EHR and Health IT Consulting
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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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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.

Technical Dr. Inc.'s insight:
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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.

 

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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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Alen Smith's comment, October 26, 2018 7:49 AM
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Fix the EHR!

Fix the EHR! | EHR and Health IT Consulting | Scoop.it

After a blizzard of hype surrounding the electronic health record (EHR), health professionals are now in full backlash mode against this complex new tool. They are rightly seen as a major cause of professional burnout among physicians and nurses: Clinicians are spending almost half their professional time typing, clicking, and checking boxes on electronic records. They can and must be made into useful, easy-to-use tools that liberate, rather than oppress, clinicians.

 

Performing several tasks, badly. The EHR is a lot more than merely an electronic version of the patient’s chart. It has also become the control panel for managing the clinical encounter through clinician order entry. Moreover, through billing and regulatory compliance, it has also become a focal point of quality-improvement efforts. While some of these efforts actually have improved quality and patient safety, many others served merely to “buff up the note” to make the clinician look good on “process” measures, and simply maximize billing.

 

Mashing up all these functions — charting, clinical ordering, billing/compliance and quality improvement — inside the EHR has been a disaster for the clinical user, in large part because the billing/compliance function has dominated. The pressure from angry physician users has produced a medieval solution: Hospital and clinics have hired tens of thousands of scribes literally to follow clinicians around and record their notes and orders into the EHR. Only in health care, it seems, could we find a way to “automate” that ended up adding staff and costs!

 

As bad as the regulatory and documentation requirements are, they are not the largest problem. The electronic system's hospitals have adopted at huge expense are fronted by user interfaces out of the mid-1990s: Windows 95-style screens and drop-down menus, data input by typing and navigation by point and click. These antiquated user interfaces are astonishingly difficult to navigate. Clinical information vital for care decisions is sometimes entombed dozens of clicks beneath the user-facing pages of the patient’s chart.

 

Paint a picture of the patient. For EHRs to become truly useful tools and liberate clinicians from the busywork, a revolution in usability is required. Care of the patient must become the EHR’s central function. At its center should be a portrait of the patient’s medical situation at the moment, including the diagnosis, major clinical risks and trajectory, and the specific problems the clinical team must resolve. This “uber-assessment” should be written in plain English and have a discrete character limit like those imposed by Twitter, forcing clinicians to tighten their assessment.

 

The patient portrait should be updated frequently, such as at a change in clinical shifts. Decision rules determining precisely who has responsibility for painting this portrait will be essential. In the inpatient setting, the main author may be a hospitalist, primary surgeon, or senior resident. In the outpatient setting, it’s likely to be the primary care physician or non-physician provider. While one individual should take the lead, this assessment should be curated collaboratively, a la Wikipedia.

 

This clinical portrait must become the rallying point of the team caring for the patient. To accomplish this, the EHR needs to become “groupware” for the clinical team, enabling continuous communication among team members. The patient portrait should function as the “wall” on which team members add their own observations of changes in the patient’s condition, actions they have taken, and questions they are trying to address. This group effort should convey an accurate picture (portrait plus updates) for new clinicians starting their shifts or joining the team as consultants.

 

The tests, medications or procedures ordered, and test results and monitoring system readings should all be added (automatically) to the patient’s chart. But here, too, a major redesign is needed. In reimagining the patient’s chart, we need to modify today’s importing function, which encourages users indiscriminately to overwhelm the clinical narrative with mountains of extraneous data. The minute-by-minute team comments on the wall should erase within a day or two, like images in SnapChat, and not enter and complicate the permanent record.

 

Typing and point and click must go. Voice and gesture-based interfaces must replace the unsanitary and clunky keyboard and mouse as the method of building and be interacting with the record. Both documenting the clinical encounter and ordering should be done by voice command, confirmed by screen touch. Orders should display both the major risks and cost of the tests or procedures ordered before the order can be confirmed. Several companies, including Google and Microsoft, are already piloting “digital” scribes that convert the core conversation between doctor and patient into a digital clinical note.

 

Moreover, interactive data visualization must replace the time-wasting click storm presently required to unearth patient data. Results of voice searches of the patient’s record should be available for display in the nursing station and the physicians’ ready room. It should also be presentable to patients on interactive whiteboards in patient rooms. Physicians should be able to say things like: “Show me Jeff’s glucose and creatinine values graphed back to the beginning of this hospital stay” or “Show me all of Bob’s abdominal CT scans performed pre- and postoperatively.” The physician should also be able to prescribe by voice command everything from a new medication to a programmed reminder to be delivered to the patient’s iPhone at regular intervals.

 

Population health data and research findings should also be available by voice command. For example, a doctor should be able to say: “Show me all the published data on the side-effect risks associated with use of pembrolizumab in lung cancer patients, ranked from highest to lowest,” or “Show me the prevalence of postoperative complications by type of complication in the past thousand patients who have had knee replacements in our health system, stratified by patient age.”

 

AI must make the clinical system smarter. EHRs already have rudimentary artificial intelligence (AI) systems to help with billing, coding, and regulatory compliance. But the primitive state of AI in EHRs is a major barrier to effective care. Clinical record systems must become a lot smarter if clinical care is to predominate, in particular by reducing needless and duplicative documentation requirements. Revisiting Medicare payment policy, beginning with the absurdly detailed data requirements for Evaluation and Management visits (E&M), would be a great place to start.

 

The patient’s role should also be enhanced by the EHR and associated tools. Patients should be able to enter their history, medications, and family history remotely, reducing demands on the care team and its supporting cast. Patient data should also flow automatically from clinical laboratories, as well as data from instrumentation attached to the patient, directly to the record, without the need for human data entry.

 

Of course, a new clinical workflow will be needed to curate all of this patient-generated data and respond accordingly. It cannot be permitted to clutter the wall or be “mainlined” to the primary clinical team; rather, it must be prioritized according to patient risk/benefit and delivered via a workflow designed expressly for this purpose. AI algorithms must also be used to scrape from the EHR the information needed to assign acuity scores and suggest diagnoses that accurately reflect the patient’s current state.

 

Given how today’s clinical alert systems inundate frontline caregivers, it is unsurprising that most alerts are ignored. It is crucial that the EHR be able to prioritize alerts that address only immediate threats to the patient’s health in real time. Health care can learn a lot from the sensible rigor and discipline of the alert process in the airline cockpit. Clinical alerts should be presented in an easy-to-read, hard-to-ignore color-coded format. Similarly, hard stops — system-driven halts in medication or other therapies — must be intelligent; that is, they must be related to the present reality of the patient’s condition and limited to clinical actions that truly threaten the health or life of the patient.

 

From prisoners to advocates. The failure of EHRs thus far to achieve the goals of improving healthcare productivity, outcomes, and clinician satisfaction is the result both of immature technology and the failure of their architects to fully respect the complexity of converting the massive health care system from one way of doing work to another. Today, one can see a path to turning the EHR into a well-designed and useful partner to clinicians and patients in the care process. To do this, we must use AI, vastly improved data visualization, and modern interface design to improve usability. When this has been accomplished, we believe that clinicians will be converted from surly prisoners of poorly realized technology to advocates of the systems themselves and enthusiastic leaders of efforts to further improve them.

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Moving into post-EHR era

Moving into post-EHR era | EHR and Health IT Consulting | Scoop.it

Consultants weigh in on what hospitals should expect from them as healthcare moves beyond digitization and into the age of consumerism.

 

Healthcare information technology is evolving in many ways, and quickly so. That means health IT consulting has to change with the times, to evolve alongside the technology consultants help healthcare provider organizations, master.

 

Consultants from top firms across the health IT consulting spectrum have various ideas about what firms must do next to successfully aid provider organizations with technology. Call them next-generation health IT consulting goals.

 

For example, health IT consultants must move beyond prediction, said Jeff Geppert, a senior research leader at Battelle, an independent research, consulting and development organization that applies science, technology, and engineering to challenges in various industries, including healthcare.

 

“The current narrative on health IT consulting services is becoming commonplace,” he said. “The focus is on data science and applications that leverage large and connected datasets, powered by predictive analytics and artificial intelligence/machine learning running in the cloud.”

 

However, there is nothing very transformative about prediction, he cautioned.

 

“It is by necessity short-term and event-driven,” he said. “Healthcare provider organization CIOs should be looking for health IT consultants with a compelling long-term and goal-driven vision, and a plan to work with them to bring that vision about.”

 

"The focus [of health IT consulting] will shift to extracting more value from investments and identifying which new investments are necessary to drive competitive advantage for the system."

“Health IT consulting today seems like the auto industry a hundred years ago with multiple companies competing to build the most technologically advanced car,” he said. “Somewhere out there is the Henry Ford of health IT who will build something inexpensive, standardized, aligned with the needs of people, and scalable from individuals to the federal government.”

 

Healthcare provider organization CIOs should be looking to partner with health IT consultants with demonstrated longevity across multiple industries, he added.

 

John Curin, vice president of innovation at Burwood Group, a healthcare consulting firm that focuses on direct acute care, physician workflow and health IT, said he sees healthcare CIOs watching consulting services expanding beyond the EHR.

 

“The vast majority of the health IT consulting space has been overwhelmingly EHR-centric up to this point,” he contended. “Today, EHR and revenue cycle systems migration is largely complete or well-understood. The focus will shift to extracting more value from those investments and identifying which new investments are necessary to drive competitive advantage for the system.”

 

Further, consultants will offer services to help healthcare providers transition – the shift will be toward internally developed interdisciplinary strategies with a focus on systemwide financial and clinical outcomes improvement, Currin said.

 

“For example, to make IT more successful, CIOs will stop reacting to external plans and timelines, such as regulatory compliance introduced by meaningful use or vendor roadmaps based on product lifecycle and implementation schedules,” he said. “Instead, they will start building frameworks to drive better financial and clinical performance.”

"The time is now for CIOs to embrace consumerism and create a digital strategy that becomes a competitive advantage"

On another note, consumerism is significantly affecting healthcare today, forcing healthcare provider organizations to meet changing patient expectations. Along with receiving the best medical care available, today’s health care consumers also expect a first class experience across every touchpoint at an organization.

 

“With expectations becoming increasingly ‘consumerized,’ executives are realizing that their healthcare organization will be judged on how patients rate their overall experience,” said Rob Barras, executive leader, health solutions, at CTG Health Solutions, a clinical and financial IT consulting firm that serves healthcare provider, payer and life science organizations. “This means that meeting these demands needs to be front of mind for CIOs.”

 

This trend toward a consumerism approach will accelerate significantly, and health IT consultants will have to be on top of it to successfully assist healthcare provider organizations, Barras said. Soon, Amazon, Wal-Mart, CVS, and Apple will consider themselves care providers, he added. And while most traditional health systems are doing business as usual, smart CIOs will plan ahead to match the future expectations set by these retail giants in yet another industry, he said.

 

“Many of these major players believe there is an opportunity to capitalize on what they believe traditional providers have been slow to do – provide easy access and quality care at a reasonable and transparent price,” he said. “The time is now for CIOs to embrace consumerism and create a digital strategy that becomes a competitive advantage, and for consulting firms to rush to assist with this stage in the planning process.”

 

And Barras said that moving forward, health IT consultants have to be getting healthcare provider organizations implementing the latest healthcare information technologies now, not later.

“For the past couple of years, many healthcare organizations have treated emerging technologies as somewhat of a luxury and not as something with immediate business value,” he said. “However, technologies have matured quickly and already are being implemented to meet business needs, meaning organizations without structured plans to roll out the latest in analytic, AI and IoT solutions are in danger of falling out of step with competitors.”

This means that health IT consultants must focus on becoming innovation hubs – as opposed to internal caretakers – of technology to provide true value to healthcare clients, Barras added.

 

“The right CIO can help change the mindset of an organization, but that change must be supported from the top down,” he advised. “A key to this is working with consulting partners who understand that using technology is a way to create a competitive advantage for the future. Providers should engage partners who can clearly articulate the value of their work and the vision.”

 

 

 
 
 
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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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Pediatric EHRs Must be Treated Differently

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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Electronic Health Records Consulting 

Electronic Health Records Consulting  | EHR and Health IT Consulting | Scoop.it

For most health systems, investment in an electronic health record (EHR) is inevitable—and possibly one of the largest expenditures they will make. To achieve the clinical, financial, and operational return on investment, you need to be strategic in your selection, implementation, and utilization.

 

Why the EHR life cycle is just like raising a child 

 

No matter where you are in your journey, our services are designed to produce results that improve efficiency, effectiveness, and quality of health care for patients.

 

Our clinically-experienced IT consultants can support you through the entire EHR lifecycle, including:

 

  • Implementation strategy and planning: We guide clients through everything that goes on behind the scenes before the “go-live,” including a full assessment of current capabilities and workflows to determine what functionalities to look for in an EHR. From there, we lead the selection process for new EHR platforms by vetting qualified vendor options, identifying the initial vendor selection pool, orchestrating product demonstrations, and assisting in the negotiation process.

 

  • Go-live: To increase the usability of the EHR, we give clinicians the ability to learn about and personalize the technology before the go-live date, with items such as common procedures or prescriptions. Once we launch, we provide around-the-clock project management at every level and work to address any challenges that may come up during the process. 

 

  • Optimization: Whether after the “go-live” or as a standalone engagement, we work to develop strategies that optimize the EHR’s capabilities and produce results that drive value and profitability in the healthcare delivery model. We often optimize EHR platforms for:
    • HCC Capture
    • Medicare Annual Wellness Visit
    • Evidence-Based Guidance

 

  • Meaningful use attestation: Attesting meaningful use requires effort from many directions—from navigating regulatory changes to overcoming operational challenges. We take some of these tasks off clients’ plates by tracking federal updates, sending actionable alerts, and validating every aspect of the attestation plan. 

 

  • Life sciences support: To support customers and grow health system partnerships, life sciences firms are leveraging EHR strategies that align with industry trends and consumer priorities. Our experts help these firms determine high-yield, value-add strategy for implementing health IT resources into the EHR. 

 

And while we use these processes to guide our clients through the EHR lifecycle, we also support any IT platform using similar methodologies.

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