What exactly is involved in the certification process as defined by the Office of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program (which as of now is a voluntary certification program designed for health IT standards, implementation specifications and certification criteria)? Today, that includes: • Regulations – the ONC issues regulations […]
A new article series presented by CTS, a publisher of medical software reviews and evaluation tools, explores some of the significant medical practice management challenges related to EMR / EHR software. Written by medical software expert and CTS President, Sheldon Needle, the series sheds light on problems associated with managing patient data electronically and how physicians and other healthcare professionals can avoid common technology traps
Electronic health record systems are becoming increasingly popular in Asia-Pacific as the region’s healthcare industry moves towards digitization.
As part of my ongoing writing about what people are starting to call the EHR Backlash , I started to think about the shifting tides of EMR documentation. One of the strongest parts of the EHR backlash from doctors surrounds the convoluted documentation that an EMR creates. There is no end to the doctors who are tired of getting a stack of EMR documentation where 2 lines in the middle mean anything to them. Related to this is the physician backlash to “having to do SOOOO many clicks.” (emphasis theirs) I still love the analogy of EHR clicks compared to playing a piano , but unfortunately EHR vendors haven’t done a good job solving the two things described in that article: fast predictable response and training. With so many doctors dissatisfied with all the clicking, I predict we’re going to see a shift of documentation requirements that are going to need a full keyboard as many doctors do away with the point and click craziness that makes up many doctors lives. Sure, transcription and voice recognition can play a role for many doctors and scribes or similar documentation methods will have their place, but I don’t see them taking over the documentation. The next generation of doctors type quickly and won’t have any problem typing their notes just like I don’t have any issue typing this blog post. As I think about the need for the keyboard, it makes me think about the various point of care computing options out there. I really don’t see a virtual keyboard on a tablet ever becoming a regular typing instrument. At CES I saw a projected keyboard screen that was pretty cool, but still had a lot of development to go. This makes sense why the COWs that I saw demoed at HIMSS are so popular and likely will be for a long time to come. Even if you subscribe to the scribe or other data input method, I still think most of that documentation is going to need to be available at the point of care. I’ve seen first hand the difference of having a full keyboard documentation tool in the room with you versus charting in some other location. There’s just so much efficiency lost when you’re not able to document in the EMR at the point of care. I expect that as EMR documentation options change, the need to have EMR documentation at the point of care is going to become even more important. Related Posts Transcriptions Becoming Medical Documentation Specialists EMR Documentation by Exception or Veracity Complaints of EMR Documentation Aren’t Completely the EMR Vendors’ Fault
HIMSS Analytics, a division of the Healthcare Information and Management Systems Society (HIMSS), has announced that 54 Essentia Health ambulatory clinics, located in Minnesota, North Dakota and Wisconsin, have reached Stage 7 on the Ambulatory EMR Adoption Model (A-EMRAM).
In the emerging consumer-centered, value-driven U.S. healthcare marketplace, the EHR vendors that survive and thrive will need to differentiate their brand by successfully competing on the value (quality/price) their product actually delivers to its end users. – Bob Coi, MD This is a fascinating look at EMRs and future differentiation in the EHR market. There’s little doubt we could use some EMR differentiation with so many EMR companies still out there. I’m just not sure that the quality of care that an EMR provides is going to be why a doctor selects one EMR over another EMR. Every doctor I know wants to provide great care to their patients. Every patient I know wants to go to the doctor who provides them the best care. The problem is that most doctors don’t see a direct correlation between EMR use and the quality of care given. Patients don’t either, and the other challenge is that patients have no way to measure the quality of care they’re given anyway. The closest we come to knowing if the doctor provided quality care is that as a patient I know I’m sick and then I get better. I guess if I got better, then the doctor must have provided me quality care. With this said, I think there’s the possibility that an EMR discovers a way to clearly show that something they do improves the care of the patient. The incremental document management and simple alert notifications that we see from EMR’s today won’t show that clear improvement in care. No, we have to think much bigger to clearly show that the care provided was better because of the EMR and that the improved care wouldn’t have been possible without the EMR. An example of this would be integrating genomic data into the care provided. What if genomic data influenced which drugs you prescribed so that the drug was perfectly tailored to the patient? This is a great example where it would literally improve the care you provide a patient and it would be impossible without the technology to do the analysis. Assuming this technology was integrated with the EMR, it would be impossible for doctors not to use the EMR. This is just one example. I’m sure creative entrepreneurs will come up with many more. Showing that EMR improves quality of care is a really high barrier. Plus, changing physicians perceptions on EMR is going to be really hard even if an EMR system does indeed improve the quality of care. Some company will do it and then Dr. Coi will be right that an EMR’s quality metrics will differentiate it from other EMR companies. Related posts: EMR Quality Metrics New Ways Of Leveraging EMRs For Quality Measurement EMR Vanity Metrics
Right now, it’s legal for hospitals to give doctors EMRs under certain circumstances, despite the existence of the Stark law banning payments intended to induce referrals. Specifically, hospitals won’t face anti-kickback enforcement if doctors pay 15 percent of the cost of EMRs donated by hospitals. But the Stark law exception established by CMS, plus a “safe harbor” rule established by the HHS Office of the Inspector General, are both due to expire at the end of 2013. This will take place despite the fact that Medicare incentives for EMR adoption will continue through 2016, notes iHealthBeat. Hoping to address this state of affairs, the Federation of American Hospitals has made the renewal of EMR exceptions to the Stark law its top recommendation in a proposed list of safe harbors, reports Modern Healthcare. More recently, Rep. Jim McDermott (D-Wash.) wrote a letter to the chief counsel to HHS’ OIG to extend those exceptions soon. Extending these safe harbor provisions at least through the life of the Meaningful Use program seems necessary and wise. After all, it’s hard enough to get smaller practices up on EMRs even with the promise of incentives. Letting hospitals pay for most of the cost of the system would meet the public policy objectives which prompted the creation of HITECH in the first place. According to Modern Healthcare , the federal Office of Management and Budget is reviewing proposed rules regarding the Stark exception and the anti-kickback safe harbor. Let’s hope they’re finalized in time to solve the problem. Related posts: EHR and Tax-Exempt Hospitals EMR Voice Recognition, EMR As Medical Devices, ACOs and HIEs, Top 100 Hospitals, and MU Stage 1 Money Hospitals Use EMR Data To Target Marketing Campaigns
We at EMR and HIPAA have been hearing a lot from our readers that there’s been some confusion with the EMR and HIPAA brand. Many readers are really confused by what we provide here on EMR and HIPAA and what to expect when they visit the website. For those who don’t know the history, I did the first EMR and HIPAA blog post back on December 11, 2005. I love how I didn’t even post my name, but instead put the name “EMR BLOG” as the writer. Just reading the post makes me a bit sheepish as I think about how naive I was at the time, but I digress. Seven years and 1659 EMR and HIPAA blogs later , a lot has changed with EMR and HIPAA. Healthcare IT is a new world and it seemed right for EMR and HIPAA to embrace change as well. Let’s start with EMR. I still love the term EMR since spell check doesn’t autocorrect it. However, $36 billion of government money says that it should be called EHR. Plus, the EHR fanatics out there have been on my case for a long time when I talk about EMR instead of EHR. No more. From now on, EMR will no longer exist as we embrace EHR. What about HIPAA? Yes, for most healthcare providers HIPAA is a curse word to them. Just hearing it makes them cringe. Why would I want to host a site that makes my beloved doctors cringe? Plus, HIPAA is now changed thanks to the new Omnibus rule. We’re ready to embrace change as well, so from now on HIPAA will be referred to as Omnibus. Who doesn’t like Omnibus? Omni means all. Bus reminds me of a party bus in Las Vegas. I think everyone can embrace a party bus where all are welcome. There you have it. We’re now going to officially be called: EHR and Omnibus Has a nice ring to it doesn’t it? I hope you like the new branding and appreciate the clarity it provides. Happy April 1st! Related posts: HIPAA Omnibus – What Should You Know? The Final HIPAA Omnibus Rule: A Sharing of Accountability A Lot to Be Thankful For at EMR and HIPAA
While it's laudable for hospitals today to be “all electronic” and meeting the advanced stages of electronic adoption in HIMSS' EMR adoption model –the highest levels of EHR use… read more