Why is it better to have specialty specific EMR software?

Some people might argue that any type of EMR software can work for a practice and there is no need for a specialty specific EMR. However, the reality is completely the opposite. You might find a generic EMR software without any costs or hassles, but in reality, your entire workflow will suffer simply because the software is not custom designed to match your practice needs. You will end up spending more hours in front of the computer trying to make the software work for you rather than focusing on the patients.

Let’s try to discuss a few points why it is better to have specialty specific EMR software for your practice rather than falling for the free, all-purpose EMR software out there in the market.

Less training time, better learning curve

With a specialty specific EMR software, it is easy for you to learn the software in lesser time as compared to learning the one that is generic. You have all the required items right in front of you which you understand and can get around to work it well for you. Instead of seeing a generic software which can take up to months to master, you will develop a faster learning curve with a specialty specific EMR software.

Better workflow than a generic EMR

If you using a generic EMR software, you will have to spend twice as much time on it to fill in the required patient information, view reports, summaries, make appointments, write electronic prescriptions, etc. A specialty specific EMR software lets you do more work in less time by making the information only relevant to you available at your fingertips.

Additional changes are easy to incorporate

Another great feature of having a specialty specific EMR software is that any further changes are easy to incorporate in the software. This is a feature that is generally not available in your generic EMR software, making it a big problem for you to keep yourself updated.

The Transitioning Industry

The healthcare industry is moving at a staggering pace with numerous changes taking place simultaneously. The road ahead lies with a lot of barriers for policy makers, implementers and healthcare service providers.

With the ominous deadline for ICD-10 implementation and Meaningful Use Stage 2, life is not going to be easy for concerned stakeholders.The final date for Meaningful Use Stage 2 and ICD-10 implementation has been extended to October 2014 – giving providers a fresh breath of air before they can plunge into the changes which come along. This extension actually shows the awareness of policy makers regarding the transitioning industry and what problems lie ahead for providers, EMR vendors, insurance companies and patients.

Sue Bowman, director of Coding Policy and Compliance at the American Health Information Management Association agreed with the deadline extension and advocated for the implementation of ICD-10 together with other initiatives such as Electronic Medical Records and Accountable Care Organizations because “they all relate together.” She adds. “To separate them out and say ‘this piece doesn’t need to be done now’ is somewhat shortsighted, they all link together and are interrelated in a way to promote value for healthcare both to improve the quality and costs. I don’t think we are going to see the anticipated benefits of all of the other initiatives unless we move to a better coding system.”

Mr. Ed Hock, a Senior Director at the Advisory Board Committee sheds some light on the importance of clinical documentations required by physicians and how specific they have to be in their diagnoses andsays, “The reality is ICD-10 will require physicians to document things they’ve never had to document before, if they don’t start documenting these new concepts, three things will happen: A claim will be coded lower than it should have and will be reimbursed less than it should have; the claim can be submitted and billed but eventually will be denied; or you don’t end up billing it and query the physicians, which is fine, but it slows down the process significantly.”

It does not end here though; the Healthcare community has to work diligently to put into practice stage 2 of the Meaningful Use program. Providers who want to be eligible for financial incentives under the Meaningful Use program have to apply specific measures and meet objectives to qualify. These objectives range from incorporating clinical lab-test results into Certified EHR Technology as structured data, generate lists of patients by specific conditions to use for quality improvement and reduction of disparities, research, or outreach. Eligible professionals have a different set of objectives than the eligible Hospitals and Critical Access Hospitals.

It is evident that as soon as the stakeholders in the healthcare industry realize the importance of the looming transitions and start working on implementing the changes, the better it will be. Those who neglect the changes will have to live in an era where every stakeholder will be operating a standardized system such as an EMR, where every process will be done electronically by every entity involved – and the ones who still operate on the previous system will eventually be alienated by their own industry.

Farzad Mostashari, the National Coordinator for Health Information Technology voiced similar concerns by saying that pushing the implementation of Meaningful Use would actually segregate the stakeholders in the industry and “both the vendor and provider communities must be given enough time to implement it successfully”.


The Future of Health I.T

The Health IT industry has been booming over the last few years, especially since the introduction and widespread implementation of Electronic Medical Records (EMR).  In the United States, health IT got a major boost in 2009 when the government introduced the Meaningful Use program through the HITECH Act (Health Information Technology for Economic & Clinical Health).

Enacted under the American Recovery & Re-investments Act of 2009 (ARRA), the HITECH Act is seen as an instrumental legislative achievement by the U.S government and health policy-makers. It is the foundation through which the implementation and execution of Electronic Medical Records EMR all across the nation is deemed possible. It stands as a road through which providers and their patients can communicate regardless of location. There are some who remain skeptical about the government’s backing of health IT, however most view the role of health IT and EMR as the primary step towards in making care more affordable, accessible and ultimately saving lives.

The Meaningful Use program is an initiative through which providers can qualify for Medicare and Medicaid incentives. By utilizing approved and certified Systems, eligible providers can earn up to $44,000 for Medicare and $63,750 for Medicaid over a period of five years starting from 2011.

As with any new method, recording medical information electronically may seem challenging for users. It is not easy for physicians to change their existing workflows that they have developed over many years, so the process of implementation and training is the most important step in converting to Electronic Medical Records.

With proper training physicians can avoid any loss of productivity, which is one of their major concerns during the process of conversion. It is also important for them to select customizable systems, that can conform to the existing clinical and administrative workflows. Link to health information exchange networks is another important capability of the system that providers should look for when selecting an EMR.

There is a general consensus within the healthcare community that the communication between all parties involved in the care delivery process is essential to extract the maximum from Electronic Medical Records. MRI scans, lab results, clinical summaries and other information can easily be shared between hospitals, doctors, payers, labs and patients within seconds. This ultimately saves the patient’s time and streamlines the care delivery process with an audit trail being maintained at each juncture.

Patients are not the only beneficiary of the EMR systems (Read more), as providers can also save time by managing their entire practice from anywhere and remain connected with their patients at all times. With the advent of integrated solutions, providers can use the same EMR system to monitor their clinical, administrative and financial performance. The inclusion of innovative tools like the patient portal ensures communication between patients and doctors, while clinical decision support systems help doctors focus more on their patients as the system checks of errors, drug interactions and in some cases even suggest the appropriate codes for billing purposes.

It is clear that not everyone in the care community is realizing the true potential of EMR systems, but recent trends indicate a significant improvement in the overall process of care delivery. The influx of providers adopting this technology suggests that it is only a matter of time before we can see a significant improvement in population health and handling pressing issues like chronic disease management across the nation.


EMR Implementation – The Expert Advice (Part 1)

With the government’s initiative to take healthcare into the new era of technology, practices of all sizes are vying to make the transition from paper to electronic documentation. For any practice seeking to make this conversion, a thorough analysis of their operations is required in order to assess how the implementation of an EMR solution should begin. Various operational aspects of the physician’s office have to be factored in prior to the beginning of the EMR implementation phase. Ray Parker, an EMR implementation specialist at a major health IT organization, gives us his take on the subject matter explaining the approach that practitioners should take in order to ensure a smooth execution of the system within their offices.

First and foremost, general practitioners and specialists alike have to identify the specific needs of their practices, while fully comprehending the reasons for conversion from paper to electronic medical records or a switch to a different EMR vendor. They have to ask whether they are looking to expedite documentation and reporting, and whether their existing solution inadequately equipped to handle these needs. Regardless of the motives driving physicians towards adoption, their eventual goal may well be common i.e. complying with Meaningful Use measures. If they are conforming to the standards set by CMS, the practice efficiency and expedition of operational processes is expected to improve by leaps and bounds. A significant determinant while finalizing your selection of the vendor should be the qualifications of the vendor organization (with special emphasis on the quality certifications) and subsequently judging the capability of the vendor in terms of meeting your practice requisites.

During the process of ascertaining the clinical and administrative requirements of the practice, some fundamental questions need to be answered and communicated with your vendor. For instance, how many clinicians are based within the practice, the workflows they follow, how many staff members need access to the system and what will be the corresponding training requirements etc? The practice has to be prepared beforehand to convey the entirety of its needs to their chosen service provider preceding a demo of the vendor system. For example a practice might want to stop getting paper faxes and want to receive their faxes electronically instead, or a practice may want to opt for an electronic lab interface with a local lab company. To help the vendor understand specific practice requirements, it’s very helpful to ensure that providers share their existing clinical data templates and specialty specific workflows before scheduling a demo with the vendor.

With respect to implementation, it’s of utmost significance that communication between physicians and vendors is crystal clear regarding data preservation requirements of the practice. Keeping into mind the legal ramifications of maintaining historical data (which varies from state to state), a provider has to aptly determine how much data has to kept and migrated. The vendor must be able to meet these necessities or propose appropriate alternatives to avoid unwarranted outcomes. Size and nature of their data plays a huge role at this stage, as clinical and billing data from older/outdated EMRs is very tedious to extract and even more complex to migrate. Apart from the data requisites of the practice, the clinician should also communicate any specific hardware requirements with their vendor. This provides an opportunity to the vendor to deal with any hardware compatibility problems that may arise at a later stage.

The Road to Meaningful Use – Certified EMR

With the enduring efforts of promoting interoperability by the federal government and health IT vendors alike, we have observed a surge in the adoption of certified EMR across the nation. For some providers, the prime reason for adoption is avoiding penalties, while others view it as a professional responsibility. Regardless of their motives, it would be reasonable to deduce that the utilization of certified EMR technology in practices has raised the bar for the quality of patient care and staff productivity as well. All providers looking to comply with the Meaningful Use objectives must employ a certified EMR. The definition of certified EMR changes with the corresponding stage of Meaningful Use. As of now, we are in Meaningful Use stage one while stage two should begin in 2014.

Stage 2 of Meaningful Use requires the use of patient portals in order for providers to qualify for the apportioned incentives. The fundamental reason for the government’s focus on the use of patient portals is for the improvement in health management for patients. Once the patient feels involved, the level of satisfaction he/she experiences increases as well. As a result, there is better coordination between patients and physicians ensuing in a lot of time and hassle being saved for both.

According to a recent report published by KLAS, more than 50 percent of all clinics and hospitals varying in specialties nationwide have implemented patient portals in their practices. Moreover, this statistic is improving by the day. The current figure strongly indicates the sensitivity of physicians towards their patients’ needs along with a willingness to comply with the Meaningful Use guidelines. The final precept of stage 2 in regards to patient portals mandates that a minimum of five percent of a provider’s patients have to be active on their portal in order for the provider to qualify for their share of incentives.

Given the aforementioned benefits and the overall response of the physician community across the U.S. towards the use of certified EMR and patient portals, we can conclude that the implementation of this technology substantially improves practice efficiency and patient health management. The results may require time to become evident; slowly but surely, we are witnessing the benefits which are inherent to the use and utilization of health IT.


Certified EMR – An Absolute Necessity

When discussing the health IT sector today, certified EMR is the hottest and most talked about topic of conversation. Before delving into why it’s so significant in the industry, we need to understand what a certified EMR is first. To put it down bluntly, any EMR which meets the requirements set by the Certification Commission for Healthcare Information Technology (CCHIT), a body established by the Office of National Coordinator for health IT (ONC) for testing and evaluation purposes, is considered a certified EMR and allows physicians to receive incentives by complying with meaningful use. In lay man’s terms, a certified EMR is any EMR which fulfills the minimum requirements set by the governing bodies to qualify for incentives set by the government.

Talking of EMRs and certified EMR, there is a lot opposition evident towards the adoption process for several reasons; one of the major ones being that physicians have become too comfortable with traditional methods of practicing medicine. Human nature is as such that by and large we’re resistant to change. The startup and training costs on any EMR are other important aspects which have their weight in this regard. Having said that, in order to avoid the inevitable penalties without conforming to set guidelines and in order to achieve meaningful use incentives, application of a certified EMR is unavoidable.

Clinicians’ only just began to fulfill Stage 1 of Meaningful Use requirements and it was  already time to get ready for Stage 2 Meaningful Use, where a fundamental anticipated requisite is to enhance the volume, as well the quality of electronic information shared between clinicians and their patients. When one analyzes the industry it’s easy to observe that patient portals aren’t a fresh concept. They have been here for over a decade now. It’s just that usage of patient portals remained latent until the concept of meaningful use came in the picture and revitalized it.

Physicians can meet two suggested central measures of Stage 2 via proper application of the patient portal. First of all through the patient portal, clinicians can fulfill the requirement of provision of a clinical summary as per total patient visits, to a minimum of half of their patients within three working days. Secondly, doctors can submit medication lists, personal medical history, lab results and so forth electronically to patients upon their request.

Basically, physicians can communicate with their patients round the clock and vice versa through the patient portal electronically; a method for a clinician to provide information on a secure channel to their patients quickly and easily. A number of supplementary benefits can also be achieved through patient portal such as prescription renewals, clinical summaries, secure SMS messaging, test results etc. In cases where doctors have been initially reluctant to go for a certified EMR, post training and application of the software feedback has generally been positive. The end result being the provider’s office being more productive and furthermore, greater satisfaction in clinicians and patients alike.


The Meaningful Use Surprises

The final rule for meaningful use stage 2 should be out any day now and while most of care community anxiously awaits the announcement, the industry experts are expecting little to no changes from the proposed rule, released earlier this year. The stage two of meaningful is to build on the stage one objectives ensuring that providers are able to utilize EMR technology in a constructive manner and add value to the care process. The focus of the second stage will be on ‘advanced clinical processes’. Keeping in line with this theme, stage 2 is expected to feature clinical decision support, electronic data sharing and patient engagement as its main components.

Farzad Mostashari, the National Coordinator for Health Information Technology admitted that there could be some surprises in store for providers looking to attest for the meaningful use stage 2 saying, “I think that it would probably come as a little surprise we will pushing on standards based exchange and on patient engagement aspects in addition to continuing really what was in stage 1.”

Health information Exchange seems to be the most significant concern at this point in time. Providers were aghast with the proposed rule and its interoperability requirements, with most admitting that there electronic medical records simply did not possess the capability to comply with stage 2. There was a definite gap between the technology available to providers and what CMS was anticipating. Dr. Mostashari in response to the concerns raised by the medical community expressed that the ONC does listen to the concerns carefully. He explained, “We have been at this for a while now and we have to really balance the needs of the situation against how fast the industry and providers can adapt to change.”

The ONC has also outlined a plan for standardizing health information exchange and will seek to accomplish three major aspects within this year, which includes a common set of rules for governance of HIEs. This also reflects the CMS stance on health information security with the meaningful use stage 2 proposed requirements.

Patient engagement is an important aspect of the healthcare reform. With the government set on introducing a preventive care culture across the nation, health system interoperability will undoubtedly benefit patients by making care more accessible and affordable. The proposed stage 2 rule adds follow-up reminders, patient education and patient access to electronic medical records as core measures. The public response has been positive with patients being allowed to access their own information for downloading and personal use.

While there has been no indication as to whether CMS has relaxed the attestation period from one calendar year to 90 days as suggested by AHA, most providers are hoping for some sort of relief from the authorities. For now it seems that the best bet is to make sure that you retain what you have learned during the first attestation period and go from there.