EMRs – Specialty Conundrum

A specialty EMR versus a generic electronic medical records solution is the hot new debate in the health IT community. To get to a reasonable conclusion, we first need to understand what specialty EMRs actually are. Any EMR which is tailored to meet the exclusive requirements of a specific medical specialty is regarded as a “specialty EMR”. A specialty solution differs from a generic one in a number of ways. It comprises a rigid tool-set to accommodate the unique workflow of specialists like dermatologists, cardiologists and ophthalmologists etc. As a result once they are utilized, specialty EMR systems are more flexible to the immediate requisites of a specialist clinician than a generic system.

Conventionally, vendors have developed their solutions to handle the clinical workflow of a general or family practitioner, rather than that of a specialist. Naturally, such systems will lack the intricacy necessary to function with medical specialties. When one ponders the matter, the inevitable conclusion reached is to have a unique system design, that caters to the specialty specific requirements of each clinician. When EMR data templates and components are designed specifically for each specialty, providers are able to accomplish one of the main causes of implementation: expedition of clinical documentation. Therefore, general practitioners often do not need to search for an EMR that can accommodate their specific requirements and prefer to use the most affordable EMR with basic functionality. However, the rapid surge in EMR adoption has meant that clinicians are now more demanding, with hundreds of different vendors trying to beat competition with advanced features related to various specialties.

One of the advantages of a ready to use generic EMR is the limited implementation lifecycle, when compared with the amount of time and input required to implement a specialty EMR. However, implementation is merely the start of the journey and we notice a complete contrast once the clinician actually starts using their system. Clinicians using a specialized system have a smooth transition, as the new solution accommodates their existing workflows and questionnaires without much customization. However, providers choosing an off the shelf EMR system often need to maintain their existing paper based documentation methods, as their generic system lacks the tool-set required to manage their existing intricate documentation.

Many EMR analysts and implementation specialists have identified the lack of specialty components as the main cause of EMR implementation failure. A dermatologist may need high resolution images of the patient’s body in order to elaborate the extent of their clinical assessment, whereas a obstetricians would need to analysis and overview of patient’s pregnancy lifecycle. Each of these specialists would need the right tool-set to accommodate the relevant information, hence selecting an EMR with a mere capability of recording textual information would result in duplication of data entry and workflow. In the examples above, both cases would require a different set of panels to display the clinical findings along with the corresponding ICD/CPT codes. This feature of identifying the relevant ICD/CPT codes and recommending the right clinical procedure is inherent to specialty EMR(s).

Keeping the end goal of enhanced clinical care and expedition of clinical workflows in perspective, an electronic medical records solution tailored to a particular specialty proves to be more effective and subsequently more practical. Statistics show that roughly fifty percent of the clinician population across the nation has already implemented electronic medical records on some level. After having the bitter experience of an off the shelf EMR, many physicians are now turning to specialty based systems. EMR vendors now need to heed to the huge gap that exists in the market and become more sensitive to the needs of their customers.


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The Importance of EMR Training

I often wondered why physicians spend thousands of dollars on purchasing electronic health records (EHR)? When I discussed this with an EMR analyst, I finally got my answer. Simply put, they purchase these systems in the hope of reducing costs, increasing efficiency and enhancing the quality of healthcare delivery. However, in order to achieve that, it is extremely important for physicians to be properly trained on the functionality of their EMRs.

“Many physicians do not achieve the optimum results from EHRs because of the lack of expert training”, according to a New York based Cardiologist.

Physicians should be provided expert training on a regular basis to assess their clinical workflows and specialty specific requirements. This would help in enhancing the clinical, administrative and financial efficiency of their medical practice. Unfortunately, extensive training is often overlooked as EMR vendors and providers just focus on the basics, given the cost and time associated with this exercise.

The fundamental problem with EMR trainers is the expectation that physicians and other practice users have prior knowledge and basic understanding of computer systems. This results in an overload of information for physicians during their training. Ideally, rather than burdening physicians with comprehensive EHR training in a single go, the trainers should being with basic features and navigation of the solution before progressing towards in-depth technical knowledge. According to a recent study, a slow and steady approach for training leads to enhanced efficiency of a practice, and provides physicians with more time to attend their patients.

Another important factor is the difference in the learning capabilities of individual users. It is pertinent to understand that although some care providers might learn certain techniques in just a few hours of training, others may need much more time. Today, a few established EMR vendors have a dedicated team of trainers for their clients. These trainers are well versed with the inherent difficulties during training because of the varying backgrounds of each individual.

On top of that, EMRs can be conformed to suit the unique workflow of each physician. EMR vendors have now started to focus on the development of specialty specific EMR solutions for this very reason, and the fact that it helps reduce the amount of training required. With many physicians still uncertain about the Meaningful Use requirements, EMR training should be more focused towards the assessment of every user along with a simplified approach towards Meaningful Use compliance. Training is an integral part of the implementation of any EMR system and must be given utmost attention by vendors and providers alike.


Specialty EMR – Is it the future?

Over the past few years we witnessed lots of developments in the healthcare industry. Although EMRs have been around for as long as 40 years, but it was not until a decade ago that EMR adoption finally gained some momentum. Although the previous administration started laying the foundation for EHR adoption, President Obama made the drizzle into a torrid that swept the medical community off its feet! With the introduction of the American Recovery and Re-investment Act (ARRA) and the CMS incentives; providers, vendors and investors all jumped on the bandwagon of Electronic Medical Records.

However as they say partying hard makes your crash harder; providers started to realize the problem with going all in; although EMRs had come a long way both in features and usability, complete shift from paper to the detailed functionality of a modern EHR is quite overwhelming. Though established vendors realizing the situation did act to provide bewildered practitioners with somewhat customizable templates, a lot still felt hapless as they forcefully tried to shape their practice to adapt to its EMR or “the way of the EMR”.

However dark clouds must part! In this evolutionary age of technology and opportunity, vendors began to develop specialty EHRs; more advanced and focused templates to provide specialists with the right tools the very least. Specialty EMR’s provided much relief to specialist groups such as dermatologists (early targets) providing advanced specialty templates to allow quicker information entry and workflow, customization to enforce best practice guide lines and pre-defined data captures.

Specialty focused EMR has definitely helped in making workflow more targeted to everyday tasks and there yet be more to come as vendors continue to develop advanced applications to remain competitive in this cut throat market.