5 EHR workflow flaws to watch out for

Many US physicians have shifted to Electronic Health Records (EHRs) with others joining them at a rapid pace. However, usability and decrease in efficiency are some of the reasons for physicians’ dissatisfaction with the technology. As a matter of fact, providers need to play a pivotal role in fixing the issues for physicians and making their products more user-friendly.solution

Here are some of the workflow flaws which providers need to iron out in order to improve physician satisfaction through technology.

Unnatural: Most EHRs are built in a way that they do not match practices’ workflow. Instead of allowing physicians to customize the product in a way that it suits their needs, physicians complain that they are required to change their workflows to match technology. This is something that is leading to frustration and inefficiency.

Inconsistent: EHRs are built with a structure that is largely inconsistent. If physicians are looking to access similar information within one system, there may be two or more ways to do it based on which module is being used. This inconsistency is only adding to physicians’ problems.

Irrelevant: One of the most commonly faced problems by physicians is the interface. In most of the modules, only some information is mandatory while the other ones can be skipped. This results in overwhelming screens with aplenty tiny check boxes – sometimes almost unnecessarily.

Unsupportive: Many modern day EHRs fail to support user-shared mental models of workflow. One of the very few benefits of paper-based workflow is that documents and forms can clearly represent a workflow. If something is missing in a chart, it needs to be filled out by the person holding the document. Compare this to EHRs and we find that workflow state is hidden in databases and complex screens.

Inflexible: One of the biggest problems EHR users face is the lack of the software ability to be flexible. Users of the system have to make do with the inbuilt workflow or rely on the way it was installed when being deployed. They cannot easily be changed to become more flexible, natural, consistent and supportive.


The Meaningful Use dropout rate—what does it mean?

The year 2012 saw a huge increase in the users of Electronic Health Record (EHR) systems, but at the same time, the retention rate dropped dramatically from 2011. According to the Centers for Medicare and Medicaid Services’ (CMS) report, in 2011 only 11,578; and in 2012, 9,188 family physicians attested to the Meaningful Use program. It is a huge dropout of around 21 percent drop, in terms of participation.

Has your practice registered for 2013? Hospitals currently participating in the Medicare EHR Incentive Program must complete registration and attestation for fiscal year 2013 according to the Hospital Attestation Deadline of November 30. Will the dropout rate continue this year? Let’s have a look into the factors which led to Meaningful Use dropout rate in 2012; and how your practice can avoid this.meaningful use

It is quite surprising that providers are dropping out because the incentives will continue to decrease in the coming years. Unfortunately, if the trend continues, only a few number of providers would have actually benefitted completely from the EHR incentive program.

It seems physicians need a motivational push to remain committed to the incentive program. Government initiated a campaign through Regional Extension Centers (RECs) in the first year (2011) to get physicians on board. RECs were provided incentives but they were not given any benefit for the next year (2012) to retain the number of registered physicians. As a result, the effort put by RECs were reduced to a sudden burst in the number of family physicians registering for the EHRs, but a negative retention rate of MU participants was witnessed in the next year.

The growing trend to replace the EHR software may very well be one reason of the MU dropout ratio. Providers, who are dissatisfied by their current EHR system, turn to replacing the system and with the latest technology available they can do so, but the implementation process takes time. The provider may well need time to train their staff and get accustomed to the use of the software. This results in missing the important date of registration.

Some physicians must’ve missed the attesting time for 2012 because of the carelessness on their part or simply the fact that information providing organizations like RECs or EHR vendors were not active enough to inform providers on the revenue they will miss upon if they did not attest. It is a mistake on the part of the provider, and failure on the part of the informants.

EHR vendors will be very active this year, because of the negative report. They should make sure this time that modify their software in a way that has efficient MU attestation dates reporting capabilities. A real-time MU reporting tool can help the practice remain on MU incentive track. When providers start relying on software, they expect their software to do everything for them. So, providers should demand such functionality from their vendors to be on track.

But wait CMS has its own plans, too. Drop rate will reduce and retention rate will improve, how? It aims to charge penalties for those providers who are unable to meet MU status by the year 2015. It wants to push forward with MU Stage 3, and for that it wants as many providers as possible on board.


How is e-Prescribing helping practice workflows?

e-Prescribing or Electronic Prescribing is a method through which practices are able to send prescriptions directly to pharmacies from point-of-care in an error-free and understandable format. E-Prescribing has become one of the major features of modern day Electronic Health Record (EHR) systems and is being used by physicians a lot in their daily workflows.

Let’s take a detailed look how ePrescribing is helping physicians improve workflows.erx

  1. Up-to-date drug knowledgebase: e-Prescribing helps physicians have instant, up-to-date drug knowledgebase from which they can select and prescribe drugs to patients easily.
  2. Medication reconciliation: e-Prescribing allows real-time checking of a patient’s current medications to the ones the physician is suggesting. This is done to avoid duplication, omissions, dosing errors or drug interactions.
  3. Complete medication history: With the help of e-Prescribing, complete and accurate medication history of the patient can be retrieved at any time conveniently. This really helps a physician check the drugs which have been administered to the patient throughout his/her life by various physicians.
  4. Age, weight-based dose adjustments: e-Prescribing also helps physicians to adjust doses based on age and weight of the patients thereby largely improving the quality of care delivered.
  5. Dosage calculator: e-Prescribing also helps physicians calculate the exact amount of dosages that are going to be administered to the patients.  This is really useful and eliminates any chances of overdose or otherwise.
  6. Process refill requests: e-Prescribing also connects with patient portals in real time to process refill requests submitted by the patients at all times. In addition, e-Prescribing also helps practices connect with pharmacies in order to send real time requests.

In addition to these, there are many other benefits of e-Prescribing like providing access to prescription benefits, prescription histories, eligibility checks, adverse reactions and recommended dosages, etc which greatly help a practice improve its workflows.


Why EHR and not EMR?

EHR stands for Electronic Health Record while EMR stands for Electronic Medical Record. Both are essentially quite different. EHR has interoperability: the ability to exchange data among different healthcare providers and hospitals across states in real-time, while EMR doesn’t have this ability. EHR are far superior to EMR.why

Some of the advanced functions of an EHR are listed below.

The data shared using an EMR is limited to a healthcare facility. Using EMR, medical information of a patient is gathered, modified, and discussed with providers and staff within a single space. When using EHR that integrates data is shared across healthcare providers. That data is used for consultation among doctors across different healthcare facilities and providers. EHR essentially allows patients and the doctors to remain connected on a larger scale.

EHR and EMR are both electronic records and save usage of paper. EHR saves paper of many facilities who are exchanging data among themselves. EMR on the other hand are reducing their paper usage of a particular facility.

The care provided by EHR goes a long way because clinician’s notes from one hospital can reach another hospital while using EMR it is not possible. EHR, as a result, save providers/hospital costs in terms of reduction of staff members and no travel is required by the provider. This results in higher rate of return in terms of invested amount, time and energy. All the data is exchanged electronically among organizations

The care provided through EHR is significantly larger than the care provided through an EMR as it operates on a larger scale. EHR focuses on complete care of the patient while EMR doesn’t do that. Data available in the EHR is able to travel easily out of facility to provide high level of care to the patient. The sooner you switch to the EHR, the better it is.


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.


EHRs under Fire: Fraud or Increased Accuracy?

Recently, there have been many calls from around the industry that medical coders are using Electronic Health Records (EHRs) software to overstate their collections and as a result, boost their payments. However, the government has taken notice of this and is taking steps to ensure that this does not go on any further. The government is investigating the potential of EHRs to aid in fraud and abuse due to an increased rate of payments to those who have adopted EHR software.

But looking at the other side of the picture presents a different story. The healthcare professionals are of the opinion that EHRs allow them to actually better document their claims and more accurately, thereby increasing the rate of payments.

So who is at fault? Are EHR systems really prone to these loopholes or there is no such grey area? Do EHR systems really increase accuracy of claims filed and improve payments? Someone who is going to adopt the EHR technology might be concerned with both aspects. The fact of the matter is, EHR systems do in fact help physicians document their services more accurately. However, up-coding for the sake of receiving higher payments might be a problem area, but nothing that cannot be controlled.

You must adhere to coding guidelines. In order to minimize your risk of exposure to RAC audits, make sure multiple patient notes do not contain identical text. This will help in having specific information about every patient and will reduce chances of any fraud.

You must educate yourself on the latest HHS coding guidelines in order to have a better understanding of how it is done.

Another important method to avoid any frauds is to conduct regular internal audits by an independent coder to know if there are any grey areas.


The iBlueButton experience – Part II

In terms of usability and simplicity, the iBlueButton is a far cry from its crude predecessors. The information gathered from the conventional Blue Button application is cumbersome to process and often confusing. Therefore, this limited the effectiveness of Blue Button and subsequently proved as a hindrance towards the adoption of this new feature in health IT. Complicated numbers and digits instead of simplistic information put a cap on the true potential on the idea behind the inception of Blue Button. However, through the iBlueButton app the feature is easy to both access and to employ for all. Using the iBlueButton on a mobile device is a totally different experience than that of the traditional Blue Button.

With respect to the resourcefulness of the mobile app Dr Mostashari added, “When I saw my Dad’s information it changed everything. Because for the first time, you hit the provider button, it brings back a list of all his doctors, and their phone numbers and their addresses. I never had that before. Now I can see his medications, diagnoses, ER visits, outpatient visits, procedures, images and labs.”

According to Bettina Expert on, CEO of Humetrix, the iBlueButton is not merely a physician or physician app. It is a mobile communications instrument which links one side of the healthcare equation with the other. Moreover, the iBlueButton grants real-time access to various healthcare resources such as a patient’s essential medical information. With an air of authority Expert on proclaims, “iBlueButton is the mobile embodiment of Blue Button”.  Expert on who is a professor of medicine at the University of California and is invited regularly to the counseling panel on healthcare in the White House also assisted in manufacturing the EHR smart card for the French national health system. As the Apple based application gains traction with the public, Expert on has unveiled that an Android based version of the iBlueButton will be available later this month as well. Additionally, several commercial health plans are going on board with employing Blue Button. This bodes well for Humetrix and the healthcare industry alike.

The amount of information accessible to patients while they are on the go will undoubtedly transform conventional healthcare practices. Instead of calling up various entities, scheduling appointments and waiting in line, one may simply view everything they require on a screen in their pocket while sitting in the comfort of their homes. This rapid access to health information will prove detrimental, especially in emergency situations where every second could be the difference between life and death.  Having the ability to obtain and share medical records at any point of care is the main differentiation from traditional EMRs. The level of convenience to the patients themselves enables them to be more informed and proactive towards personal care as well. Innovation in health IT is finally catching up with our daily lives and providing avenues for continuous improvement in care delivery. Such advances in technology will without question shape the future of healthcare as we know it.