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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IBM’s Watson Extracts EHR Patient Data to Improve Care

IBM’s Watson Extracts EHR Patient Data to Improve Care | EHR and Health IT Consulting |

Anyone who enjoys watching the quiz show Jeopardy! has heard about the computer system Watson, which was initially developed to compete on the show but has since garnered the attention of leaders across a variety of industries. Watson can even be used to better analyze EHR patient data and lead to improved quality of care.

The company division IBM Watson Health has announced today that it is working with Epic and the Mayo Clinic to apply some of the computing capabilities of Watson to analyzing EHR patient data and systems in order to boost patient health outcomes. Providers will also gain advantages when applying Watson’s power to EHRs and gaining faster analysis of the many issues that affect a patient’s health and wellness.EHR Patient Data

Using secure, cloud-based Watson services will help physicians with clinical decision making and understanding of patients’ medical conditions. Over the last year, Epic has exchanged more than 80 million patient health records within its community and outside of it.

“Building on our recent announcement of IBM Watson Health, we are collaborating with Epic and Mayo Clinic in another important validation of the potential of Watson to be used broadly across the healthcare industry,” Mike Rhodin, Senior Vice President of IBM Watson, remarked in a public statement. “This is just the first step in our vision to bring more personalized care to individual patients by connecting traditional sources of patient information with the growing pools of dynamic and constantly growing healthcare information.”

The hope is to have Watson and Epic software be utilized to effectively create patient treatment protocols and more customized health management solutions for patients with chronic conditions. Watson would be used to bring forth relevant case studies and medical knowledge that is applicable to treating a patient when doctors and other healthcare professionals share EHR patient data with Watson in real-time.

Epic will be incorporating Watson’s computing features into its clinical decision support tools including Health Level -7 (HL7) Fast Healthcare Interoperability Resources (FHIR) Application Programming Interfaces (APIs). Through this combined system, clinicians will be able to more quickly access the knowledge necessary to more effectively treat patients and improve health outcomes.

IBM and Mayo Clinic is collaborating on ways to revolutionize cognitive computing by applying it to clinical trials matching among cancer patients. With the streamlined and accurate processes available through Watson’s computing capabilities, physicians are able to register patients much faster in relevant clinical trials that are customized to each individual’s needs. With more than 1 million patients seen at the Mayo Clinic every year and more than 1,000 clinical trials available year-round, integrating Watson should lead to significant progress in quickly assigning patients to innovative studies.

“Patients need answers, and Watson helps provide them quickly and more thoroughly. We are excited by Watson’s potential to efficiently provide clinical trials information at the point of care,” Dr. Steven Alberts, an oncologist at Mayo Clinic, said in a public statement.

IBM’s Watson offers significant opportunity for healthcare providers to bring about high-quality care through the use of cognitive computing capabilities tailored to each individual patient.

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Records Exchange Raises Privacy Worries

Records Exchange Raises Privacy Worries | EHR and Health IT Consulting |

A new survey shows that many consumers are concerned about whether their healthcare information will remain private once electronic records are routinely exchanged among providers. But experts say a good way to address those concerns is for organizations to be transparent with patients about who's accessing their data and why.

Devore Culver, executive director and CEO of HealthInfoNet, Maine's statewide health information exchange organization, says that HIEs and healthcare providers should take key steps to earn patients' trust that their records will remain private.

"Acknowledge their concerns," Culver says. "Be clear and transparent about how data will be used and by whom. Confirm that the organization adheres to current data security practices and standards. ... Provide the option for consumers to access audit reports of who is looking at their data."

Survey Results

The new survey, published this month in the Journal of the American Medical Informatics Association, found that more than half of California consumers believe that EHRs worsen information privacy and nearly 43 percent believe they worsen security.

When it comes to the impact of health information exchange, 40 percent of consumers surveyed say it worsens privacy and 43 percent say it worsens security.

The report was based on a phone survey of 800 consumers in California conducted by researchers at the University of California's Sacramento and San Diego campuses.

"While consumers show willingness to share health information electronically, they value individual control and privacy," the researchers wrote. "Responsiveness to these needs, rather than mere reliance on HIPAA may improve support of data networks."

Access Reports

Consumer confidence in EHRs and HIEs could be boosted if patients are given the opportunity to get reports on who accesses their records, says David Whitlinger, executive director of the New York eHealth Collaborative. The group coordinates activities for the Statewide Health Information Network of New York, which is the state's health information exchange.

SHIN-NY plans to provide consumers will such access reports through the HIE's patient portal, he says.

"They'll be able to look to see who accessed their records via SHIN-NY," he says. Providing patients with access reports about their health records is akin to credit bureaus providing consumers with reports about who accessed their credit reports, he says. "If patients ask who has accessed their records, and can get a report, that will go a long way to alleviate concerns."

Regulatory Activity

In fact, federal regulators have been working on a proposals regarding an accounting of health information disclosures and EHR access reports for patients.

The HITECH Act mandated the Department of Health and Human Services update HIPAA requirements for an accounting of disclosures of protected health information. In May 2011, HHS' Office for Civil Rights issued a notice of proposed rulemaking for updating accounting of disclosures requirements under HIPAA. The proposal generated hundreds of complaints from healthcare providers and others. Many of the complaints were aimed at a controversial new "access report" provision.

As proposed, the access report would need to contain the date and time of access, name of the person or entity accessing protected health information, and a description of the information and user action, such as whether information was created, modified or deleted. That access report would include EHR disclosures for treatment, operations and payment, which are categories of disclosures exempt from the current HIPAA accounting of disclosures rule.

Many of the public comments that HHS received on the access report proposal claimed that it would prove to be technically unfeasible for EHR vendors to implement, and complex and expensive for healthcare organizations.

But Whitlinger doesn't buy those arguments. "The provider community realizes that they will get challenged about who accessed [a patient's] record, and they don't want to deal with that," he says. And he believes that some EHR vendors "don't want to have to go down the path of how to make these access reports representative and valuable" for patients.

OCR Director Jocelyn Samuels said in January that the agency was considering a possible request for additional public input on HHS' proposed accounting of disclosures rule making. OCR is still evaluating the comments it received on the proposed accounting of disclosures rule it issued in 2011, as well as recommendations from the HIT Policy Committee about refining the rule, she said.

Patient Control

An executive at EHR vendor Athenahealth says that patients will become more confident in the security and privacy of their health records if they have more control over that information.

"Too often, patient data and its sharing is controlled not by the patient but by large care organizations and their health IT vendors," says Dan Healy, Athenahealth's vice president of government and regulatory affairs. "Our vision is of a system of patient-centered information exchange, putting control back in the hands of the patient. That will do more than anything else to increase confidence."

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Documenting Patient Data in the EHR

Documenting Patient Data in the EHR | EHR and Health IT Consulting |

Many years ago, my first preceptor taught me how to write a SOAP note. I started with the subjective — what the patient described in her own words. The objective described my physical exam findings, vital signs, and diagnostic studies.  Next, I was expected to develop a thoughtful assessment — one which combined the subjective complaint, my objective findings, and application of medical knowledge. The assessment naturally led into a well-reasoned plan of care. I've had numerous notes reviewed over the years — some by interns or residents who helped me develop more succinct documentation, some by attendings responsible for assigning me a grade for the rotation, and many by nurses and other physicians involved in the care of my patients.

Despite being out of medical school for more than a decade, I still go back to that first lesson to develop the notes that document the care that I provide. I often reject the standard template in order to tell my patient's story in the subjective. Despite the ease of documenting an exam in the EHR, I pause to make sure that I don't over-document what I didn't do or simply default and exam to normal. At the conclusion of the note, I try to capture what I am thinking both for the benefit of those taking care of the patient next, and for my own memory. My fear is to produce a note that has a lot of words, a few numbers thrown in for good measure, and numerous hyperlinks to all sorts of random and useless data which, in the end, says nothing of substance.

The ability to document so many things in the EHR is a blessing and a curse. Remember the days of chart reviews? Another physician would read your patients' charts to make sure you were doing the right thing. Now, this type of review is done primarily by the EHR itself. You may have written paragraphs about your conversation urging the patient to quit smoking, but if the right box isn't checked, you haven't done the counseling in the eyes of the computer. This type of chart review is a form of data mining that is increasingly tied to how we get paid. Not because the care we provide is poor, just that it is considered to be poorly documented.

I struggle with this. The office visit note is for the primary purpose of documenting the patient's care. Everything else is secondary. Yes, the documentation can be used to assure high-quality, high-value care. Yes, it can provide data to fill in an Excel spreadsheet or population health database. And yes, it helps insurers determine if they are getting what they are paying for. However, when the main purpose of the documentation is to provide data that is secondary to the patient sitting in your office receiving care, I hesitate.

The information available to us is amazing and overwhelming and frightening and vast. I can Google pretty much any topic and get more information in three seconds than it used to take in three hours (or days) to retrieve at the library. I love this convenience and think the best parts of it should be leveraged to provide top-notch healthcare. Yet, a big part of me longs for the days of a pen and paper when all I needed to worry about was getting enough documented that I could pick up where we last left off at the next visit.   

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New Medical Tech Not Hard to Swallow, Just to Implement

New Medical Tech Not Hard to Swallow, Just to Implement | EHR and Health IT Consulting |

The "always on" smartphone world of today matched with personal digital diagnostic technologies in development by the likes of Microsoft, Apple, Google, and other digital powerhouses promise to revolutionize chronic disease management and empower population health to stratospheric levels.

The development initiatives using data created and transmitted via smartphones using wearable, clothing embedded, ingestible, and other personal sensors are limited more by imagination than technology.

Just one little problem: The ability to convert another tsunami of new patient data into usable and actionable information for physicians using existing EHR technology is more than a decade in the rearview. The existing system platforms are static warehouses, not digital highways.

Further, each EHR's warehouse is an island unto itself because it uses a different layout, nomenclature, and even language designed to make changing to a competitor as difficult as possible by making data migration to a new system an expensive and daunting process. Until Congress stepped in, exorbitant ransoms imposed by some EHR companies to translate the data into the standard language are effectively bad memories.

The Wall of Interoperability

Still, federal law, which prescribes that all EHR data is to be contained in a standard format called a CCDA (Consolidated Clinical Document Architecture, if you must know), to be certified. The law, however, has more loopholes than grandma's knitting.

That makes the new healthcare information highways, population health, and similar programs that convert EHR warehoused data into usable information for physicians and other healthcare providers (among a host of other enabling and time-saving features), the ultimate solution hobbled by that EHR industry manufactured wall to data called "interoperability."

Circumventing EHR companies by automating removal of the CCDAs out of EHR systems has been solved by a very clever few, as has even making them interactive, but it comes at a cost because each version of each EHR has to be done separately.

To achieve a single-keystroke model (inputting data only one time), which is not only desirable but the only way to get people to use it, tons of EHR data has to be machine translated into a common language, delimited, mapped, parsed, validated, and, finally, populated into a common platform so that it can be made into something useful for providers. Every day. That takes lots of time, money, and skill, which can be undone by EHR companies at will every time they issue an upgrade, new version, or even a simple update — and expensively redone.

In return, providers get useful, time-saving tools that can allow them to do much more in much less time, which is the key to a reasonable quality of life for physicians.

That makes effective population health, let alone enhancing it by new wireless, personal smartphone app-enabled diagnostics, equivalent to baking a cake by having to get and process the raw ingredients from farmers and dairies instead of a cake mix from the supermarket.

The obvious solution, of course, is to pull the data directly into the information manufacturers' systems, circumventing the EHR warehouses, which will be hoisted by their own petard in the open ocean without a paddle because information systems cannot be EHR-specific to be effective.

In the end, there is a bright future for developers, physicians, healthcare providers and, especially, patients.

EHR companies? They took a different road. The survivors will join the program, and the time to do so is so very close.

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Electronic Health Record Vendors Take Patient Data Hostage: What Should We Do?

Electronic Health Record Vendors Take Patient Data Hostage: What Should We Do? | EHR and Health IT Consulting |

In today’s interconnected world it seems intuitively true that instant access to comprehensive medical patient histories will help physicians to provide better care at a lower cost. This simple argument was persuasive enough for the federal government to spend $26 billion to incent medical providers to adopt electronic health records (EHR) systems so that they can electronically share medical records. The initial investment appeared to be large, but it was an economically sound solution to control the rising healthcare expenditure. The resulting HITECH act is one of the few healthcare laws that maintains bipartisan support. To establish a nationwide health information exchange network, officials designed a two-stage plan. First, incent every medical provider to create an electronic archive of their patients’ medical records. Second, connect these electronic archives together so that the providers can share their patients’ records. The $26 billion in federal incentives was a lucrative source of revenue for hundreds of different software vendors to develop and aggressively market their own type of EHR products in a medical market that knew little about information technology. According to the Office of National Coordinator for Health IT, in 2008, less than 10 percent of hospitals had basic EHR systems, and a mere five years after, 94 percent of the hospitals use a certified EHR system.

The next step forward is to connect these electronic silos together so that physicians can share their patients’ records. The billions of dollars in federal spending will only have any tangible benefit if this is done successfully. EHR vendors have taken patient data hostage and are not willing to release it unless they receive a big ransom. They typically claim that technical problems limit the interoperability of their products. This prevents physicians from sharing their patient records with other doctors. This is like T-Mobile claiming that its users cannot make calls to AT&T customers. The claimed interoperability limitation does not end here. The vendors are proposing hefty charges to allow data sharing between their own customers.

As I have discussed in detail before, this a hole that the government has dug for itself. A nationwide health information exchange network sounds great, but it is not possible to achieve this goal without the proper alignment of economic benefits for every player in the healthcare market. In the face of this problem, the government has three choices:

  1. Pay EHR vendors the ransom that they are asking to release their hostage and allow sharing of the patient data among medical providers.
  2. Regulate the industry and force the EHR vendors to allow sharing of patient data among medical providers.
  3. Do nothing.

The government appears to be following the first plan. Officials had not anticipated interoperability challenges and assumed that all of the providers with EHR systems would have the capacity to exchange records. Based on this assumption, the third stage of the EHR incentives program was designed to encourage physicians to actively engage in the exchange of medical records. Today nearly every physician has an EHR system and although many of them also want to exchange information, the EHR vendors do not allow them. The incentives, which were initially planned to encourage physicians, will end up with EHR vendors and help drive future profits. As Rep. Phil Gingrey (R-GA) put it, "we have been subsidizing systems that block information instead of allowing for information transfers, which was never the intent of the [HITECH] statute.”

Regulating the industry seems like the only feasible solution to this problem. Rep. Michael Burgess (R-TX), the leader of the House Energy and Commerce trade subcommittee is drawing up a bill to enforce data sharing. The benefits of regulating the EHR industry, if any, will take a very long time to become tangible. The EHR vendors will furiously push back against any kind of regulation and will insist that technical challenges are a real barrier to interoperability. Congress is poorly situated to adjudicate this claim. Time is a critical factor in the long term success of HITECH plans, which threatens the viability of this strategy.

The best solution for the government is to do nothing. The new pay for performance payment methods in which the medical providers are being paid a fixed amount for treating patients would drive them to become more efficient and increase their profit margin by seeking solutions such as health information exchange to cut costs. Because the market for new EHR products is now saturated, the only revenue source for EHR vendors are charges for data exchange. Currently, they can get away with outlandish charges because they know the incentives from the federal government allow doctors to cover their costs. But if the free money from the government were to stop, then EHR vendors would have to persuade the physicians to pay for the exchange fees. Just like any other service, the highest price that the medical providers would pay is equal to the value of the service for them. If the electronic exchange of information helps medical providers to cut back on their costs and save some money they will be willing to pay a fair price for it. EHR vendors will end up lowering their fees to a reasonable level or will eventually go out of business.

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How Electronic Health Records Will Be More Helpful To Doctors And Patients

How Electronic Health Records Will Be More Helpful To Doctors And Patients | EHR and Health IT Consulting |

Twenty years ago, if patients wanted to read their own medical records, they likely had to sue their healthcare provider for access. Even after the Health Insurance Portability and Accountability Act was passed in 1996, legally guaranteeing patients the right to their medical information, the process to obtain records was so arduous that few people bothered.

Today, the picture is different. Not only do patients have the right to view their records, technology is improving their ability to access them.

When three hospital systems in Massachusetts, Pennsylvania and Washington took the step of offering patients online access to their health records and physicians’ notes, more than two-thirds of the patients reported positive results: having a better understanding of their health and medical conditions, taking better care of themselves and becoming more regular with their medications. Encouragingly, this did not significantly add to physicians’ workloads: Only 3 percent spent more time answering patients’ questions outside of visits, and 11 percent spent more time writing or editing notes.

Tapping New Models

These hospitals are not alone. Several healthcare executives are experimenting with similar models and a new generation of electronic health records (EHRs) is on its way.

The legacy EHR systems, rooted in PCs tethered to server computers and built primarily to meet regulatory requirements, have become unwieldy and expensive for most healthcare organizations to support, according to the latest report from market research firm IDC. It predicts a massive structural shift to web-native technologies like cloud, allowing organizations to store and access data and programs over the Internet and pay a fee based on how much computing power is used.

“The new concept of flexible, mobile, cloud-based acute care EHR supports digitizing paper workflow and reengineering processes, ” explains IDC research director Judy Hanover. It also enables better integration with analytics, big data, mobile and social tools.

Wearable health records are knocking on doctors’ doors too. Drchrono, for instance, has made patient-facing and provider-facing Apple Watch apps to complement its iPhone and tablet versions. Using the app, a physician can view a patient’s information, respond to patient messages using quick text and assess a patient’s refill requests as well as lab results without taking out his or her iPhone or iPad.

Others in the industry seem to agree that there is demand for such seamless connectivity. The 2015 Middle Market Healthcare Outlook, conducted online by the Harris Poll on behalf of CIT, confirms that the benefits of technology are clear to most healthcare executives. According to this study, about 3 in 4 recognize the positive impact of technology in reducing costs for consumers. However, a majority of those surveyed also feel that the stakes are higher for the healthcare industry with respect to technology, and they struggle to figure out which technological advances will be most relevant.

Moving Beyond Regulation

According to Hanover, there is an acute innovation gap in EHR. Her studies indicate that doctors see fewer patients today and spend more time on documentation than they did when using paper charts in 2009. She believes that the healthcare industry has been so focused on meeting regulatory mandates like Meaningful Use — policy designed to ensure that clinicians and hospitals actually use the computers they bought through government subsidies — that there was no real push for innovative, flexible software.

But business needs are now overtaking regulatory mandates and several healthcare executives are exploring the next generation of medical records software, built on cloud as a foundation. These cloud-based systems offer lower up-front capital expenses, predictable maintenance costs and flexibility to scale up or down based on requirements. They will make it easier to access patient data from multiple endpoint devices and analytics services to understand it better.

EHRs of the Future

“There’s a huge appetite for getting better workflows into healthcare, looking at department specific and mobile apps. I would see an environment where hospitals and health systems would perhaps rip out and replace in some cases,” says Hanover. The Harris Poll study also predicts higher investments in IT. The study found that IT was the third most likely reason for healthcare executives to seek financing in 2015 after “new hires” and “new construction.”

Is it time for healthcare providers to swap their current EHR and upgrade to the new cloud-based software? Hanover expects investments to flow into this next generation of EHRs in the next one to two years. The industry will see several EHR systems move to the cloud within three to five years, she believes.

“There’s an opportunity for healthcare technology suppliers to really innovate and offer a compelling option,” she says.

Early Days for Data Sharing

The latest guidelines released by the Centers for Medicare & Medicaid Services require healthcare providers to share data with other providers and patients, without compromising on security. Many in the industry expect data sharing capability to be the biggest game changer. Will this mean a doctor can pull a new patient’s medical history — blood work, blood pressure and medication details — from another hospital? “Not so fast. Healthcare moves slowly,” warns Hanover.

It’s early days yet for opening up access to patient data, and the new generation of EHRs might begin with better workflow, improved productivity and tighter integration with analytics of patient data.

Laurie Bolick Wolf's curator insight, June 17, 2015 2:46 PM

This article specifically focuses on the changes expected in healthcare as technology improves and changes.  The expectation is that care will  improve as providers are able to access information from multiple facilities and locations easily and immediately.  While this does increase productivity and the ability to see more patients, the downside is the documentation within the EMR itself.  The shear volume of data that must be entered with EMR is much higher than when documentation was done on paper.  In the end, the time saving with technology advancements may be lost in the extra time spent on documentation.!

Electronic Data Key for Patient Engagement Initiatives

Electronic Data Key for Patient Engagement Initiatives | EHR and Health IT Consulting |

Patient engagement initiatives within the healthcare industry are moving past the patient portal, as pilot programs called OpenNotes allow patients to view their medical doctor’s notes taken during the visit. The latest version of the initiative even allows patients to comment and correct any information available in the physician records.

The New York Times reported on one patient that followed his own medical records and healthcare data with rigor. Steven Keating, a young doctoral student from the Massachusetts Institute of Technology’s Media Lab, had a brain scan eight years ago that found an anomaly and required monitoring over the years.

In a follow-up scan three years later, no issues were uncovered. However, based on his own research, Keating knew the problem was located near the olfactory center of the brain and, when he began smelling vinegar, he knew these were “smell seizures.” Three weeks after conducting an MRI, surgeons removed a cancerous tumor from his brain.

Medical experts believe this type of patient engagement and self-education can be gained when patients have full access to their own healthcare records. These type of patients are thought to be better able to stick to their prescription drug regimen and even identify early symptoms of disease.

Today, more and more hospitals and physician practices are adopting patient portals to meet Stage 2 Meaningful Use requirements as well as offer patients easy access to their medical information. Through the OpenNotes program, more patients are integrating wellness goals in their everyday life, taking their medications on time, and gaining a better understanding of their chronic diseases.

Currently, more than 5 million patients have received open access to their physician notes through these pilot programs. Nonetheless, Keating told the news source that obtaining one’s own medical information still has its share of barriers.

“You can get (access to data), but the burden is always on the patient. And it is scattered across many different silos of patient data,” Keating said.

Federal agencies are providing policies to support patient engagement initiatives and access to medical data in order to overcome these barriers. For instance, the Stage 3 Meaningful Use proposed rule sets forward a key objective for boosting patient engagement initiatives.

Health IT Now, a coalition of physician and patient groups that advocates health information technology, finds the Stage 3 proposed rule and the 2015 edition health IT certification criteria favorable, especially regarding its patient engagement initiatives.

“These changes are important steps forward. The Patient API change in and of itself is elegant. It allows patients to control more of their information while expanding interoperability,” Joel White, Executive Director of Health IT Now, stated in a press release. “We also support reducing burdens on healthcare providers, the folks who have to implement these changes. We believe HHS could go one step further and only approve measures that can be reported electronically. We need to scrap paper and pen in the health IT program.”

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Survey Reveals Patients' Perspectives on EHRs

Survey Reveals Patients' Perspectives on EHRs | EHR and Health IT Consulting |

I spend a lot of time studying and understanding EHRs. I am a “superuser” within both the inpatient facility in which I have medical staff privileges, and in the private outpatient practice. I made the leap to EHRs more than two years ago, and haven’t looked back.

I can honestly say that the two EHRs I use have improved patient care, documentation, accuracy, and quality of life for me. I realize that systems vary, but I feel fortunate that I have good tools for accessing and using the EHR.

We seem to always talk about the EHR from the perspectives of the provider, facility, and the system. But what about the patient? That seems to be an afterthought in this process. How can we leverage the data that we are collecting and storing to make the patient's experience more inclusive and meaningful to improve the health or our communities?

The National Partnership for Women and Families just published a survey that demonstrates that patients also value the EHR, and are eager for more access and features in better understanding their healthcare and options.

Here are some of the key findings from the survey of 2,045 U.S. adults:

• Eighty-five percent to 96 percent of all respondents found EHRs useful in various aspects of care delivery, while only 57 percent to 68 percent saw paper records as useful.

• Patients’ online access to EHRs has nearly doubled, surging from 26 percent in 2011 to 50 percent in 2014.

• Patients want even more robust functionality and features of online access than are available today, including the ability to e-mail providers (56 percent); review treatment plans (56 percent), review of doctors’ notes (58 percent), and and review of test results (75 percent). They also want the ability to schedule appointments (64 percent), and submit medication refill requests (59 percent).

• Patients’ trust in the privacy and security of EHRs has increased since 2011, and patients with online access to their health information have a much higher level of trust in their doctor and medical staff (77 percent) than those with EHRs that don’t include online access (67 percent).

• Different populations prefer and use different health IT functionalities. For instance, Hispanic adults were significantly more likely than non-Hispanic Whites (78 percent vs. 55 percent) to say that having online access to their EHR increases their desire to do something about their health; and African American adults were among the most likely to say that EHRs are helpful in finding and correcting medical errors and keeping up with medications. Specialized strategies may be necessary to improve health outcomes and reduce disparities in underserved populations.

In many ways, the survey findings really surprised me, as this is the first time that I have seen substantial survey data about how patients see the whole process of the EHR. Their understanding of the utility of the EHR was refreshing.

Some findings raise concerns, however. Patients' desire to have more electronic access may be problematic. Think of the increased workload in responding to a new access point, and the potential for misunderstandings and conflict in care plans if diagnostic data and records can be viewed unfiltered and without the assistance of the care provider.

On the other hand, the EHR seems to provide at least some of the tools that a provider needs to improve health outcomes and reduce healthcare disparities among diverse populations. It was good to see that the EHR was seen by some ethnic populations as a way to motivate them to be healthier and to take more responsibility and control of their healthcare.

Much has yet to be learned and uncovered in the wake of the push to automate and digitalize the health record in the United States. Sometimes the law of unintended consequences can work in the favor of the healthcare system.

One fact remains for all providers, learning to survive in the post-EHR world, and acquiring the skills needed to become efficient in the use of the EHR, have never been more important. There is no going back to the paper record.

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Mobile EHRs forge a patient journey platform

Mobile EHRs forge a patient journey platform | EHR and Health IT Consulting |

As last year wound down, Practice Fusion optimized its electronic health record service for Apple and Android tablets — and, in so doing, joined the growing number of vendors making mobile EHRs.

In addition to the obvious benefits of cutting the proverbial cord and arming clinicians with software tuned to specific devices, mobile-optimized EHRs lay a foundation for providers.

On tap for 2015? Patient check-in.

“Very soon the front office staff will no longer have to get out paper forms,” Practice Fusion CEO Ryan Howard says, stressing that this upcoming Practice Fusion feature would finally cover “every step of the patient journey.” 

Indeed, Practice Fusion revealed online check-in earlier this month and explained that patients will be able to submit insurance information, prescription status, and the reason for their upcoming visit before they even set foot in the doctor’s office. 

The company claimed that its new service will eliminate a quarter-billion pieces of paper this year by replacing the average 3-7 page forms patients complete at the doctor’s office.

Beyond check-in, Practice Fusion will also be looking to gear its cloud-based offering toward medical specialists.

“We’re pretty focused on flow sheets this year and really delivering a lot of functionality for subspecialties,” Howard revealed. 

As far as legislation and regulation go, ICD-10 and telemedicine mandates will be huge in 2015 and key at HIMSS15, Howard says. Meaningful Use Stage 3 will also be entering the fold this year, a fact the industry is hard-pressed to heed given the difficulties currently unfurling with Stage 2.

And EHRs optimized for mobile use will be underlying all of the above, Howard explains.

That’s because patients want mobility as much as doctors do.

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