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Patient Experience vs. Patient Engagement

Patient Experience vs. Patient Engagement | EHR and Health IT Consulting | Scoop.it
The patient experience is about perceptions and patient engagement is about actions and behaviors.

 

The Beryl Institute, a global community of practice and premier thought leader on improving the patient experience in healthcare, defines the patient experience as “the sum of all interactions, shaped by an organizations culture, that influence patient perceptions across the continuum of care.”

Similarly, the Robert Wood Johnson Foundation describes the patient experience as “comprised of research reports and administrative information that reflect quality from the perspective of patients by capturing observations and opinions about what happened during the process of health care delivery. Patient experience encompasses various indicators of patient-centered care, including access (whether patients are obtaining appropriate care in a timely manner), communication skills, customer service, helpfulness of office staff and information resources.”

 

How is the patience experience measured?


Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).  The HCAHPS Survey is the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.  HCAHPS is a 27-item survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience.

CMS publishes HCAHPS results on the Hospital Compare Website four times a year, rolling the oldest quarter of patient surveys off and the newest quarter on each time. Since 2008, HCAHPS has allowed valid comparisons to be made across hospitals locally, regionally and nationally.

 

What is the driving force behind improving the patient experience?


Value Based Purchasing (VBP) incentive payments.  The Hospital Value-Based Purchasing Program is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide to people with Medicare.

Hospital VBP incentive payments to hospitals will come from the regular fees Medicare pays hospitals through its Diagnosis-Related Group (DRG) system. Hospitals participating in Hospital VBP will have their base operating DRG payments for each patient discharge across all hospitals reduced by a small percentage each year.

Taking into account the reduction in base Diagnosis-Related Group operating payments to hospitals (1 percent for Fiscal Year 2013), CMS estimates that roughly half of participating hospitals will receive a net increase in payments as a result of this rule, while the rest will receive a net decrease in payments.

The Fiscal Year 2013 Hospital VBP Program consists of two domains including 1) Clinical Process of Care and 2) Patient Experience of Care.  For FY 2013, these weighted values are 70 percent for Clinical Process of Care and 30 percent for Patient Experience of Care.

The Patient Experience of Care score is the sum of a hospital’s Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) base score and that hospital’s HCAHPS Consistency score.  The Experience of Care domain is broken out into eight equally-weighted dimensions:

Communication with NursesCommunication about MedicinesCommunication with DoctorsPain ManagementCleanliness and Quietness of Hospital EnvironmentResponsiveness of Hospital StaffDischarge InformationOverall Rating of Hospital

What is patient engagement?


To my knowledge, there is no common definition of patient engagement.  I believe patient engagement can be defined as a person’s active participation in managing their health in a way that creates the necessary self-efficacy to achieve physical, mental and social well-being.  This means that healthcare delivery must entice a person to actively participateover the long-term while fostering health related self-efficacy which yields meaningful physical, mental or social benefit.  In only this way can healthcare organizations depend on the active and sustained participation required to improve clinical outcomes.

This definition clearly differentiates the patient experience from patient engagement.  Whereas the patient experience is based on the patient’s perception of quality, patient engagement is based on the patient’s active and sustained participation in managing their health.  The patient experience is about perceptions and patient engagement is about actions and behaviors.  A patient can conceivably be satisfied with their healthcare experience while  having minimal engagement.

 

How is patience  engagement measured?


Medicare and Medicaid EHR Incentive Programs Proposed Stage 2 Meaningful Use Criteria.  CMS published in the Federal Register the proposed rule which would specify the Stage 2 criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet in order to qualify for Medicare and/or Medicaid electronic health record incentive payments.  Among the many topics addressed in the proposed rule are patient and family engagement measures.

The proposed Stage 2 patient and family engagement measures focus providers and/or hospitals on:

Making visit/inpatient information available to patients timely and onlinePresenting visit/inpatient information in a manner that leads to patients viewing, downloading or transmitting the informationProviding patient-specific education resourcesPromoting patient and provider interactions that lead to patients sending secure messages to their provider

Providing the ability for patients to access and exchange information online seems like a basic, reasonable and early step towards engaging patients.  However, I believe it falls woefully short as an overall measurement of patient engagement.  The proposed patient information access and exchange in and of itself does not create patient engagement, rather,  it creates a channel where patients can engage in some aspects of managing their health. Even when providers meet the proposed Stage 2 measures they will still be saddled with the more complex task of actuallyfostering patient engagement.  So, the really hard work lies ahead for providers and hospitals.

 

What is the driving force behind improving patient engagement?


The Patient Protection and Affordable Care Act (PPACA) Payment Reform.  The PPACA has many provisions related to payment reform.  These reforms include Medicaid & Medicare payment adjustments, payment reductions, incentive payments, bonus payments, bundled payments and shared savings programs.  Payment reform is increasingly shifting away from fee-for-service to performance based payments.  As such, improved healthcare delivery models have significant dependence on the active and sustained participation of patients post their hospital or provider visits in order to achieve financial targets.  Higher levels of patient engagement will be essential to achieving targeted health outcomes that trigger additional reimbursement.

 

For example, let’s look at Accountable Care Organizations (ACO).  The CMS.gov website describes ACO’s as groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.  The key to this payment structure is to generate healthcare savings through better healthcare delivery which then can be shared between the ACO and the government.  Generating these savings will be significantly dependent on patients actively participating in the management of their health as a means of driving down cost through reduced utilization of services.

 

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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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Most doctors with EHRs still not taking advantage of their benefits

Most doctors with EHRs still not taking advantage of their benefits | EHR and Health IT Consulting | Scoop.it

Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control.

About 8 in 10 U.S. physicians had an electronic health records system in 2015. One-third of these doctors electronically sent, received, integrated or searched for patient health information — indicating that most physicians still aren’t using EHRs to their fullest extent. These findings come from the NCHS Data Brief from the CDC, State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015.. Only 9 percent of physicians took advantage of all four functions.

 

Full use of EHRs varies by state:

  • The percent of doctors who electronically sent patient health information to other providers ranged from a high of 56.3 percent in Arizona to a low of 19.4 percent in Idaho.
  • The percent of doctors who electronically received patient health data from other providers ranged from a high of 65.5 percent in Wisconsin to a low of 23.6 percent in Louisiana and Mississippi.
  • The percent of doctors who electronically integrated patient health information from other providers ranged from a high in 49.3 percent in Delaware to a low of 18.4 percet in Alaska.
  • The proportion of doctors who electronically searched for patient information from other providers ranged from a high or 61.2 percent in Oregon to a low of 15.1 percent in Washington, DC (the District of Columbia).

These data come from the 2015 National Electronic Health Records Survey which polled a national sample of nonfederal office-based patient care physicians between August and December 2015.

 

Health Populi’s Hot Points:  Most U.S. physicians have purchased, installed and are using electronic health records systems, driven primarily by financial incentives they’ve derived from the HITECH Act — part of the Stimulus Bill (more formally, the American Recovery and Reinvestment Act of 2009). Why was this part of the Stimulus package? The policy thinking was that health care costs in America were a key driver of the long-term deficit and so the U.S. health system had invest in the means to measure health spending and outcomes and then manage what we measure.

Without interoperability — that is, the ability to move data where it needs to go throughout the continuum of care and shared across providers who all serve the patient — we can’t fully measure, and thus manage, costs and quality for that N of 1 patient.

U.S. taxpayers have made the investment into EHRs for their doctors. But we’ve still miles to go before we see and benefit from the ROI from fully interoperable digital health records systems. There are promising technologies and standards beginning to be adopted by pioneering informaticists and healthcare systems — FHIR standards for innovating within the EHR environment, and APIs bringing patient-generated data to their personal health records. May 2017 be a new year for health data liquidity and sense-making out of EHRs

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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Top 5 ways to bring doctors to the EHR optimization table

Top 5 ways to bring doctors to the EHR optimization table | EHR and Health IT Consulting | Scoop.it

While some speak optimistically about the "post-EHR era," electronic health records are still very much a going concern – and will be of great interest to many of the 45,000 or so attendees at the 2017 HIMSS Annual Conference & Exhibition later this month.

There will be education sessions on topics ranging from enabling EHR analytics to resolving usability issues that could impact patient safety to better integrating genomics data into clinical workflows. There's even a half-day User Experience Forum at HIMSS17 –  a major theme of which will be the ways UX can be improved for care teams to create a more transparent, intuitive way of care delivery.

Long story short: For all their ubiquity, EHRs still have a lot of improving to do.

 

As a physician informaticist, I'm fortunate to be invited to many meetings about electronic health record optimization: big meetings, small meetings, fantastic meetings … YUUUGE meetings.

 

But there is always one thing, or rather, person, missing: Inevitably, I'm usually the only doctor in the room … and I haven't seen an actual patient in more than five years!

With only 34 percent of physicians reporting that they are "satisfied" or "very satisfied" with their EHR according to a 2015 survey conducted by the American Medical Association, this is a definite problem. Not only that, but as the AMA's Vice President of Professional Satisfaction Christine Sinsky, MD, and colleagues reported, physicians spend another 1-2 hours on computer and other clerical work during their personal time each day, contributing to the increasing rate of professional burnout.

Nearly every hospital and health system has an EHR in place, and are hard at work optimizing their investment in a system that typically cost millions or even billions to implement. EHR optimization, for those unfamiliar, is the continuous improvement of the primary technical tool that provides care to the patient through the clinician. Healthcare organizations are simply not going to get the results they want if practicing physicians aren't at the table.

 

To a layman reading this, this sounds laughable that they are not at the table. Just having guys and gals like me – "the geek doc," "the techie nurse," or "the ex-clinician turned 'suit'" – is not enough. While we haven't forgotten the years we spent providing care for patients at the bedside, you must include the current bedside providers into the decision-making processes.

I understand this is easier said than done – doctors are among the busiest people on the planet, and most do not show up or speak up if it means leaving their patients or taking a significant productivity hit (code word for "financial"). Many clinicians will remember the days of pharma reps bringing in catered lunches in exchange for some of their time. I think the question you need to ask yourself is: "What is the new drug rep luncheon that we can offer busy physicians in order to get a bit of their time to get feedback, versus make a sales pitch?"

In my 15 years of expertise, most physicians and nurses care about "buttons, clicks and lists," which translates to usability, configurations, and technical workflows that match their real-world workflows. So the next question you should have is "How do we get this level of input without needing them to leave the bedside and join a meeting?" I'm glad you asked. I will put on my technical and organizational 'chef hat' to share with you a few recipes for getting the docs and nurses to the table!

 

Here are the top five ways to bring doctors to the EHR optimization table:

1. Email. I know what you're thinking: Did he really open No. 1 with email? Don't doctors get enough messages already? Keep reading: They do, but in my experience in leading EHR efforts at healthcare organizations across the country, it still works. Be sure to leverage the account they use most—for many docs, this is not their hospital-issued account and may be the Gmail account they check every evening instead. If you're unsure, ask them which address they prefer to communicate about EHR matters, which is their new "black bag." Asynchronous (non-real time) communication allows physicians to respond on their schedule. It might take a while to get a reply, but if you include a clear call to action and it's formatted properly, you'll get it eventually. Which leads me to my next point…

2. Images. As I mentioned above, most of the time when you're seeking physicians' opinions for EHR optimization, it centers on how something looks or feels to them: Which design for a particular screen do they prefer, or which workflow diagram makes more sense for their reality? When you can use images—a screen capture or mockup, a Visio, a chart—you're much more likely to get a response. Try to avoid the tyranny of choice by giving no more than three options per question, and always remind them what the current state looks like alongside the future state options: Physicians are typically visual learners, and they also may not realize what the current state looks like. You'll get a much better response when presenting the status quo and three redesigned options under consideration versus a "Here's the new design for this alert, what do you think?"-type question. Minimum 'free-thinking' allowed: Provide focused and well vetted choices.

3. Screencasts. If a picture is worth a thousand words, how much are short videos worth? Screen recording technology tools such as Camtasia and Snagit are inexpensive and user-friendly ways to showcase and explain EHR changes or proposed changes. Other industries have used this method for years, and it often can replace an in-person meeting. EHR builders and analysts can record themselves actually going through a new screen or workflow in the EHR, as they explain what they are doing and why it was designed this way. Doctors can easily watch the video on any device; the small .mp4 files can be sent via email, and email replies or comments on the video itself (preferably web hosted, but follow the guidelines of your health system and vendor) make it easy and efficient to collect physician feedback. Your technical teams will love it as well.

4. Surveys and polls. I've used tools like Surveymonkey for over a decade to survey physicians across organizations. They can be accessed inside or outside of organization firewalls and can be incredibly effective. For example, you may have an EHR developer or analyst create various options for the physician home screen. By embedding images with clearly written captions in the survey, you can get a clear indicator for which one is preferred. This method also gives you objective feedback, which can often be better than random anecdotal feedback—which is the most common thing heard in meetings with many docs. You can use the survey results as support for critical decisions. I once had a doctor voice concern about the new format of an order set, but when I was able to point out that more than 80 percent of her peers selected it as their top choice, she was more amenable to the decision given that so many of her peers had weighed in favorably, and objectively. I've coined this "evidence based optimization!"

5. Meeting etiquette. If you've tried all of the above, and you just really need an in-person meeting, follow these simple etiquette tips to make doctors more inclined to participate. Depending on the group(s) you're targeting, you may have different optimal meeting times. For example, you'll have the best luck with primary care docs around the lunch hour, but hospital-based docs are usually more available in the early mornings or evenings. No matter when you schedule it, be sure to use the best virtual meeting tools you can afford, so docs have no problem logging on and viewing the deck if they're remote. You can also record the meeting to share with those who couldn't attend. If you can't schedule an exclusive meeting, try to negotiate a bit of time during a meeting already on their calendar, such as a recurring "med exec" (hospital meetings that docs typically attend) or "monthly ambulatory practice management" meeting. Design meetings to cater to "WIIFM" (what's in it for me): Before gathering their input on EHR changes and the like, provide a few tips and tricks that can help streamline their current EHR workflow right now. Once you have the "oohs and ahs," the door will be open for gathering their feedback and their suggestions will be more candid and focused. By continuously showing them the results your EHR optimization efforts are achieving, the more invested they will be in the ongoing process.

Nothing is foolproof, but I'm confident that using a combination of these methods will help you bring doctors to the EHR optimization table at your hospital. The pharma reps may bring the food, but effective EHR optimization efforts using the above methods can engage clinicians and garner candid feedback–and that's a pill that's not hard to swallow.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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Building the right IT team for a successful EHR go-live

Building the right IT team for a successful EHR go-live | EHR and Health IT Consulting | Scoop.it

In the world of healthcare IT rarely is one person or small group of individuals able to complete the entire value chain of delivering IT solutions that properly define operational requirements and workflows and translate these needs into technical programs or application builds. A variety of backgrounds are needed including input from people with diverse and unique expertise that lie in different areas of the organization. As a result, comprehensive teamwork is essentially required to successfully launch and deploy projects that result in ongoing improvement in patient care, advancements in research and overall operational efficiency. 

So what are some of the specific essential components of building the right team to ensure success in an environment that requires absolute preciseness and accuracy? 

 

Based upon my healthcare organization’s successful deployment of an integrated electronic medical record throughout the ambulatory, inpatient and homecare environments, the following are some elements that delivered optimal results via an integrated teamwork approach:

People: Recruiting the right people into the right roles is the number one starting point to begin an initiative. Clearly communicating each person’s role on a project accents the defined contribution expected from each participant. In our organization, we focus heavily on selecting people who exude energy, have a positive attitude and demonstrate a proven record of aptitude in their specific area of expertise.

Chemistry: Blending operational and information services personnel together is a critical component needed to collaborate and most effectively evaluate all required application functionality for delivery.

Project Leadership: Guiding the project and removing barriers from issues ensures that staff level employees can be successful in their role.

Process: Using a tried and proven methodology with agreed upon milestones binds the various teams together and aligns goals and tasks for execution.

Culture: Building an environment to foster recognition that we are all in this together results in developing respect for one another. This aspect is paramount to gaining positive momentum in working as a highly functioning team. No “drama” is tolerated.

Enterprise Leadership: Working with other leaders throughout the organization ensures proper staffing, goal setting and achievement of set objectives.

In a healthcare environment — which is characterized by continuous change, increased transparency and a wide variety of diverse accountabilities — the need for a solid, mission oriented team has never been greater. Organizations that have invested in using the integrated team approach are recognizing the benefits of their investment by more readily enabling their business objectives. And these organizations are better prepared for the next wave of challenges.

 

The journey on the road to achieve the many benefits of healthcare IT is long and winding, but the need for comprehensive teamwork along the way will always be vital to achieving success.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
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‘Will It Work Here?’: Health Systems Need Contextual Evidence Before Adopting Innovations

‘Will It Work Here?’: Health Systems Need Contextual Evidence Before Adopting Innovations | EHR and Health IT Consulting | Scoop.it

Health systems are eager to learn about better ways to deliver care. This requires innovation—doing something differently from how it is currently done. In a recent Health Affairs article, Elizabeth McGlynn and Mark McClellan noted that innovations often fail to meet expectations, particularly when they are spread from the initial site that piloted the innovation. McGlynn and McClellan pointed to the absence of evidence as to what makes these innovations work as a source of these failures and encouraged health systems to evaluate innovations. In addition to the critical role evidence plays in making decisions of whether to adopt an innovation, health systems factor in other important criteria.

 

Even if there is solid evidence for the innovation, such as from a systematic review of research, health system leaders will need to decide whether the innovation is likely to work in their own systems. What worked in one, or even many places, will not necessarily achieve the same results elsewhere. Furthermore, leaders need to consider not only whether they can achieve those results but also how important it is for their systems to do so. Making a wrong decision is costly; either leaders miss out on an improvement, or they spend valuable time and resources on a failed implementation attempt.

 

McGlynn and McClellan described what they call the assessment phase—the point when an organization has identified an innovation that might improve care or reduce costs but before the innovation is introduced. They implied that there may be reasons for an organization not to adopt an innovation that has been successful elsewhere (for example, baseline performance is already high, so there is not much room for improvement), but since their focus was on evaluation, they didn’t dwell on helping organizations think through whether they want to implement the innovation at all.

 

Picking up where McGlynn and McClellan left off, this article addresses an important component of innovation diffusion – whether to adopt an innovation. As an organization that is in the business of helping health care systems learn how to improve, the Agency for Healthcare Research and Quality (AHRQ) published a guide, Will It Work Here, to assist health system leaders in making adoption decisions. AHRQ contracted with RTI International to conduct research to inform the guide, including a review of the literature on innovation adoption and case studies of organizations that had adopted innovations that had been developed elsewhere.

Does The Innovation Fit?

First, health system leaders need to learn how the innovation worked in the past. Where has it been used, and what’s the evidence that it worked? When evaluating the evidence, understanding the context in which the innovation operated and how it is similar or different from their own environment is critical. They also need to understand how the innovation achieved its results. As suggested by McGlynn and McClellan, a logic model can be a valuable tool to capture how the innovation’s inputs and activities are expected to produce outcomes. In other words, a logic model makes explicit which processes will be used and what results they will generate.

 

Second, health system leaders need to determine whether the innovation will solve any of their system’s problems or contribute to achieving their system’s goals. If there’s a problem that needs fixing, carefully define the problem and honestly assess whether the innovation will address the root cause.

 

Third, think about whether the innovation is compatible with the mission, values, and culture of the organization. A clash with a system’s mission and values is likely to be a fatal flaw. The occurrence of a cultural clash is less cut and dry. Organizational culture, that is, the norms that guide behavior in the organization, is not monolithic. Several organizational cultures—such as patient-care and patient-safety cultures, business and management cultures, and professional and interpersonal cultures—come into play. Research indicates that certain kinds of organizational cultures—such as those with strong leadership, clear strategic vision, good managerial relations, comfort with experimentation and risk taking, and effective data systems—are more conducive to adoption of innovations in general.

 

But beyond general receptivity is the question of the match of a particular innovation with a health system’s organizational culture. If the innovation is not congruent with how the organization operates, can the innovation be adapted to improve compatibility? For example, a practice adopting a care management innovation might decide to hire another nurse and integrate care management functions across the nursing staff instead of hiring a separate care manager if nurses view the addition of a care manager as a threat to their relationships with patients. Whenever an innovation is adopted, there is some reinvention to fit the local context, but the innovations are not infinitely malleable. And while organizational culture can be transformed, it is a long-term proposition. If implementing the essential elements of an innovation runs counter to a system’s way of doing things, it may not be a good fit.

Should We Do It Here?

If the innovation isn’t rejected as unsuitable, the organization will want to consider the arguments for and against adoption. Some innovations aim to increase efficiency or decrease costs. Potential adopters may calculate the return on their investment, taking into consideration the upfront and maintenance costs of the innovation along with savings or revenues the innovation may produce. Even if there is a good return on the investment, it is important to compare that gain with alternatives. Opportunity costs of adopting an innovation might include delaying, precluding, or interfering with other initiatives.

 

It’s not only about dollars and cents. Hard-to-quantify aspects of a business case for adoption include the benefits to patient and families, staff, and other stakeholders. These might include increased patient involvement in health care decisions, better health outcomes, reduced stress on the workforce, or enhanced reputation. An innovation may be responsive to requirements of insurers, regulators, or accreditation organizations. Non-financial factors, such as a mission-driven system’s imperative to satisfy its charge, have to be weighed along with financial matters.

Any change entails uncertainty, so the risks—both the risks of adoption and of inaction—figure into the adoption calculation. Risks are not just financial; they include political, medical, and operational risks. It takes imagination to anticipate risks, and each system’s appetite for risk will vary. Consider the following:

  • What are the best and worst case scenarios?
  • What can go wrong?
  • How can we mitigate these risks?
  • How likely is it that the innovation will fail or that we will be worse off than we are now?
  • What risks are we unwilling to take?
  • What risks would we be taking by not adopting the innovation?

Can We Do It Here?

Just because adopting an innovation would be advantageous, doesn’t mean that the health system will be able to make the changes necessary to make it successful. First, an organization has to be ready for change. Organizational readiness for change has been described as “a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so.” Lack of a perceived need to change and confidence the change can be made, or widespread resistance to the proposed change, will diminish the likelihood that implementation of the innovation will be successful.

 

Leaders have to take stock of the magnitude of structural, process, workforce, and other changes that would be needed. Structural changes might mean centralizing (or decentralizing) certain functions or adding new teams. Changing processes, such as workflow or communication, can be hugely disruptive. Furthermore, some alteration to the workforce invariably will have to be made to accommodate the innovation. Even small changes in staff roles or the need to train staff in particular skills are likely to trigger a reaction. Once an inventory of needed changes has been generated, leaders will need to honestly appraise whether and how the changes could be made.

 

Determining whether the system has the capability to integrate the innovation into its operations also entails examining whether it has the ingredients for successful adoption. For example, having champions—key individuals, such as opinion leaders, in favor of the innovation—is an important means to generate support and overcome resistance. A learning health system will also reflect on past experiences with innovation adoption. It should use past experience to inform the current adoption decision by asking:

  • What were the major factors responsible for the success or failure of the innovation?
  • How is the proposed innovation similar to or different from past innovations?
  • Are any of the elements that were critical to success in the past missing this time? Is there any way to compensate for this absence?
  • What can be done differently this time? Is this enough to make the innovation succeed when others have failed?

How Will We Do It Here?

The final phase of the adoption decision involves envisioning how the organization will implement the innovation. The adage “the devil is in the details” comes into play here, as systems that should and could adopt an innovation may find that there are still obstacles. For example, lack of capacity to monitor and evaluate the innovation could trigger a red flag. Conversely, the ability to try the innovation on a small scale or for a short period of time may increase willingness to pursue adoption. Developing a change management plan can further increase confidence in a successful outcome if the innovation is adopted.

 

McGlynn and McClellan asserted that health systems have given way to pressure to adopt innovations that are not always evidence-based. As this post demonstrates, the decision regarding uptake of an innovation requires more than evidence of the innovation’s effectiveness. Researchers can help organizational leadership decide whether an innovation is a good fit—or an appropriate stretch—by not only producing evaluation findings but also fully describing the particulars of the innovation and its context when writing up results. When formal evaluations have not been conducted, accounts of innovations that contain credible evidence that they will be effective should include information about context. Contextual data, coupled with using the heuristics in the AHRQ guide “Will It Work Here?” can help health systems make better adoption decisions and save both time and money.

Technical Dr. Inc.'s insight:
Contact Details :

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

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Tips to help prepare for EMRs, even before you choose your software

Tips to help prepare for EMRs, even before you choose your software | EHR and Health IT Consulting | Scoop.it

The reason to purchase EMR or any medical software is to make your practice work better for you, your staff, and your patients. Keeping this at the forefront of your medical software decision will put the brakes on foolish purchases that may offer glitter but don’t offer your practice enhanced functionality and don’t offer your patients improvements in the quality of care they receive.

Though there is no need to leap  blindly into an EMR no matter how many incentives are offered to you,  you can be quite sure than an EMR is in your future. There are certainly preparatory steps to take for a transition to EMR. Even if you are a year or two away from making your EMR / EHR software buying decision, there are many things you can do now to make the eventual medical software implementation easier. Though the purchase should not be rushed, the transition is going to happen, so get ready now.

As the marines say, “semper preparatus” always  be prepared.  Here are ways to begin your implementation even before you know which EMR system you will choose:

  1. Make sure that everyone in your organization is extremely comfortable with using his or her computer. Not just your desktop computer, but your laptop and tablet PC need to be easily managed by all hands on board.  Support staff – administrators, receptionists, sonographers, and x-ray technicians, and nurses who already use many electronic instruments for tests and for administrative tasks  – are perfectly comfortable with using different types of computers, but many doctors are not.  If your physicians  will not be comfortable using your EMR and its associated technology, the war is lost before it has begun. Which brings us to the next readiness step:
  2. Your medical practice requires what the marketing people call “buy-in”!  Everyone has to be on board with the plan to move to an EMR. If they are not, discuss their reasons for opposing the move.   Often, it is because of lack of comfort with the technology.  Some vendors will offer preliminary seminars on EMR in order to interest prospective clients.  Offer one to your employees, so that they can see the types of change their use of EMR will bring.
  3. Talk to colleagues who have already made the move to EMR or other medical software. Find out which features they like, and which they don’t. Find out how difficult it is to maintain HIPAA compliance with different systems. Find out which vendors offered good support and training.
  4. Read medical software reviews. There is a tremendous amount of valuable software information available at no cost to you online.   You can learn about different features, and think about how they might be used in your practice.
  5. Consider which parts of your practice are most amenable to going electronic and which are least amenable.EMR and medical software is not an all or nothing proposition.  It could be that your practice should not be moving all of its functions to electronic media just yet. And it almost surely should not be moving all modular functions at once. Discuss this question with key people in your organization: your medical billing specialists, your nurses, and your doctors.
  6. Consider whether your might want an in-house client-server solution, or a web based Software-As-A-Service solution that you lease and log into from any location. EMR and medical software solutions like this are becoming more feasible and are often more affordable than having your own in-house server and having to manage security and backup of your data.

  7. If your medical billing is not yet electronic, this may well be the way to begin your transition to medical software. Your medical billing must become electronic almost before anything else. Medical billing presents the quickest ROI of all EMR modules, because it allows for quick turnaround on claims denials, code lookup, and an opportunity to be more easily HIPAA compliant than your paper files allow.  Prepare your staff and data to migrate to a medical billing module as quickly as possible. Otherwise,  because of reporting requirements and claims processing alone, your bottom line will be compromised.
  8. Identify an in-house leader and liaison. If you already have an IT person on board, and he has the people skills as well as the technical skills to act as a liaison when you are planning your purchase, ask her to read up different EMR configurations, on implementation schemes, and EMR priorities in relation to your practice. If you are a large enough practice, identify a physician who you think can be the physician liaison for the implementation.  Give these people time and space to do some  research – talking to colleagues, attending free or low cost seminars, reading, etc.
  9. Make use of your scanner today! If you haven’t already, buy a good quality scanner that is easy to use, and make sure everyone know how to use it. Start scanning your newer patient documents now so that when you actually get to implementation stage, you do not have to re-invent the wheel scan every piece of material within  your archives and records.

These preparatory steps will make your move to an EMR simpler, and should give you some insight into criteria for choosing the right EMR.  Never buy into an all-or-nothing strategy for implementation. You cannot expect to change the entire workflow of your practice when you implement an EMR – and you do not want to.  You need to follow the demands of your practice, when reasonable.  And most of all, you need to work with your staff as a teamso that when you find the right EMR you can begin with a full complement of invested, able people who want your investment of money, time and effort to make sense.

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EHR certification provides a baseline security safety net

EHR certification provides a baseline security safety net | EHR and Health IT Consulting | Scoop.it

EHR certification and security is always top of mind in choosing a healthcare software application. Not only does a software application have to prove its clinical or infrastructure value, but if it cannot do so in a secure way it will never be the product of choice.

The security questions asked of software vendors can vary in nature. Generally they revolve around meeting HIPAA requirements for access, authentication, and encryption. In addition, having a product tested against a threat model, such as OWASP, or some other type of security audit provides an extra sense of security for potential buyers. However, the healthcare industry already has a certain level of security standards provided in EHR certification testing.

EHR certification is normally linked to EHR vendors helping their customers meet Meaningful Use requirements. Within the EHR certification, there are a set of security criteria. And any software vendor can test to these security measures as a health IT module, without testing all the other requirements related to Meaningful Use. In this way, healthcare software products can ensure that they meet the same security requirements as an EHR and give their customers peace of mind that they at least meet a certain level of security standards as defined by the ONC.

The security measures included in the 2015 Edition EHR certification include:

  • 315.d.1 Authentication, Access, Authorization
  • 315.d.2 Auditable Events and Tamper Resistance
  • 315.d.3 Audit Reports
  • 315.d.4 Amendments
  • 315.d.5 Automatic Access Time-out
  • 315.d.6 Emergency Access
  • 315.d.7 End User Device Encryption
  • 315.d.8 Integrity
  • 315.d.9 Trusted Connection
  • 315.d.10 Auditing Actions On Healthcare Information

User access

The criteria in d.1, d.5 and d.6 have to do with validating the user seeking access to electronic health information. The software application is tested in a number of different ways to ensure that unauthorized users are not allowed to authenticate or access the system. This includes having automatic time-outs to help ensure that a malicious user cannot follow behind an unsuspecting valid user. These criteria do include an option for emergency access if the need arises.

Encryption

The criteria in d.7, d.8, and d.9 focus on encryption of data, both at rest and in transport. The software application must have a way to either encrypt data at rest, or show that no personal health date is left behind once the application is closed. And for data in transit, encryption and hashing must be used to protect the data, or the use of a standard secure transport such as TLS.

Audit logging

The criteria in d.2, d.3, and d.10 focus on logging and reporting when PHI is handled. This handling of PHI can include a variety of actions such as querying, changing, deleting, adding, printing, or copying. Other related actions are logged as well, such as changing user privileges, disabling the audit log itself, or turning off encryption. All of the logging is required to be included in a report that can be run over a given date range.

These three key areas of security (user access, encryption, and audit logging) provide a baseline that all software applications can meet. Certainly, any EHR is going to meet these security requirements because of Meaningful Use, but other software vendors can also test to these requirements to ensure the industry that they are on par with EHRs when it comes to security. This helps give providers the peace of mind they want, while setting the same baseline for all vendors in healthcare across the board.

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EHR vs EMR - The Key Differences

EHR vs EMR - The Key Differences | EHR and Health IT Consulting | Scoop.it

Many think that electronic health records (EHR) and electronic medical records (EMR) are the same, but there are important differences. Electronic medical records have been around longer and are focused on the diagnosis and treatment of medical conditions carried out by a single provider. Meanwhile, electronic health records are specifically designed to be shared or transferred.

Compare EMR and EHR features with your most important requirements by using a EMR/EHR Software Requirements Template

What are Electronic Medical Records?

Electronic medical records are the digital equivalent of old-fashioned paper medical records. They allow doctors to track data on patients associated with their practice. Some major applications of EMRs include identifying which patients are due for preventative screenings, vaccinations or check-ups. They are a useful tool for tracking quality of care–making them useful business intelligence tools–but they don’t easily allow information to be transferred to other health care organizations.

What are Electronic Health Records?

Electronic health records fulfill many of the same purposes as EMRs, but they have a much stronger focus on the individual patient. Electronic records are designed to transfer easily between health care organizations when the patient moves or starts seeing a new provider. Health care providers can easily share information using this type of record. Further, providers can benefit from implementing an EHR system from the EHR incentive program. As a result, EHRs build up a much broader picture of a patient’s overall health, whereas EMRs held by single providers often focus on particular medical conditions.

Read more on EHR system requirements.

The Basic Difference Between EHR vs EMR Software

EMR software allows you to enter information about a patient’s medical care, including test results and prescription medications. You can use this kind of software to issue repeat prescriptions, schedule appointments, and bill patients. EHR software also allow e-prescribing, but also provide communication features to allow health care providers from different organizations to collaborate in patient care.

Should You Use EHRs or EMRs?

If your health care organization regularly needs to share information with other health care providers, then using a certified EHR technology is an excellent decision. For example, if your health care practice regularly refers patients for tests or consultations with specialists outside of your practice, then it is highly beneficial for each patient to have an electronic health record. However, if your practice is self-contained and focused on treating a particular medical condition, then an EMR system may be a simple and adequate addition to the suite of business intelligence tools you use to run your health care business.

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5 ways to get the most out of online healthcare software training

5 ways to get the most out of online healthcare software training | EHR and Health IT Consulting | Scoop.it

When it comes to online training, I often find that many participants have reservations about online courses. Many think it will be hard to focus and they won’t learn as much as an in-person class. I can relate – when given the option to take an online class versus an in-person class, I used to always pick the latter. That was before I realized the benefits of convenience that online training offers.

After taking and also teaching many online training sessions, I’ve gathered a few tips to help you get the most out of your online training experience.

1. Tell coworkers you are in a training session.

The idea here is to minimize the amount of distractions that can occur during class. Set expectations in advance by letting coworkers know you may take longer than usual to respond to requests during the training session. Try setting up automatic email replies that alert others you are in a training session and will reply as soon as possible. It may also be a good idea to block off your online calendar so coworkers will know you are attending a class.

However, if you need to leave the training session to attend to an urgent work matter, let the instructor know.

2. Log in to your online training course from a different location.

If your regular work environment is particularly distracting, minimize distractions by attending training from a different location. Whether this is from a conference room or your home (assuming it’s quieter there), relocating can be extremely beneficial to ensure you absorb the information presented during class.

3. Check your internet connection before class

A strong and reliable internet connection is key to your success in an online training class. This will help you hear and see the presentation as designed, as it is presented. A wired connection is almost always preferred over Wi-Fi. If that is not possible, ensure the Wi-Fi signal is strong prior to class so you don’t experience technical difficulties.

4. Don’t be shy! Participate in online class dialogue.

Participating more than you would in an in-person class can help you stay engaged with the online class material. Try regularly asking questions or try answering questions posed by the instructor, even if this isn’t your typical approach (don’t worry, no one can see you online). The more engaged you are during online training, the more likely you are to retain the material and remain focused throughout the duration of the class.

5. Speak up when you need help.

During in-person classes, the first indication that a student may need help is a furrowed brow or a confused look on a his or her face. With online classes, however, the instructor usually doesn’t have visual cues alerting them when to intervene. Speak up if you don’t understand a concept or have a question! Otherwise the instructor will assume you are comprehending the information as intended.

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Patient Management Software Features

Patient Management Software Features | EHR and Health IT Consulting | Scoop.it

The phrase “patient management software” (PMS) refers to a number of efficient automated systems for tracking patient information, diagnoses, prescriptions, interactions and encounters within healthcare organizations like medical clinics or hospitals as well as integrations for obtaining and storing information from medical devices. Some of these software applications focus on general patient management while others address specific processes such as inpatient tracking or blood testing.

Benefits of Patient Management Automation

Administrative staffing is one of the big drivers of high healthcare costs. Automating routine processes, like patient flow management, helps medical clinics and hospitals minimize their administrative expense while maintaining efficiency and excellence in patient care.

Solo practices benefit significantly from automation because of their limited resources. A patient management solution streamline recordkeeping, patient appointment scheduling, claims processing and billing functions. The physician has instant access to patient information and a reliable method for updating charts, noting medications and other important data. Accurate billing and bookkeeping keeps the practice running smoothly.

Larger clinics and hospitals enjoy similar benefits while also making patient-related processes more efficient. PMS delivers more accurate, timely and better quality patient care. A comprehensive management program enables immediate record transfers, enhances patient workflow and eliminates treatment errors that result from inaccurate or incomplete paper records.

Digital storage capability saves actual space for a neater, more welcoming office. Additionally, digital information is more secure than paper files, so patient management programs help clinics and hospitals comply with HIPPA privacy regulations.

Automated process management streamlines and standardizes many administrative tasks, freeing medical staff to focus on what they do best: patient care. As a result, staff members find their jobs to be more fulfilling and patients enjoy a higher standard of medical care.

Efficiency, accuracy and fewer errors directly benefit the facility’s bottom line. Patients who receive quality care from a professional and focused medical team will remain with the practice and tell their friends. With management software in place, clinics and hospitals have the ability to increase their patient capacity while still providing quality care. More patients mean more profit.

Functions of PMS

Not all the features of patient management software listed below are included in any single software application. However, each feature is part of an actual patient management system currently available.

Medical Records Software:

  • Records, updates and archives electronic medical records
  • Produces a medical records flow sheet for each patient, which shows immunizations, illnesses, surgeries, test results and other patient information using graphs and charts
  • Combines electronic health records from all providers treating the same patient
  • Issues alerts when preventive care appointments are due
Scheduling Software:
  • Books appointments online 24/7
  • Makes automated appointment reminder calls/texts/emails
  • Reserves required equipment for scheduled appointments
  • Cancels and/or reschedules appointments
  • Records appointment history for each patient
  • Patient portal for self-service
Patient Encounter Software:
  • Provides electronic office check-in
  • Generates electronic intake forms that streamline a patient’s initial clinic or hospital visit
  • Tracks the time each patient must waist in the lobby
  • Monitors exam room availability
  • Tracks the progress of each exam
  • Engages patients remotely
  • Monitors patients remotely for medication compliance, diet and exercise schedules
  • Automates patient checkout, including copay collection
  • Schedules follow-up appointments
  • Captures patient reviews
Software for Inpatient Encounters:
  • Manages admissions
  • Plans and manages patient discharges
  • Generates e-charting
  • Schedules bed occupancy and maintenance
  • Tracks patients’ locations
  • Monitors patients’ vital signs
  • Tracks patient waiting times
  • Graphs patient flow
  • Manages medication
  • Coordinates emergency response
  • Schedules surgeries
  • Manages lab workflow
  • Manages ER patient workflow

Medical Billing Software:

  • Manages patient accounts
  • Automates billing processes
  • Issues payment reminders
  • Coordinates insurance billing
  • Verifies patient insurance coverage
  • Tracks claims status
  • Reviews claims for accuracy
  • Enables online patient payment

Electronic patient management sets new standards for excellence in patient care. It provides healthcare facilities of all sizes with greater economy, enhanced quality of service, accuracy and efficiency. Programs are available to suit a variety of medical practice needs. This type of software has become so integrated into the practice management as well as patient information portal, that the FDA now considers digital health tools like this “Software as a Medical Device”.

Patient management and practice management software are often synonymous. We’ve created a report on the top patient/practice management software here, as well as a large product directory. Have a look around and request the full report if you want to get more in-depth information about the best software options available.

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Medical Practice Management Software For Different Practices

Medical Practice Management Software For Different Practices | EHR and Health IT Consulting | Scoop.it

Medical Practice Management (MPM) software is vitally important for all sorts of healthcare practices, from general practices to speciality practices, and it’s part of the cornerstone of technology for innovating in healthcare today. Medical Practice Management tools allow healthcare providers to streamline aspects of administration, to improve the quality of care for patients, and to keep things running smoothly for both the clinical and record-keeping sides of the business.

Family Practice Doctors

Family practice offices are busy places. There’s always a flood of patients moving through the practice at any given time. Doctors have to manage patient time very effectively, and handle many other aspects of administration, to avoid getting behind throughout the day.

Medical Practice Management tools help in many different ways. They allow doctors quick access to patient information, (and also enable quick and effective recording of data during consultation) and help with the billing cycle that is so important for every patient visit. They help provide an effective chain of communication for things like diagnosis and procedure codes. They also help with scheduling and other aspects of patient interactions, such as handling release forms, issuing prescriptions and maintaining access to records.

Specialist Offices

Different kinds of specialists also use Medical Practice Management software to make sure they handle information well, and provide a good experience for patients.

For example, dermatologists may use specific types of MPM solutions for the patient processes that are most common in their offices. Because dermatology consultation involves so much visual tracking of changes in the skin, MPM systems for dermatologists may feature easy interactive image handling, and the funneling of visual information into charts and forms.

For other specialists, such as gastroenterologists, there may be more of a general focus on helping doctors to handle routine aspects of business administration. Many of these doctors are particularly skilled in technical aspects of care, and may not be as connected to the business administration side of the provider’s office. Medical Practice Management tools can help provide intuitive ways for doctors and nurses and others to run the offices and keep on top of administrative details.

Oncology and Pathology Offices

Medical Practice Management is also extremely important in those offices that deal with oncology or disease management. In many of these practices, time is of the essence, and having a better handle on timely communications and scheduling can make a big difference in outcomes.

For these practices, some of the benefit of Medical Practice Management software involves a smooth chain of communications, and having all of the important data on hand when it is needed. In these types of practices, it’s important not to let anything fall through the cracks — whether it’s related to conducting and delivering test results, or sending referrals, or anything else related to this kind of very important care. One way that MPM helps these offices to improve patient care is through the use of sophisticated timeline observation tools that help doctors to make sure that critical tasks are being done in a timely manner.

Surgical Providers

Surgeon’s offices may also use Medical Practice Management resources to help manage administrative aspects of a healthcare business. Some of the benefits here relate to good record-keeping and its use against the risk of medical malpractice. Where the threat of medical mistakes exists, good data handling practices and visual MPM solutions are effective ways to help decrease or eliminate such mistakes that can be tragic for patients and enormously expensive for practices. MPM tools incorporate these sorts of “best practices” to minimize risk and drive better patient outcomes.

Large Facilities

Many types of Medical Practice Management software are built specifically for large facility providers, such as hospitals or other parts of modern medical networks, such as health campuses.

In these cases, where there are dozens of doctors involved and many different types of clinical work going on, there’s a precise need for systems that can handle large quantities of information. MPM vendors will provide packages with specific features and functionality, whether that’s for scheduling and appointment setting, referrals, prescriptions, blood tests or anything else that’s part of the common process for the provider.

Medical Practice Management systems also help these offices, and smaller offices, with specific types of compliance and security issues. The U.S. Health Insurance Portability and Accountability Act or HIPAA strictly governs the use and release of personal health information for patients. All practices need to be compliant with HIPAA, and can use modern MPM tools to affect the integrity of the data that they hold.

In all of these different sorts of situations, Medical Practice Management holds a very real value for medical provider offices. Although they may be integrated with broader and more comprehensive electronic health record solutions, MPM toolkits are precisely focus on helping to manage the healthcare business day to day. The concrete benefits they provide are based on certain kinds of automation and precise data management that help a digital healthcare industry to move forward in serving patients, and delivering excellence to communities.

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The Ultimate Guide to Choosing Medical Practice Management Software 

The Ultimate Guide to Choosing Medical Practice Management Software  | EHR and Health IT Consulting | Scoop.it

Running a doctor’s office or patient clinic comes with all the ordinary challenges of doing business, plus a host of healthcare industry challenges.  These include a sprawling body of governmental and insurance regulations, continually-tighter budgets, and a plethora of patient concerns. Medical practice management software helps to streamline and automate the tedious and time-consuming activities at both the front desk and the back office. If you’re upgrading to a new system or are looking for your first medical practice software, there are several important considerations to make before you begin your search. Here is your guide to choosing the practice management system that best meets the needs of your bustling medical practice.Know what to look for during the selection process with a free Medical Software Requirements Template

Choose Medical Practice Management Software That Can Accommodate the Entirety of Your Clinical Workflow

You’ll want a software system that is as feature-packed as possible in terms of what it can handle regarding the clinical workflow. Look for a system that can automate activities like appointment scheduling via a patient portal.  A patient portal gives your patients direct access to their records whenever they want them, decreasing the number of calls your staff has to field on a daily basis.  This not only makes them available for other work, but also frees up your phone lines for emergencies.

The right system allows you to collect a rich body of information, including your patients’ appointment histories (appointments they made, canceled, missed, etc.). You might also opt for a system that allows patients to log into the patient portal online ahead of their appointment time and complete their required forms. This saves time when they get to the office for their first appointment.

Most medical practice management software has document management capabilities, but you will probably want one that is capable of handling documents relative to imaging, such as X-rays. A good software system should also provide resource planning capabilities so staff can quickly and easily identify which patient rooms are available, what equipment is in use, and which staff members are tied up with patient care or other important activities. Finally, be sure you choose a system with robust accounting capabilities, including insurance billing, patient billing, some collections capabilities, and features to handle your outgoing expenses.

Choose Software That Offers E-Prescribing

If you have never used e-prescribing, you and your staff are going to love it. E-prescribing functionality allows your office to send patient prescriptions to your patients’ pharmacy electronically, without the need for a signed paper prescription or a phone call by your staff. E-prescribing not only saves the medical practice time and money, it also makes the process of issuing prescriptions more secure.

Choose Software That Allows for Comments & Internal Messaging

The ability to make notes on patient records and accounts is incredibly handy. For example, if a patient discusses an unusual situation with one of your staff, the ability to make notes and share them internally means that your patient won’t have to repeat the explanation over and over. Your software should make it easy to note and see such things as special payment arrangements and other details.  This takes the level of patient care to the next level, as nothing ever gets lost or forgotten.

Choose Software That Integrates Easily With Other Back-End Systems

It’s an excellent idea to get input from other medical offices before you believe vendor claims about integration and compatibility. Some medical practice management software claims to be compatible with your EHR or other systems, but the process of integrating the software isn’t always easy. The ability to integrate back-end systems means you have a more holistic picture of your practice and staff doesn’t have to spend lots of time manually transferring the data (which tends to be a process riddled with errors).

Choose Software With Excellent Vendor Support

As with any software purchase, you want to make sure the vendor selling your medical practice management software stands behind their products. Again, it’s better to do your own research and see what other customers have to say about a vendor instead of taking their website’s word for it. Would you say you’re the worst in town regarding customer service? Neither will they.

Choose Between Cloud-Based and On-Premises Software

Traditionally, medical practice software had to be installed and operated from your local computer systems, meaning you had to have the storage capabilities and processing power the system needed. This is no longer your only option. Doctors offices that have no internal IT department can opt for cloud-based software that comes with no on-premises installation, no onsite storage requirements, and no ongoing updates or software maintenance to worry about. Choosing whether you prefer on-premises or cloud-based software helps narrow your search considerably.

One word to the wise, there are some practice management systems that “specialize” in a specific type of medical practice software, such as software designed for pediatricians or orthopedic surgeons. Don’t buy the hype. Any system that is robust, full-featured, and well-designed (by a reputable software developer) will work fine for any type of medical practice you happen to run.

The good news is, there are tons of superb systems out there. Which one is best? That depends on a number of factors, including the size of your practice, your budget, and the tech skills of your staff members.

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eClinicalWorks to pay $155 million to settle suit alleging it faked meaningful use certification

eClinicalWorks to pay $155 million to settle suit alleging it faked meaningful use certification | EHR and Health IT Consulting | Scoop.it

Electronic health records vendor eClinicalWorks has agreed to pay $155 million to resolve a False Claims Act lawsuit that alleged it gave customers kickbacks for publicly promoting its products.

“This resolution demonstrates that EHR companies will not succeed in flouting the certification requirements,” said Acting U.S. Attorney for the District of Vermont Eugenia Cowles.

 

Cowles was referring to the requirements EHR vendors must meet under the American Recovery and Reinvestment Act’s HITECH Act that their software satisfies criteria by an accredited testing body so that customers can use it to attest for EHR reimbursement under the meaningful use program.

“The government contends that ECW falsely obtained that certification for its EHR software when it concealed from its certifying entity that its software did not comply with the requirements for certification,” the DOJ statement said.

The DOJ alleges that eClinicalWorks opted to added the 16 drug codes necessary for certification into its software rather than enable the product to access those from a complete database, failed to accurately record user actions with audit log functionality, did not always accurately record diagnostic imaging orders or conduct drug-drug interaction checks and, finally, eClinicalWorks did not satisfy data portability requirements designed to enable doctors to transfer patient data to over vendor’s EHRs.

“As a result of these and other deficiencies in its software, ECW caused the submission of false claims for federal incentive payments based on the use of ECW’s software,” the Vermont DOJ said. 

 

eClinicalWorks disputed the allegations that its customer program was unlawful but said it settled to avoid the expense of litigation. 

“Today’s settlement recognizes that we have addressed the issues raised, and have taken significant measures to promote compliance and transparency,” said Girish Navani, CEO and co-founder of eClinicalWorks. “We are pleased to put this matter behind us and concentrate all of our efforts on our customers and continued innovations to enhance patient care delivery.”

Navani, along with CMO Rajesh Dharampuriya and COO Mahesh Navani are liable for the payment of $154,920,000, while developer Jagan Vaithilingam is on the hook for $50,000 and two project managers, Bryan Sequeira and Robert Lynes, each owe $15,000, the Vermont DOJ said. 

The lawsuit was originally filed by whistleblower Brendan Delaney, who at the time was a software technician at the New York City Division of Health Care Access and Improvement. He will receive approximately $30 million as part of the resolution.

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Medical Practice Management VS. EHR Software - The Key Differences

Medical Practice Management VS. EHR Software - The Key Differences | EHR and Health IT Consulting | Scoop.it

It can be a bewildering challenge trying to figure out the difference between various software tools commonly used by medical practices and facilities providers. One common tool is Medical Practice Management (MPM) software; the other is an Electronic Health Record system. They do two distinctly different jobs and help with different areas of healthcare operations.

What is Medical Practice Management Software?

Practice Management software helps with the day-to-day work that goes on in a medical office. It bridges the gap between some types of clinical work, such as the documentation of diagnosis and procedure codes, and other clerical work such as scheduling patient appointments, verifying insurance, and performing billing tasks. However, MPM is much more weighted toward the clerical work. It’s about managing patient flows and general documentation for the medical office as a whole, and less about patient documentation. While you might find patient identifiers in MPM, there should be scant medical data involved.

What is an Electronic Health Record System?

An electronic health record system is an overall digital system that stores patient information in a digital way. An EHR is a modern and comprehensive tool that often includes such different elements as chart notes, patient histories, demographics, allergy information, test results, and diagnosis coding, along with various other types of information that are useful throughout the clinical life cycle of patient treatment. EHRs have been promoted by the federal Department of Health and Human Services and incentivized by laws like the Health Information Technology for Economic and Clinical Health or HITECH Act as a way to help doctors meet federal meaningful use standards and generally improve the quality of patient care through improving documentation models.

The Difference Between MPM and EHRs

One simple way to think about this is that while MPM handles aspects of practice management, EHR is a very patient centered resource, and the two may not overlap to any great extent. It’s also helpful to understand the role of an Electronic Medical Record (EMR), which is similar to EHR but very practice-centered. (see more from the U.S. Department of Health and Human Services). For example, an Electronic Medical Record may only contain documentation that’s proprietary to the specific medical office – it will not usually be “portable” in the ways that EHRs are portable. So experts often talk about MPM being linked up to EMR, but they don’t talk as often about MPM being linked up to EHRs. In some ways, you could see the EMR as the “middleman” in this equation — a solution that’s practice-centered but still somewhat clinical in nature, that integrates with MPM.

The bottom line is that all of these services have become more diversified and full of specialized components to help practices do everything from patient consultation to billing. Shoppers have to look for the specific features and functionality that they need, and understand how each vendor service is going to integrate into a bigger software architecture. For example, practices may rely on broader EHR systems for almost all of their software needs, but integrate a certain amount of functionality from an MPM resource, just in order to manage the administrative aspects of the office. But again, most of the clinical information will either be in an EMR or an EHR setup. This setup might be fully integrated into other parts of the IT architecture, so that data flows through easily without being kept in data silos.

One way to handle the challenge of shopping for these various tools is to look at many systems side-by-side in a selection platform. A handy software selection site presents many different types of systems together, so that you can see what features and functionality they have. Shoppers can do research by clicking into various systems looking at the specific tools they offer, and starting to understand more about what’s standard in the industry and how the average medical practice runs on these tools. However, vendors are also willing to customize to a particular provider’s needs, so in-depth conversations with vendors can also be useful. Those who are responsible for procuring this type of software have to think about cost, functionality and transparency, as well as how to set up and keep good vendor relationships, and how to understand Service Level Agreements, to make sure the provider is getting value for cost.

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Don’t drink the Kool-Aid: Tips for easing into medical technology if you're afraid of EMRs

SoftwareAdvice.com recently posed the following questions to its readers in a survey format: “Are more doctors buying electronic medical records than before? Or, has the Stimulus bill only brought out the tire kickers?“. The results of the survey are available here; while the survey wasn’t scientific and it didn’t have enough participants to draw wide scale conclusions, the results do imply a general feeling of positive momentum towards the purchase and implementation of EMRs.

As an experienced healthcare IT professional I am very happy to see that people are looking towards EMRs and automation to improve healthcare staff productivity. However, I’d like to urge a bit of caution and be sure that buyers don’t jump into the market for the wrong reason. My rule about automation and insertion of software in any workflow process is simple: if you can’t repeat it, don’t bother automating it.

 

How to choose the right software and technology

For most potential users of EMRs, EHRs, and other “complex” workflow automation tools you should ease into the technology. What that means is that before you install any new technology, ensure that first and foremost it does no harm. All technology takes time to implement and get significant improvements; what’s important is that while you’re working towards improvement you don’t harm your business in the process. Technology should first and foremost not make a practice, department, or hospital worse off than it was before the technology was introduced. Then, it should start improving or “healing”.

Second, focus on interoperability and best of breed. Our desired tendency is to go for “all inclusive” or “complete solutions” but healthcare is too complex for any single vendor or package to do everything. By focusing on best of breed and interoperability you can grow at your pace and choose solutions that you really need versus those that the vendors think you need.

Third, Ask the right questions of your vendors and staff when they’re selecting any new technology. Don’t worry about features, functions, and technology. Worry more about your business (which is healthcare and patient happiness) by asking questions like this:

  • Will my patient be more satisfied because I’m using the system?
  • Will the outcome of care be improved because I’m using the system?
  • Can I spend more time on my patient’s care versus documenting the encounter?
  • How many more patients per day will I be able to see because of the system?
  • Can I go home earlier because the system helps me finish my work faster?
  • How many fewer lawsuits will be filed because I used the system?

Fourth, make sure the technology fits with your desired outcomes (not tasks). Almost any software will improve some aspects of your business — but, the question is will the software improve the aspects you care the most about? When asking technical questions, start with some of these:

  • How can I easily transmit my patient’s medical records in a safe and secure manner without spending all day making copies?
  • How many more lawsuits will I win because I used the system?
  • How will the system be able to increase my patient population or help me market my services better?
  • How much faster can I get paid for my services after I’m using the system?
  • Can I get secure access to my data while I’m away from home or the office?

Fifth, be sure it can handle all the different kinds of data you have. Most vendors or technology providers focus you on what kinds of data they can manage. But, any reasonable office deals with all the following kinds of data and you need to make sure your selection can manage it:

  • Structured data (fully coded ICD, CPT, etc)
  • Semi-structured data (machine understandable but with keywords and such)
  • Unstructured data (natural language)
  • Images
  • Faxes
  • Audio
  • Video
  • Chat logs, e-mail logs
  • probably many others

Most software systems handle structured data quite well. In fact, EMRs are an excellent way to capture structured data but in my experience structured data makes up only a small fraction of healthcare data. Semi-structured data and completely unstructured data along with faxes make up a big portion of data and medical images make up an even larger portion of the healthcare data pie. Video and email, chat, and other upcoming technologies will be taking up larger portions of database space as well.

When you’re choosing a technology, be sure to look at the kind of data you’re capturing regularly and ensure that the vendor you choose and the deployment model you pick are geared towards the data you create rather than the kind of data the vendor can store. Again, almost all vendors are great at structured data but there are very few that are good a non-structured data, faxes, images, and similar information. When looking at “cloud providers” (online software) make sure that the larger data you capture can be fit through your network pipes.

 

An EMR isn’t necessarily the first way to automate

While most people who are new to healthcare IT or looking to jump in quickly always point to EMRs as the most important application, there are actually many different healthcare IT applications that make up the “industry” as a whole. When you’re dealing with healthcare IT, EMRs might be a good entry point for some folks but it’s actually more likely that EMRs aren’t your first place to start your automation journey. These are some other techniques I’ve used to kick off automation before jumping into full-fledged EMRs:

  • E-mail (beware of HIPAA, though) — internal office messaging and email is a great place to start. If you haven’t started your office automation journey here you should.
  • E-Prescribing — e-prescribing is a great place to start your automation journey because it’s a fast way to realize how much slower the digital process is in capturing clinical data. If e-prescribing alone makes you slower in your job, EMRs will likely affect you even more. If you’re productive with e-prescribing then EMRs in general will make you more productive too.
  • Office Online and Google Apps (scheduling, document sharing) — Google and Microsoft have some very nice online tools for managing contacts (your patients are contacts), scheduling (appointments), dirt simple document management, and getting everyone in the office “on the same page”. Before you jump into full-fledged EMRs see if these basic free tools can do the job for you.
  • Clinical groupware — this is a new category of software that allows you to collaborate with colleagues on your most time-consuming or most-needy patients and leave the remainder of them as-is. By automating what’s taking the most of your time you don’t worry about the majority of patients who aren’t.
  • Patient registry and CCR bulletin board — if you’re just looking for basic patient population management and not detailed office automation then patient registries and CCR databases are a great start. These don’t help with workflow but they do manage patient summaries.
  • Document imaging — scanning and storing your paper documents is something that affects everyone; all scanners come with some basic imaging software that you can use for free. Once you’re good at scanning and paper digitization you can move to “medical grade” document managements that can improve productivity even more.
  • Clinical content repository (CMS) — open source systems like Drupal and Joomla do a great job of content management and they can be adapted to do clinical content management.
  • Electronic lab reporting — if labs are taking up most of your time, you can automate that pretty easily with web-based lab reporting systems.
  • Electronic transcription — if clinical note taking is taking most of your time, you can automate that by using electronic transcribing.
  • Speech recognition — another “point solution” to helping with capturing clinical notes; you can get a system up and running for under $250.
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Can EHRs evolve from minimally usable to delightfully indispensable?

Can EHRs evolve from minimally usable to delightfully indispensable? | EHR and Health IT Consulting | Scoop.it

Electronic health record platforms are among the most complex, interconnected, data-intensive software applications on the planet. Think about the seemingly endless fragments of patient information that an EHR is asked to store and maintain – basic demographics, diagnoses, chart notes, medications, allergies, upcoming appointments, previous surgeries and procedures, historical lab values, imaging studies, standing lab orders, e-prescription transmission transactions, claim submissions, and on and on.

 

Physicians and their staff also need to be able to review, transmit, reconcile, approve, and synthesize all of that clinical information to help make better, more informed decisions with their patients.

In 2008, fewer than 1 in 10 physicians were using an EHR, and the functionality that existed in those systems then would not qualify as a federally certified EHR product now. Over the last decade, to achieve federal certification, vendors worked at a feverish pace to add hundreds of features and change dozens more in order to achieve parity with the rest of the market. This transition from paper to digital happened so rapidly that usability suffered, innovation lagged, and real customer needs were under-prioritized.

 

Now that all certified EHRs share minimum functionality and can exchange information with each other, the time has come to refocus this entire industry on improving customer satisfaction.

The Office of the National Coordinator for Health IT has attempted to regulate the design of EHRs in a way that has not resulted in broad usability improvements to date. Approaching this immense problem from a more prescriptive regulatory perspective barely scratches the surface of what customers are demanding. While there should be required minimum standards for any software that is utilized by medical professionals to help them manage something as critical as patient health, no regulatory framework for usability will lead to more delightful user experiences for medical professionals or their patients.

 

What technology is needed in a modern medical practice?
Most complaints from EHR users stem from the feeling that the computer interferes with the ability of physicians to provide great, human-centered care for their patients. Many user interfaces look like they are 10 to 15 years old (because they are) and fail to meet customer expectations for how a modern application should function. Alert fatigue, infrequent software upgrades, and inefficient workflows contribute to this general dissatisfaction. In a recent study, researchers found that physicians spend 3 times the amount of time with computers as they do with their patients during a typical day. It's no wonder that EHR usability is consistently rated poorly across most software vendors.

Physicians and their staffs ultimately need software that supports their practice throughout the entire patient journey. Technology vendors must completely rethink their offerings by applying the essential components of user-centered design that have worked well in other industries.

 

Implementing an intentional approach to usable software
Usable software applications are intuitive, easy to learn, and memorable. They also must be efficient and prevent errors, all while deeply satisfying their users.

To achieve these six goals in health software, vendors must first gain a deep understanding of how a physician's office works – from the beginning of the day until the lights are turned off. A team of user researchers dedicated to this scientific task, investigating directly in doctors' offices, is crucial.

Tip: Merely dropping in for a few hours of office time is insufficient.  

Shifting to a user-centric approach in EHR design also requires gathering as much information as possible about how technology can assist customers with common tasks and data-intensive decisions.

Tip: It helps immensely to have a central place on the web where customers can request features. Often, the conversation that occurs in the comments section is crucial for software development teams to smartly refine feature requirements and improve usability.

Executives of EHR companies must embrace and encourage iterative software development within their product and engineering teams, with customer feedback directly informing each iteration.

Tip: Pair "minimum viable product" software development methodologies with user experience personas to turn users into happy evangelizers of products they love using every day.

 

Achieving indispensable EHR technology
For decades, physicians have pleaded with software makers to build functionality that helps them make better treatment decisions and provide better care for their patients. EHR vendors have instead delivered technology that is minimally usable and slows down the practice of medicine. Fortunately, this is not how it has to be.

As the entire healthcare industry transitions its business model from fee-for-service to value-based care, modern medical practices will find themselves relying even more on healthcare technology that efficiently collects, reports on, and synthesizes clinical data. To truly capitalize on this opportunity for smarter decision-making that leads to improved patient outcomes, current basic EHRs must evolve into mature, highly usable, indispensable tools that physicians and their staff enjoy using.

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Top 10 Steps to Health IT Implementation and Long-term Success

Top 10 Steps to Health IT Implementation and Long-term Success | EHR and Health IT Consulting | Scoop.it

Successful implementation of information technologies in a clinical environment often involves dozens of key stakeholders, hundreds of clinical and technical considerations, and thousands of end-users. With this many factors and technical details to manage, it’s easy to forget the fundamentals. From articulating a clear vision for your organization, to tracking the right metrics, to prioritizing training and education, it can be difficult to know just where to begin. To help you with the process, here are 10 steps to health IT implementation and long-term success.

  1. Create a culture of collaboration and partnership. Ensure that each member of the vendor and customer teams understands that both parties will either succeed or fail together. In a culture of cooperation and shared priorities, the vendor helps the customer reach the highest level of success, and the customer helps the vendor earn the highest reputation for the work they do.  
  2. Clearly identify key leaders. One of the most important investments any healthcare organization can make is in its leadership team. The customer team members must include (at the very least) an administrative champion, physician champion, and technical champion.
  3. Select and empower a physician champion. Formally select a qualified physician champion based on his/her excellent communication/teaching skills, commitment to the mission, and leadership capability.
  4. Document team mission, vision, and values. Have all team members contribute to and sign-off on these foundational documents. Together, they will help to establish the direction, priorities, and guiding principles that will keep everyone on task and on the same page.
  5. Establish rules for communication and decision-making. Set a rule from the outset that all communications are shared among key stakeholders. Document each implementation task, assign a responsible owner, and create a due date to ensure that each person is accountable and appreciates that an incomplete task means a project delay.
  6. Establish clear objectives, success measures, and timelines. Success often requires changes in technology, processes, and personnel. Start by identifying important benchmarks and metrics that best match your values and project domain.
  7. Training. A training team should be established at the start of the project, including a lead trainer from the vendor, the physician champion, and other appropriate customer personnel. And remember, training is an ongoing process. It doesn’t end upon implementation.
  8. Standardize implementation to boost quality and efficiency. Strongly consider creating an imaging-centric master file of procedure types rather than just adopting what was used in the previous system.  Think of the procedure list as the DNA of your imaging IT implementation. (Ideally, it should include less than 1,000 procedures.)
  9. Agree on white-glove inspection requirements. Clearly delineate the system and personnel tests that must be completed before you go live and before you complete on-site training. For example, set up a checklist that specifies pre-go­live system validation testing, including best practice default configurations, master-file setup, and emergency procedures.
  10. Measure, compare to benchmarks, and market the benefits. Use technology and the patient visit to communicate with your patient population and continuously solicit their feedback. Applicable technology may include your patient portal, your website, or patient hand-outs. Similarly, let your referring staff and contracted payers understand and appreciate your achievements. Don’t be afraid to make bold claims now that you have the data to back them up.
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How to Choose the Right EMR?

How to Choose the Right EMR? | EHR and Health IT Consulting | Scoop.it

MR is an acronym for Electronic Medical Records.

EMR is a computer based electronic system for maintaining patient data.

EMR systems are intended to keep track of patient’s entire health and medical history in a computerized format instead of the paper and folders that occupy entire racks and sometimes rooms in a clinic. These records grow over time and it become increasingly difficult to manage them. EMR makes these records more easily retrievable.

 

EMR systems have not been adopted by physicians and providers of healthcare as quickly as they should have been. There are several issues and reasons ranging from cost, issues of privacy, standardization and above all, physicians lack of knowledge of computerized systems and adaptability.

An ideal EMR should be able to provide complete, accurate, and timely data, alerts, reminders, communications, and other help at all points of care for all healthcare professionals at all times in a way that quality of healthcare can be dramatically improved. However, these promising functions are far from being realized in current EMR, and the resistance to current EMR from healthcare professionals is still strong.

 

Will this dream ever be realized? Will EMR ever be accepted universally by healthcare professionals? What is wrong with EMR?

Paper based records are still the preferred method of recording patient information for most physicians and providers, rather than EMR. The majority of doctors still find their ease of data entry in paper versus EMR and low cost hard to part with. However, as easy as they are for the doctor to record medical data at the point of care on paper, they require a significant amount of storage space compared to EMR. Most states require physical records be held for a minimum of seven years. The costs of storage on paper including the space it requires is much higher as compared to EMR. When paper records are stored in different locations, getting them to a single location for review by a provider is time consuming and complicated, whereas the process can be simplified with EMR.

Because of so many benefits of EMR, federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of EMR across the country. Congress included a formula of both incentives (up to $44K per physician under Medicare or up to $65K over 6 years, under Medicaid) and penalties (i.e. decreased Medicare/Medicaid reimbursements for covered patients to doctors who fail to use EMR’s by 2015) for EMR/EHR adoption versus continued use of paper records as part of the American Recovery and Reinvestment Act of 2009.

How to Choose the Right EMR?

There are many factors that should go into deciding which EMR software is the best for your practice. There are some key EMR areas that must be decided before you can commit to any EMR. There are literally 100s of EMR software today and choosing the right EMR can be the difference between success and failure.

First and foremost, EMR software must be Certified under the new ARRA guidelines.

Ease of Use

Any EMR software must be easy to use. If you have EMR software that is difficult to use, it might be time to scrap it and look for another EMR software solution. A big mistake many practices make is once they choose an EMR software company, they feel as if they are stuck with them. This should not be the case. Your best option would be to choose the right software for your practice the first time, but this doesn’t always happen.

Software Updates

In the ever-changing EMR world, updates are key more so given that requirements from ONC are changing everyday and requires EMR companies to be certified and re-certified. Software that is current one week, is out-of-date the next week. How often does your EMR software company provide updates? Are they releasing critical updates often? With web-based technology, EMR vendors are now able to update servers quickly, thus updating the software is painless.

Cost

The cost of everything is going up, and EMR software is no exception. EMR software companies have raised their rates drastically in the last 5 years. While many physicians are aware of the cost that an EMR solution requires, make sure your EMR software vendor is not ripping you off. There are lots of Great EMR solutions out there and some are drastically cheaper than others. Look for a Certified Web Based EMR that has all the bells and whistles but will not rip your pocket.

Support

If you are having a problem with your EMR Software, you might need to call support. This is inevitably going to happen so make sure you know who to call in case your EMR software is not working properly. How good is your vendor’s EMR software support? Will they be able to solve my problem fast and easily?

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Impacts we can expect from ICD-10 transition

Impacts we can expect from ICD-10 transition | EHR and Health IT Consulting | Scoop.it

Q: How will the additional specificity required by ICD-10 pose a challenge for clinicians and the way that they currently track patient information?
A: For clinicians with “simple” requirements – such as specialists or those that don’t perform too many different diagnoses or procedures the transition will be annoying but not catastrophic. For primary care and other physicians that see a wide variety of conditions or perform many different kinds of procedures or diagnoses they will have more work and will take a little more time to transition.

 

Q: Is there a potential for a negative impact on patient care as kinks are worked out during the transition?
A: In the short term there will may be a negative impact on patient care as visits may now take longer on the administrative side and reduce the amount of time practice staff spend with patients on the clinical side.

 

Q: What special challenges will come with the ICD-10 implementation in the United States, as opposed to the rest of the countries that use it?
A: There are many more challenges in the USA because we have an intermediated payer system with many payers that care delivery organizations need to support on behalf of their patients. Even a small clinic will have to deal with many different payers that have their own payment rules and processes. Large institutions will have even more challenges (but they also have bigger IT staff). In other countries many of the payers are government centric or have a smaller number of payers to deal with.

 

Q: What financial consequences will ICD-10 have on the healthcare system?
A: In the short term the financial consequences will be slower payments to care delivery organizations as systems are sync’d and they work through issues and bugs on the payer side. Unlike Meaningful Use, which primarily affected hospitals and clinicians’ internal systems and processes, ICD-10 is a “fully system challenge” which encompasses payers, providers, and ancillary institutions. Long term, though the financial consequences are likely to be positive because we’ll have more granularity of data and physicians can get paid more for complex services.

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How Medical Software Can Help Your Medical Practice

How Medical Software Can Help Your Medical Practice | EHR and Health IT Consulting | Scoop.it

What Are the Different Types of Medical Software and How Can They Help Your Medical Practice?


There are plenty of software solutions on the market today offering services to solve some of the more traditionally complex tasks inherent to a medical office. For a medical practice, it can be a little overwhelming to sort through all the platforms and their features, from medical billing software to medical scheduling software, practice management software to medical information systems.

What you may find as you explore the various medical software brands is that there is a lot of overlap, with some services offering a little of this and that. To help give you an overview of some of the medical software options available, we put together this quick roundup.

EMR
There’s often confusion between EMV vs. EHR, so here’s the difference. An EMR (Electronic Medical Record) is all the internal information a practice collects on a given patient. This data is built up over various visits to a doctor. As such, EMRs are not usually shared outside the walls of a medical practice, but are kept on-hand internally to help treat and track the patient’s various diagnoses and progress. EMR software makes it easier for doctors and staff to keep, store, organize, and access this information whenever needed.

EHR
On the flipside, EHR (Electronic Health Record) is very similar to EMR, except they’re meant to be more comprehensive with medical history and shared amongst various practices for the benefit of both doctors and patients. EHR software has been around for a while, but government incentives to go digital have made its use a lot more prevalent. Really solid EHR software will allow your practice to save and access an incredible amount of aggregated patient data with just a few clicks.

Practice Management Software
Every medical practice needs some degree of organization to be successful. Practice management software can help your business take control of its day-to-day activities by streamlining operations. Common to this type of software are features such as appointment scheduling, patient registration, insurance filing, specialized calendars and billing.

Medical Scheduling Software
Few things can be more frustrating for a practice than having a patient schedule an appointment and then not show up. It’s an incredibly frequent occurrence that costs the U.S. healthcare system up to $150 billion annually in lost revenue. Medical scheduling software can help with this problem by sending automatic alerts and notifications to patients to remind them of appointments, which has been shown to reduce no-shows. It’s worth noting that there are lots of different types of medical scheduling software available, even some free versions, and you may also find this type of functionality already included with certain EMR/EHR and practice management services.

Medical Billing Software
Every medical practice needs to keep its lights on, and medical billing software certainly makes it a lot easier for your staff to do just that. Good medical billing software allows you to manage insurance and patient payments, and track their status through the submissions process. It’ll also keep you updated on evolving payer rules, and changes to codes and formats. Collecting your revenue for services rendered shouldn’t be a headache, and medical billing software will take the sting out of it.

These are just a few of examples of the various types of medical software available to practices that can help make their professional lives a little easier.

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7 Types of Healthcare Information Technology

7 Types of Healthcare Information Technology | EHR and Health IT Consulting | Scoop.it

The 3 Main Categories of Healthcare Information Technology

There are three main categories of healthcare information technology that you’ll find in both hospitals and physician offices:

Practice Management

Practice management is pretty much exactly what it sounds like: it helps you manage the different aspects of your practice.  This category centralizes your practice’s various systems so you can run it more efficiently.  Practice management software automates just about every task that fits under the “health information management” umbrella.  They take away the stress and give you back the time spent on time-consuming tasks.  The overall goal is to help you provide better short- and long-term care.  To achieve this goal, most practices integrate other systems to truly centralize the platform (more on that later).

EMR

Electronic medical records software, or EMR, is one of the most popular medical software categories.  EMRs replaced paper records by making digital versions of charts and patient histories.  They have similar features to business intelligence, in that they can track data over time.  This alerts you when patients are due for preventive procedures and screenings.  In addition, EMRs help diagnose and treat patients by looking at their history and comparing their health data.  All these features allow you to provide consistently better long-term care.

EHR

Electronic health records software, or EHR, is another extremely popular category.  As you may have guessed by the name, they have similar functionality to EMRs.  An EHR provides health information management in the form of digital health records.  The differences from EMR begin, however, by providing a broader view.  EHRs include a patient’s history, diagnoses, treatments, medications, allergies, X-rays, test results and more.  Another advantage is the ability to share information.  While EMRs give a healthcare provider a great overview of a patient, they can only do so for that provider.  EHRs, on the other hand, can share patient data with other EHRs.  This allows a healthcare provider other than the patient’s primary provider to access the same information.  So when a patient moves or goes to an emergency room, they can still be properly treated.

The 4 Smaller Categories of Healthcare Information Technology

There are also smaller categories of healthcare information technology that aren’t as common.  These systems are often integrated with practice management software to provide robust functionality and better patient care.

Patient Portal

Today’s consumer expects more transparency and accessibility than ever before.  This is certainly true for the healthcare industry, where patients want access to their medical records.  You certainly can’t blame them, so patient portals were developed.  They’ve increased in popularity among hospitals and medical practices in recent years, and appear to become an industry standard.  Patient portals allow access to just about everything in an EMR and EHR, including their history, treatments, medications, etc.

Scheduling

Scheduling software oftentimes goes hand-in-hand with a patient portal.  This allows patients to login to the portal, view their previous treatments, receive an alert that it’s time for a check up and then schedule it.  Possibly the biggest advantage of scheduling software is reducing your phone traffic.  Rather than having to call every time they want to make an appointment, patients can just go online and do it.  Plus, in today’s digital age, they prefer to do it on their device of choice anyway.

Medical Billing

One of the more time-consuming tasks for practices is managing patient billing.  Writing up, sending and processing payments takes a lot of time, especially for busy hospitals and practices.  That’s where medical billing software steps in.  A medical billing system automates all of this, so you don’t have to think about billing at all.  If there’s an issue such as a late payment, the system alerts you so you can act accordingly.

ePrescribing

One of the last parts of an appointment is sending the patient’s prescription to their pharmacy.  In order to expedite the process, physician offices began using ePrescribing software.  In just a few clicks, a prescription is sent, filled and waiting for the patient when they get there.  This saves not only your time, but your patients’ as well.  Additionally, ePrescribing systems ensure that there’s never a prescription mix up due to, say, poor handwriting (no offense doctors).  The system displays the prescription to the pharmacy so they can ensure patient safety by giving the patient the right one.  A study by Decision Resources found that using ePrescribing software has increased the prescribing of generic drugs.  This furthers your mission of patient care by providing them with cost-effective medicine.

Although there are lots of different medical software categories, hopefully this list has helped clear up any questions you had.  If you haven’t used any of these systems yet, you might want to start looking into some options.  Just think of how much better you can run your hospital or practice with some or all of these systems.

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Benefits of EHR Systems - Benefits of Using EHR

Benefits of EHR Systems - Benefits of Using EHR | EHR and Health IT Consulting | Scoop.it

The Affordable Care Act (ACA) radically changed the healthcare landscape, and the rise of electronic health records (EHRs) as critical tools for delivery and continuity of care is one of its more involved outcomes. There are significant benefits of EHR systems for healthcare providers from small private practices to large hospitals and provider groups. To find the best EHR software for your business, make sure it provides these seven key benefits:

 

Meaningful Use

The ACA’s Meaningful Use mandates began to go into effect last year, and providers who aren’t caught up are losing money. The best EHR software is designed to help your practice meet Meaningful Use guidelines and prepare you for upcoming mandates in future stages. There are a number of EHR Incentive Programs that optimal EHR software will help you take advantage of so that you aren’t leaving money on the table.

Scalability

Third party EHR software can grow with your practice and be scaled up rapidly to include larger patient bases. And cloud-based EHRs can quickly integrate patient populations in the event that your practice chooses to join an accountable care organization or group practice.

Accessibility

Online EHRs are always accessible. Unlike EHRs stored on a single server in your office, you can access EHRs managed by a third party vendor from any location with an Internet connection. This allows you to improve collaboration with other health care providers, involve patients in management of their care and respond to patients’ concerns from anywhere.

Support

An EHR vendor who provides customer support around the clock can make your IT concerns disappear. They can also provide on site support that will significantly reduce your IT costs. Data migration, updates and patches are handled automatically so that you don’t even have to think about IT support.

Interoperability

EHRs that can interface with other systems allow your practice to optimize continuity of care. If your patients need to see specialists, manage chronic conditions such as diabetes or plan on transitioning to a home health care environment for recuperation or hospice, an EHR system that offers interoperability is critical.

Customization

Every practice is somewhat different, and EHR systems can be customized to meet your practice’s individual needs so that you get the best possible package. An EHR package that can be tailored to fit your practice’s workflow will make the transition virtually seamless.

Security

Protecting electronic health information is critical. One of the benefits of EHR systems is that they can make sure your practice is HIPAA-compliant and that your health records are protected. EHR companies that are compliant with IDC9/10, CPT and other EHR standards offer the highest security.

Adopting a robust EHR software platform isn’t just about maintaining compliance with Meaningful Use or even about ensuring the best delivery of care to your patients. It’s also about optimizing your practice’s ability to make smart business decisions based on patient data. This kind of business intelligence is critical to growing your practice and optimizing your bottom line.

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Medical Billing Software vs. Medical Billing Services

Medical Billing Software vs. Medical Billing Services | EHR and Health IT Consulting | Scoop.it

review the features and benefits of each method:

Medical Billing Services

When you opt for outsourcing, your staff will forward bills and other financial documents to a medical billing service provider. According to The Profitable Practice, once the service receives your paperwork, the company will manage your claim submissions, tracking and basic data entry tasks. Typically, you’ll pay a medical billing company a percentage of the amount that they collect. Currently, the industry average is around 7 percent.

Medical Billing Software

Traditionally with medical billing software, you’d have a software installed locally that to manage your practice’s finances. Cloud-based medical billing software is becoming more prominent and is also a viable option. In most cases, medical practices only require basic billing software, but if your system is outdated, you may consider upgrading to a billing management program. The extended framework includes features that will help you manage your entire facility. Features include using it for scheduling, storing electronic medical records and assessing imaging.

How They Differ

Because billing can be time consuming and emotionally challenging, you may prefer to outsource. Medical billing service companies follow up on rejected insurance claims, and they will contact patients regarding delinquent accounts. This type of service is set up to send invoices to your patients. If your practice is short-staffed, then a service provider may be more helpful than in-house software since outsourcing decreases the amount of labor needed to operate your facility. A major benefit to choosing a medical billing service provider is the convenience that it offers.

Medical billing companies may provide better transparency. If you select this type of service, make sure that the company supplies detailed performance reports upon request. This will let you review your billing operations. Outsourcing ensures that you will have access to a billing staff at all times. The service also delivers operational consistency as most companies agree to perform a specific set of services. One of the downsides to outsourcing is its variable cost. This feature delivers budgeting challenges since the company’s fees will change every month. Also, outsourcing may include extra fees. Before contracting with a billing service provider, confirm their exact pricing structure. In addition, you will need to hand over billing control to another entity.

By choosing in-house software, you’ll be retaining complete control of your practice’s operations, which provides peace of mind. Once you’ve paid for medical billing training and the processing software, you’ll have a better return on your investment. If problems arise, then you’ll have immediate access to your records. With in-house billing software, you can quickly address any administrative issues.

One of the drawbacks to in-house billing is the cost. The additional salaries and expenses for employee benefits are likely to increase your practice’s overhead. Billing technology systems can be pricey, and cash flow problems may arise when you have a small staff of one or two billers. If one of your employees becomes sick, takes a vacation or quits, then you’ll be facing retraining expenses for a new employee as well as a potentially stalled billing department in the interim.

Final Considerations

Billing management can be a tough choice since service providers and in-house software offer advantages and disadvantages. When making the decision, consider the size, age and needs of your practice. For instance, if you’re just getting started, it may make more financial sense to outsource. If your practice is established with a billing system in place, then a system upgrade may be all that you need.

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EHR Software Replacement Guide - Changing EHR Systems

EHR Software Replacement Guide - Changing EHR Systems | EHR and Health IT Consulting | Scoop.it

In the world of electronic health record software, things are changing rapidly.  The healthcare industry is trending towards replacing outdated or obsolete EHR systems, or EHR systems that are seen as ineffective or troublesome by users.

A look at the medical industry today shows that practice leaders are updating and replacing EHR systems at a pretty significant rate — some studies last year showed almost a 60% increase in the number of providers looking for new EHR systems. If it’s not exactly a stampede, it’s a significant trend that shows how important it is for medical practices to have the right support software backing their daily operations.

Reasons for EHR Replacement

One obvious reason that so many doctors are considering updating their EHR systems is simply obsolescence. Cloud computing and other major advances have led to quick progress in enhancing this type of practice management software, and there are a lot more features and functionality that are commonplace now than there were in EHR systems just a few years ago.

Another major reason for replacement is that doctors and clinical workers may not see the interface of their existing EHR system as intuitive or easy to use. A 2015 report from HealthcareITNews cites “cumbersome” and “faulty” EHR interfaces driving 24% of the movement to change EHR providers.

In some cases, it’s simply too hard to enter data or select results. In other cases, the programs experience significant downtime, or even crash. It doesn’t take much for a busy medical professional to develop a very bad opinion of the support software they use, if it’s not available in real time. A doctor’s schedule is so rushed during the course of the day that they don’t have time to wait for screen updates, or re-do instructions on faulty or unresponsive systems.

Yet another reason for replacement is the failure of some EHR products in being “interoperable” or compatible with other parts of an IT architecture. The overall design of the software is ultimately important, and it’s a good indicator of whether or not physician offices will stay with these products as happy customers, or move on to a different vendor.

However, medical practices have to be careful when making a move with EHR. That’s because these support resources are so fundamental in day-to-day clinical work that they can have a big impact on how an office functions.

The right EHR choice can provide streamlined, efficient services and help doctors feel confident that they can get through everything that they need to do during a day. Inferior or mismatched products can eat up valuable time, confuse doctors and other users, and really create problems for a practice.

Here are some guidelines to use when trying to replace EHR software:

Develop Legacy Data Management Strategies

This long term really just refers to figuring out how ‘legacy’ data, or data sets existing in current tools, will be used in the new system. Understanding this equation is crucial to making sure that doctors and others get the most out of what’s assimilated into the new EHR system.

Part of the struggle is in evaluating the resources at the practice’s disposal and the data sets that will be worked with. Practice leaders can think about:

  • The prospect of data loss — think about backups to keep legacy data on hand, in case it doesn’t automatically update or populate in a new system
  • Consider the cost of manual data entry where automation isn’t available
  • Understand where bits of key data will show up in a new product system

Getting ‘Vendor Buy-in’

Getting internal buy-in for new EHR systems can be tough enough, but there’s another hurdle healthcare providers need to go through when they’re looking to update their practice management systems by going with an alternative EHR vendor.

Medical offices have to have a frank discussion with their existing vendor to understand how the process works. By skipping this step, practice leaders can be setting themselves up for unpleasant surprises.

In recent medical press, some EHR vendors have gotten black marks on their records for seeming to ‘hold data hostage’ — to attach some demands to the continued provision of the services that help medical offices serve their patients on a day-to-day basis. If all of the office’s health records, scheduling, billing information and other data sets are resident in a piece of vendor software, that vendor has a certain amount of power in their hands. Of course, the vendor can’t legally make off with that data, due to existing rules and regulations, but they can make things tough for the medical office if they’re not on board with their client making a switch. Talk and make sure that everything is worked out before going ahead with the system to replace EHR software.

Going Slow

It’s also just as important that there’s a consensus inside the business, and that everybody knows what’s going on. When people have more of an idea of how a new EHR system will work, they’re more likely to embrace it, and opt to go ahead and update. The medical office also has to recognize the challenges of starting all over with a new system — it’s going to take work.

It helps to get preliminary training manuals or introductions to the new systems before they actually are put in place, so that people at all levels of staff can start to get familiar with the interface and how it’s built. It’s also critically important for practice leadership to develop a sufficient training schedule with the vendor, and tell people about it as soon as possible.

A Selection Platform

With so many EHR systems on the market today, it can be difficult just to understand the features and functionality that each one offers in the context of the market. That’s where a selection platform comes in. A selection platform helps you organize the steps you need to take to implement a new EHR system.  In addition, practice leaders can take a look at an array of products on a single website to start to compare and contrast their choices. Using a selection platform can make the job of EHR replacement a whole lot easier.

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5 Ways to Maintain Healthcare Information Security - SelectHub

5 Ways to Maintain Healthcare Information Security - SelectHub | EHR and Health IT Consulting | Scoop.it

Even in 2017, the healthcare industry lags behind on data security.  Almost 90% of healthcare businesses had their data breached within the past two years.  This resulted in an estimated $6.2 billion loss for the industry as a whole.  Although data theft isn’t limited to the healthcare industry, the amount outpaces most other industries.  So why is maintaining proper healthcare information security such a problem?

Changing your electronic health record (EHR) or electronic medical record (EMR) vendor probably isn’t the answer.  Stephanie Tayengco, SVP of Operations at Logicworks, said in Becker’s Hospital Review that there are several complicated factors.  Among other factors, she discusses how health IT involves several manual processes, that HIPAA requirements aren’t sufficient and that the value of patient data makes them targets for hackers.  Despite these factors, healthcare businesses need to better protect their data.  This is for the safety of not only their clients, but their employees as well.  Although it’s not an easy task, it’s a necessary one that will pay off long-term.  To help, we came up with a list of strategies to better maintain healthcare information security:

Take Note of the Devices Your Data Passes Through

The Internet of Things means that our world is filled with more devices seemingly every day.  In today’s workplace you’ll find a plethora of laptops, tablets, smartphones and more.  With more employees accessing business software on their mobile devices, more personal devices are used to conduct business than ever.  But more devices accessing your data also makes it more vulnerable.  To reduce the chances of a data breach, have your IT staff assess the risk of every device that will access your data.  Even personal tablets/smartphones need to be assessed to ensure they’re secure.  In fact, they’re more important as they tend to be more vulnerable than devices used exclusively for business.  To be clear, this doesn’t mean digging through your employees’ private information.  But you can and should look at the security capabilities of each device accessing your data.  If you haven’t already done so, start ASAP.  The longer you wait, the more you’ll have to catch-up, and the more vulnerable you leave yourself and your data.

Secure Your Wireless Networks and Messaging Systems

Similarly to more devices making you more vulnerable, more wireless connections does the same.  If your practice offers free WiFi for patients and a messaging system, your data is more vulnerable.  Now, we’re not saying get rid of either of these; they’re probably reasons why patients chose you in the first place.  But their security is oftentimes overlooked, since they don’t store patient records.  Alison Diana at InformationWeek recommends creating automated procedures to update devices and users.  This helps make sure ex-employees don’t continue to have access and that new technology isn’t left unprotected.

Go Above and Beyond HIPAA

Many organizations believe that if they’re complying with HIPAA they’re doing enough.  Unfortunately, this isn’t the case.  As Tayengco says: “Many healthcare organizations mistakenly believe that HIPAA compliance is a checkbox, and once infrastructure is configured, it is ‘all set’ or somehow guarantees the security of their environment.  However, even following both HIPAA and NIST guidelines is not enough; these recommendations can take years to catch up to new technology shifts.”  There are plenty of steps healthcare businesses should take beyond HIPAA to protect their data.  For example, Tayengco recommends encryption.  Encrypting your health records, medical records and other data is a (relatively) small step that is a big step towards protecting against a breach.

Training Employees

With the adoption of healthcare information technology still in its early stages, employees are still getting used to it.  Policies and procedures need to change to accommodate the digitization of patient records.  But just making new policies only goes so far without proper training.  Make sure to train your employees, both new and old, on new data security procedures.  Robert C. Covington at Computerworld likens it to putting together a bike without instructions.  “Unless you happen to be an engineer, attempting this will result in a string of expletives, and a disappointed kid.”  To put this in perspective, Kelly Jackson Higgins notes that 36% of data breaches occurred because of an unintentional employee act.  Such an act is usually avoidable, and proper training goes a long way towards avoiding those kinds of mistakes.

Paper Records

Yes, not every problem lies in your health information technology.  Sometimes, you need to look at something a little old-school to keep your data safe.  You may have the most secure EMR and EHR system in the world, but ignoring paper record security can just as easily lead to a data breach.  The security of your paper records goes hand-in-hand with proper training, as paper records resulting in a breach can occur from a lack of training.  For example: leaving a file open on the front desk, or, even worse, leaving records out in the open unlocked.  Despite your digital data being the most easily accessible by hackers, you can’t forget about securing good ol’ fashioned paper records as long as you have them.

Although these strategies will drastically reduce the likelihood of a data breach, the reality is that owning any kind of valuable data carries inherent risk.  Cyberexpert Jim Lewis says that you have to “Think of it as a continuum of risk.  You can do nothing, and you’re at 100% risk.  Or you can do a lot and you can get the risk down to 10% to 15%.”  Now don’t fret healthcare businesses; there’s still good news.  According to studies done by security rating firm BitSight, healthcare information security has improved of late.  Comparing the average security ratings for the healthcare industry from 2015 to 2016, the industry as a whole improved by 5%.  Clearly, the industry is becoming more proactive about reducing data breaches.  Hackers beware; the industry won’t be vulnerable for much longer.

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What Does Medical Software for General Practices Do?

What Does Medical Software for General Practices Do? | EHR and Health IT Consulting | Scoop.it

A general practice or family practice medical office typically uses a range of medical software solutions to enhance clinical workflows and deliver quality patient care. Although some of these may be purchased as stand-alone systems, the general practice office often uses a centralized platform offering several of the same benefits.  Let’s take a look at the features and systems that enhance a medical office’s practice management:

Compare centralized medical software solutions with a free comparison report

Appointment Scheduling Software and Patient Identification

Generally, a medical practice will use a set of digital solutions that will help to identify and schedule new and established patients. Many of these will also have features for checkout, as well as auxiliary features for courtesy calls or text reminders. This type of medical software has become something of a standard for a medical office, in the same way that similar systems have been developed for retail and other segments.

These types of tools will fall under the category of “front office” tools: they’re mostly be used by clerical personnel, not in a clinical setting, and they tend not to have much relevant to clinical workflows.

Billing and Coding Software

Medical practices also rely on medical billing software and coding software to help document clinical services.

Billing and coding software takes the documentation components of clinical care and presents them in a way that meets standards for the diverse community of payers that the medical practice must interact with, both government agencies and private health insurance companies.

With that in mind, billing and coding software can take in data sets such as:

  • diagnosis and procedure codes
  • place of service codes
  • patient identifiers
  • medical staff identifiers
  • date of service and other visit documentation

All of this data will be presented in a way that honors a contractual agreement between the medical office and its patients.

Patient Charts and Benefits

Interestingly, much of the data that is used in billing and coding is also used by doctors and other clinicians in the documentation of patient care. For instance, new ICD-10 codes are a component of medical billing, but they also show up in chart notes and other types of internal documentation, to identify the diagnosis the care that a doctor has ordered as a result.

Many of the software projects that general practices use will have detailed digital functions revolving around diagnosis and procedure codes. They will have templates for automatic tools that help doctors to more effectively enter a diagnosis, document a procedure, or dictate the results of the consultation or exam.

As a side note, it’s important to look carefully at the features and functionality of these key clinical systems.

It’s important that these systems support a doctor’s intuitive use. They must be versatile enough to allow for unique patient notes and unique documentation for patient visits. They have to be easy for the doctor to understand in terms of use. They can’t promote a cut and paste result, or confuse the clinician by automatically changing that person’s input. For example, doctors become frustrated with medical software systems that might “auto-correct” their notes in similar ways as the auto-correct tools built into the average smartphone.

With the right design, these types of clinical tools provide more transparent clinical documentation.

Patient Access

Patient access is another major part of medical software for general practices and specialists that’s growing at a tremendous rate.  The idea is based on the concept of medical information transparency.  Before patient access tools existed, patients had to go to the medical practice to ask for record releases, and were often given printouts or faxes, or some form of documentation that was hard to dispense and transport.

The new model is much easier — each patient gets a password and username, and they can individually access the system to see what’s going on with their health. They can get test results, exam results and other key information from the doctors, as well as the medical history that the practice has built for them, without going into an office and signing release forms. The practice can dispense this information without worrying about HIPAA or other privacy regulations.

Beyond this, patient access is a tool that enhances a two-way street of communication between a patient and their doctors. With general practice physicians so pressed for time, they don’t always get all of their key communication done in a routine office visit. The patient access portal becomes a way for a patient to stay in touch with the practice, and even to ask questions and resolve issues.

All of the above types of functionality can be packaged into a comprehensive EMR/EHR system for general medical practices.

Many of the most common and popular medical software tools that practices use will have most of this functionality included. Established vendors will promote the many different types of functionality that their platforms offer to doctors and others, for example, the patient access portals that they have built. Practices looking at obtaining one of these systems or changing their vendor should do a direct apples-to-apples comparison of systems, in order to come up with the best result for their practice.

Technical Dr. Inc.'s insight:

Contact Details :
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