Patient Centered Medical Homes – Changing the industry

Patient Centered Medical Homes (PCMH) provide mechanisms for organizing primary care to provide a full range of high quality health services to the individual’s healthcare needs.

Evidence according to a recent report suggests that medical homes have a positive effect on patient experiences and preventive care services. Indeed, the principles of a PCMH revolve around a wide ranged, team-based care system which is purposefully catered towards the treatment of a patient while being coordinated across all elements in the healthcare system.

With a patient centered orientation towards the individual, the PCMH provides greater access to care which uses alternative methods of communication involving a sustained partnership and personal relationship with the patient over time. Patient Centered Medical Homes comprise of Primary Care Physicians, a committee, a case worker for every patient and care coordinators. The committee measures the quality of care, the care coordinator oversees patients who do not have very serious problems and the case worker becomes the focal point of the medical home and constantly interacts with patients who have serious problems, assisting them in every possible way.

The PCMH model uses a systems-based approach to quality and safety, focusing on care which is accountable for addressing a majority of personal health needs. PCMH is aligned with the Meaningful Use program which allows the medical home to operate in a more efficient and effective manner. Through the use of Electronic Medical Records, patients now have an electronically documented medical history which reduces the time-taken to treat patients and decrease operating costs for the practice. Services such as the Patient Portal allow for easy communication between the patients and the medical practitioners who treat their condition without the need to visit the practitioner’s office.

Through another report, it is statistically evident that costs are cut down through the implementation of Patient Centered Medical Homes as there were 70% reported reductions in emergency room visits and 40% reduced hospital readmissions.

Dr. Jason Hand who is a member of a Patient Centered Medical Home in St. Louis says “We have to find a way to control cost without lowering quality,”

“I saw a lady the other day (who) had seven different doctors she was going to that were not her primary care physicians. She was so overwhelmed with those appointments that she could barely think straight.”

“If I send you to a cardiologist four times a year, you’re going to get four EKGs and a stress test every year. That alone will cost $5,000, $6,000 or $7,000. It’s not necessary to see a cardiologist that often if you don’t have a major heart problem. We want patients to feel like they can go to their regular doctor and ask questions and get answers, and they don’t necessarily have to go to a specialist.”

With the surge in medical protocol standardization such as the EMRs and the efforts to enforce these standards by the government and medical institutes in the country, things are finally changing.

Patient Centered Medical Homes have changed the industry by empowering patients. The patients have mobile access to their medical history and better access to their doctors. The costs of healthcare are also reduced with one team treating the patients instead of various physicians and specialists.


EMR Adoption and Change Resistance Management

You’re a medical practice manager with eyes on that CMS incentive program and its time to go EMR shopping. You’ve picked a product, everything looks great, the budget’s been allocated, partners & providers are with you, the vendor’s shared their magical implementation plan and you can’t wait to order the hardware.

This is where you slow down and go back to that smooth implementation plan to take a good look at it for the part that talks about “CHANGE RESISTANCE MANAGEMENT”. What! There isn’t one? Maybe you think you do not need one.  After all what can be so challenging about adopting an electronic medical record and a practice management system that will only require tweaking your business workflows while twisting arms of the back office staff. Also, don’t worry about the grumpy old radiology technician who firmly believes that technology ended with the invention of x-ray machines. The MAs’ won’t bite you just because the charts are now a few clicks away, far from that trusty old file closet.

Maybe you thought that it’s not the vendor’s responsibility to help you manage the commotion their product is going to cause at your front desk while the billers refuse to send the claims out in the back office. Your doctors probably don’t care about what product they are signing up for as long as they can still create notes on paper, slap them on scanners and beam them into an EMR.

A good EMR vendor with a mature implementation team will discuss change resistance with you; in fact they would ask you to establish all your business critical operations before sharing the implementation project plan with you. Chances are they will also share their workflows and rebuttals against each item you’ll share with them. This is usually the first step an implementation team will take with you. They should also ask you about the key staff members at the practice for establishing implementation partnerships. The chief biller at the practice can work with the vendor to facilitate a smooth deployment while acting as a key – post live communication person for his or her department. Same is the case with front desk, facility (lab, radiology etc…) and provider representatives at the practice.   A half decent implementation team will design their trainings around the concept of toning down the resistance that may surface with the adoption of their product.

Access to legacy data, adequate trainings, an established knowledge base and efficient pre live implementation communication are some of the key factors that contribute towards reducing the intensity of change resistance. Establishing a communication plan with the vendor before the start of the implementation process really pays off, since calling them every 20 minutes for the next six months is not healthy, certainly not for a practice. Find out if your vendor offers portal based communication such as e-ticketing or an action list.

Never underestimate the importance of legacy data so don’t leave any stone unturned when it comes to data migrations. Find out what you’re paying for and make sure your staff gets a memo about what information will be accessible in the new EMR and what needs to be saved in Human Readable Format on a shared network. Insist on test data migration if your vendor has not offered one already and get a consensus on it from all stake holders.  A good vendor will probably ask you to sign an approval on the test data migration before conducting a final one.

Ask for training agenda against each scheduled session and then adhere to time and staff requirements.  Insist on post live Q&A sessions and share your staff’s concerns with the vendor beforehand.

Find out what kind of online training material is offered by your vendor and promote its usage amongst your staff. Identify leaders in all the departments and establish an effective leadership that can assist you in finding and implementing solutions  while communicating with vendors on your behalf.

Finally it does not matter how new the technology may be; the same old rule of “Nobody likes change” still applies.



EMRs – Keeping Healthcare Green

We talk a lot about the benefits of Electronic Medical Records (EMRs). We accept that EMRs promote patient safety, encourage care quality, save cost and time, allow for accountability in the healthcare industry, but we forget to mention the benefits of EMR adoption in regards to the sustainability of our environment.

Doctors at George Washington University have estimated that complete conversion to Electronic Medical Records saves around 2000 pieces of paper per physician on an annual basis. If we assume that this figure is accurate and 100,000 practicing doctors have completely converted to Electronic Medical Records, then around 0.2 billion pieces of paper are being saved each year. According to research, An average tree provides around 80,000 sheets of paper. This essentially means that if every doctor in the United States uses EMRs, the country could save thousands of trees every year.

We can therefore extrapolate from the above information that apart from obvious benefits such as improving patient safety, care quality and cost optimization, usage of EMR also reduces paper and hence saves trees which are valuable for the health of our planet.

Research according to ‘Globodox’ states, that there are 8 million physicians, 200,000 dentists, 5000 hospitals, 15,000 nursing homes and 200,000 laboratories present in the United States today. Most of these use a medical records system based on paper. On average, a single patient needs 11 sheets of paper and the care provider sees between 75 to 100 patients in a week. This means that each week, one thousand to fifteen hundred sheets of paper are used.

The research also found out that around 3 in 10 tests are re-conducted just because the information was lost. The use of Electronic Medical Records saves the amount of paper used on a daily basis. It also saves time for the staff that does not have to rely on hand written notes for every single procedure and minimizes the risk of data loss.

Kaiser Permanente, a healthcare provider committed to keeping the environment healthy, conducted an audit after its conversion to Electronic Health Records and found out that by shifting to Electronic Health Records it had approximately eliminated 1000 tons of paper records, 68 tons of x-ray film, 38 tons of toxic chemical used to process x-ray films, saving 71.5 million gallons of water per year and by reducing medical visits, saved 3 million gallons of gasoline.

Kathy Gerwig, VP for Workplace Safety and Environmental Stewardship says, “There is a strong correlation between environmental health and the health of our communities. As health care providers, it is our responsibility to reduce our negative impact on the environment and ‘do no harm.” She added, “The results of this study show that the healthcare sector is on the way to improving our environment through the broader adoption of Electronic Health Records.”

Terhilda Garrido, VP of HIT Transformation and Analytics said, “Prior to this study, the benefits of electronic health records were categorized primarily by their impact on the quality of care and potential to improve efficiency. As the country increases its ‘meaningful use’ of HIT, we should consider other macro impacts as well.”

The report also highlighted the fact that transition to Electronic Health Records in the United States could result in reduction of carbon dioxide emissions by at least 1.7 million tons across the country. This leaves no doubt that usage of Electronic Medical Records is not only beneficial for population health; it is also beneficial for the health of our planet and enables environment sustainability.

Play your Part in keeping healthcare green by reducing the use of paper at your medical practice, Get EMR Solution from the most trusted vendor Request Free EMR Demo today.



Remote Patient Monitoring

As a result of the growing healthcare needs of an aging population, technologies such as remote video monitoring have transpired into a reduction in hospital visits and ensured cost effectiveness within the industry.

Pertaining to various technologies envisaged to manage and monitor a wide array of health related conditions, remote patient monitoring includes the use of devices such as blood-pressure monitors, weight scales and blood-glucose strips among many others. These technologies are useful in the collection and reporting of data and can also be integrated within a healthcare system such as EMR which transmit data to every element in the system and help in alerting clinicians in the event of declining patient health conditions.

Especially beneficial for the elderly who find it difficult to access traditional care settings, these technologies support care coordination and decision support systems for patients. They also incorporate features of remote patient monitoring which can be used by providers such as the Patient Portal.

A report by ‘Kalorama Information’ states that, “Patient monitoring systems with advanced features, especially wireless or remote capability, are among the fastest-growing medical devices. The aging population and the associated increase in diseases such as congestive heart disease and diabetes as well as the cost of treating those conditions, is driving sales of such devices. Use of new patient monitoring technologies can result in a need for fewer personnel, increased coverage by existing personnel, and a reduction in errors and are expected to lead to better patient care and the recognition of serious health problems before they become an issue.”

The report also stated that remote patient monitoring grew to $10.6 billion in 2012 from $8.9 billion in 2011. A future forecast estimates that the value of the market would increase to a staggering $20.9 billion in 2016.

Talking about the growth of the remote patient technology, Melissa Elder, an analyst at ‘Kalorama Information’ said, “We expected growth and that growth was certainly seen between 2011 and 2012. The market has benefited from the demand to move to a more wireless and streamlined operation both within major health facilities and in the home treatment markets. The demand to integrate data processing capabilities and EMR transfer options has also fueled the market.”

According to recent research, sales of remote patient monitoring technologies have increased by 20% in 2013 from the previous year. The United States Healthcare industry can reduce the costs of healthcare by $200 billion in the next 25 years if used with patients suffering from chronic diseases. David Lindeman, Director of the Center for Technology and Aging states, “Remote patient monitoring (RPM) technologies have been shown to be effective in helping to manage chronic disease, post-acute care and monitoring the safety of older adults. These technologies can help slow the progression of chronic disease, speed recovery after discharge from an acute care setting and help vulnerable adults avoid injuries.”

Numerous studies have proven that despite the initial high costs associated with implementation, remote patient monitoring technologies are cost beneficial and have been shown to reduce the amount of hospital visits by at least 26%.

Conclusively, remote patient monitoring technologies are instrumental to the future of the healthcare industry as they will allow providers to keenly engage patients and help them manage their medical conditions with the help of integrated Electronic Health Records and Health Information Exchange. These technologies will be able to monitor patient condition in real-time and improve the overall quality of human life.