Now that your office has decided to invest in an Electronic Medical Record (EMR) system, you’ll need to choose a vendor. What should you look for?

Of course, there are some basic requirements that any EMR should meet, such as meaningful use. The Certification Commission for Healthcare Information Technology (CCHIT) also now tests EMRs for basic functionality and certifies vendor products meeting the tested items.

But you’ll want to look beyond these basics when selecting an EMR. First, you may require functionality specific to your medical specialty. Additionally, you’ll want a product that feels right, and the CCHIT tests only for functionality, not for usability,

Another important—and often overlooked—element in EMR selection is support. The EMR you choose will be an integral part of your practice’s operation for many years, so you’ll want to select an EMR vendor that will be around to support it.

Clearly, it isn’t possible for an EMR vendor to operate in every location it sells EMRs, but it can still offer local support in many ways.

That’s important, because assistance with installation and training are critical. Additionally, as with any software, you can expect occasional problems—and your EMR vendor should be available to fix them quickly and efficiently.

The bottom line: Be sure to ask potential vendors about local support. Your EMR vendor will be your partner in a long term undertaking—and as with any partnership, it’s best to get to know your partner well before you commit.

An EMR may be the biggest technology investment you make—which is why you want to look for one that’s built on proven technology.

gloStream’s EMR, gloEMR, is one such solution. It’s the only EMR that has Microsoft Office built into its applications, and the result is significant to health care professionals. Here’s how:

• gloEMR has features you can use to collaborate with other team members, whether they’re in your office or working remotely.

• You probably already know how to use these features, since you most likely use Microsoft Word. This decreases training time and increases time you can spend on other tasks—like seeking patients.

• Because we store your data in Microsoft-based formats such as Microsoft Word, you gain peace of mind. Microsoft technology has been tested for decades and is supported by thousands of technology partners—it will likely be around forever.

• Microsoft technology is only getting better. Microsoft spends $5 billion annually to improve its Office suite—which improves your EMR.

Read our press release here, or contact us for more information.

An EMR may be the biggest technology investment you make—which is why you want to look for one that’s built on proven technology. gloStream’s EMR, gloEMR, is one such solution: It’s the only EMR that has Microsoft Office built into its applications. And the result is significant to health care professionals.  Click here to learn why.

Why is it that doctors understand the benefits of adopting an electronic medical record (EMR), yet aren’t rushing to implement the technology? Cost is one factor, as is resistance to change—but the biggest reason, in our opinion, is that much of the available technology doesn’t match the way doctors think.  An EMR built on a balanced architecture model can fix that problem.

A balanced architecture model combines three essential elements that help doctors practice medicine electronically, but on their own terms:

• The doctor dashboard: a home screen from which each section of the patient’s medical chart can be accessed with one click.

• Discreet data elements: Values that can be chosen from a list, such as a drop-down menu.

• Free flow text: the ability to input information by typing text into a Word document, using voice recognition technology, or using Microsoft drawing tools (for example, to highlight a portion of an x-ray).

The combination of these elements creates unprecedented flexibility in an EMR that allows doctors to drastically increase efficiency – and therefore productivity.

For example, doctors can quickly check boxes to indicate a patient’s complaint and current medication. All of that data can then be augmented with dictation that reveals the doctor’s findings and instructions.

For more information, read our balanced architecture white paper “Increasing Efficiency and Productivity in the Modern Day Medical Practice“

Two big announcements have been made in regard to electronic health records (EHRs).

The Centers for Medicare and Medicaid Services (CMS) has issued its draft definition of “meaningful use”, and the Office of the National Coordinator for Health Information Technology has issued an interim final rule on certification criteria.

Meaningful use

The meaningful use definition describes the proposed criteria for achieving meaningful use.

As expected, the definition follows the major parameters actually written into the bill: An EHR should be certified, include e-prescribing, be able to exchange information, and be able to report quality data.

However, the criteria are now broken into stages. Initial meaningful use criteria are referred to as Stage 1. Two additional updates—referred to as Stage 2 (proposed by the end of 2011) and Stage 3 (proposed by the end of 2013)—are anticipated. Here are the basics.

Stage 1: The meaningful use criteria in this stage focuses on electronically capturing health information in a coded format; using that information to track key clinical conditions and communicating that information for care coordination purposes; implementing clinical decision support tools to facilitate disease and medication management; and reporting clinical quality measures and public health information.

Stage 2: The proposed goals expand upon Stage 1 criteria “to encourage the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible, such as the electronic transmission of orders entered using computerized provider order entry (CPOE) and the electronic transmission of diagnostic test results (such as blood tests, microbiology, urinalysis, pathology tests, radiology, cardiac imaging, nuclear medicine tests, pulmonary function tests and other such data needed to diagnose and treat disease).”

Stage 3: The proposed goals focus on promoting improvements in quality, safety, and efficiency; decision support for national high-priority conditions; giving patients access to self management tools and comprehensive patient data; and improving population health.

Certification

The IFR on certification details the technical specifications necessary to support secure, electronic exchange and meaningful use of health information.

An ongoing process

Keep in mind that meaningful use as defined for 2011—as well as the certification criteria to support it—are only the first major steps in a continuing process.

“These criteria will set a level of expectation for what can be achieved today and in the near future through the adoption and use of a certified EHR system,” wrote David Blumenthal, national coordinator for health information technology, in a press release. “We fully expect that, over time, as needs and technologies evolve, the expectations can evolve as well. “

You can weigh in

Finally, the initial proposed rules aren’t final yet. We are currently in a 60-day comment period to help inform the final 2011 meaningful use criteria. And although the certification standards will go into effect 30 days after publication, after publication there will be an opportunity for public comment for 60 days. We encourage you to voice your opinion. You can comment on behalf of your organization by visiting the Department of Health & Human Services or by using the Regulations.gov portal.

The government has released its long-awaited definition of meaningful use—in a lengthy proposed regulation entitled “Medicare and Medicaid Programs; Electronic Health Record Incentive Program.”

As you probably know, health care professionals can receive incentive payments for implementing an electronic health record (EHR), but they must demonstrate meaningful use of the EHR. What that means, exactly, has been unclear until now.

As eagerly as you’ve likely been anticipating the proposed regulation, chances are you don’t want to read that much “legalese”. So below we’ve listed the basic “Stage 1” criteria as we understand it. You can review a more thorough explanation of these criteria here.

• Use Computer Provider Order Entry (CPOE)
• Implement drug-drug, drug-allergy, drug-formulary checks
• Maintain an up-to-date list of current diagnoses
• Transmit prescriptions electronically
• Maintain an active medication list
• Maintain an active medication allergy list
• Record demographics
• Record and chart changes in vital signs
• Record smoking status
• Incorporate clinical lab-test results
• Generate lists of patients by specific conditions to use for quality improvement.
• Report ambulatory quality measures to CMS or the state
• Send reminders to patients for preventive and follow-up care
• Implement certain clinical decision support rules
• Check insurance eligibility electronically
• Submit insurance claims electronically
• Provide patients with an electronic copy of their health information
• Provide patients with timely electronic access to their health information
• Provide clinical summaries to patients for each office visit
• Exchange key clinical information among providers electronically
• Perform medication reconciliation at encounters
• Provide a summary of care record for each transition of care
• Submit electronic data to immunization registries
• Provide data to public health agencies
• Protect health information

As many physicians struggle with the financial and technical hurdles it takes to successfully implement an EHR, it’s easy to forget the reason the federal government is pushing for EHRs in the first place: improvement in health care.

Case in point: A recent study shows physicians are more likely to report drug side effects through an EHR than they are through traditional paper reporting.

To conduct the study, Pfizer surveyed 300 physicians, two-thirds of whom utilized an EHR and one-third of whom used a paper-based system.

Half of all respondents said they would be more likely to report drug data using an EHR. That’s because an EHR is a much more convenient and efficient way of reporting. Paper-based reporting an adverse drug event could take up to 40 minutes to complete; EHR reporting takes minutes.

Moreover, 60 percent of respondents think the use of EHR will improve patient care. That’s because EHR reporting of adverse drug effects could increase the FDA’s product safety profiles.

Although the study confirmed a common barrier to EHR adoption is cost, the federal government is offering up to $44,000 in incentive payments to physicians who prove “meaningful use” of an EHR—and those who start early stand to benefit the most.

Contact us for more information.

Related article:

Study shows ehrs may increase physician drug safety reporting

The federal government is determined to see that every American has an electronic health record (EHR) by 2014—but many physicians are still wary of implementing one.

While physicians generally recognize an EHR’s ability to improve patient care and reduce costs, they struggle with the financial and technical hurdles it takes to successfully implement one.

The absence of a solid business model also provides a sticking point. “For the primary doctor in practice who adopts an EHR, the practice doesn’t get any bigger, the revenue stream doesn’t go up any higher and the workload doesn’t become measurably more efficient,” says George Halvorson, chairman and CEO of Kaiser Foundation Health Plan and Hospitals “The front-line providers need some kind of financial reason to move.”

That reason to move, of course, is the up to $44,000 in incentive payments available to physicians who prove “meaningful use” of an EHR. And physicians who start early stand to benefit the most.

But then another obstacle arises: Just what is meaningful use?

It’s true that the definition of meaningful use is still under debate. But a final definition of meaningful use is expected within a few months—and we know, for the most part, what it will include.

“The major parameters are actually written into the bill,” says Mark Leavitt, president and CEO of the Certification Commission for Healthcare IT, “It has to be a certified EHR, it has to include e-prescribing, it has to be able to exchange information and it has to be able to report quality data. “I’m not sure if we have to know more than that—if you are a provider—to be able to make a technology investment now.”

Contact us for more information.

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Overcoming obstacles to HER implementation

By now you’ve heard that implementing an electronic health record (EHR) early is key to success. Not only will you be able to take advantage of all federal financial incentives, you’ll also be up and running before the rush to implement likely hits in 2010 or 2011—and of course, you’ll receive all of the benefits of an EHR sooner. But it’s important to remember that implementing the right EHR is just as important.

Perhaps a California hospital’s experience best illustrates this concept. More than five years ago, the University of California San Francisco (UCSF) Medical Center decided to implement an EHR with a $50 million investment. This summer, with the system still not up and running due to technical difficulties, the hospital terminated its contractor and prepared to start part of the project from scratch—being forced to write off more than a third of the money it spent. The setback for UCSF Medical Center illustrates the challenges health care providers of all sizes face when trying to implement EHRs.

However, it’s worth noting that UCSF Medical Center has not been deterred by its experience, and is forging ahead with its EHR implementation. This says a lot about UCSF Medical Center’s faith in EMRs, which is well placed. For every UCSF Medical Center, there is a health care system that has successfully implemented big-budget EHRs and is realizing the benefits (such as the University of Pittsburgh Medical Center).

Smaller health care providers can face the same setbacks—and realize the same successes. The key to success is to select the right EHR from the right provider. The product should meet all defined standards, and the provider should be willing to work with you to ensure successful implementation.

Related articles:

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How the healthcare industry can increase the number of successful EHR/EMR initiatives

Health care providers often ask why they should implement their organization’s preferred electronic health record (EHR) when a less expensive option promises to meet meaningful use standards. The answer lies in difference between certification and meaningful use—two concepts worth reviewing.

Meaningful use refers to the way documentation and data exchange can enhance efficiency and quality among providers, payers, and patients. As a result, meaningful use is not about products, but about processes. It’s about how data flows through an entire system of stakeholders. Thus, it can be argued that vendors should not be making claims about meaningful use.

Certification, on the other hand, refers to a product’s features—something a vendor can make claims about.

The problem is, we don’t yet have final certification criteria.  The certification process will be defined in a December 2009 “notice of proposed rulemaking” (NPRM). However, a period of comment will follow, so we won’t have the final definition until the spring. As a result, we’d argue that it’s too early for any vendor to claim its product will meet all certification criteria.

So, what should you look for in a EHR today? Until certification is defined, a vendor can claim that its product conforms with the latest Certification Commission for Health Information Technology (CCHIT) criteria—the best indicator of functionality we have at the moment. And, a vendor can promise that it will modify its product to meet certification standards when they are released—which allows you to purchase an EHR today and begin reaping the benefits sooner.

Keep these things in mind as you decide which EHR to use.

Related articles: Certification versus meaningful use