How does EHR help improve workflow

EHR stands for Electronic Health Record and its main feature is interoperability: exchanging, sharing, and making use of patient data in variety of formats to be used by healthcare organizations for better decision making purposes. EHR software improves your workflow, this is an understatement because it not only does that but is able to do a lot more. Let’s have a look.workflow

Providers can schedule their patients by using an EHR by automatically allowing the software to manage the scheduling process or by advance scheduling. By doing so, the patient and the practice is informed through alerts of the patient’s revisit or rescheduling.

EHR have the ability to automate clinical workflow of your practice. It makes the slow process of registering patients for lab tests fast. The arrival of results from labs and its accuracy both are maintained through the software. In case of error by the doctor in interpreting the result, or by lab technician, EHR has the capability of informing the practice through its automated error detection system that a mistake has been made. EHR can precisely read and match information provided through lab reports. It is done through built in ICD codes. It reduces the human-error factor in the interpretation of codes.icd

EHR allows your practices’ workflow to improve by providing management systems that deal in real-time. EHR connects healthcare providers and hospitals, across multiple States to instantaneously connect to patients’ data. It allows providers to remain up-to-date with their patient’s condition as he goes from one healthcare provider to another. This exchange is crucial when providers need update on medication and allergy lists of their patient under consideration from another healthcare provider. It is a step forward in the improvement of your workflow because it integrates information that can be used in decision making at the point-of-care.

ObamaCare is pushing EHR as a much valued software that will change healthcare industry. To be very honest, it will take time. EHR definitely improves your practices’ workflow flow but still a lot of training of doctors all across US is needed. The adoption will take time but when EHR vendors deliver result, providers will want to shift.


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.


EHR – Does certification matter?

As part of the healthcare industry, the providers, health IT consultants and other healthcare bodies are well aware of the CMS funded financial incentives for complying with Meaningful Use requirements in regards to Electronic Health Records (EHRs). More importantly, they are also familiar with the need for EHR certification that would serve as a helping hand in achieving the aforementioned target. So, at the end of the day, it is the Meaningful Use of certified EHRs that would help physicians get their hands on the incentive funds.

Today, with millions of physicians in the U.S, not every physician is comprehensively acquainted with the concept of EHR certification. Many believe that a certified EHR is the one that comes with the seal of Certification Commission of Health and Information Technology (CCHIT). However, it is not the CCHIT’s approval seal that meets the certification criterion for incentive funds. It is the set of minimum standards and that needs to be complied with.  This set includes the review of various functions and parameters like storing patient demographics, security parameters, integration, computerized order entry, information exchange and specialties, etc.

“The biggest dilemma amongst physicians, today, is the failure to understand the concept of Certified EHRs. Be it any industry, certification of a certain product comes by meeting the minimum requirements set by controlling authorities”, says an Ohio based Health IT Consultant.

Considering the financial incentives and benefits that EHRs have brought to the providers, it should not be difficult to think of EHRs as a long term investment. Therefore, before choosing an EHR, it is essential for physicians to make sure that they get their hands on the right product and the right vendor. With more than 700 EHR vendors, almost everyone claims to provide a certified solution. However, it is only until the solution is implemented that the physician is exposed to the realities.

“I can recall several so called “certified EHRs” which have caused disappointments amongst physicians. It is not always a one sided game, where vendors need to be careful while marketing their products. Physicians shouldn’t be negligent either while purchasing the product”, says a Nebraska based Health IT consultant.

Since physicians are the sole beneficiary of CMS incentives, it is their responsibility to make sure that the EHR being implemented is not only certified but also being used meaningfully.


EHRs – Breaking the Constraints

The developmental pace of the health IT industry has been astounding. With numerous innovative products making their way into the market, the healthcare industry is headed for an extreme makeover. Healthcare reforms are the need of the hour considering the current economic crisis of the country, as they aim to bring affordable and quality care to every household in the US. The first step has obviously been the promotion of electronic health records. Serving as a cornerstone of healthcare reforms, EHRs will eliminate paper based medical trails while increasing efficiency through clinical decision support and electronic data interchange.

While EHRs have existed for a while now, their objective is significantly different from what it was two decades ago. Created only as a digital repository, EHRs had minimal functionality. Defining features were limited to input control and basic reporting. Today, the EHR is defined by its data mining capabilities. With the healthcare industry focused on population health management, the importance of ‘big data’ utilization is now more than ever.

Keith Smith, a health IT consultant explains that electronic health records (read more) are the platform for change in healthcare, “We are talking about re-inventing the system, introducing performance incentives for physicians and inducing a culture of accountability. We are talking about coordinated care and patient connectivity. We are talking about better care, lesser mistakes, population health and affordable care. To truly be able to transform to such an extent we must digitize healthcare. We must improve information accessibility and enable connectivity. We must move to EHRs.”

The idea is to remove the constraints of paper based system and enable better communication amongst healthcare professionals. Care quality is often determined by the information available to the attending physician. “There have been countless examples whereby physicians had to treat patients in emergency with little or no information, jeopardizing both the patient’s health and their own professional careers. It is a shame we have to go through these dilemmas in the 21st century,” explains a retiring physician from New Jersey. EHRs are designed to bridge this gap in healthcare by creating self sustainable digital health records, accessible to patients and providers across the care continuum.


Why Physicians Prefer to Choose their own EMR?

Most physicians customarily like to associate themselves with multiple practices or hospitals. In today’s competitive environment, reimbursements are meager and costs are high. This compels most physicians to seek additional hours at hospitals or establish their own private practices. Keeping pace with the ever evolving healthcare industry is also an arduous task. With healthcare moving towards automated care, physicians must adapt accordingly or risk being left behind. While the recent report from CDC shows an improved EMR adoption rate for single providers, smaller practices are still playing catch up.

“It is not that physicians have not been exposed to the technology. Most physicians have access to electronic medical records at hospitals if not at their private practices.”, says Keith Smith, a health IT consultant. He believes that the gradual increase in EMR adoption will undoubtedly influence physicians across the nation. Keith further adds that, “Physicians are usually very sociable. If all of their friends are using electronic medical records, then they would want to use it too.”

This is one reason why most physicians tend to choose EMR solutions popular amongst their peers and colleagues. That being said, physicians tend to avoid electronic medical records being used at hospitals that they are affiliated with, while purchasing an EMR for their private practices. This may seem unusual given their level of familiarity with such systems, but hospital based EMRs are often designed to conform with generic requirements, whereas physicians prefer choosing an EMR that can provide for their individual practice workflows.

Another reason may be that most hospital based EMRs are configured to operate in a specific environment. Hospitals have more resources at their disposal compared to a private practice. Hence, while a large health organization might be able to derive efficient workflows from implementing an EHR solution, the outcomes may not be the same for a smaller practice. Therefore, unless a physician has other factors to accommodate, they would refrain from choosing hospital based systems.

“Every practice has their own unique identity and their workflows should be able to reflect that. This is why practitioners seek customizable EHRs that fit their practice structure and requirements.”, says a Florida based practice office manager.


Who is Getting the EMR Incentives?

The Government Accountability Office (GAO) recently released a report on last year’s EMR adoption statistics titled Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011. The report looks into the first successful year of Medicare payments for EMR adoption and meaningful use.

GAO explains that the idea was to gauge diverse reactions to provisions under the Health Information Technology for Economic and Clinical Health (HITECH) Act. There were several factors such as practice location (rural or urban) or the practice size which had an influence. The report also illustrates the sort of providers which would most likely participate or receive incentives in the future.

According to the report, 761 hospitals representing 16% of the total number of eligible hospitals along with 56,585 medical providers representing 9% of the total for eligible professionals were able to receive a total of $2.3 billion in Medicare EMR incentive payments.

The hospitals shared nearly $1.3 billion from the total payment disbursed by CMS, with the south receiving the highest proportion at 44% and the northeast accumulating a total of 12% as the lowest. However, it is pertinent to note that nearly 86% of the total hospitals receiving EMR incentives were acute care hospitals. The report also found acute care hospitals to most likely receive Medicare payments than other hospitals.

Similarly, about 67% of the hospitals that received EMR incentives successfully were located in urbanized locations. The other key factor in determining the share was the hospital size (determined by the number of beds), and nearly 46% of the hospitals that received the incentive payments were represented by the top third segment in terms bed numbers.

The 56,585 eligible professionals shared a total of $967 million in between them. With the largest proportion again represented by the south of the country with 32%, while the west received the lowest at 17%. General practice physicians were 1.8% more likely to receive the EMR incentives when compared to specialty doctors.

A significant proportion of physicians who received their EMR incentives were located in urbanized locations. It was also highlighted that professionals who had earlier participated in the prescribing program were 4 times more likely to successfully attest and receive their incentive monies than those who did not. GAO also reported that physicians collaborating with Regional Extension Centers were 2 times more likely to receive the incentive payments.

Read more: EMR – The Red Pill or the Blue Pill


EMR – Bespoke Vs Off The Shelf

The recent surge in health IT has helped several innovative companies proliferate the healthcare market. Healthcare in the US has traditionally lagged behind other industries in terms information digitization, but the government’s backing has lead to the rapid growth of health IT with CDC reporting an overall EMR adoption of 55% with the country.

While electronic medical records have existed for a long time, it was not until late 1990s that vendors began to produce commercialized solutions. Some hospitals at that time had already been using bespoke EMRs, that were specifically designed for their requirements. With limited information exchange at the time, these bespoke systems worked through intra office networks utilizing standard security protocols. Health Insurance Portability and Accountability Act (HIPPA) was introduced in 1996 anticipating growth of health information exchange.

Today providers have a choice between 800 EMR vendors providing a range of specialist products. EMRs have come a long way. Working closing with the early adopters, EMR vendors were able to focus on usability leading to the development of interactive solutions. However, with bespoke EMRs there was no standardization and interoperability was always an issue. The government attempted to sort this out through the meaningful use (MU) campaign, highlighting effective methods of EMR utilization.

While Health IT had already started to gain momentum by that time, the government’s support under the American Re-investment and Recovery Act brought a host of IT vendors to the healthcare industry. With the basic functionality outlined in the MU program, vendors had a base to build upon. More license based applications started making their way into the market. This trend also instigated a change in deployment models, as cloud and web-based models quickly began capturing significant market shares.

The license based products were more cost effective than their predecessors. Deployment time was quicker and there was a marked improvement in functionality while they lacked the extensive flexibility of bespoke systems. Bespoke design is in accordance with the organizational model, hence increases its competitive advantage.

However, since the application is uniquely configured, the organization’s reliance on the vendor increases significantly as well. Bugs and errors are a common place for bespoke software as testing is limited. Modifications and upgrades are expensive while development takes time and requires significant resources. Lastly, bespoke vendors usually don’t provide support services and practices have to employ technicians privately in most cases.

These hassles are greatly reduced by purchasing licensed software. Training manuals and support is readily available while extensive testing, modification and live runs reduce the chances of unexpected errors. In the world of health IT, established EHR vendors were quick to gauge the discrepancies in workflows. Application rigidity was a discouraging aspect for most providers, hence established EHR vendors allowed basic customization to increase flexibility.

“Off the shelf electronic medical records are less of a hassle. Most physicians today are more tech savvy. I myself use a tablet for most tasks. I think it’s more about getting a good vendor with reliable support and decent functionality. Everyone would like a custom-made EMR but simply cannot afford it. More importantly, we just don’t have the time.”, says one physician.

While there are advantages and disadvantages of both types of EMR systems, the size of the enterprise is the key factor in determining product selection. However, there are plenty of good off the shelf EMRs to choose from today. All you need is to find the right fit for your practice.