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Clinicians who deal with the unique needs of transgender patients should use electronic health records differently than they do for non-transgendered patients, according to a recent perspective piece by the World Professional Association for Transgender Health (WPATH) EHR Workgroup published in the  Journal of the American Medical Informatics Association . read more

Over the weekend while working in the orchard, I found a small garter snake trying to eat an enormous toad, pictured above. Did the toad not realize that by wriggling its feet, it could easily escape? Was the toad unaware of the impending threat? Might the toad have given up and thought that the end […]

It’s time for the next installment in my series of posts looking at the long list of EHR benefits . Eliminate Staff The idea of eliminating staff is a really hard one to talk about. Often the staff in a medical office becomes a family and so it’s really hard to think about losing a staff member in order to pay for the EMR. In fact, it’s incredibly common for staff in a clinic to fear an EMR implementation because they’re afraid that their job is in jeopardy. From my experience, it’s incredibly rare for any existing staff to lose their job during an EMR implementation. There are two main reasons why it’s unlikely that someone will lose their job because of an EMR implementation. The first is that most healthcare organizations have a natural employee attrition. When this happens the organization can just choose to not replace the departing employee. This is one way to save money on staff without having to actually fire any employees. The second reason that people don’t lose their job to the EMR is that those people get reassigned to new jobs. For some people this can be nearly as bad as losing a job, but for many it’s basically a shift in job responsibilities. This shift can often be welcome since the EMR implementation can free them up to do work that they always wanted to do and never were able to do before. The areas of healthcare that I’ve seen most affected by an EMR implementation is medical records, transcription, billing, and the front desk. We’ve already written previously about transcription and EMR . The front desk and billing can be affected, but generally stays close to the same from what I’ve seen. A lot of this depends a lot on what type of staffing you had before the EMR. I have seen some organizations implement an EMR and save money on front desk and billing staff. Medical records (or HIM if you prefer) is usually the most impacted. Certainly they still have an important place in the office for things like release of records and other records management functions. They also have to continue to deal with the legacy paper charts. However, their days of finding, organizing and filing charts are over when an EMR is put in place. In some cases the chart organizing and finding gets replaced with things like scanning into the EMR. In other cases, there isn’t as many medical records staff needed. Many who are reading this post are probably balking at the idea of eliminating staff being a benefit of an EMR implementation. They’d no doubt point to the EHR backlash that we see from many doctors who complain that an EMR makes them much slower and takes up too much time. This is an important item to consider when evaluating the benefits of an EMR in your organization. It’s not much of a benefit to save other staff cost if the doctor spends twice as much time per patient. However, on the other side of the coin is those doctors who swear by the efficiency their EMR provides them. I’ll never forget this older OB/GYN I met who told me he would NEVER use an EMR. Two years later that same OB/GYN was proclaiming his love of EMR. He described how he wouldn’t be able to see nearly as many patients as he did each day without the EMR. He acknowledged the slow down that occurred when they first implemented the EMR, but once they adapted to the EMR workflow they were able to see most patients. No doubt Eliminating Staff can be a mixed EMR benefit basket depending on your unique situation. Although, this is true with almost every EMR benefit we’ll cover in this series. This can be a tremendous benefit of EMR or it can also be an expense as you find you need to hire more staff. Related Whitepaper: Getting Lean with Your Practice: Five Tips for Improving Provider Productivity with an EHR One of the major reasons that health care providers resist implementing an electronic health record (EHR) system is the belief that using it will slow them down, reducing the number of patients they can see and therefore reducing practice revenue. In fact, an EHR that is designed around an efficient workflow can enable providers to work faster and more efficiently. “Lean” methodologies, originally introduced by Toyota, have recently been used by health care providers such as Massachusetts General Hospital, ThedaCare, and Beth Israel Hospital (Boston) to streamline patient workflow. By understanding and measuring the workflow, health care providers can determine best practices, which will ultimately enable them to achieve the level of efficiency they desire. Download Whitepaper or see More EMR and Health IT Whitepapers Related Posts EHR Benefit – Space Savings EHR Benefit – Accessibility of Charts EHR Benefit – Legibility of Notes

As I mentioned in my previous post on EHR Penalties and Meaningful Use Failure , I had a really good discussion with Stoltenberg Consulting about rural hospital EHR at HIMSS this year. While Stoltenberg no doubt works with hospital systems of every size, I could tell that they had a real affection for the rural hospital EHR challenge. Plus, it was great to be educated some more on the challenges rural hospitals face when it comes to meaningful use and EHR since I’ve been doing a lot more writing about it on my Hospital EMR and EHR website. I collected a few observations from my chat that I think are worth talking about when it comes to the unique rural hospital EHR situation. One of those ideas is the challenge that rural hospitals have in providing EHR help desk support. It’s worth remembering that hospitals are 24/7 institutions that need 24/7 support in many cases. Now imagine trying to staff an EHR help desk for a small rural hospital. From what I’ve seen, most can barely have an IT support help desk available, let alone an EHR help desk. Stoltenberg Consulting wisely sees this as a great opportunity for EHR consults to provide this type of service to rural hospitals. If you spread the cost of a 24/7 EHR help desk across multiple hospitals, the costs start to make sense. Another interesting observation was that most rural hospitals are mostly Medicare and Medicaid funded. I’m not an expert on the pay scales of rural America, but when you look at the costs of living in the rural areas you realize that they don’t need to make as much money to live. Plus, I imagine in some cases there just aren’t that many jobs available to them. If they aren’t making as much money, then they’re more likely to qualify for Medicare and Medicaid. Why does this matter? The amount of Medicare a rural hospital has matters a lot since if they don’t show “meaningful use” of a “certified EHR” then they will incur the meaningful use penalties. It’s simple math to see that the more Medicare reimbursement you receive the larger the EHR penalty you’ll incur. There’s something that doesn’t feel right about the rich hospitals who’ve likely implemented an EHR before the stimulus getting paid the EHR incentive money while rural hospitals who can barely afford to keep their doors open getting not only penalties, but large penalties because of their large Medicare reimbursement. It’s probably water under a bridge now, but I could see why Stoltenberg Consulting suggested that rural and community hospitals should have been given more time to show meaningful use of an EHR. As I mentioned, I’m still learning about the rural hospital EHR space, but I found these points quite interesting. If you have a different view or have experience that differs, I’d love to hear about it in the comments. No doubt there are thousands of unique rural environments and I’d love to learn more about them and how they’re approaching EHR. Please share your experiences and thoughts in the comments. Related posts: EHR Penalties after Meaningful Use Failure Rural vs. City Medical Record Perspective New Hospital Specific ARRA EHR Certification Program – EACH

The March HIT Standards Committee focused on streamlining test scripts for certification, an overview of FDA Universal Device Identifier rule making, clinical summary formats for Long Term Care, and the latest updates from ONC.

Today’s EHR and HIT news includes news of two products that were launched at HIMSS 13 earlier in the Month.  The first is from LifeMed , who launched SecureReg and the second is from Healthcare Holdings Group , who launched their SmartFormsMD Voice-Command medical template module.

By Patrick Conway, MD, MSc Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs The next step on the path of meaningful adoption of health information technology (HIT) for providers—will launch later this year for hospitals and next year for eligible professionals. How will this next phase improve health care and reduce the burden on providers? Achieves Electronic Data Reporting With the increase in adoption of EHRs, we are moving away from technology as an end goal and towards the use of technology as a key tool in health care quality improvement. The next phase of the EHR Incentive Programs will encourage the adoption of broad scale electronic reporting of quality data. Aligns of Quality Measurement One of the foremost goals of Stage 2 is the alignment of quality measure reporting across CMS programs. CMS has worked with partners and representatives from industry to identify and finalize a set of unified quality measures which meet the requirements of multiple programs, such as the Physician Quality Reporting System (PQRS) and Physician Value-Based Modifier, in addition to meeting EHR Incentive Programs requirements.  Accountable Care Organizations can also report quality measures from their EHRs to meet reporting requirements for participating eligible professionals. The quality measure set—released by CMS last October—includes only measures that have been field tested, meet validation standards, and align with the National Quality Strategy, which outlines improvement goals for health care. How Providers Benefit For providers, program alignment means:  Using a single submission method to report on a unified set of quality measures  Choosing the submission method most suited to their unique needs For example, eligible professionals may submit through a data-submission vendor or submit reports generated from their certified EHR technology directly to CMS. As we look toward full implementation of meaningful use Stage 2 in 2014, CMS is committed to continuing to improve processes, support program alignment, facilitate interoperability and feedback to providers, and focus on the strategic use of health IT to drive quality improvement in our health care system and better outcomes for patients. Learn more at HIMSS We encourage you to learn more about CMS’ efforts during the CMS Quality Measurement Session at HIMSS13 today. Filed under: Uncategorized

I am excited to announce that today, February 11, 2012, we are releasing CONNECT version 4.0, which supports the current federal IT standards and Meaningful Use Stage 2 core objectives related to the secure electronic exchange of information. This is done through CONNECT’s support of Direct project specifications and NwHIN transports (i.e., electronically sending and receiving patient data, registering immunization information, public health reporting and patient access to data). What is CONNECT?

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