Do You Need a New EHR System

Why would you need a new EHR system? The question arises because of certain reasons; one possible reason could be your continued dissatisfaction with your current EHR system/vendor. The other and as good a reason as the first one is, your current EHR vendor isn’t providing the package you need.curemd

EHR vendors have increased manifold in the past couple of years. This happened because of the initiative taken by President Obama to introduce Obamacare: a program to encourage healthcare uninsured people to register for insurance plans to improve healthcare system and to promote providers to use electronic health recoding technology.

Meaningful Use standards:  Your software should meet the criteria in Meaningful Use. You may need to replace your system because your vendor may not be compliant with Meaningful Use standards. The framework is arduous to remember and the only thing you are relying on is your software, so buy a system that is up-to-date with Meaningful Use compliances.

Fast Processor: Do you want slow, clunky, and choppy software that slows down your system? The answer should be a big NO! So, what you need to is a big RESEARCH! But you can obviously hire a consultant that will do the job for you. Always remember you are choosing the EHR system that does work for you, that smoothes out the work flow of your business, whether clinical or operational. Try few software before buying one, free demos are your best option. Ultimately, choose a one that you feel intuitive. Salesman is always there to draw you in the software, take your time, don’t rush into buying anything. You need a fast system that produces results or does what you ask the machine to do. Too many clicks and still you are stuck on step one, is no good. The basic functions should be fast and efficient to perform.

Final advice: choose EHR vendor that has a strong financial backing. It will give you some surety that the company will be responsible for their actions, and in case of loss will compensate for the loss. And do try out those new Mobile EHR apps that may serve your purpose and may end up choosing Mobile EHR that is iPad-compliant!


US Healthcare System – The Problems Within

Ever since the inception of Electronic Health Records (EHR), we have been hearing the slogans of quality care and improved healthcare system. But the question is that despite spending a large chunk of our federal reserve on healthcare system, why is it difficult to point out prolific outcomes?

This is a clear indication that something is wrong with the US healthcare system. There are various reasons that could be attributed to the failure of healthcare system, let’s divulge into the details of some of the reasons.

One of the major factors obstructing the improvement in healthcare system is the excessive use of paper. This has not only resulted in increasing cost but also led to the loss of patient records. According to reports, as a result of patient information loss, 30% of the patient records have to be rerecorded annually. However, as the number of providers adopting electronic health records would augment, the probability of such occurrences would surely decrease.

This reminds me of an article that I recently read. It explicitly talked about the increased healthcare costs and how difficult it has become for the citizens to afford quality healthcare in the U.S. Well, I couldn’t agree less. No doubt, overtime, through research and development we have come to make revolutionary advances in medical sciences, nevertheless, the expensive nature of these treatments has discouraged citizens from making the most of them.

Another culprit in the continuum is the insurance companies. The concept of co-pays has given insurance companies an opportunity to design policies that would cover a handful amount of charges and throw the remaining financial burden to the citizen. Moreover, in this chain of deteriorating factors, it would be biased to ignore the role of our eating habits. Yes, it is the fast food that I am referring too. Just because it is readily available and cheap, the amount of fast food consumption has been increasing like anything. The eventual results are increasing rate of heart diseases and cholesterol issues amongst citizens.

While the EHR adversaries consider this technology to be a helping hand in deteriorating healthcare situation, being an advocate of Health IT, not elaborating the advantages would be unjustified at my end. Besides facilitating physicians with digitized patient information, EHRs also have the potential to improve the quality of care delivery with the help of built-in preventive care mechanisms and data mining techniques. The former can automatically check for any drug to drug interaction or allergy – eventually enhancing patient safety. Once considered a time consuming and costly technology, the advent of cloud EHRs has made it affordable as well as adaptable for physicians to implement the solutions.

While it is impossible to put an end to the conventional, we spend more on military expenditure than on healthcare, debate. It is more important for us and well as the government to realize that the problems exist and finding a plausible solution is the need of the hour.

Read more: The Physician’s Guide to Patient Portals: Don’t Waste Time, And Get Your Portal Online


EMR – The Word on Street – Part 1

I have always enjoyed discussing state of healthcare and its affairs with physicians, EMR consultants, health IT gurus and basically anyone with professional knowledge that cares to throw a bone. However, recently I got engaged in a friendly debate with a group of friends, unrelated to the world of healthcare. It was fascinating to learn their views on the healthcare reform along with the turn towards EMRs and electronic information exchange. There is much to share, hence I have decided to write a series of blogs regarding just this. In this post I will be covering exam room encounters and the general perspective of non-medical professionals about the world of health IT and Electronic Medical Records.

As a patient, your view about the healthcare reform is simple, ‘computers are better at storing information, less prone to human errors and help save time, which is why electronic medical records are important’. I had to educate some members of the group to extract their opinions about the subject matter, but nonetheless it was a unique experience and I thoroughly enjoyed the feedback from people outside the care structure.

Most of the participants had not yet encountered a physician using an EMR within the exam room, while the few who had done so found the interaction quite satisfactory. I understand that my sample data is limited, but it was enlightening nonetheless to understand some of the concerns a patient might have. This is how one participant described his encounter, “It was fine. I could see the screen so I knew what the doctor was doing. It did take him a few seconds to type, but the encounter seemed really structured as if he had prepared a set of questions beforehand.”

Physicians are quickly improving exam room technique and ethics while documenting on the EMR. I myself have experienced that change. Sharing the screen with the patient and educating them simultaneously can add to the patient’s experience. While I may not have enough information to determine whether or not electronic medical records are making patient encounters more structured, the group of patients that I met, seemed to think that they have. It is also true that most physicians like to maintain an air of professionalism in the exam room, which sometimes results in robotic encounters. Although, with that said, structure and standard of procedure is not a bad thing in medicine.

After explaining the basics of the clinical decision support (CDC) system in an EMR, I invited some questions from the group. Most of the participants seemed content with the structure, admitting that the EMR system (read more) will enable physicians to make more informed decisions. One group member expressed his relief, confessing that he would still prefer physicians to have the ultimate control over clinical decisions as he was not ready to leave his health to computers. There is a good feel about the healthcare reform and although most individuals are unaware of how it affects them, the government’s backing of health IT adoption has provided reassurance to the general populous.


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.


EMR Adoption and Health Information Exchange

The last few years have been monumental for health. Electronic medical records have flooded into the mainstream with a recent report from Center for Disease Control (CDC) suggesting that nearly 55% of physicians in the US are at some stage of adoption. The survey also indicated that most respondents felt that EMRs had improved the overall quality of care. Industry analysts view this as a huge achievement for the healthcare industry and a giant leap towards the reformation process. One industry expert says, “The EMR has the numbers now. With more than half of the physician populous already using electronic medical records, physicians still using paper will have to join in or risk becoming obsolete.”

The U.S has been quick to utilize emerging technology in healthcare and with EMR adoption on the rise, physicians are likely to respond positively to innovation. “Our objective is connecting care and to reach this goal, we require an electronic health information exchange platform. EMRs provide just that”, says a hospital administrator.

John Lynn from shared a similar opinion in his blog. He believes that most of the healthcare community is aware of the benefits of Health Information Exchange (HIE). John argues that while standardization and development costs are two main barriers, the scale of EMR adoption in the country may be the biggest impediment to growth in the sector, he writes, “We want HIE’s to be successful, but can an HIE be really successful for doctors and hospitals that don’t have an EHR? The lack of EHR adoption might be the biggest impediment to HIE.”

The transformation of the healthcare system hinges on the success of electronic medical records. Having realized the importance of EMR adoption, the government extended its support through Regional Extension Centers and other educational communities in various states. The ONC highlighted the need for outreach programs targeting the rural and underdeveloped areas. While cost is a major deterrent here, education and exposure are the other key constraints.

The CDC survey also listed solo providers as the laggards in the adoption cycle, with only 30% reporting for adoption. However, the outlook is not so bleak. An industry expert highlighted that it’s common for independent businesses to lag behind in industrial changes, saying, “The adoption may be slower for independent doctor offices but it would change in the long run. Physicians are likely to follow large health corporations and hospitals in adoption. In fact there is an increasing trend of independent doctors adopting EMR systems with an HIE interface with their local hospital.”

HIEs are a step in the right direction and should help reduce cost in the long run. The communication process will simplify and health organizations will be able improve the patient care process through coordination. EMR adoption will continue to be the top priority and the government remains optimistic as it aims to shift America to electronic medical records by the end of 2014.

Read more: Data migration: Why is it important in Healthcare?


The Value of EMR Data Mining

We live in a world that is driven by information and technology. The advent of internet has changed the schematics for information dissemination and it has made information more accessible. Hence, people are now more informed and there is a level of transparency. However, while the free world may be more susceptible to change, the healthcare industry has to crawl slowly under the weight of regulations, controls and certifications. It is not easy to bring about change. After all, healthcare has always been more of a reactive industry, struggling with the pressure of performance and budgeting. However, in the last few years the health IT industry has amassed trillions. The EMR adoption rates have doubled over the last couple of years while stock for mobile health has skyrocketed, luring venture capitalists from all over the world.

It would not be wrong to deduce that within in the world of information technology, health IT is aiming for the summit. Dr. Barry Chaiken from DocsNetwork recognizes this as a digital age. He believes that by using technology, information can be captured at every point and stored for later use. Using connected medical devices along with interoperable EMR systems, the process can be simplified to a great extent. Dr. Chaiken explains that while the data generated this way is a byproduct of other activities, it carries more value for medical research and development purposes. However, Dr. Chaiken also states that while data collection is becoming more expansive and granular, the utilization is still poor in most cases.

The data mining capability of EMRs can help physicians create useful data for analysis. “It is one of the key benefits. The healthcare industry has a lot to gain from data mining. By collecting and utilizing systematic data effectively, healthcare organizations can become more efficient as this opens them up for further business opportunities.”, says a health IT expert.

However, the benefits of effective data utilization are not limited to health economics. Dr. Chaiken believes that this will promote Accountable Care Organizations and help them derive more value. He said, “Only through innovative analytical techniques will we be able to truly leverage the healthcare data collected and improve the way we deliver care.”

A nationwide healthcare network will allow organizations to play a more active role in the community. Information exchange will accelerate response times and improve clinical learning across the nation. Centers for Disease Control (CDC) can benefit from the systematic data pooling which will allow them to track diseases and outbreaks better. When looking at health IT and electronic medical records, the possibilities are endless. However, effective utilization of valuable information remains a challenge.

Read more: Supporting Your EHR Post Go-Live Stage – Challenges and How to Overcome Them


The Misconceptions About EMR Based Documentation

When considering office based practices, there is much dispute regarding the ability of EMRs to add to practice productivity. Where large hospitals and medical groups have been successful in driving improved outcomes, small practices have struggled to develop consistency. This disparity can be attributed to the limitation of resources in case of smaller practices.

Documenting patient encounters electronically or otherwise is often regarded as a killjoy in the medical profession. However, physicians recognize its importance in providing better care. EMRs are largely promoted as a quality assurance check, with their built in clinical decision support systems allowing physicians to work more fluidly. In practice though, most providers end up reporting productivity losses in the year of implementation. Vendors will be quick to suggest a learning curve for effective use and while this carries weight, the general provider consensus regarding electronic documentation is that “it’s just not efficient enough.”

A health IT expert explains why physicians and other medical professionals find it exhausting to document electronically, “It’s the perception. Physicians expect automation to relieve them of their documentation responsibility.” He adds “when they are comparing, they use the time it takes to compose a self written paper note with the time it takes for them to document it electronically.”

When introduced EMR documentation merely provided physicians a platform to input and store information. However, technology has brought these solutions to a much more advanced level. Template based documentation has become a norm for majority of the vendors today. A number of these vendors offer intuitively designed templates that allow physicians to customize their clinical workflow and documentation, based on their preferences. Templates can be pre-configured to allow physicians to document similar cases by tweaking just a few items from previously recorded notes.

One physician talks about the overall impact of EMRs on the practice workflow. “There are improvements in workflow transition which has decreased the collective effort. Information is more transparent which ensures that we are on the same page.” He added, “Our billing has also improved tremendously and my biller goes home on time.”

Paper based documentation is no longer relevant in a rapidly evolving healthcare industry. The emergence of Accountable Care Organizations along with the need for accessibility and interoperability has made EMR based documentation a necessity to pave the way for quality care.

Read more: 9 Steps to Successful EHR Implementation