EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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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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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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EHR Data Architect: A successful conversion and data integrity

EHR Data Architect: A successful conversion and data integrity | EHR and Health IT Consulting | Scoop.it

Over the last decade, adoption of EHR systems has increased dramatically among providers. While many healthcare providers have made the shift from paper to electronic health records, there has simultaneously been a growing need among healthcare organizations to change EHR providers. The two largest reasons for this change in systems are dissatisfaction and mergers and acquisitions.

When changing EHR systems, many healthcare organizations turn to experienced EHR Data Architects to help ensure the integrity of their patient data. For those EHR Data Architects, it is the process, not the EHR provider, that allows them to guarantee a successful conversion and data integrity. 

As is true with the initial adoption of electronic records, changing EHR providers is a very large project. As healthcare organizations work to convert legacy records and adopt new systems, patients continue to generate more data.

It can be quite challenging to determine the best method for maintaining and storing legacy date while also utilizing a new system. As a result, most healthcare organizations opt to incorporate legacy data into the new EHR system from day one. Out of the myriad of options available for guaranteeing data integrity, the best way to accomplish this is through an automated EHR data conversion.

What is EHR data conversion?

EHR data conversion utilizes a process known as ETL to move patient data from one EHR system to another. During an ETL conversion, patient data is EXTRACTED from the legacy system, TRANSFORMED to align with the map created for the new system, and LOADED into the new system. EHR data conversion can either be performed manually or through an automated process.

 

Manual data conversion carries a significant risk of data manipulation. As a result, many healthcare organizations choose automated EHR data conversion when working with large sets of data.

During an automated data conversion, not a single record is touched. Companies who specialize in healthcare data conversion utilize a failsafe ETL methodology specifically designed to mitigate clinical risk.

What are EHR Data Architects?

EHR Data Architects are the specialists who structure and run an automated data conversion. They are experts in extracting data out of any source system/database, using the necessary means specific to that system. EHR Data Architects have customized toolsets that allow them to transform the data to meet the specific needs of the target system.

An EHR Data Architect has experience working with all genres of data. The process and tools allow for the Data Architect to perform an ETL for data from any system and to any system. They ARE NOT specific system experts, or specialists, in any specific system's operations, usability, or recommended workflows.

While they are not subject matter experts (SMEs) in any EHR system, they are in the process of data conversion. As a result, they are able to successfully convert data no matter what systems are being utilized.

It is important that your data conversion partner has developed a failsafe process for extracting, transforming, and loading data. A strong partner will have experience in many different EHR systems and potentially have extensive experience working with your EHR provider and system. However, experience working with your EHR provider is not enough.

Without a failsafe process and methodology, your patient data is still at risk. Furthermore, when the right process is in place, an EHR Data Architect can convert from any source system to any target system and ensure the integrity of your data.

To learn more about how you can adequate assess a potential EHR data conversion partner’s experience, download the EHR Data Conversion Guide and Workbook.

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Trends in EHR Software, 2017 and Beyond

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

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

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

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

 

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

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

 

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

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

 

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

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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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What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration

What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration | EHR and Health IT Consulting | Scoop.it

Participation in pay-for-performance plans like MACRA’s Quality Payment Program (QPP) poses new challenges for resource-strapped healthcare organizations. Many provider sites lack the time and technical expertise needed to retool their EHR implementation to document new metrics under value-based reimbursement models like the Merit-based Incentive Payment System (MIPS).

Nonetheless, that is precisely what clinicians must do to deliver on quality reporting requirements. When using EHR documentation tools, many factors must be considered for a provider to get credit on having met clinical quality measures (CQMs). How that information gets stored in the EHR directly affects reporting. Many healthcare organizations are finding that customizing an EHR to recognize when a measure has been met—preferably in a manner that poses as few interruptions to patient engagement as possible—is easier said than done.

 

Overcoming EHR Limitations

Many outpatient and inpatient settings still struggle with common EHR data management headaches. As clinicians bring new quality measures into the EHR, those underlying data management issues can foil even the best-laid reporting plans.

Discrete Data Capture

The push to better document clinical quality is causing a transition in EHRs to focus more on structured or discrete data that is easier to trend over time. Unfortunately, many healthcare providers still receive patient data from healthcare affiliates via fax. Those faxed documents show up as attachments in the patient chart and are not fully integrated into the patient data file. If that information was sent via HL7 interface instead, details on the care rendered by that hospital or other healthcare entity would flow into the EHR as discreet data variables. For many providers today, capturing that information in a manner that makes it usable in reporting and analytics still requires timely, manual data entry.

Documentation and Data Consistency

Provider sites with multiple clinicians may also encounter issues related to the slightly different way that each EHR user documents care. MIPS and other quality programs require consistency and a high degree of specificity in clinical documentation. If a clinician does not get diagnosis specifics into the patient chart, that patient may not be included in the CQM calculation they need to be included in. Many clinicians are having to modify their documentation process during patient encounters so they and the staff can capture all the necessary information in the EHR.

Clinical documentation will have even bigger repercussions under the Cost component of MIPS, which is slated to be factored into performance scores in coming years. Take, for example, a patient that is in for the flu. That patient has a certain anticipated cost impact (the average Medicare spending per beneficiary), calculated based on past medical history and services rendered. If a patient goes to a physician and has the flu but also has diabetes, heart failure, and asthma, that flu patient is probably going to cost more to care for. If the physician only submits the flu diagnosis and fails to document patient co-morbidities then the healthcare organization will not get the same allowance under the MIPS Cost category and could be labeled as “higher cost” than a comparable provider encounter for a patient that required fewer resources to care for.

Clinicians, coders, and staff need to make a mental transition away from “we’re submitting claims” to “we’re submitting data” to better serve clinical reporting initiatives and patient care analysis.

 

Making Informed CQM Selections

Beyond adapting to new data management processes, clinicians reporting under value-based programs also have a great deal to learn as they layer in additional quality measures under MACRA. One of the biggest challenges clinicians and administrators face is selecting the best measures for their specific healthcare organization. With limited spare time on their hands, many healthcare teams are leaning on outside expertise to help them evaluate the implications of various measure selections.

Measures Without Benchmarks

Many quality measures under MACRA are carry-overs or “relics” from other reporting programs. For these CQMs, providers can look to prior performance averages to evaluate the likelihood of success should the healthcare organization elect to report on those measures. That data does not exist for some CQMs, which are referred to as “measures without benchmarks.” On measures that have no benchmark data available, providers will be limited to a maximum of three reporting points instead of the ten points available on measures with benchmarks established.

To further complicate things, details on the availability of some benchmark data will not be calculated until after the March 2018 QPP reporting deadline. Providers may wish to further diversify or report on additional measures that could help offset low point earnings on measures without benchmarks.

Topped Out Measures

Another CQM caveat that providers should be aware of relates to “topped out” measures. These relic measures from other reporting programs are very engrained in many healthcare settings. Medication reconciliation, for example, was a requirement under Meaningful Use. Widespread adoption and universally high compliance rates on that measure makes it more difficult for clinicians to out-perform peers. Achieving maximum points on such measures requires a perfect or near-perfect score.

Keep average performance thresholds in mind when evaluating CQM selections, not just the healthcare entity’s individual performance track record. Look at a broader set of measures to maximize MIPS score potential. Clinicians could earn more points by scoring 70 percent on a non-topped out measure than they would earn scoring 95 percent on a topped out measure. Some topped out measures will likely be eliminated in future years to help diversify CQMs, as was the case under Meaningful Use.

Understanding the intricacies of CQM selection and EHR data management will be vital to success under value-based payment programs. Healthcare administrators and clinicians who proactively work to better understand the impact of various measures and streamline EHR processes will be best positioned to maximize program incentives.

 

Does your organization have the resources it needs to successfully navigate MIPS? Learn how Pivot Point can help with your value-based strategy.

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Philips Launches EHR-Integrated Patient Monitoring Solution for Clinicians

Philips Launches EHR-Integrated Patient Monitoring Solution for Clinicians | EHR and Health IT Consulting | Scoop.it

Philips has announced the launch of their next-generation Patient Monitoring solution, an enterprise-wide system that consists of bedside, transport, mobile and central station monitoring technology backed by a new approach of consulting, training, service and customer support.

Helping Clinicians Improve Patient Care

When patients are admitted to the hospital, they are frequently transferred between departments, which can make it difficult for clinicians to obtain complete data from monitoring systems that operate independently of one another. Incomplete data not only limits clinicians’ view into the patient’s condition, but can put a patient’s safety at risk. In a recent Philips-sponsored study, results revealed patient safety is still a top concern for physician and nurse leaders in the U.S.

In an effort to alleviate this concern, Philips designed this solution to help clinicians improve patient care, drive clinical performance and assist health systems in lowering costs, by harmonizing monitoring system updates and improved service agreements.

IntelliVue X3 Patient Monitor

The IntelliVue X3 is a highly portable, dual-purpose monitor with intuitive smart-phone-style operation. With this monitor, there is no need for caregivers to change patient cables during transport or at bedside, allowing them to spend less time dealing with equipment and more time caring for the patient. With alarm fatigue a top concern for healthcare professionals, the Patient Monitoring solution also includes IntelliVue bedside monitors with Alarm Advisor, a tool that tracks how clinicians respond to alarms and alerts them when set thresholds may be too sensitive.

EHR-Integrated Patient Monitoring

As a comprehensive system, the Patient Monitoring solution captures a steady stream of detailed patient data from monitors and medical devices, and feeds it securely to the hospital’s EMR for virtually gap-free patient records from admission to discharge, even during transport. The integrated solution fits securely into health systems’ existing IT environment, delivering vital signs, waveforms and alarms directly to caregivers.

By incorporating these clinical decision support tools and advanced algorithms, caregivers have better visibility into a patient’s changing condition. All Philips bedside, transport, and mobile monitors share the same look, feel, and interface for consistency and to reduce complexity, accelerate care, making it easier for clinicians to provide the best quality care throughout patients’ transports around the hospital.

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