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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Planning for Successful EHR Training

Planning for Successful EHR Training | EHR and Health IT Consulting | Scoop.it

A successful EHR training program is the result of many months of planning and communicating organizational expectations. There is always a myriad of logistical elements that go into the EHR training planning process – identifying training locations, setting up classrooms and determining how registration and completion of courses will be tracked is essential to identify early on, as this will likely be one of the most significant training initiatives the organization has undertaken.

 

Identifying trainers who understand the system and workflows, and how different types of employees may require different types of learning, whether it be web-based, classroom or one-on-one training, is essential. Finally, communicating EHR training expectations for future users of the system will ensure that everyone is trained and ready for the system to go live.

 

Physician Personalization Labs - A key feature within Epic is the ability to personalize the software for each physician’s needs. The modules will be the same for all users, but Epic can be customized to accommodate an individual provider’s preferences when entering clinical documentation and orders, allowing providers to focus on time spent with their patients rather than time spent in the system.

 

In the weeks leading to go-live, personalization labs – an extension of training – should be set up where trainers can work with physicians to make sure their templates and orders are set up; Every step that can be taken to prepare for go-live helps ease the transition, and this is a big one.

 

Technical Dress Rehearsal - The technical dress rehearsal is a planned event where all equipment that will be used during the Epic go-live is checked before the actual event. This includes everything from servers to monitors, scanners and devices, printers, etc.

 

For example, printing is a common issue during Epic implementations, and Technical Dress Rehearsals allow your implementation teams to check and recheck printing processes before they go-live.

 

End-User Dress Rehearsal - Dress rehearsals allow end-users to marry the new EHR technology with what may be newly redefined processes to evaluate how well they are functioning together. End-users are asked to sign on to the EHR system, test their training, validate that they can accomplish what they need to achieve during a typical day’s work, ask questions and continue to learn in a safe environment.

 

It is an extension of training, allowing end-users to build much-needed confidence going into go-live. It is also an opportunity to address any last-minute quirks in the system’s setup. A constant dialogue between end-users, Super Users, application teams and IT is vital to taking advantage of this opportunity.

 
  

SuperUser Preparedness - Super User Preparedness, and to a great extent your Super User Program overall, maybe the most important personnel aspect of a successful go-live and sustained long-term success.

 

When establishing the parameters of a Super User program, organizations must look, think and plan for the long term. If your Super User program is only set up to get you through go-live, you’re doing end-users and your organization a significant disservice.

 

A well thought out and managed the Super User Program should serve as your primary source of knowledge transfer from implementation specialists and go-live consultants to in-house staff and full-time employees.

 

Super Users should be engaged during the planning process, implementation, optimization, and beyond. They should act as the liaison between the application teams and end-users. Super Users are distributors and gatherers of information as they communicate directly with end-users and report issues back to the application teams. When done correctly,

 

it’s one of the most effective ways to check the pulse of the end-users and ensure that you’re addressing the issues that matter to them the most.

Technical Dr. Inc.'s insight:
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3 Reasons Why Medical Practices Should Embrace the EHR Dashboard

3 Reasons Why Medical Practices Should Embrace the EHR Dashboard | EHR and Health IT Consulting | Scoop.it

The electronic health record (EHR) dashboard is an important tool for medical practices. It is often overlooked, but the dashboard provides valuable insights that can benefit your practice in many ways.

 

An EHR collects so much data, but it’s what you do with that data that will make the biggest impact. The dashboard provides a quick glance at information that can be used to improve your practice. Here are three reasons why medical practices should utilize the EHR dashboard:

 

1. It provides a holistic view of a practice in a way that’s easy to understand.

 

Dashboards give medical practices an accessible, easy-to-understand view of how their practice is performing in real-time. A dashboard enables a practice to quickly understand practice performance, uncover areas for improvement and make decisions based on real data, instead of assumptions.

 

2. Provides key insights for clinical, operational and financial success.

 

Dashboards provide insight that is instrumental to your practice’s success. A good dashboard will provide a consolidated view of clinical, operational and financial information. This allows practices to easily keep track of three key areas that need to be running smoothly in medical practice.

 

3. Improves productivity and efficiency.

 

Dashboards provide high-level information in real-time that helps practice managers, billers and physicians be more productive day-to-day and long-term. A dashboard should include information on practice financials, patient flow, and tasks that need to be completed so that everyone in a practice can do their jobs effectively. Here’s some of the information the Practice EHR dashboard provides to help optimize the practice workflow:

  • Appointment status provides an overview of which patients have been seen, no shows and canceled as well as how many have rescheduled.
  • Copay status: provides an overview of how many copays have been collected on a weekly, monthly and yearly basis.
  • Visit counts: provides the total number of patient visits and visits by payer types.
  • Key performance trends: provides an overview of important practice financial information such as charges, payments, and account receivables.
  • Aging by practice: provides an overview of account receivables that are current, 30, 60 and 120 days out.
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Reduce the Pain of Switching EHR Software with These Four Steps

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

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

 

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

Start your search for a new EHR vendor with these steps

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

Step 1: Develop a Request for Proposal (RFP)

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

Step 2: Give them a wish list

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

Step 3: Research, research, and more research

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

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

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

Have questions ready

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

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

A partnership built on trust every step of the way

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

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4 Ways To Automate Your Practice And Improve Productivity

4 Ways To Automate Your Practice And Improve Productivity | EHR and Health IT Consulting | Scoop.it

There’s a lot of work that goes into running a medical practice. From scheduling to phone calls to seeing patients, there’s most likely not a lot of downtimes. In order for medical practices to operate smoothly, it truly takes a team effort and the right technology.

 

There are many ways to streamline operations and improve productivity by using automation. And it doesn’t have to be costly or complicated. With the help of an electronic health record (EHR) practices can automate some of the daily processes that slow them down.

Here are four ways practices are automating their practice with Practice EHR:

 

  • Appointment Reminders - Appointment reminders eliminate the inefficiencies that come with calling every patient to remind them about their appointment. Most likely, you don’t get them on the first ring anyway and are leaving a voicemail. With appointment reminders, you can improve this whole process and remind patients about their appointment with an automated, customized message.

 

  • Eligibility Checks - Automated eligibility verification improves productivity for your front desk staff, while saving your practice time and money. Automated eligibility allows you to verify patient coverage more efficiently, without having to call to verify by phone. Instead, the system will automatically pull a patient’s insurance status 24 hours before a scheduled appointment, freeing up your phone lines and your staff.

 

  • Patient Portals - Patient portals are great for your patients and great for your practice, and they are gaining popularity. Patient portals improve productivity for the entire team by automating tasks like scheduling, check-in paperwork and sharing of health records and patient results. This gives your staff the ability to make better use of their time and dedicate resources to other activities that need more attention. Portals give patients more ownership and at the same time reduce the workload of the practice by eliminating a lot of unnecessary phone calls and time spent on activities that can ultimately be handled more efficiently through the portal.

 

  • Claim Scrubbing - Claim scrubbing is a win-win for physicians and billers. Using an integrated clearinghouse, codes are automatically checked for errors and warnings, before it gets sent to be billed. With automated claim scrubbing, physicians code with more confidence and spend less time on the phone with their biller, while simultaneously reducing denials and ensuring quick payment.

 

From the front office staff to the physician, every team member is busy with daily responsibilities within a medical practice. There’s no need to sacrifice any more time, productivity and profitability than necessary. As you look for ways to improve productivity and efficiency in your practice, consider the benefits of an EHR that can provide automation.

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Speed Up Healthcare Practice Office Management Using an EHR Solution

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

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


          1.  Automatic Appointment Reminders

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


          2.  One Screen to Rule Them All

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


           3.  Automatic Claim Management

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


          4.  Integrated Clearinghouses

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


           5.  Patient Portal

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

 

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

 

Technical Dr. Inc.'s insight:
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20 Questions to Ask an EHR Vendor Before Making the Switch

20 Questions to Ask an EHR Vendor Before Making the Switch | EHR and Health IT Consulting | Scoop.it

Choosing the right electronic health record (EHR) for your medical practice is a big decision. There are so many software's on the market today and it can be difficult for medical practices to find one that’s the best fit for their practice.

 

In order to make the best decision, it’s important to ask the right questions and have an honest conversation with the vendor about their software. Where do you start? The following is a list of 20 questions medical practices should ask before making the switch. This list is a compilation of the most commonly asked questions we hear from our prospective customers.

 

Ask the following questions and add a few of your own based on the needs of your practice. Asking the right questions and digging deep will help you find not only an EHR vendor but a partner who’s also committed to helping your practice be successful.

Learn about the company.

1. How many other practices use your software that our similar to my practice size and specialty?

2. Aside from EHR/PM, what other products and services can you offer my practice?

3. How do you keep my data secure?

4. Who owns the data in the system?

5. What sets you apart from other vendors?

 

Get to know the software.

6. Do you have an integrated practice management system? 

7. What clearinghouse do you use?

8. What types of devices can I use with your software?

9. Is your software cloud-based?

10. Is your system easy to use?

11. Is your software ONC 2015 Edition certified?

12. What reports are available in your EHR?

13. How will this software help improve patient flow and operations in my practice?

14. Are there any extra costs related to the software?

 

Ask questions about training, implementation, and support.

15. How long is the implementation process?

16. How is my data migrated into the EHR?

17. How does training work?

18. How responsive are your product development team and customer support team?

19. What are your support hours?

20. Are there costs related to set up, training, implementation or support?

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Practice EHR Success Story: Britt Larka, D.P.M

Practice EHR Success Story: Britt Larka, D.P.M | EHR and Health IT Consulting | Scoop.it

Situation

 

As a solo podiatrist, Britt Larka, D.P.M struggled to find an electronic health record (EHR) system designed to meet the needs of her Houston-based practice. In an effort to find the right system for her practice, Dr. Larka implemented multiple EHR's, continually facing the same three challenges. With each new system, Dr. Larka experienced financial, workflow and operational challenges.

  • Financial - Implementation, training, etc., on top of system pricing, became a financial burden
  • Workflow - The EHR's were not made for a practice of her size and difficult to navigate
  • Operational - The EHR's were cumbersome,  negatively impacting patient care, day-to-day operations, and efficiency

Unsure where to turn next, Dr. Larka received a recommendation from her long-time billing services provider,  leading her to Practice EHR - an EHR with built-in specialty-specific content and a simple workflow designed for small practices. 

 

Results

  • Seamless implementation.  Implementing Practice EHR was a smooth process for Dr. Larka and her office staff. For all new clients, Practice EHR offers data migration, integration, training and customer support at no additional cost, easing the financial burden and the learning curve that small practices typically experience with an EHR implementation.

 

  • Improved efficiency of documentationAfter implementing Practice EHR, Dr. Larka and her team quickly appreciated the system’s easy-to-use and intuitive workflow. Practice EHR's ease of use enabled her team to work more efficiently. In addition, with built-in podiatry templates and clinical content, Dr. Larka could easily log patient care, allowing her to spend more face time with patients. 

 

  • Improved efficiency of billingDr. Larka’s staff improved practice management and efficiency with the help of Practice EHR’s electronic claim submission feature. With Practice, EHR encounters get sent electronically to billing providers from within our system, increasing efficiency for the staff and helping physicians get paid faster.


About Practice EHR

Practice EHR is a cloud-based and specialty-specific electronic health record (EHR) and practice management (PM) solution designed exclusively for small practices. We realize that a one-size-fits-all EHR isn’t right for all care settings, that’s why we designed Practice EHR to meet the needs of small practices and their specialty. Simplifying the entire documentation and billing process, Practice EHR helps more than 1,000 physicians in 23 different specialties deliver care while running a more profitable and efficient practice. Interested in learning more about Practice EHR? Request a Demo by clicking below and a member of our team will contact you.

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EHR Features for the Modern Medical Practice

EHR Features for the Modern Medical Practice | EHR and Health IT Consulting | Scoop.it

Keeping up with the changing healthcare landscape can be a challenge for many healthcare providers. There’s been a lot to tackle in 2017, from regulatory changes to new physician reimbursement systems, and changes like these can make it difficult for independent medical practices to stay afloat. Aside from MACRA, one of the biggest challenges we hear from our customers is the increasingly competitive nature of healthcare.

 

With increasing patient expectations and demands causing a consumer-driven healthcare environment, it’s time for medical practices to start considering how they can adapt to stay competitive. Our tip: strive to be the modern medical practice— one you and your patients will love. And leverage your EHR to help in this transition. A good EHR should provide great features to help medical practices stay ahead of the curve and be more successful.

 

What functionality and features should forward-thinking medical practices look for in an EHR? We’ve narrowed it down to three simple categories:

 

  • Features that support patient interactions and engagement. 

Does the EHR have a patient kiosk that will create a more enjoyable check-in experience? Is there a patient portal that allows patients to conveniently schedule appointments, make payments, access their records, download educational resources and securely message the physician? Features similar to those that improve the overall patient experience are necessary in today’s world. They not only help a practice stand out from the competition but also add conveniences for the patient and the entire care team.

 

  • Features that help keep you mobile. 

Medical practices who want greater flexibility should consider a cloud-based EHR. With modern features, like cloud accessibility and applications, physicians can securely access their EHR whenever and from wherever they want, using the device they are most comfortable with (i.e. desktop or iPad). Imagine conducting a patient visit virtually, or getting to choose between documenting using free text and clicks or a voice recognition program. Features like Televisit and voice recognition make these convenient scenarios possible.

 

  • Features that improve practice productivity and efficiency. 

Healthcare is an ever-changing environment and with so much to manage there’s even more reason for medical practices to make sure they run optimally. Your EHR should support that goal. A modern dashboard and a good document management setup that is easy to navigate, allows physicians to find what they need, when they need it, and also improves the amount of time it takes to facilitate care. In addition, medical practices can highly benefit from integrated features like e-prescribing, billing, and reporting. These features support better practice operations all around, such as more timely and accurate reimbursements, improved efficiency, staff communication, and patient experiences.

 

But Not All EHR Systems Are Created Equal

Some EHR solutions don’t offer these modern features and benefits. Practice EHR comes standard with these features.

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Which Multiregional EHR Vendors Fared Well Globally in 2018?

Which Multiregional EHR Vendors Fared Well Globally in 2018? | EHR and Health IT Consulting | Scoop.it

Among multiregional electronic health record (EHR) vendors, Epic and Cerner contracts accounted for the most new hospital beds in 2018, according to a new report from KLAS Research.

 

Last year, more than 180 healthcare organizations outside the U.S. made EHR purchase decisions—impacting 377 hospitals, according to the Utah-based KLAS, which released the report on May 9, a week after it released it’s U.S. hospital EHR market share report. Last week’s U.S.-based findings revealed that for the second year in a row, Cerner signed the highest number of new hospitals, but large private sector hospitals are almost exclusively choosing Epic technology.

 

The global EHR market share report for 2019 similarly discloses that Epic and Cerner are leading the way in terms of volume of beds contracted in 2018. Epic’s 2018 contracts were some of the largest in scope, accounting for more new beds than any other vendor. The majority of these beds came from a regional decision in Singapore in which Epic was chosen as the go-forward vendor in two of the country’s three integrated healthcare clusters, KLAS reported. In total, Epic signed four new contracts (across three regions), which was one of their lowest totals in recent years.

 

Cerner, meanwhile, was selected as the go-forward EHR platform by two counties in Sweden that will be migrating to Millennium from a legacy Siemens solution. These decisions represent two of the largest contracts signed in 2018, both in size and technology scope (they include population health management) and are Cerner’s first Millennium deployments in the Nordics. The Millennium platform was not purchased outside of Europe in 2018.

 

Other multiregional vendors such as Agfa HealthCare, Dedalus, and InterSystems were each selected in eight or more decisions, according to the KLAS findings.

 

Agfa HealthCare was selected in 10 separate decisions (more than any other multiregional vendor). The “wins” occurred in two regions and include a number of net new large multihospital decisions. Dedalus had the most hospital wins of any multiregional vendor; these wins came mostly through GHTs (territorial hospital groups) in France; additional wins came from other decisions in France, Italy, and Kuwait. InterSystems was third in terms of new contracts, with eight, and saw the most geographic diversity, signing contracts in Asia, Europe, the Middle East, and Oceania

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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.

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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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The EHR Journey – Selecting an EHR Vendor

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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Epic Launches Sonnet with Rhyme and Reason

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

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

 

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

 

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

 

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

 

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

 

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

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How an Integrated EHR Enables Ease of Use For Doctors

How an Integrated EHR Enables Ease of Use For Doctors | EHR and Health IT Consulting | Scoop.it

As a physician in small healthcare practice, you value your time, your practice’s profitability, and, of course, your patient relationships. Success in these areas ultimately stems back to the efficiency of your processes — and the technology you’re leveraging to enable a simplified workflow.

 

When determining which type of EHR system would make the most sense for you and your staff, consider an integrated solution that will be easy for your entire practice to quickly adopt. According to a report on doctors and their EHRs recently released by Software Advice, 89 percent of doctors said that integration is an important feature in their decision-making process.

 

If you’re worried that implementing a new EHR system in your practice will hinder productivity, you’re not alone. An anticipated loss of productivity continues to concern physicians considering a transition to an EHR system. In fact, 59 percent of office-based physicians who haven’t yet adopted an EHR say the loss of productivity is one of the biggest barriers, according to a 2014 report published by the Office of the National Coordinator (ONC).

While this fear is understandable, the benefits associated with having connected and interoperable software in your practice outweigh the risks. Here are key reasons why implementing an integrated EHR will allow your practice to run more smoothly and increase efficiency with ease.

Quick and Accurate Data Entry

When doctors have software that combines their EHRs, Practice Management (PM), and billing into one comprehensive process, they can save time on repeatedly inputting the same data. Not only does this increase time savings and boost productivity, but it also minimizes the risk for error when transferring data.

Stronger Practice Management and Visibility

An integrated EHR solution can enable physicians and medical administrators to better oversee their practice. Integrated software provides doctors and office managers visibility into every step of an interaction with a patient. EHR platforms can help patients schedule their appointment, help doctors fill out the patient’s chart, and help accounts receivable track the claim being submitted and paid. Integrated software allows practices to submit cleaner claims and more easily schedule appointments.

Many EHR software even has a dashboard function that can report metrics, including revenue and the number of patients seen. This allows doctors to better understand the strengths and weaknesses of their practice and how best to improve and capitalize on these analytics.

Consistency and Accessibility

Integrated EHR solutions allow doctors to be involved in every aspect of practice without switching between software. When the solution is cloud-based, physicians can help manage their staff and deal with any claim issues, even when working from another clinic or office.

Meaningful Use Time Savings

According to a recent National Ambulatory Medical Care Survey, EHR systems that meet Meaningful Use (MU) criteria are more likely to save physicians time on certain tasks. Specifically:

  • 82 percent of physicians with an EHR system that meets MU criteria agree that E-prescribing saves them time, compared to 67 percent of physicians whose EHR system does not meet MU criteria.
  • 75 percent of physicians with an EHR system that meets MU criteria agree that their practice receives lab results faster, compared to 61 percent of physicians whose EHR system does not meet MU criteria.

If you are looking for a reliable way to save time and improve your practice simply and efficiently, a Meaningful Use certified, integrated EHR system could be the cure.

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Operational Involvement in EHR Adoption

Operational Involvement in EHR Adoption | EHR and Health IT Consulting | Scoop.it

Among many reasons why EHR implementations fail, one that comes up repeatedly is the perception that the project was an IT-driven project – a system chosen and implemented without significant input from those who would be using it most.

 

A lack of operational involvement. Three things are key to establishing governance, involving the operational team and gaining acceptance of the world that new EHR users will be expected to live and thrive in:

 

Getting the right people into the proper roles


The best physician champions are not ‘picked’ at the start of the project, the surface as the project begins to move forward. There are some people who not only have an interest in and aptitude for these types of projects, but their natural energy and positive excitement can conjure up the same enthusiasm in others.

 

Those are the people, or influencers, who you want leading and running these projects. In many instances, multiple application team members can excel at their jobs for very different reasons. You may have one that is exceptionally knowledgeable about the intricacies of the build while the other who came from Operations and possesses a detailed understanding of the workflow.

 

Later in the project, when a principal trainer needs to be chosen, which will make the better trainer? The decision may ultimately come down to a variety of factors including application or workflow knowledge, but the communication skill set and which one resonates better with end users and will help them adopt the technology better may be the deciding factor.

 

Empowering people to make and take responsibility for decisions


It’s imperative to find people who are not only empowered to make decisions but can accept the responsibility and accountability for those decisions. Create a culture where there is an acceptance of the concept that sometimes a decision is based on the best information available at the time to move forward, but that it may need to be revisited at a later date when more and better information is available.

 

When people are in decision-making roles, they must be experienced, knowledgeable and decisive with conviction. Some people are fit for that role while others are not. It is the responsibility of project leaders to determine which individuals possess the necessary leadership and decision-making skill sets to keep the project moving forward successfully.

 

Communicating with and ensuring operational involvement in project activities including, but not limited to, workflow design, content development, and standardization, testing, and training.


Involving operations in project activities is one of the most critical pieces to a successful EHR implementation. While IT team members may know the ins and outs of the system, operational team members are the folks who will be using it daily to do their jobs.

 

Who better to ask when it comes to workflow decisions and content development? When the time comes to create test scripts and training materials, involving the operational folks will ensure that you are testing the most relevant ‘day in the life’ scenarios and using examples for training that is relevant to their practice — cross-functional planning and vetting help to ensure success in both.

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3 Key Areas to Address During EHR Optimization

3 Key Areas to Address During EHR Optimization | EHR and Health IT Consulting | Scoop.it

If you have ever purchased a new home, you are rarely 100% satisfied when you move in. You may want to add some new furniture, paint a few walls, update the flooring or even do a complete remodel. When implementing a new Electronic Health Record (EHR), many times the need to “get the system live” as soon as possible, results in a rushed implementation of basic functionality and “out of the box” workflows.

 

There is not always time to look at current issues and identify ways to improve processes. Many times the current problems are merely transferred into the new system. Even if you love everything about your new EHR, Optimization of the system will always be necessary due to factors such as advances in medical treatment, compliance & regulatory changes, adding of new specialties and more.

 

Whether it is your existing EHR or a new system, for optimization to be effective, experts with clinical, operational and technical experience will need to look at how the system is working. You may have such experts employed, or you may need to bring in consultants. Either way, these experts will assess how users are interacting with the EHR and if they are having functionality and/or workflow issues. Sometimes, problems can be addressed by merely providing additional training, especially if new features and functionality have been deployed.

 

By taking a thorough look at the system and its users, experts can determine what improvements need to be made.

Below are three areas to take into consideration: 

  1. Governance: A strong governance structure is critical to having a successful optimization plan. Requests for changes to the EHR must be prioritized and evaluated.  An agile governance group made up of the right members, should meet monthly to review all requests and prioritize according to the overall needs of the organization.
  2. Training:  A comprehensive training program is a critical factor that impacts the usability of the EHR. Many times organizations provide new employee training but do not offer any “ongoing” or “refresher” training. Supplemental training can increase basic and advanced knowledge of the system and improve efficiency. As system upgrades and new functionality are implemented, users should have an option to attend classroom training. eLearning can be helpful, but there is no substitute for hands-on classroom training where the user can ask questions and get answers.
  3. Communication: Organizations should have effective and comprehensive communications regarding training, new functionality, and any other changes to the EHR. The creation of a formal enterprise-wide communication plan using a variety of forums and a broad spectrum of communications resources is essential. Being proactive versus reactive such as having the EHR topic as a standing agenda item at a section and other scheduled MD meetings can be very useful.
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Why Are Some EHR Systems Confusing and Inefficient?

Why Are Some EHR Systems Confusing and Inefficient? | EHR and Health IT Consulting | Scoop.it

In theory, EHR systems can alleviate informational errors, increase efficiency and allow doctors to spend more time with patients. The reality, however, is that many EHR solutions can talk the talk, but they can hardly walk the walk.

 

Why is this?

Some EHR companies in the marketplace have produced software without doing their due diligence to completely understand what a doctor’s real day looks and feels like -- they’ve produced generic platforms that don’t address doctors’ real concerns.


Any EHR System Must:

  • Be Scalable
  • Integrate Seamlessly with Other Software
  • Have a Simple User Experience
  • Priced Fairly for the Practice

The third bullet, ‘Have a Simple User Experience,’ is the benefit we’re going to be discussing today because it’s often taken for granted. 

A Simple User Experience

Inputting data into a computer is easy, but the problem arises when EHR solutions can’t correctly identify a doctor’s workflow. Doctors have hundreds of patients, and since no two are alike, thousands of records of unique data are created. This data demands distinct form fields to capture a patient’s specific information. EHR systems must be prepared to capture, organize and file this data away so that a doctor can easily recall it when needed. And when it is recalled, this information must be easily understood by the doctor who may have forgotten exactly how he inputted it.

The solution is intuitive form fields and workflows.

EHR systems should allow for any doctor or office manager to easily understand where to input the right data into the right field. This may sound simple, but most EHR systems just do not comprehend the gravity of proper user experience.

When form fields are misunderstood and unobvious, data finds itself into the wrong reports. In the healthcare industry, this is alarming. Not only does this open up practices and doctors to lawsuits, but before you know it, the EHR system that was supposed to save your practice time and money is now doing the exact opposite.

The Power of Practice EHR
Next-generation, cloud-based software can and will improve a doctor’s day, but not every EHR system is created equal. The Practice EHR team was frustrated by the poor quality of the very EHR systems that were supposed to be improving doctors’ day-to-day lives. So we went and built a better one.

Practice EHR is a solution built by doctors for doctors. It’s specialty-specific, meaning it comes out of the box purpose-built for your specialty practice. It’s also the perfect system for smaller practices of about 1-3 doctors and it was made to alleviate time and hassle in doctors’ busy schedules.

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3 Reasons Physician Practices Need a Cloud-Based EHR

3 Reasons Physician Practices Need a Cloud-Based EHR | EHR and Health IT Consulting | Scoop.it

Cloud-based EHRs are becoming a key requirement for medical practices looking for a new electronic health record (EHR) system. According to a Black Book survey, nearly 85 percent of physicians shopping for a new EHR required mobile access from their new system.

Why have cloud-based EHRs become increasingly popular? Many small to medium size medical practices who’ve transitioned to this type of software are realizing the benefits. Let’s look at three reasons web-based EHR systems are a great solution for physician practices.

Benefits of a Cloud-Based EHR

  1. Cloud-based EHRs offer cost-savings and scalability. 

Unlike costly server-based systems, cloud-based EHRs are centrally hosted and do not require any hardware installation, maintenance or software licensing, making them much more affordable and easily scalable for practice growth.

Cloud-based EHRs are offered as software as a service (SaaS), meaning practices simply pay a monthly fee to use the software. Practices also don’t have the headache of worrying about updating the system, as updates are made automatically. Additionally, when a practice expands, new users, physicians or locations can easily be added.

  1. Cloud-based EHRs result in better accessibility and patient care.

Cloud-based EHRs are a win-win scenario for physicians and patients. With cloud-based systems, physicians always have important information at their fingertips, allowing them to provide better, more efficient care to their patient. Imagine a scenario where a physician is out of office but needs to follow up on an emergent case. With a web-based system, the physician could still log in to the EHR remotely and access the patient record as well as integrated clinical decision support. Having access to that pertinent information, at the right time makes it possible for the physician to provide better patient care.

Cloud-based systems also provide an opportunity for better patient interaction and engagement. Most cloud-based EHRs are accessible via an iPad, laptop or mobile device, meaning physicians are no longer tied down to a computer screen. Cloud-based systems allow for better mobility and patient interaction. For example, a physician can easily go from exam room to exam room with a handheld iPad and even engage the patient by showing them certain diagrams, charts or health information.

  1. Cloud-based EHRs improve communication.

Cloud-based EHRs provide greater flexibility than ever before. With cloud-based systems, small practices have secure access to their EHR whenever they want, from whatever device they want, as long as there’s internet access. The ability to access the system remotely, whenever necessary, allows for better communication and collaboration between physicians, staff, and patients. While patients won't have access to the EHR they do have 24/7 access to an online patient portal where they can send a secure message to the practice. Depending on the scenario, the practice can then log in to the EHR to follow up with the patient immediately or respond accordingly. The practice also has access to important patient information for scenarios that occur outside of office hours that will help them make more informed decisions for follow up procedures.

Cloud-based EHRs provide a lot of advantages for physician practices. Many who’ve already made the transition to a cloud-based EHR are experiencing the benefits.

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Practice EHR Success Story: Cooperative City Chiropractic

Practice EHR Success Story: Cooperative City Chiropractic | EHR and Health IT Consulting | Scoop.it

Transitioning to an electronic health record (EHR) can be a daunting task for any healthcare organization, especially for small practices. However, going electronic can also have numerous advantages.

 

Situation

 

Coop City Chiro, a five-physician chiropractic facility in Bronx, NY, manages 3,000 patient visits per month. With a growing patient load on top of the maintenance associated with existing medical records, Coop City Chiro needed a better way to manage their practice on the back end without disrupting patient care. In order to find the right EHR for them, Coop City Chiro started their search with the following needs in mind:

 

  • Find an EHR that organizes and optimizes patient documentation.
  • Implement an EHR without causing distractions or unnecessary obstacles for their patients and staff.
  • Train staff and doctors on an EHR without disrupting their busy schedules.
  • Adopt an EHR that fits their practice’s budget and capacity.

 

The chiropractic facility chose to implement Practice EHR, an EHR system priced for small practices and built specifically for each specialty.

 

Results

  • Live within minutes. Coop City Chiro implemented Practice EHR within minutes and without any disruption to patients or staff because the EHR is so easy-to-use.

 

  • Improved efficiency of documentation and billingCoop City Chiro noticed an immediate improvement in practice management and overall efficiency because they could easily log patient care and bill for all their patients in one single platform.

 

  • 50,000 in cost-savingsAfter implementing Practice EHR, Coop City Chiro reported $50,000 in cost-saving by going electronic and eliminating postage, ink, toner, envelopes, paper, etc.

 

 

 

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3 EHR Features to Improve the Patient Check-In Process

3 EHR Features to Improve the Patient Check-In Process | EHR and Health IT Consulting | Scoop.it

While the patient experience begins long before a patient steps into the examination room, it’s important to make a good impression the moment a patient steps through the doors of your medical practice. Starting off on the right foot during the check-in process can positively impact the patient experience and determine the pace of the patient visit.

There are many moving parts to an office visit that all demand attention. With the help of technology, patient check-in can be less of a burden for patients and staff. Here are a few EHR features your practice can use to improve patient check-in.

Patient Kiosk

One of the most popular features being used to improve patient check-in is kiosk. This technology is similar to what is used today at airports and fast-food chain restaurants. In a medical practice equipped with the Practice EHR kiosk, patients can check in on an iPad or tablet using interactive forms that guide them through the check-in process, collecting medical history info, patient information updates, signatures for consent forms and payment. Once the patient completes check-in, the information collected is automatically integrated into the EHR. Medical practices who implement a kiosk can reduce the resources required for check in at the front desk and improve efficiency.

Patient Portal

Medical practices looking for an alternative to the kiosk model can implement a patient portal. With a patient portal, patients provide information and complete forms online, prior to the visit, eliminating the need for paperwork when they arrive. Portals typically provide additional time-saving features, such as online scheduling, secure messaging and easy sharing of test results and medical information. Medical practices who’ve implemented portals are using them effectively to reduce costs and the amount of time it takes for a patient to check-in.

ID Scanner

An ID scanner will quickly become a favorite for your front desk staff. With this technology your practice can capture the front and back of patient cards and documents digitally in seconds, eliminating paper copies from the workflow. Medical practices who use ID scanners can significantly speed up the patient registration process. There are several ID scanners in the marketplace. However, Practice EHR is integrated with Ambir Technology, ensuring captured information gets populated automatically in the EHR.

As the healthcare industry shifts to a value-based and consumer-driven model, it’s important that medical practices review current processes and work to improve the patient experience 

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Practice EHR Success Story CareMed

Practice EHR Success Story CareMed | EHR and Health IT Consulting | Scoop.it

Situation

CareMed is a multi-location practice offering a unique blend of primary care and urgent care to the Suffolk County of New York. After an increasing patient demand for access to convenient healthcare, CareMed expanded into a second location and realized the EHR system they had in place could no longer support the needs of their growing practice. To achieve long-term success, CareMed knew they needed to consider a more modern and comprehensive EHR solution with features designed to support a busy practice with multiple locations. 

Results

  • Decreased costs. Priced at only $149 per month, per provider, Practice EHR is one of the most affordable and cost-effective systems on the market. By switching to Practice EHR, CareMed decreased costs by 40 percent. For a growing practice like CareMed, this significant amount of savings was hugely beneficial to their practice.

 

  • Improved efficiency. CareMed quickly realized the benefits of Practice EHR’s simple workflow. With such an easy-to-use system, CareMed could easily onboard new staff members and train them on the EHR system in minutes. The simple workflow also helped CareMed save valuable time on daily tasks.

 

  • Improved operations. The Practice EHR reporting tool also became a fundamental feature, providing CareMed with a detailed view of their practice. The Practice EHR reporting tool gave CareMed essential clinical and financial insights about their practice that was instrumental in their growth and success.

 

  • Improved patient engagement. With the help of Practice EHR’s integrated patient portal, CareMed also experienced improved patient engagement. An increasing amount of patients were using the portal to make payments, schedule appointments and communicate with the practice. The patient portal became a favorite feature, resulting in benefits for both the patient and the practice.

 

 

About Practice EHR

Practice EHR is a fully-integrated, cost-effective and easy-to-use electronic health record (EHR) and practice management (PM) solution exclusively designed to support small practices and drive a healthy practice. With no startup costs and free data migration, training, and support, Practice EHR is perfect for startup practices and growing medical practices.

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4 Key Considerations for Analysts When Implementing an EHR 

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

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

 

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

 

1 – Start with the end goal in mind.

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

 

Here are several questions analysts can ask when gathering requirements:

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

 

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

 

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

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

 

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

 

3 – Communication is key.

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

 

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

 

4 – Strike a balance between functionality and maintainability.

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

 

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

 

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

 

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

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

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

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

 

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

 

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

 

Here are five details from ProPublica's investigation:

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

 

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

 

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

 

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

 

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

 

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

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Stanford Launches App That Connects to Epic EHR & Healthkit

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

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

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

• Make appointments

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

 

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

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

 

• Manage your prescriptions and medications

• View your health summary

• Access and pay your bills

• Share your vitals with your doctor via HealthKit integration

Secure Messaging


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

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

 

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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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