carefully with our customers and, so far, things have gone well.”

HASA CEO Gijs van Oort also spoke about the patient engagement measures the recently implemented ManaCloud platform from Mana Health has helped the organization achieve. The HIE was able to meet the patient portal objectives under Stage 2 Meaningful Use requirements.

“We’ve been able to meet many of the patient portal requirements for Stage 2. With Stage 3 just coming out, we’re starting a dialogue with ManaHealth as well as our analytics portal, which is the trigger for the population of the patient portal to evaluate which particular measures we can meet,” he said. “So far, we are getting positive feedback from CMS.”

“The patient portal needs to be patient-oriented. It doesn’t necessarily need to be a medical application. When we found ManaHealth, we were very excited about their capabilities and their history in social media. We’ve learned over the years, that if you put a medical application in front of a patient with the hope that the patient will adopt it, we won’t be very successful.”

Health Information Exchange“Currently, our patient portal is able to view, download, and transmit medical information, which is one of the requirements. It also adds the education component which is very intuitive. It adds proxy access so parents, with the approval of a child, can get access to a child’s medical record. It has direct messaging and we’re working on building out these kind of services so that the portal will indeed become meaningful for the patient and not only to meet meaningful use criteria.”

Gijs van Oort continued by explaining the stages and objectives under the EHR Incentive Programs that the ManaCloud platform enabled the HIE to achieve.

“So we’re still trying to finalize Stage 2 Meaningful Use measures. Stage 3 measures are not final yet. We are looking collectively how we can best meet them and which ones we can meet,” Van Oort stated. The HASA CEO also mentioned how HIEs may be able to help providers meet Objective 5 under the Stage 3 Meaningful Use requirements.

“One of the things that we’re interested in is to find out if you look at Objective 5 in Meaningful Use Stage 3, there is no mention of HIE being able to meet some of these criteria,” Van Oort stated. “The HIE would be the perfect place for that in the fact that it aggregates patient data and it would be a patient-friendly way to provide the patient copies of their medical record. We’ve made some preliminary inquiries with CMS to ascertain whether an HIE would be a qualifying source for meeting those particular objectives. So far, it seems to be positive.”

“Objectives five and six, which have to do with patients having access to their record and the engagement of the patient” are met with the help of this cloud platform.

“HIE capabilities are under objective seven, which we’re doing through our other application. From an HIE perspective, I feel that we can provide plenty of support to these providers,” Van Oort said.

Cloud PlatformWhen asked what benefits the cloud-based system has offered their organization, Van Oort stated, “We are looking at reducing duplicate testing and identifying unnecessary emergency department visits. We’re working closely with a local Medicaid HMO who has been receiving daily updates about ED visits. It allows them to more quickly develop innovations and case management [decisions].”

When asked how implemented health IT systems at HASA improve care coordination, Van Oort stated, “In order to provide value, we need to put multiple functionalities in place so that our community gets optimal benefit from it. We started with a provider portal, which is a typical HIE functionality where data is brought in from different sources and aggregated and homogenized.”

“We then coupled that with an analytics portal that provides real-time and clinical data back to the community. That has benefits for public health. Thirdly, the ManaHealth portal is linked to our analytics portal to pull data for the patient, so that patients get a copy of their medical history. With these three platforms tied together and data flowing in near real-time, we now can support clinicians in the community, the hospitals, public health, and patients.”


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Why Should Your Practice Have a Cloud-Based EHR? - HITECH AnswersHITECH Answers

Why Should Your Practice Have a Cloud-Based EHR? - HITECH AnswersHITECH Answers | EHR and Health IT Consulting | Scoop.it

If you’re still debating whether to go with a web-based EHR or a server-based EHR, you should know why a growing number of practices are choosing to go with a cloud EMR.

How does a web-based EMR differ from the older technology of a client server-based EHR system?

A cloud EMR is different (and better, in our opinion) due to the following factors:

Your software is always up to date
With a web-based EMR, the software is always up to date, usually at no additional charge. No more expensive upgrades causing delays; just open the SaaS-based software and you have the latest version.

Rest easy on HIPAA data requirements
Data security is much easier to manage with a web-based system. Cloud EHR vendors can provide much more security for your data than you can internally with office servers. As reported by the Business Insurance site, “Data breaches seem to be everywhere these days except the one place everyone fears—the cloud.” That could be because cloud EMRs offer financial-level security for your data.

Accessibility—work from anywhere
One of the things many users love about the cloud is the ability to work from anywhere—whether it’s e-prescribing from a smartphone or checking a patient record from the beach while on vacation. We don’t recommend you work on your vacation, but we understand the realities of medical practice.

Cloud-based EHR systems allow continued functioning during and immediately after disasters
Hospitals and physicians discovered the benefits of cloud-based data first after Hurricane Katrina and again after Super Storm Sandy; with a web-based system, you can practice (and bill) from anywhere.

Reduced expense for both software and hardware
A cloud-based system is more cost-effective, particularly for small to medium sized practices, since there are no large hardware expenditures and the software expense is a consistent, low subscription rate. You won’t have to plan for large hardware and software expenditures.

Better IT support
Damn it, Jim, you’re a doctor—not an IT person. And you will probably not be able to hire IT support of the same caliber as the staff of a web-based EHR vendor. Why not make use of their resources and eliminate your headaches?

You can use a cloud-based EHR on a mobile device such as an iPad or other tablet
A survey of physicians by web-based EHR review group Software Advice showed that 39% of physicians want to use their EHR on a tablet such as iPad, and in another survey, a majority of patient respondents indicated that they find use of an EHR on a tablet in the exam room to be “not at all bothersome.”

Satisfaction levels are higher among mobile EHR users
A recent survey by tablet-based EHR review group Software Advice found that providers using a mobile EHR expressed twice the satisfaction levels of those using EHRs via non-mobile systems. And as mentioned above, an effective mobile EHR needs to be cloud-based.

It’s particularly important to note that cloud-based systems are nearly always more secure than any system you could set up in your office. For most practices, data security and HIPAA best practices are not their area of expertise—excellent patient care is. But for cloud EMR systems, those areas are key to our success. We are better at it because we must be in order to continue in business. And as mentioned above, the proof is in the lack of data breaches among cloud-based companies.

One proof of the idea that a cloud-based EHR is the best choice is the fact that most EHRs that were originally server-based have since developed cloud-based offerings as well. If server-based technology is state of the art, why are those vendors switching platforms?


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CureMD Selects DrFirst for Electronic Prescribing of Controlled Substances (EPCS)

CureMD Selects DrFirst for Electronic Prescribing of Controlled Substances (EPCS) | EHR and Health IT Consulting | Scoop.it
CureMD has selected DrFirst to provide controlled substance e-prescribing (EPCS) capability to users of CureMD EHR, its cloud-based electronic health record system.

CureMD is adding DrFirst’s EPCS GoldSM 2.0 controlled substance e-prescribing functionality as part of its effort to help providers nationwide curtail the epidemic of prescription drug abuse in the U.S. Additionally, CureMD EHR is used by a significant number of providers in the state of New York and its EPCS functionality will support compliance with New York’s Internet System for Tracking Over Prescribing Law (I-STOP), which requires electronic prescribing for all legend and controlled drugs beginning March 27, 2015.

“Before implementing EPCS Gold, many of our providers wanted to be able to send controlled substance scripts electronically,” said Bilal Hashmat, CEO of CureMD. “We chose DrFirst’s solution because the technology was easily integrated into our EHR, is cost-effective, and allowed our users to begin using EPCS quickly. DrFirst also manages provider onboarding and identity proofing for individual users and ensures they complete the necessary steps to start sending controlled substance prescriptions.”

While many doctors have access to or are familiar with e-prescribing for legend drugs, e-prescribing for controlled medications (Schedules II through V) requires additional components as governed by the Drug Enforcement Agency (DEA), including provider identity proofing, two-factor authentication functionality, and enhanced audit capabilities.

Controlled substance prescriptions represent approximately 10 percent of all prescriptions issued in the U.S. This coupled with greater technical requirements have historically slowed provider adoption of EPCS capability. However, EPCS offers significant social benefits to the greater healthcare system as it has been proven to assist providers in reducing prescription drug abuse and drug diversion, as well as in identifying ‘doctor shoppers’ attempting to attain controlled medications, such as hydrocodone combination drugs which are abused at epidemic levels.

DrFirst currently processes over 60 percent of all controlled substance electronic prescriptions nationwide, making it the leader in this field. The company’s recent data shows that provider adoption of EPCS is now increasing significantly. In the last three-month period, August through October 2014, EPCS prescription volume has jumped by more than 200 percent compared to the same period one year ago. Growing provider recognition of the benefits of EPCS, the rising number of pharmacies nationwide that are EPCS-enabled, and the greater number of EHR, EMR and HIS systems that are ready to handle EPCS, such as CureMD EHR, have all contributed to the large increase in EPCS volume. However, New York’s I-STOP law is seen by many as a leading indicator that similar initiatives will be pursued by other states and many healthcare organizations and providers have been encouraged to pursue EPCS in recent months as a result.

“Controlled substance management should be top-of-mind for EHR, EMR and HIS system vendors,” said G. Cameron Deemer, president of DrFirst. “For those with New York providers, they must allot time not only for the integration and implementation of the EPCS functionality itself, but also for the identity proofing process that each provider must complete. CureMD moved quickly to ensure its New York users will be ready to meet the requirements of the I-STOP mandate, which means CureMD is also ready to support providers in any of the 49 states and the District of Columbia where EPCS is now legal.”
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Preparing Health IT Infrastructure for Artificial Intelligence

Preparing Health IT Infrastructure for Artificial Intelligence | EHR and Health IT Consulting | Scoop.it

Artificial intelligence requires much health IT infrastructure planning to support the storage and computing power needed for a successful solution.

Artificial intelligence (AI) has been working itself into health IT infrastructure as organizations need more advanced technology to handle the growing amount of healthcare data.

 

As AI becomes more of a reality, organizations have to realistically work AI solutions into their IT infrastructure. This can be a challenging process because AI requires a significant amount of computing power and skills to manage the new layers of technology.

 

Organizations are finding that it’s challenging to integrate AI into their operational processes, according to a recent Tractica report.

Dig Deeper

  • How Artificial Intelligence Can Shape Health IT Infrastructure
  • Artificial Intelligence Uses EHRs as Smart Analytics Tools
  • Artificial Intelligence Adds Pressure to Health IT Networks

AI was created to emulate the human mind and working processes, and can independently solve problems without needing to be programmed to do so. AI can accept new information and learn from it without human intervention.

 

The computing power behind AI allows it to process information exponentially faster than a human could, fixing problems or drawing conclusions that the human mind would never be able to achieve.

 

“Enabling AI at the enterprise scale is not a plug-and-play proposition,” Tractica Principal Analyst Keith Kirkpatrick said in a statement. “Significant time, resources, and capital must be deployed, and in most cases, internal company teams are not experienced enough with AI, nor do they have the cutting-edge data science skills to adequately embark upon a truly transformational AI implementation.”

 

Entities need to decide how they’re going to handle the infrastructure changes needed to process and store data. Organizations must also find the staff needed to manage and monitor the AI solution.

 

AI is one of the more robust technologies that’s part of the digital transformation, and can be applied to analytics and cybersecurity.

Healthcare entities having a broad surface area is one of the biggest IT infrastructure security challenges facing organizations today. The wider surface area means there are more potentially vulnerable places cyberattackers can take advantage of.

 

With more ground to cover, IT security staff can be stretched thin and legacy network security systems might not be able to catch evolving security attacks.

 

Applying AI to cybersecurity solutions will help organizations find gaps in their security infrastructure and prevent future attacks.

AI is also used heavily in healthcare analytics. A computer with AI can look at an image of a healthy brain scan and an image of a brain scan with tumors. The device could then recognize the difference between the two images by breaking them down into machine-readable patterns.

 

The machine can remember and reference these patterns, then apply them to future images to determine which patterns indicate that a brain tumor is present.

 

Most healthcare organizations cannot afford to deploy an AI solution on-premises or have the space to accommodate the required hardware.

 

Cloud-based AI solutions and cloud storage are good options for healthcare organizations.

 

Cloud-based storage is a flexible storage solution, and often provides healthcare organizations with a more cost-effective storage strategy over traditional on-premise deployments.

When organizations begin to consider the future costs of scaling up based on the increased amount of data, budget concerns come to the forefront of the decision-making process.

 

On-premise storage solutions require organizations to purchase hardware and only offer a finite amount of space available before additional hardware needs to be added. Cloud services act as a utility with organizations paying monthly or yearly fees based on what they are using.

 

As organizations need more space, they scale up their cloud service requirements and increase payments accordingly.

AI is still a young technology when it comes to enterprise IT infrastructure implementation, but it is expected grow significantly worldwide over the next several years.

 

As healthcare organizations look to implement an AI solution in the near future, ensuring the organization’s health IT infrastructure can support it is key to deploying a successful AI analytics solution.

Technical Dr. Inc.s insight:
Contact Details :

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

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How Cloud-based EHR Platform Improves Remote Monitoring

How Cloud-based EHR Platform Improves Remote Monitoring | EHR and Health IT Consulting | Scoop.it

One type of EHR system that could improve patient health outcomes and revolutionize basic health IT processes is the cloud-based EHR platform. Storing medical data on the cloud provides more opportunities for physicians and other healthcare professionals working remotely and allows the use of mobile devices to track patient health information.

Dr. Amy Hutchinson, an ophthalmologist from the Emory Eye Center, discussed with EHRIntelligence.com how adopting a cloud-based EHR platform from Modernizing Medicine has helped her organization succeed. The EHR system from Modernizing Medicine is specialty-specific and currently serves eight different specialties including dermatology and ophthalmology.Patient Portal and Meaningful Use

The cloud-based EHR platform is able to provide clinical decision support to clinicians at the point of care and offer a stronger mobile solution to each care setting. For instance, the system allows for remote patient monitoring, Hutchinson explained.

“We are able to access EMA Ophthalmology from any location, either on an iPad or on a desktop computer, and as such, can monitor our patients remotely in terms of viewing their clinic visit notes and other attachments to the medical record,” Dr. Amy Hutchinson stated. “We are also able to perform queries on patient data (such as view a list of patients who meet certain criteria, an ICD9 code, for example) from any location at any time.”

Hutchinson goes on to mention a specific mobile application that her facility uses to monitor patients through a tablet or other mobile health device.

“Currently, the only mobile app that we are using is the EMA iPad app,” Hutchinson explained. “EMA Ophthalmology allows us to access all of our patients’ records on an iPad, from any location, which is helpful to our enterprise since we have a number of locations and our doctors are constantly moving between them.”

Since Modernizing Medicine’s cloud-based EHR platform is specialty-specific, there are specific types of functions the EHR includes that benefits ophthalmology in particular. Dr. Amy Hutchinson discussed the “eye log” feature on the EHR system.

“The ‘eye log’ feature is a way to look at data trends, enabling us to review clinical results like visual acuity, intraocular pressure etc. over time,” Hutchinson said. “It is helpful to be able to see how a patient’s vision or pressure has been trending over time without having to open each individual visit note. In addition, the program is designed to improve efficiency in clinic and also allows physicians to customize visit notes and correspondence to other physicians.”

Additionally, Hutchinson mentioned that the Emory Eye Center attested to meaningful use requirements under the Medicare and Medicaid EHR Incentive Programs in 2014. The cloud-based EHR platform was useful in helping the medical facility reach these requirements.

“We attested to meaningful use in 2014,” said Hutchinson. “Having EMA Ophthalmology absolutely made it easier for us to meet the requirements.”

Currently, Emory Eye Center has its own patient portal and focuses on increasing patient engagement among its consumer base. The portal allows the medical facility to meet the patient engagement objectives under both Stage 2 and Stage 3 Meaningful Use requirements.

“Since we are part of a larger enterprise with a patient portal of its own, we are still optimizing our ophthalmology patient portal, but EMA Ophthalmology’s portal includes education handouts and provides patients with copies of their exam notes, both of which will serve to better engage patients,” Hutchinson concluded. “The system also provides a venue for secure messaging to other physicians in the practice and to the patients themselves.”


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Important Features For Your Practice Computers

Important Features For Your Practice Computers | EHR and Health IT Consulting | Scoop.it

Medical computers are an essential element of the modern health care system. They help increase efficiency in every setting from the front office to exam rooms, surgery, and radiology departments. Choosing computers for your practice is an important task, so here are some features to look for:


Sanitation Promoting Features


A clean environment is indisputable in health care facilities, and a critical component of a medical grade computer is their ability to support one. Hygiene-promoting features on your practice computers should include the following:


  • Sealed enclosure resistant to liquid and can be cleaned with disinfectant.
  • Antimicrobial coating on keyboards and monitors or all-in-one computers.
  • Fanless design to reduce dirt accumulation in the system and dust from circulating.
  • Minimal crevices that are potential homes for bacteria.


Mobility and Accessibility


When medical computers are mobile and accessible, health care organizations can save time, money and improve patient care. Nurses and doctors can bring computers with them on patient rounds or during check-in. This accessibility in medical computers lets doctors and nurses focus on patients, not hardware, during appointments. Look for computers that fit into a variety of settings, whether they can be placed on wall mounts, medical carts or nursing stations. VESA mountable computers are the preferred industry standard. The medical computer supplier you choose should offer assistance in installing your computers where you need them. Also, check for an internal lithium battery that allows for mobility without interrupting data management.

Touchscreens are another significant option that lets caregivers focus on patients. When they are easy to use, caregivers can easily enter data and interact with the computer, while still giving attention to patients. Medical Computer touchscreens are also more hygienic since they can come with an antibacterial coating.


Administrative Tools


A high performing and efficient hospital or clinic has central coordination, and medical grade computers reinforce this. With medical grade computers, administrative staff can enter and edit a patient’s medical, insurance and billing information in a patient environment. Each computer on the network should have access to this information, with a setup that allows for HIPAA compliance. Elimination of redundant inputs, reduction of errors and the switch to electronic rather than paper billings all save costs.


Low-Cost Installation


While changing to a medical computer system or getting an overhaul of your current system will undoubtedly involve some expense, you can minimize it in a few ways. One is by choosing a system compatible with as much of your existing systems as possible. For example, inquire about the extent of inputs and outputs that would be necessary with a new system; you may be able to make use of parts of your current system and thus save trouble and money from redundant equipment purchases.


Another way to reduce the initial investment cost is to consider the time and resources required to get doctors and other employees able to operate the system. First, software should be easy to use. Look for medical grade computers that support your preferred software programs or that come with new software that is simple to learn. Insist on getting a free trial before committing to a purchase.

Second, be sure to train employees before your upgrade is complete. Extra time from tutorials is expensive to a hospital or clinic, so find out how long it typically takes for users to master the system. If possible, purchase your medical computers from a company that provides follow-up support..


Cloud-Based Systems


Your practice computers need to be compatible with the cloud. As recently explained on this site, 96 percent of health care organizations are using or considering the cloud. Those who do can hope for average cost savings of 20 percent each year.


Using the cloud has additional advantages over cost savings. It allows for unlimited storage and frequent backups. Also, storage on a remote server rather than a large server on site prevents the risk of losing data in case of a flood, fire, etc. Check for a computer with EN/UL 60601 medical certification with which protects against power surges, failures and improves on-site safety.


A quality medical grade computer has a number of important characteristics that allow for reduced costs and upgraded patient care. Keep a list of necessary features in mind when you shop for your new computer or system, and your health care organization may soon see benefits.


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Ensuring a Smooth Transition to the Cloud - HITECH AnswersHITECH Answers

Ensuring a Smooth Transition to the Cloud - HITECH AnswersHITECH Answers | EHR and Health IT Consulting | Scoop.it

Moving to the cloud is a smart business move for many medical providers these days. The security, convenience, and scalability are attractive attributes for busy practices that don’t want the hassle of attempting to handle all their IT needs in-house. Plus the mandated move to electronic health records (EHR) is causing many enterprises to rethink their entire IT strategy.

While there are many benefits to moving to the cloud, reaping the rewards takes some serious preparation. Following best practices for pre-migration planning is key to ensuring the success of cloud operations. Sure, planning the move sounds simple, but it’s so simple that many firms fail to do it. The result of inadequate preparation is often lost data.

Check the Paper Trail

First, it’s important for medical practices to look closely at the service-level agreements (SLAs) they have with existing vendors. And then look at them again.

Practice groups should make sure the answers to the following questions are clear:

  • What constitutes an outage: Is it lack of access to service or to data?
  • What does the contract cover in terms of storage, data transfers, metadata functions, and copying and deleting files?

Have an Itinerary

It’s important for practitioners to know where data will “live” during the entire process. There should also be a plan spelling out who is responsible for maintaining the data during the migration. For businesses that can’t afford a lot of downtime, it might be a smart option to replicate data rather than doing a straight transfer.

Then, it’s critical to consider every operation the data touches and how those systems will communicate after the move.

Consider Security

Obviously, testing security is key in any case. But when migrating to the cloud it’s important to test it twice. Security should be checked both before porting the data and again after it resides in the cloud. Keep in mind that some aspects of security may need to be reconsidered after the data is refactored for cloud optimization.

Practice groups should also work with their service providers to formulate a porting plan so they can ensure they have a plan for retrieving data.

The upshot: Working with an IT partner that can understand the critical needs of practices’ data integrity and business continuity is key to ensuring a smooth transfer with minimal interruption.


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