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Tips for Changing EHRs and Transferring Patient Data

Tips for Changing EHRs and Transferring Patient Data | EHR and Health IT Consulting | Scoop.it

One of the challenges of choosing a new EHR is considering the long-term investment.

Implementing any new system into a medical clinic is a potential short-term disruption, so there needs to be an assurance that your decision to change EHR services will serve you well moving forward.

The rapid pace of technological ensures that most doctors will switch their electronic records system throughout their career.

Some doctors start building a medical practice with a budget, and then become ready to pay more for a full service EHR. Others are simply dissatisfied with their current system and want to move to something more suited to their needs.

Very often the big issues that arises is with data continuity. Changing EHR systems should ideally mean that you retain access to your previous patient records. But this is not always the case. The fear of transferring data and losing vital information is a real threat.

With the recent growth in cloud-based EHRs, your patient data is no longer stored on a local server in-house, rather it is under the care of the EHR vendor.

The good news is that the ease of transferring medical records has been steadily improving over the last several years. The recent wave of federal regulations relating to Meaningful Use includes a set of standards developed to enable electronic referrals and cross-provider communication.

These standards describe the specific structure and elements of a patient record, so that any two EHR applications which adhere to the standards, should be readily able to exchange patient data from one to the other.


The creation of these standards makes it easier to transfer patient care data from one provider to another. This technology process is also used to import all patient records from one EHR to another.

For any two EHR applications, it is unlikely that all data will transfer over seamlessly. You need to check with your new vendor which information is essential.

Start with Structured Data.

This includes ICD9 Diagnosis codes, medication lists, procedure lists, allergies, and immunizations. Detailed chart notes and SOAP-type templates can prove to be difficult because the data is unstructured, and free text format may not transfer easily from one EHR technology to another.

In order to meet Meaningful Use certification, EHR vendors are required to be able to produce this data in a standardized, structured format for any given patient. However, they are NOT required to be able to automatically export all data for all patients.

With some EHR vendors, they may charge a processing fee for creating an export file of all of your patient data. A new EHR vendor may also charge you a fee for importing previous data.

This fee will vary based on the volume and complexity of your previous record set.

 

Testing the new System

Once the data transfer has been the second step is testing. Anyone familiar with the process will tell you the the transfers are rarely executed perfectly on the first round. So be patient and persistent.

It is necessary to perform careful quality testing to validate that your data in the new environment is accurate, just like in the old environment.

The simplest way to do this is to select a small test group of your patient population and manually verify that everything is exactly correct for those people. Check both systems to see that everything is correct and orderly. Ensure that you check more than contact information, also review medication lists, procedure lists, allergy lists, and immunization lists. Detailed chart notes and SOAP-type templates can also show if the data has transferred effectively.

If you find an error in the record of one individual, chances are that it is a systemic problem that is affecting many other patient records in your population.

If you identify any problems, you will then need to work with both EHR vendors to determine the origin of the issue and correct it. This can be time consuming, but also worth fixing early.

Even with cloud based date, and modern EHR systems, data transfer can still be a challenging process for any provider to undertake.

 

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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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9 Steps to Successful EHR Implementation

9 Steps to Successful EHR Implementation | EHR and Health IT Consulting | Scoop.it

Healthcare organizations need an efficient way to process and share care delivery information to increase productivity, deliver better quality care, save money and ensure compliance.

Properly Switch EHR can deliver on this promise and provide most benefits associated with adopting digital technology.

Are you ready?

It comes as no surprise that technology continues to be an increasingly prominent part of our society.  Technological advancement isn’t going anywhere, but does this mean your organization needs it? Determining whether or not your practice is ready for EHR is the first step toward reaping all the benefits that information technology provides. Get together with business leaders, managers, and other key stakeholders to determine, infrastructure, people, technology and investment challenges that come with this change. Carefully consider whether or not implementing an EHR would be a step toward reaching or exceeding your business goals and strategy.

Be honest about your current status

Before implementing the new system, you must have a clear understanding of where you and your team stand. Do you have a proper infrastructure (internet, computers, printers, scanners etc.)? Does your team run efficiently? Are there any clinical or administrative process that is creating the bottleneck. How information and documentation are currently organized and processed? Is the staff proficient with computers? Are they willing and able to learn? These are important questions to assess your readiness for a successful EHR implementation. Be sure to be critical, honest, and true; inaccurate assessments will only hinder your team’s progress.

Set goals

Goal setting is almost always a constructive pursuit, and when setting goals for your team it is crucial to consider what factors will drive EHR success. Goals should be relevant, specific, measurable, achievable, and deadline oriented. Work with members to brainstorm a set of realistic and attainable goals with a time limit and budget to achieve them. If you haven’t already, assess and fully understand the time needed to complete tasks and work with team members to set standards and requirements. Determine what actions are benefiting your organization and those that are not; identify processes that can be improved and work with your team to strategize and redesign standard operating procedures.

Assign Roles

Delegating clear positions and responsibilities to allow for a smooth and productive transition. Be certain that those in charge fully understand why changes are being made and have the resources and time available to effect such change. Having clear objectives established will help drive the team ownership and productivity. Ensure that team members understand their duties, how to best execute them, and who they can reach out to for assistance, questions, and collaboration. Communication is key in any group environment, especially one undergoing significant change.

Find the best tools for your organization

Tools are only as useful as you make them. Expand your perceptions and be fully aware of all available resources. Your Regional Extension Center (REC), IT and EHR vendors should be able to provide you with the tools necessary to ensure a smooth transition.

Consider cost

$12,000 is the average cost of an EHR system. This includes software, hosting, maintenance, support, and upgrades. Connecting with health information exchange (HIE), customized reports, and premium features may be more. Before jumping in, consult a legal or financial counsel to determine costs and contract terms. Medical associations provide many open source templates and checklists to help.

Pick a certified EHR

It is helpful to pick an EHR that will customize to support the way your organization runs and help achieve your objectives quicker. Take careful consideration of other products such as practice management software, patient portal, text messaging, business intelligence tools, and public health interfaces.

Implement and train

Designate a leader to manage the transition and work closely with them to create a clear plan. Figure out what technological elements will be needed in converting data and paper charts into your new EHR, and what sorts of limitations you may encounter. Consider the value of information such as patient demographics, insurance, and appointments. Familiarize yourself with how HIPPA and business associate regulations will impact your patient services process. In evaluating your current and future workflows, be sure to create a backup plan for problems that you might come across.

Revise and improve

During and after implementation, meet your team and consider whether or not your goals have been met. If so, is there a way to improve efficiency? Do not overlook the need for further training, as efficiency can be compromised if you don’t know how the new system works especially shortcuts. Adjustments often do not go as planned, the continuous evaluation will help reassure the team and fix problematic issues.

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Why does EHR customization Matter?

Why does EHR customization Matter? | EHR and Health IT Consulting | Scoop.it

Electronic health records shouldn’t be frustrating. However, many providers are finding themselves disappointed or aggravated by EHR systems that don’t provide the tools they need to support the very best care for their patients.

In fact, the American Academy of Family Physicians has noted a 30 percent decrease in physician satisfaction with EHRs within the past five years. Reasons for this dissatisfaction include inefficient systems, deluges of tools that don’t apply to their practice or even generic modules that lead to inaccurate documentation.

Fortunately, customization presents a key solution to these issues and much more.

 

Your Practice, Your EHR

Every practice is unique, and this should be reflected in each health records system. An EHR system for a small practice will need to operate differently than that of a large practice. Layouts, prescriptions, scheduling, patient education, and countless other EHR tools should reflect the needs of providers and their patients. Customized EHR systems impact not only the efficiency of providers and their staff but also the experiences and health outcomes of patients.

 

The Impact of EHR Customization

Tailoring electronic health records to the unique needs of an individual medical practice impacts all parties involved, from the physicians and their staff, to administrators, to patients. For physicians, EHR customization can result in improved specificity and accuracy of data, whether with a patient or reviewing records outside the exam room.

EHR customization examples can include setting dosage parameters, accommodating in-house test results, or even modifications to make the system mimic familiar and intuitive paper charts.

A system that is carefully tuned to the needs of a specific practice is far more efficient for users, and saves time for both providers and patients alike. And those specific needs are naturally different across varying specialities. An ophthalmology practice, for example, would likely benefit from a very different EHR layout than a physical therapy practice or an urgent care clinic.

Not only can the speed and ease of utility improve with the adoption of a customized EHR, but also the quality of that data and accuracy of the information. A 2006 study illustrated that after customizing EHRs, more than 50% of surveyed practices reported improved accuracy and quality of records. More accurate records and data means better patient care and ultimately better health outcomes.

 

Configuring the Best EHR

Determining the configuration of a system to maximize its usefulness and alignment with best practices requires careful planning. Resources who can help a medical practice ideally customize their systems include EHR vendors and third-party consulting firms, and of course, in-house experts such as providers and administrators who understand the practice’s needs and challenges best.

Customization of an EHR system is an effective method of improving practice efficiency, accuracy, and communication for a medical practice.

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Critical Roles in EMR Training Success

Critical Roles in EMR Training Success | EHR and Health IT Consulting | Scoop.it

Every component of a successful electronic medical records system implementation requires a thoughtful, strategic approach. Naturally, this includes EMR training, and one of the best places to start is to establish roles and expectations for all parties involved to ensure smooth implementation and effective training. It’s important to remember that internal management is just as important as vendor support, and below are just some of the important in-house roles to assign before beginning training.

  • The Executive Sponsor: Visualizing the Big Picture

For any project, either through a small business, large corporation, healthcare organization, or anything in between, the executive sponsor must be an individual who understands the organization’s needs and goals thoroughly. Often involved with management, the executive sponsor must have a big picture perspective, and for ” For this role, knowledge of how the EHR system will interface with the organization is more important than technical know-how.

  • The Project Coordinator: Pursuing EMR Training Outcomes

Unlike the executive sponsor, the project coordinator manages day-to-day issues with groups and individuals. The project coordinator should be a leader who understands the technical side of implementation sufficiently to serve as a knowledge source for the rest of the organization. Ownership of EHR training and its outcomes is critical for this role, and the assigned individual must be able to take accountability for this crucial stage of implementation.

  • Roles of Providers and Other Billable Staff

EMR training roles do not end at the management level. For providers, billing staff, nursing, technicians, QA specialists, and others, key training roles exist that can complement an EMR training program – only if managed properly. Physician super users as trainers or guides during an EMR training program, for example, have demonstrated mixed results. One significant benefit of assigning physician super users is having an in-house expert who understands not only technicalities in the EHR system and how they relate to the individual clinic or practice, but who are available as a resource for providers and staff. Clinician super users should not, however, become a primary resource for information, as this can quickly lead to frustration and significant training gaps.

Always Consider Your Training Strategy

The Office of the National Coordinator for Health Information Technology (ONC) reviews three training strategies commonly employed by healthcare organizations during EMR implementation: super user training, role-based training, and process-based training.

Naturally, the selected training strategy will affect the structure and roles of your training team and road map. In all of these strategies, however, a common underlying theme is assigning training roles to individuals who can serve as an information resource for others who perform similar tasks.

Leverage Expert EMR Training from Your Vendor

In many cases, the EHR vendor itself provides expert trainers. Leveraging an EHR vendor is important throughout the implementation process, and this certainly applies to the training period. From classroom-style sessions to one-on-one instruction, different EHR vendors may provide various types of training to help you and your staff achieve fluency in your records system.

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Successful EHR interoperability starts locally

Successful EHR interoperability starts locally | EHR and Health IT Consulting | Scoop.it

Interoperability is one of the most difficult challenges with electronic health record optimization: The ability to share clinical data across health systems and respective EHRs. Sometimes it takes a personal experience to drive home the meaning of interoperability, not only to the healthcare professionals who regularly interface with the EHR, but the patients.

When EHR interoperability hits home

For those that read my last post, you know that I lost my 40-year-old brother to a heart attack in 2015.  I had a physical about two months after my brother died, but due to my family history of heart disease, I also made a long-overdue appointment to see a cardiologist. Both my primary care physician and cardiologist work within the same system and use the same ‘integrated’ EHR. And yet the scheduler for the cardiologist requested I fax my EKG and history, including labs, to the office prior to my appointment.

Needless to say, we know interoperability will doubtlessly improve patient care and experience. But it can often feel like a mammoth, unachievable task. Some staff are accustomed to jumping through hoops to access data, but it doesn’t have to be that way. The secret is to approach interoperability on a smaller scale and address the changes you can make more locally to move the needle forward. Interoperability is a spectrum, and the right answer for one health system may not be the same for another. 

Small steps toward interoperability

Every health system executive has interoperability on their priority list these days, with exciting strides in personalized medicine, the day-to-day demands of care management and reducing unwarranted care variation.

So where should you start?

First, as leaders in this industry, we need to recognize interoperability isn’t just a technology problem. Opening up access to clinical data across different care settings must be a strategic priority that starts with an honest assessment of a health system’s technical capabilities against the imperative to deliver better patient care. Health systems can’t afford to be left behind here, but can’t do it alone. In an industry rife with mergers and acquisitions, health systems should work from the inside out. While that might seem obvious, many systems struggle to make sure internal stakeholders have access to data on the system in some way or another. 

Second, there’s more than one right technique to achieve some level of interoperability. While a truly integrated EHR is the ultimate goal, it’s typically more costly, time-intensive and organizationally disruptive than other options. There is a myriad of interface engines/brokers, health information exchange tools, APIs and custom-built options that can be implemented much more quickly and provide real value, at the point-of-care, now.

Most health system executives assume that to achieve interoperability, they need to implement or migrate every provider in their system onto the same EHR. And often this course of action is advised. However, I’ve seen clients use some innovative methods to tackle interoperability.

One of my favorite examples is a large health system in the northeast that explored different methods to standardize access to data without moving to the same EHR platform.

As the health system acquired new physician practices, it faced limitations that made an integrated EHR financially and operationally prohibitive. After exploring its options, the health system opted to create an HIE, a safe way to send and standardize patient records between EHRs. While the data are not truly in one single place, HIEs give clinicians access to data across separate systems within a couple clicks.

Achieving interoperability will be a long journey that will only grow in importance as healthcare shifts from a volume to value mindset. When possible, health systems should move to an enterprise EHR architecture and go beyond minimally meeting regulations. There’s no such thing as true, complete interoperability: There will always be a new source of data with a different set of access issues. But in the interim, work with community partners to craft solutions to affect patient care now.

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Trends in EHR Software, 2017 and Beyond

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

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

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

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

 

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

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

 

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

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

 

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

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Technology can get patients more involved or alienate them

Technology can get patients more involved or alienate them | EHR and Health IT Consulting | Scoop.it

Technology can do a lot to improve care and boost efficiency at healthcare organizations. But if the right steps aren’t taken, it can also make patients feel alienated and ignored by their doctors.

 

Healthcare technology can go a long way to boosting the quality of care and increasing efficiency and performance. Most healthcare organizations seem to agree, as electronic health records (EHR) adoption rates continue to grow, especially among smaller physician practices.

However, as EHR and other health IT adoption quickly increases, it’s important for doctors, management and staff to consider how that technology will impact day-to-day interactions between doctors and patients.

If the proper precautions aren’t taken, technology can act as a wedge between doctors and other people, including nurses, other doctors and patients.

Limit interaction

While electronic systems make it easier for doctors to do their jobs, they also make it easier to do those jobs without interacting with anyone else. For example, tests and treatments can be ordered through the system, eliminating the need to speak with nurses or other doctors. That can take away valuable opportunities for those parties to share information.

Those systems can also make it too easy to copy and paste information between electronic files, Schumann ways. That can eliminate good chances to ask patients to offer more information or apply fresh thinking to a situation.

And, given all the information that’s available in an EHR system, some doctors may be tempted to make more eye contact with the computer screen than with the patient during a visit. Even if that doesn’t affect the quality of the care that’s given, it can have a serious negative impact on patient satisfaction.

Make sure technology doesn’t get in the way

Here are some steps organizations can take to make sure technology doesn’t get in the way of doctors’ relationships with patients and others:

  1. Organize workspaces properly – If doctors use desktop computers to access EHRs in exam rooms, make sure those stations are set up in a way that makes it easier for the doctor to face and look at the patient while working on the computer.
  2. Consider tablets for EHR viewing – Mobile devices such as tablet computers can also be used to access EHRs in a way that retains the same feel as working with a paper chart.
  3. Use technology to increase interaction – Doctors should look for times when they can use the technology they have available to educate patients and get them more involved in their own care. With the number of apps that are around today, doctors can have round the clock correspondence with patients which enables them to become more involved in their their treatment plan.
  4. Have doctors explain what’s happening – Making patients feel better about the change in doctor-patient interaction might be as simple as doctors explaining that although they’ll need to take time to type information into the EHR, they’re still listening. Also, when doctors do something on the computer, they can explain what they’re doing and how it’ll benefit the patient.
  5. Use social media to communicate with your patients – Blogs, websites and social media platforms give your facility the ability to get a large amount of information out to patients. Now instead of articles on how to cure ailments, you can write about how to prevent them.
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How EHR is different from EMR?

How EHR is different from EMR? | EHR and Health IT Consulting | Scoop.it

EHR and EMR have been in our vocabulary for nearly 20 years. Since the 1990’s, clinical environments have increasingly relied on technology to function and improve patient care. Today, our methods are becoming incredibly sophisticated, particularly following the application of Stage 3 of Meaningful Use in 2016. Because of this, it’s important to take a look at a commonly misunderstood distinction: EHR (electronic health records) and EMR (electronic medical records).

 

The Basics of EHR vs EMR

Back in 1995, one could arguably use EHR or EMR interchangeably. This is because electronic medical records systems were just that: an electronic version of the medical chart. But as the years have gone by, our technological functionality became more robust, stretching far beyond the exam room or even the clinical setting. In fact, it’s very common now for the patient to have access to their own records, physician communication, and more all from within their home.

It is for this reason that the Office of the National Coordinator for Health Information Technology (ONC) has made a detailed study on EHR vs EMR.

 

How Records Systems Affect Different Parties

One way to better understand records systems in healthcare is to consider how those systems affect different parties. Let’s take a look at EHR vs EMR systems in terms of three different major parties in healthcare.

 

Patients  Improving patient outcomes is one of the largest and most important objectives of healthcare records systems. Patients rarely cross paths with EMRs. However, they are affected by them through follow-up exams, regular checkups, and other indicators over time. EHR systems, on the other hand, enable the patient to view their health reports, contact their healthcare providers, view referrals, pay their bills, and much more.

 

Providers  For providers, records systems not only help to improve patient care through improved data accuracy and alerts such as medication contradictions, but they also help to close gaps in communication and improve clinical workflow efficiency. This is true for both EHRs and EMRs, but the advantage an EHR has over an EMR for physicians is its ability to communicate information beyond the practice to patients, specialists, hospitals, and more. EHRs “move with the patient,” as explained by the ONC, as opposed to staying solely inside the walls of one practice.

 

Vendors  While vendors are responsible for providing a health records system, requirements for those systems can change over time, especially for certified EHR technology. EMRs are no longer sufficient to support a medical practice and its patients. Instead, EHR systems enable vendors to offer comprehensive, customizable services to medical practices that include everything from billing, to charting, to scheduling, and more, all while staying abreast of federal requirements like HIPAA and Meaningful Use regulations.

 

In the end, EHR systems are a direct reflection of how far technological advancements have taken the industry of records systems in healthcare. What once was simply an electronic version of a chart has become a real-time reflection of a patient and their health. This makes an EHR more powerful to the benefit of all parties involved, but in particular, to the patient.

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5 Benefits Of EMR Integration

5 Benefits Of EMR Integration | EHR and Health IT Consulting | Scoop.it

Electronic medical records (frequently abbreviated to EMR) are traditional medical records that have been converted from paper to digital format.  Although the conversion can be a time-intensive process, it’s definitely worth it.  Once records are digitized through EMR integration, they can be accessed more quickly. Doctors, nurses, and other staff will spend less time on paperwork and more time with patients.

Are you a key policymaker at a hospital or medical facility? If so, you may be contemplating integrating EMR into your own medical organization.

If you’re still on the fence, check out these five benefits of EMR integration. They just may help you make up your mind.

1. Widespread Access

If a doctor needs a file on a patient, where do they have to go to get it? Is it nearby or all the way at the other end of the hospital?  If these records are available on any computer throughout the hospital, that saves doctors time trekking from one floor to another. Those are valuable minutes that could be spent saving lives.

While distances are shorter in small clinics and private practices, the time spent finding records is no less valuable.  EMR systems are beneficial to health organizations of all sizes.

2. Analytics

EMR integration is about more than making the swap from paper to digital record-keeping. It’s also about keeping better track of patient health and how the organization runs.  Through EMR, it’s possible to gather analytical data that can improve the operations of the practice. Stakeholders in the organization can make decisions on supply inventory, scheduling, workflow, and more based on the data provided by EMR.

3. Up-to-Date Documentation

Medical coding is an ever-evolving job field. That said, sometimes organizations don’t have the time or the manpower to make sure coding practices are up-to-date.

This can be dangerous for patient health and for the practice’s reputation. By moving to digital with EMR, it’s possible to update coding quickly and easily. Instead of spending hours going through patient records by hand, this can be done with digital efficiency.

4. More Money-Making Potential

Although EMR integration can be expensive, the money a hospital can make back through digitizing more than covers the cost. Here’s how:

  • Less time wasted by doctors, nurses, and medical staff flipping through paper records. That increases productivity.
  • Better health outcomes for patients, which means a better reputation for the practice. That could lead to more patients choosing the practice for their medical needs.
  • Fewer chances of mistakes in coding or documentation. That saves money on potentially pricey lawsuits on insurance claims.

5. And the Biggest Benefit of EMR Integration Is…A Better Practice

Medical offices are high-energy places on a good day. On a bad day, the stress levels are palpable. The fewer complications preventing a practice from achieving optimal performance, the better.

That’s why EMR is such a great choice for organizations still using paper records. Whether your clinical staff needs to be more productive or you want to save some money, make the switch from paper to digital records.

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Improve Patient Care with EHR

Improve Patient Care with EHR | EHR and Health IT Consulting | Scoop.it

EHR systems did not appear overnight. Since the Institute of Medicine’s strong endorsement of computerized medical records in 1991, developers and providers have worked closely to employ the use of information technology to improve patient care. Modern applications like today’s integrated and robust EHR systems is simply an extension of this idea that technology can help us better serve patients. Nonetheless, it’s not uncommon for administrators and providers to find themselves frustrated at the perceived distance between the realities of EHRs and their goals for practice workflow and patient care.

Patient Record Software and the Roots of Best Practices

It is easy to lose sight of the purpose of an EHR system. For example, a common complaint is feeling like EHR implementation means staring at a computer and not at patients.

But, it’s important to remember both the end-goal of EHRs (excellent patient care)as well as effective implementation strategies to maintain the best practices of accurate documentation methods and good bedside manner while still adhering.

EHRs have demonstrated incredible strides in patient safety and continuity of care and have proven themselves worth the investment for even the smallest medical practice.

Patient Care By the Numbers

It’s an exciting time for the electronic records industry. Part of this is due to the years of valuable data to which we now have access – data which has shaped HIPAA, Meaningful Use, and ultimately, the quality of patient care. EHR systems have contributed to increased data accuracy such as patient history, medications, CPOE processes, and more. And for chart access and patient report maintenance, research shows that not only do EHR systems support the accuracy of these activities, but also the speed of completion in a clinical environment.

In addition, patient record software systems’ ability to interface with clinical tools have generated huge improvements in health outcomes, for example,drug interaction alerts via data sharing between an EHR system and an electronic prescription system. And patients are responding positively, too. In fact, patients are beginning to associate EMR use with higher-quality healthcare and perceived increased value with the use of electronic records systems.

Buy-In and the Importance of Practice Investment

It may seem obvious, but an EHR system can only be a useful tool for improving patient care if all of its users are invested. Success requires the commitment of physicians, nurses, technicians, billing and front desk staff, administrators, and everyone in between. This can take patience. Research indicates that it can take up to a year for physicians in primary care to report increased efficiency, communication, and overall clinical quality as a result of the implementation of an electronic health records system. But commitment throughout the stages of implementation and optimization can help ensure the very best functionality of a health records system, provide the best ROI for the organization, and result in the best possible patient care.

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The Changing Healthcare IT Consulting Landscape

The Changing Healthcare IT Consulting Landscape | EHR and Health IT Consulting | Scoop.it

The last several years of healthcare IT consulting, specifically around EHR implementations, has been busy and fruitful. For a period of time there, it seemed that anyone who could both breathe and type would be hired on, trained, and thrown into the fire, working at a feverous pace to digitize our Nation’s medical records. Largely, this onslaught was driven by the financial incentives of Meaningful Use – get up on an approved medical record system, hit specific targets, by specific dates, and reap large financial rewards. The incentives were highly effective and as a result the vast majority of US hospitals are now utilizing some form of electronic health record solution. But there is a murmur out there: “what’s next?”

To begin, two significant dates come to mind. The first date was May 25, 1961, when President Kennedy committed to having a man on the moon by end of the decade. To many it was an impossible goal. Something that seemed so absurd considering we had only just witnessed the first American to orbit the Earth some 20 days prior. The next 8 years were filled with collaboration, heavy investments, long hours, and much ingenuity, which all culminated to the first human to walk on the moon on July 20, 1969.

 

The second date was January 20, 2004, when President Bush, during his State of the Union address, announced his vision for the majority of American enjoying the benefits of computerized medical records within 10 years. Here we are, 10 years later, and the majority of Americans are provided care at a facility that utilizes an Electronic Health Record. The parallels between the two announcements and efforts are apparent – unbelievable amounts of money were invested and an innumerable number of people were involved in realizing the vision, similar amounts of time were allotted, and both meant accomplishing something that seemed impossible. In both cases we were successful. We successfully landed on the moon by the end of the 60’s and today the majority of Americans are provided care at a facility that utilizes an EHR.

 

We’ve accomplished what we’ve set out to do. Sure, not all facilities are utilizing an EHR yet, and not all that are using an EHR are yet meeting “meaningful use guidelines”, but for the most part, the big push is complete. The big question that looms is: what’s next? And this question is one that riles many who were involved in this great undertaking. It’s alarming and concerning to know that what you’ve become accustomed to will be changing – demands of great effort and great ingenuity working tirelessly to discuss, plan, build, configure, test, train, implement, and support, and then repeat and repeat again – this will be changing. But this is the nature of IT. Without successfully completing our mission, would be akin to Neil Armstrong not taking the first step onto the Moon. But as with NASA, that first step wasn’t the last one either, but the beginning of what would become its greatest era with the likes of the Hubble Space Telescope, Space Shuttle, and Rover programs.

 

I believe that this is just the beginning of a more exciting time for healthcare IT. That the real bread and butter, the real pleasure from the work we do, and the real benefit to patients is just beginning. Now that the majority are utilizing an EHR, we can now leverage the efforts and investments through optimization, integration, and interoperability. Through optimization, we can make the experience more effective for both the clinician and the patient. Through integration with other health software, we can extend the capabilities of the EHR further using the EHR as the jumping off point. And through interoperability it’s easier to share patient information when it’s needed the most; no more burning CDs with images or faxing results.

 

About the only tangible benefit of utilizing an EHR over a paper based documentation system is legibility; it’s not having an EHR that matters, rather it’s how the digital bits of information are used and leveraged that makes the difference. Walking on the moon did very little for us, it’s what it took to get there, what it represented, and its ability to make us realize our potential that mattered most.

It’s important that we never stop progressing, that we never settle down and accept status quo. We must continue to innovate.

 

Moving to an EHR from a paper based documentation system should never be the end goal but rather the means to getting there. As a healthcare IT professional, your continued success will be in driving this progress forward. Continuing to look for opportunities – by recognizing issues when they present themselves and developing solutions, continuing to develop yourself through continuing education and certifications, and networking with other professionals. The possibilities are endless really, and now is the time when we get to see the real benefit of this investment. Now is the time for leverage.

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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

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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.

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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.

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9 Best Practices For Choosing EMR Software 

9 Best Practices For Choosing EMR Software  | EHR and Health IT Consulting | Scoop.it

Selecting an electronic medical record (EMR) or electronic health record (EHR) for your medical practice is a challenging, but very important task. Purchasing and installing a new EMR system require a lot of research and time. The best EMR software for your practice will fit in with your practice’s workflow and increase efficiency, but a bad EMR will halt your workflow and cause frustrations.

The following best practices should be considered before selecting and implementing a new system, to ensure you select the best EMR for your practice. 

1. Create a list of requirements.

Make a list of EMR software requirements based on the needs of your practice. This list may include the need for e-Prescribing software, automatic billing, scheduling features, and others. Also map out your ideal practice workflow and usual patient visit flow to determine how potential EMR software could complement your workflow instead of hindering it.

It is important to involve all the physicians and staff in your office in the development of this list, ensuring that all aspects of the practice have been considered. However, a physician should be in charge of the decision, not the back-office or IT staff. This decision requires leadership and an understanding of the medical requirements.

2. Analyze your budget.

Purchasing and integrating an EMR system into your practice workflow can be costly. However, the benefits of EMR systems can be worth the financial investment and may even help your practice save money in the long run. Besides the initial EHR / EMR costs, there are hardware, implementation, training, and maintenance costs to consider when purchasing a new system. Find our more about what EMR costs you can expect with a new EMR system.

3. Only consider specialty-specific EMR systems.

EMR software that is designed for your particular specialty is customized to deal with the unique characteristics associated with your specialty. The customization includes specialty-specific features and templates. It is crucial that you only consider software that is designed for your specialty, not software that you need to make adjustments to in order to use. This will help your practice workflow tremendously.

4. Systems architecture.

There are many factors of the EMR system to consider, including the system architecture of the software: web-based or client/server. One type of system architecture is not better than the other, however, one may be better for your particular practice. When choosing EMR software, you will need to decide which type of system architecture is best suited for the needs of your practice and will complement your workflow. Read more about web-based vs client/server EMR.

5. Ensure the EMR System has been certified

Any EMR system you are considering for your practice should be tested and certified by an ONC-Authorized Testing and Certification Body (“ONC-ATCB”). The ONC (Office of the National Coordinator for Health Information Technology) is the responsible agency for establishing EMR certification standards and certifying vendor EMR products. ONC-ATCB certification assures that your EMR has met required Meaningful Use (“MU”) objectives and measures. This is a prerequisite to obtaining MU Medicaid (up to $63,750) and Medicare (up to $44,000) incentives for adopting an EMR, and avoiding penalties for not adopting one.

6. Get advice from other physicians and staff.

The best way to understand how an EMR system will fit in with a practice’s workflow is to witness it first hand. You may want to visit a practice that currently using the EMR software you are considering implementing. Talk to physicians and the staff about the EMR software to find out if the software would be suited to your practice and what issues you may face with usage or installation.

7. Decide how much support you will require.

Most vendors will offer 24/7 support, but you need to make sure you understand what sort of support you will be receiving. You may need nighttime or weekend support if your practice is open beyond normal office hours. You may also need on-site help instead of help from a call center. Lastly, understand the extent of the support you will be receiving. Instead of just technical assistance, you may want additional assistance installing new features and upgrades, and fixing bugs. Be sure to ask these questions before purchasing from a particular EMR vendors.

8. Have a lawyer review the purchase agreement.

Since purchasing an EMR software is a big commitment, have an attorney review the purchase agreement to make sure the software is what was promised and includes the right features. Also be sure you understand all the costs and additional fees associated with the EMR software purchase.

9.  Spend time installing the EMR system.

Transitioning to electronic medical records takes a lot of time, so do not underestimate the time and effort you will need to put in. Apart from installing new hardware and software, you will also need to manually scan or input existing paper records into the system. Be prepared to hire additional help during this process, as it can be time-consuming and disruptive to your workflow. It is also recommended that physicians schedule fewer appointments during the transition time.

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Essential Questions for Picking EHR Patient Portal Software 

Essential Questions for Picking EHR Patient Portal Software  | EHR and Health IT Consulting | Scoop.it

It’s time to revisit the much undervalued, if much maligned, patient portal. To date, patient portals remain an underutilized resource. But a convergence of trends may change your thinking about their value — especially when selecting or upgrading EHR software. To help with that process, we offer a 10-point checklist for evaluating a patient portal’s usability and functionality. 

Patient Portals: A Mixed Bag

Most of us have used a patient portal, and the reviews are mixed at best. A product of meaningful use requirements, they were mandated as a way to provide patients with timely access to their healthcare.

At their most basic, they’re used to retrieve lab results, ask a question or update patient profiles and insurance providers. Some allow patients to schedule appointments and pay bills. For providers, they represent an opportunity to increase patient engagement, promote loyalty, manage costs and streamline workflows.

In reality, their potential has yet to be harnessed. Hard to access, patient portals are often badly designed, cumbersome to navigate and limited in utility. It’s sometimes easier for patients to pick up the phone and call their provider than to look up their user name or create a new password. For staff and physicians, they require time and resources that aren’t usually billable.

Emerging Trends Impacting Patient Portal Usage and Importance

So beyond next-stage meaningful use requirements, why should the patient portal receive greater consideration in the EHR selection process?

Value-Based Care

First and foremost, as healthcare moves from fee-for-service to value-based care, providers will have further incentive to improve the patient experience, track compliance and manage costs.

In a medical research paper — Patient portals and health apps: Pitfalls, promises, and what one might learn from the other — issued last year, the authors asserted that “the push for reimbursement that relates to value-based care creates an opportunity to develop high-quality patient portals.”

In addition to improving patient health and facilitating wellness, patient portals have the potential to free up staff time, lower call volume (including call backs and phone tag), increase accuracy, reduce duplication and cut down on time spent on patient records, payments and prescription refills.

Data

The future of health and medicine points to the primacy of data. Patient portals can yield a trove of information not captured in a doctor’s visit or clinical interaction — resulting in better population health management and a better ability to track patient engagement and improve adherence to treatment plans.

Patient as Consumer

Patient portals will grow in popularity as patients evolve into healthcare consumers. Increasingly, they want better, faster access to their health information, and to be involved in the medical decision-making process. Patient portals are a natural extension of the trend to go online to select a provider or research medical conditions and treatments. They’re going to expect a positive user experience, rewarding those who do with their loyalty.

Mobile Apps/mHealth

The growing use of mobile apps, smartphones and wearable devices to monitor and upload information about their health and physical activity facilitates more patient self-management and data exchange with their patient portal.

10 Point EHR Checklist for Evaluating Patient Portal Usability

Given the patient portal’s potential and growing importance, how should you evaluate the best portal for your practice or facility?

As a healthcare provider, you can select a standalone patient portal that oftentimes is hosted by a third-party vendor. This approach can result in compatibility issues with your EHR system, requiring your EHR vendor’s cooperation — often at a price.

Alternatively, you can select a patient portal as part of an EHR bundle of services. The good news is that most EHR systems provide a patient portal component. When evaluating their product, you need to remember that patient portals are not all created equal, and can vary in functionality and usability. As such, you need to take into consideration:

  1. Cost – What is the cost to design and activate the portal? Do they provide training, maintenance, troubleshooting and upgrades?
  2. Customization – Do you have flexibility to customize the interface to take into account your practice, specialty and patient profile?  Is it white-labeled to allow for branding?  Do providers have the ability to make refinements?
  3. Patient Management – Does it provide the ability to refill prescriptions, monitor compliance, track patient progress, schedule/cancel appointments, pay bills, upload documents and download practice forms? If they don’t provide all these services, which ones are most important to you?
  4. Communication – How easy is it for patients to send and receive emails and messages? Can patients upload documents? And does it easily and securely integrate with mobile health apps, in a format that providers can use?
  5. Patient Access – How complicated is it for patients to set up an account?  Is it a multi-step process?  Does it incorporate “responsive design” so that it’s accessible and easily readable on a computer screen, mobile device and a smartphone?  
  6. Usability and Navigation – Is the user experience intuitive, consumer-friendly and easy to navigate? Does the portal present information such as test results in a way that patients can understand and interpret? Can it account for sight-impaired patients and patients who don’t speak English?
  7. Content – Can patients view laboratory results and track immunizations, medications and allergies? Can they access personal health data, notes from physicians and medical histories?  Can they renew medications; update their information (insurance, address changes, etc); view discharge and medication instructions; and access an online healthcare library of educational resources?
  8. Security – Is the site HIPAA-compliant to ensure privacy? How secure is the connection in protecting stored data and guarding against data breaches? Does it meet confidentiality and legal requirements for minors? What is the process for setting and resetting passwords?
  9. Workflow automation – Once patient information has been reviewed and approved, can it be uploaded into your EHR (including care plans, clinical visits, insurance coverage, billing) without additional keying or extra work that can result in errors? Can this process be customized to meet your current and future requirements as procedures and policies change? Can it send alerts?
  10. You: The patient portal is evolving, gaining wider acceptance and growing in importance. Not every EHR can address all of these considerations in a manner that meets your needs. Its components are only part of the equation. The other part is you and your commitment.

For starters, do you have a physician champion or super-user who’ll advocate for your patient portal?  Can you ensure that staff are properly trained, and that it’s maintained and regularly upgraded? Are you willing to commit the resources to ensure it’s routinely monitored and being used properly? Do you have the resources to create awareness and educate patients on how to use and maximize its benefits? And do your internal policies and procedures encourage usage?

Ultimately, you can’t guarantee patient compliance or participation. However, you can select a portal that helps you achieve your business goals and meets your patients’ needs.

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Decoding Meaningful Use For Your EHR System 

Decoding Meaningful Use For Your EHR System  | EHR and Health IT Consulting | Scoop.it

During EHR implementation, it can become confusing to successfully navigate federal and locally-mandated requirements for regulations concerning HIPAA and Meaningful Use. For many healthcare practices, Meaningful Use attestation has become less of a collaboration in good patient care, and more of a headache – but it doesn’t have to be.

Decoding Meaningful Use and understanding its requirements will not only improve implementation and optimization of an electronic health records system, but it will also result in improved clinical processes, and ultimately, better patient outcomes.

 

What is Meaningful Use?

Back in 2009, Meaningful Use was developed by the federal government as a way to regulate electronic health records systems, and ensure that providers are on track to make the most out of those systems. Their incentive programs for Medicare & Medicaid generated incredible interest, and within just a few years, had captured most of the US industry. Last year, the ONC reported that of Critical Access and other eligible hospitals, 95 percent had demonstrated Meaningful Use. Meanwhile, according to CMS, over half a million providers had received over $25 billion in federal payments through the Medicare & Medicaid incentive programs as of this summer.

But this brings up an important question: just who benefits from Meaningful Use? The answer is encouraging. When employed properly, Meaningful Use benefits everybody. Providers and their staff benefit from improved clinical processes, billing and insurance parties benefit from standardization, and patients benefit from better care.

 

Understanding Meaningful Use Incentive Programs

The role of federal incentives is simply to encourage providers to adhere to Meaningful Use requirements through certified EHR systems. Finding vendors that provide certified EHR technology is critical to qualifying for these incentive programs, which have to-date paid tens of billions to providers who have successfully met the requirements of the incentive programs. Not only are these programs designed to improve health outcomes through compliance with important measures, but also encourage certified EHR adoption through effectively lowering the cost of EHR implementation for healthcare organizations.

 

The Future of Meaningful Use and EHRs

Each year, CMS and the ONC release new updates for Meaningful Use. Currently, the incentive programs have been widely successful, with over 500,000 medical practices having attested for Meaningful Use as of this year. And moving forward, there is still a great deal of opportunity for benefit to both providers and their patients.

There will still be significant pressure from the federal government to achieve even more universal adherence to Meaningful Use. Many of the most ambitious goals of the program can only be achieved through near-universal participation including those regarding information exchange. For Medicaid, 2016 represents the final year of beginning participation in the incentive program. And while CMS’ final rule published in 2015 extended through to 2017, the Center for Medicare & Medicaid Services has already begun constructing their 2017 requirements.

Successfully attesting for Meaningful Use isn’t always easy. That’s why it’s crucial to find an EHR vendor that is ready to support you and your practice every step of the way towards successful implementation.

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Your nurses may hate your hospital’s EHR: Here’s why

Your nurses may hate your hospital’s EHR: Here’s why | EHR and Health IT Consulting | Scoop.it

While most talk about electronic health record (EHR) systems has centered on doctors’ troubles with adapting to them, hospital nurses are also having major difficulties with EHRs.

 

A new survey highlights just how frustrated nurses are with most hospitals’ EHR systems. Ninety-two percent of nurses are currently dissatisfied with their hospital’s EHR, according to the Q3 2014 Black Book EHR Loyalty survey.

The survey polled almost 14,000 RNs from across the country who all used hospital EHRs in the past six months, and participants had mostly negative things to say about their facility’s systems.

Most nurses said their hospitals’ EHR systems contributed to lower productivity and workflow disruptions affecting the quality of patient care. And 85% of nurses said they continually struggle with their facility’s flawed EHR.

Reasons for frustration

Communication issues are a major contributor to why nurses aren’t happy with hospital EHRs. Ninety percent of nurses surveyed said their hospital’s EHR negatively affects communication between nurses and patients, and 94% thought it hurt communication between nurses and other clinical staff, including doctors and pharmacists.

Some of the communication problems between nurses and other medical staff come from a lack of consistency when it comes to documentation in the system. Only about half the nurses working in large hospitals with more than 100 beds said that all clinical staff access and document patient info on the same EHR screens.

Because everyone accesses patient info differently, there’s more room for confusion and miscommunication when it comes to patient care.

Another big problem for nurses is a lack of IT resources, which can cause delays in entering information in a patient’s EHR. In fact, 91% of nurses in for-profit facilities said they had difficulty even locating an available EHR workstation during their shift.

The survey also showed many hospitals are lacking when it comes to troubleshooting EHR problems. Less than a third of nurses said that their IT departments or administrators responded quickly when nurses pointed out EHR vulnerabilities in documentation.

Rather than solve their problems, many nurses are just given temporary workarounds, and that makes them more frustrated with the system. Almost 70% of nurses surveyed have been told to use workarounds with their facility’s EHR.

Heading off problems

Not only can these issues compromise the quality of care your hospital provides, they can also cause issues with retention and recruitment for nurses. Several nurses surveyed indicated they were currently looking for new jobs, and for close to 80% of these nurses, the reputation of a specific hospital’s EHR is one of the top three factors that determine whether they’d accept a position at a facility.

So it’s clear: Your nurses’ needs should be considered when selecting or upgrading an EHR. This is why it’s key to include representation from your nursing staff throughout the process.

Nurses spend most of their time directly interacting with patients – possibly even more than your doctors. So it’s important for nurses to be able to accurately and effectively document vital signs and other key medical info in patients’ health records. Getting their feedback about what should be included in an EHR system will improve their efficiency and the quality of care they provide.

Besides getting input from nurses about your EHR – and implementing their suggestions – it’s also important to make sure they have easy access to the technology required to use the system.

One suggestion: Instead of limiting nurses to a few EHR workstations, consider allowing them to access the system using secure handheld electronic devices, such as tablets. This could help them enter clinical information into patients’ records faster, boosting productivity and reducing frustration.

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Physician resistance to EHR systems and how to overcome it

Hospitals face a number of challenges when they implement a new electronic health records (EHR) system. One of them is often getting doctors on board with the new system. Due to this and other issues, facilities may struggle to maintain productivity at first. 

The key to overcoming these obstacles is communication.

The benefits of an EHR system need to be stressed by the folks in charge from the initial planning stages on. Organizations need to be honest about what the system will achieve so that doctors aren’t disappointed in the actual results.

Effectively communicating the benefits of electronic records, training everyone properly and providing strong technical support can help organizations overcome doctors’ three most common complaints about EHR systems:

Productivity drops

Implementing an EHR system is a huge undertaking, and as with any new tech system, it will take some time for an organization to adapt to it. That means doctors might not see any productivity gains for a while. In fact a survey conducted by American EHR Partners found that in many cases, productivity drops dramatically right after a new system is installed.

Physicians may also become frustrated that they’re no more productive with their documentation than they were before the EHR system implementation. That’s why it’s important to stress the benefits of EHRs to doctors in terms of what they’ll allow docs to do for their patients and not so much in terms of saving time.

So if physicians start feeling like data entry clerks, you may need to take a look at the system and make sure it is working properly or get providers more training so they can use the EHR system more effectively.

The bottom line is: Hospital administrators need to make sure doctors still have time to focus on what they’re best at — treating patients – to keep physicians happy.

Overreliance on EHR systems

EHR systems have a lot of features to help doctors make better decisions — and some doctors will interpret that to mean the system will be making decisions for them. Facilities, however, need to emphasize during EHR training how doctors can combine the information they get from the system with their own expertise to give patients the best possible care.

Another benefit to emphasize is the fact that EHRs can greatly increase efficiency for administrative staff through patient self-service tools.

Hospitals can save a lot of staff time by having patients enter data into the system themselves. For example, many patient forms can be filled out beforehand through online portals or at a computer kiosk in the waiting room.

Interfere with patient communication

Little changes that are caused by EHR adoption can have a big impact — for example, facing a computer instead of holding a chart can make it more difficult to make eye contact with a patient and make it clear the doctor is listening.

To help, hospitals might want to consider using tablets instead of laptops to access records. This makes it feel more like providers are holding paper charts and are still able to focus on the patient, rather than sitting with their backs to patients typing away.

What’s extremely important to getting physician buy-in for an EHR system is to find one that’s easy for doctors to use and has all the features the hospital needs. Just remember, there’s no such thing as a perfect system. In a hospital with numerous physicians, there will always be some gripes about any given EHR system.

That’s why finding a system that’s flexible enough to meet the greatest number of end users’ needs is the best bet.

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What does practice leadership have to do with an EHR system?

What does practice leadership have to do with an EHR system? | EHR and Health IT Consulting | Scoop.it

Like any practice-wide implementation, a successful electronic health system relies on leadership and coordination. Because an EHR system impacts an entire practice, an effective leadership team should comprise a number of individuals from practice administration to physicians, to nurses or technicians, to billing, and more, depending on the size of the practice.

This leadership team is key for a successful EHR implementation, along with one critical decision-making individual who is capable of leading that team.

 

Who makes the EHR Decisions?

Determining the configuration of an EHR system is no small task.While effective leadership in EHR design requires confident decision making from a focused individual, EHR decisions should be influenced by other players in the practice and their workflow needs, highlighting the importance of a leadership team as described above. Individual doctors, for example, are a critical source of valuable information for the EHR decision-making process, as their needs and challenges in an electronic system impact the entire practice.

 

Leadership in EHR Systems

The transition to electronic records in healthcare has witnessed challenges of adoption and usability, many of which are still common today. Whether implementing a new EHR system for a small practice or a large group, common complaints from providers or staff include feeling mandated to use a system that perhaps they do not enjoy using, or that they themselves would have configured differently.

Other common complaints include the concept that EHR operations are not part of a physician’s job, for instance, and that data management tasks should be allocated to specific data specialists or data entry clerks. These sentiments may lead providers to disperse EHR system tasks down to nurses, technicians, and other staff, leading to productivity bottlenecks and increased frustration.

EHR leadership helps to address these and many other challenges. Consolidating decision making to this team can minimize time and costs, and also improve the overall quality of data captured in the electronic records with standardized use.

 

Ways to Calm the Storm

Fortunately, there are methods of EHR implementation that create fair and realistic expectations for providers and staff in a medical practice.

  • Customization

One of the best ways to prevent issues stemming from frustration is to configure a custom EHR tailored to the specific needs of an individual practice. Customization can improve reception and adoption of a records system, leading to effective use.

  • Training

Training is critical for a successful EHR system implementation. Some of the many decisions for the EHR leadership team are training providers and staff on the new system, deciding who will provide this training, and assigning individuals as points of contact for questions.

  • Leadership

While an EHR leadership team should be equipped to address individual challenges as they arise, it is critical for this team and the leading individual to keep in mind “big picture” goals and management. Patient outcomes, best practices, “meaningful use,” and other practice-wide goals should always be part of the leadership team’s considerations throughout a new system implementation.

Designing a consolidated EHR takes leadership. Keeping the goals, challenges, and needs of the practice as a whole in mind, while also addressing the concerns of individuals throughout the practice’s workflow, requires thoughtful management and guidance.

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The Pros and Cons of Customizing Your EHR

The Pros and Cons of Customizing Your EHR | EHR and Health IT Consulting | Scoop.it

Customizing an EHR can offer incredible benefits to a medical practice, but it is critical to understand the cost-benefit analysis of customization before implementation for the benefit of the practice and the health of its patients.

Customization is a common path for modern practices; research from Medical Economics reveals that in a 2-year survey, over 50 percent of practices were starting to customize generic EHR templates. Analyzing both the pros and the cons of customizing an EHR system can help a practice best plan for the future.

 

To Customize of Not to Customize

One of the first questions to ask before deciding to move towards a customized EHR is about the health or the efficiency of an existing system. Are there currently bottlenecks in flow? Would EHR customization better support “meaningful use” and best practices? Do providers and staff find themselves frustrated on a routine basis with data entry or records management? If so, it may be time to consider a tailored records system.

Despite the benefits of customization,there are associated costs which must also be weighed in the decision-making process. Resource consideration is important when deciding if customization is appropriate, for example. Are the resources (both time and financial) available? Creating a cost-benefit analysis can help to determine whether or not to adopt a customized EHR system.

 

Pros of Customization

Designing and implementing a customized EHR system has many incredible benefits. Custom modules lead to better capturing of data and improved accuracy of that data. SuchEHR system impact affects not only practice flow, but also health outcomes.

Another important benefit of a customized records system is utilization by providers and staff. With a system carefully tailored to the needs of the practice (and in-turn its staff), practice-wide adoption can become much easier. It is no coincidence that staff will be eager to use an EHR system that’s more functional; when appropriate screens and modules appear when and where they are needed, and the system is tailored to the flow providers desire and follow, staff is more invested.

 

Cons of Customization

Despite its advantages, practices need to be aware of the cost of implementing a customized EHR system, both in terms of time and financial investment. The cost of implementation can by high, which is a common barrierto EHR customization for practices. This cost comes in the form of financial investment, but also the investment of time.

Adaptation and training take commitment on the part of providers, staff, and administrators, and customization management requires thoughtful and careful leadership. Other points of consideration include long-term system changes such as updates, as vendor updates down the line may create rifts with interfacing custom systems. Careful communication with a vendor before customization about future changes is key to best prepare for such events.

Understanding the advantages and costs of implementing a custom EHR system is an important step in deciding if customization is right for your practice.

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5 Signs You Need EMR Consulting Services

5 Signs You Need EMR Consulting Services | EHR and Health IT Consulting | Scoop.it

Let’s face it, medical records can be frustrating. Between keeping up with new information and making sure that things are orderly, it’s a tough task.

Thankfully, you can get some help. EMR consulting can make your medical facility run smoother than ever!

Ready to learn more? Keep reading for some telltale signs that it’s time to look into an EMR service.

1. It Takes Too Long to Find a Patient’s Medical Records

Let’s face it, the old pen and paper format just isn’t as effective as it once was. These days we have the cloud and all sorts of EMR consulting services that make finding records easy.

And in the medical field, time is of the essence. Every second you waste looking for a patient’s records is a second that could be spent with the patient.

You’ll also lose money due to basic logistics and time management issues. Using an EMR service is just more cost efficient.

2. You’re Looking to Boost Your HIPAA Compliance

You already know that it’s critical that your medical facility complies with HIPAA. But by switching to an EMR system, you’ll make things far easier on yourself.

Under HIPAA, each and every patient is afforded a few things:

  • A copy of their medical records
  • The correction of any mistakes on their form
  • Specific information on how and with whom their medical history is shared

Take a moment to think about how difficult all of that could be with paper correspondence. By contracting an EMR consulting service, your patient will have easy access to their pertinent info.

Best of all, you’ll have backups of your files in case something goes wrong.

3. Your Current Records System Is Uncoordinated and Messy

Of course, there’s always a chance that your current MR system is a bit of a bust. Whether you’re using paper or electronic services, you’ll want to make sure that organization is a priority.

With the right product, there’s little to no room for error. Best of all, you’ll have access to all sorts of analytics.

So when the patient comes in for a visit, you’ll have tons of hard data that you can use to better inform your care.

Give yourself and your staff a break. Get in touch with EMR consulting services and watch productivity go through the roof.

4. You’ll Have Support When Things go Wrong

One of the best reasons to invest in EMR consulting is the support it offers. Most companies, such as ourselves, offer a robust support service. With more than 25 years’ experience in the health informatics industry, CIS understands that a system is only as good as the efforts lifting it to success.

Leave the technical details to someone else, you and your team already have enough on your plates. When something goes wrong, don’t hesitate to seek support.

In the case of an emergency, our staff is ready to help at a moment’s notice.

5. You Need an Easier Way to Access Medical Records

Perhaps the biggest reason to invest in an EMR service is due to the sheer convenience it offers. No more clipboards and shuffled papers; today’s technology allows for a more streamlined and organized system, with information available at the touch of a button.

Believe it or not, all you really need is your phone, a tablet, or a smartwatch.

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What is Certified EHR and Why is it Important?

What is Certified EHR and Why is it Important? | EHR and Health IT Consulting | Scoop.it

The advent of electronic health records (EHR) systems was built on a foundation of improving patient care. Establishing infrastructures that support highly accurate patient data, closing gaps in communication between healthcare providers, and securely storing records are all among the goals of a certified EHR system. To standardize this, certified EHR systems were conceived and built.

Why is Certified EHR Technology Necessary?

Certified EHR technology is simply a method of taking the ideas of improving patient outcomes through technology forward in a standardized, regulated fashion.

But what does this mean for providers?

Not only does adopting a certified EHR system ensure that your records adhere to requirements for HIPAA and Meaningful Use through CMS and the ONC, but they also can qualify medical practices for federal incentive programs, which can greatly reduce the cost of EHR implementation.

Who Certifies EHR Technology?

The requirements for certified EHR technology are generated and regulated by the federal government. Both the Centers for Medicare & Medicaid Services (CMS) as well as the Office of the National Coordinator for Health Information Technology (ONC) determine the regulatory requirements for certified EHR systems.

Overview of Requirements

In order to adhere to Medicare and Medicaid requirements (and to qualify for incentive programs), an EHR system must meet a set of requirements, and then further, a medical practice or organization must put those features appropriately to use. Meaningful Use was broken down into three stages, and while details on all the requirements for the three stages can be found here, below is a brief overview of requirements to demonstrate Meaningful Use.

• Data capture and sharing

Stage 1 of Meaningful Use focuses on essentially capturing and tracking KPIs (key performance indicators) within a clinical setting. Coordinating care with this new information includes both in-office communication, and communication with patients and their families.

• Advance clinical processes

Stage 2, advance clinical processes, focuses on honing electronic processes such as e-prescriptions, online laboratory reports, electronic delivery of patient care summaries such as after visit reports, and a new focus on Health Information Exchange (HIE).

• Improved outcomes

Finally, Stage 3 focuses on demonstrating improved health outcomes, decision making on high-priority conditions, and patient portal access and utility, including access to laboratory results, provider communication, and more.

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5 must-have traits to require from your EHR and infrastructure vendors

5 must-have traits to require from your EHR and infrastructure vendors | EHR and Health IT Consulting | Scoop.it

You are past the big go live. You and your team are focused on optimization, enhancements, ongoing support issues and upgrades. So, what should you expect from your vendor in this ongoing relationship?

I have worked with all the major EHR players and many other IT application and infrastructure vendors over the years. I have worked with three of the major EHR vendors just in the last 18 months given my interim CIO engagements.

My post “Keys to successful vendor management” covered the importance of the product roadmap, service, total cost of ownership, reputation, contract, implementation, and escalation.

It’s time to look at the ongoing vendor relationship that clients should expect. Vendors, take note. I assume most of your clients would share this view. There’s a reason that the KLAS Research reports carry a lot of weight for CIOs, they are vendor evaluations from their peers.

Whether it is a large, proven vendor or a small start-up, here’s what you should expect:

  1. Excellent customer service: this means being highly responsive, providing quick resolution to issues without escalation, and well-trained, expert support staff. All in the context of a service culture.
  2. Effective account management: every client needs a primary point person who is the face of the vendor, who effectively and expeditiously navigates the vendor’s organization regardless of its complexity on behalf of the client, tracks and reports on all open issues and ensures overall excellent customer service.
  3. Executive level relationship: vendor executives who regularly meet with client executives to ensure an effective, ongoing win-win partnership and who understand and support the client’s strategic plans.
  4. Long term value for the investment: vendors should work with their clients to help them fully leverage and utilize current products they have already licensed, have deep knowledge and transparency around the product roadmap, and sell new add-on products only when there is a clear client need.
  5. Support mergers and acquisitions: provide pricing, licensing and maintenance models that enable and support continued mergers and acquisitions; not create burdens and roadblocks that hinder growing integrated delivery systems.

No vendor or product is perfect. As clients, we must make tradeoffs. But we invest big dollars in long term relationships with our vendors. There is a reason that the Gartner magic quadrant has two dimensions – “ability to execute” and “completeness of vision.” We need robust products that work reliably today and that will evolve in the future to meet changing needs.

How does your vendor stack up against these expectations? Yes, “awesome” is a very high bar. But if you gave them a low grade, it may be time for some face to face discussions.

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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.

Technical Dr. Inc.'s insight:
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