When implementing an electronic health records (electronic medical records) system, you will need to perform the following tasks. Adapted from "EHR Implementation in Ambulatory Care," a 2007 white paper from the Healthcare Information and Management Systems Society, this list is intended to give practices a better idea of how to allocate staff and whether you'll need to hire a project manager when implementing an electronic medical records (EMR) software system.
1. Develop an implementation plan. Establish the plan, which might include having the most computer-savvy physicians "go live" until the EHR's idiosyncrasies are identified and resolved, and then adding the remaining physicians.
2. Develop a scanning and abstraction policy. Convert paper records to electronic format. This might include having physicians review charts and select files important to patient care for scanning into the EMR.
3. Analyze workflow. With input from the practice's whole staff and help from the vendor, map how the practice's work will flow using electronic records. Use the study to train the entire practice.
4. Facilitate third-party interfaces. Set up the EMR system to communicate with several devices and entities, including: labs, hospitals and pharmacies; picture archiving and communication systems; diagnostic devices; and practice management systems. Consider paving the way for e-prescribing, patient e-mail and patient portal access.
5. Develop templates. Get input from all physicians on the template for physician note entry. Typically, these "electronic charts" are modified vendor templates or are designed by the practice.
6. Conduct training. Develop training material for all existing and future staff. In a sample workflow system from HIMSS, medical assistants enter simple patient history and vitals directly into the electronic medical records software, and physicians enter data from a patient worksheet into exam-room EMR terminals.
Showing posts with label electronic health records. Show all posts
Showing posts with label electronic health records. Show all posts
Tuesday, October 16, 2007
Sunday, September 9, 2007
Top Reasons to Implement an Electronic Medical Records Software System
Implementing an electronic medical records (or electronic health records) software system can be a daunting task for smaller physician practices - so daunting, in fact, that it's easy to lose sight of all the reasons why making the transition is worth the trouble. There are countless benefits of electronic medical records (EMR) systems. Here are a few of our favorite reasons why you should ditch the paper and add an EMR to your office practice.
EMRs Give You Better Access to Data
Pull a patient chart within seconds, not minutes. Even the most basic electronic medical records systems mean no more wasting time searching for charts.
Open a patient's chart on any computer in your office. With many EMR systems, you'll be able to open a patient's chart from anywhere in the world! Medicine isn't always practiced in the office. Duty sometimes calls at home or on vacation - usually late at night, right?
It helps that more than one person can work with a chart at the same time. In most cases, that means greater efficiency and reduced costs.
An EMR Facilitates Better Charting
With an EMR, you'll stop worrying about chicken-scratch handwriting. You might be able to read what you wrote, but your local pharmacist (and your malpractice carrier!) will appreciate the improvement in your notes.
Let your patients complete a computer guided medical history at home or in your office. Many EMR or EHR systems facilitate this process, and allow the information to be automatically uploaded into the electronic medical record.
Effortlessly (well, relatively effortlessly) import diagnostic images, lab results and hospital discharge summaries into the patient record. Almost all EMR software systems will also let you update medication and problem lists with every visit.
Build flow sheets and create graphs for all kinds of data. Visually analyze blood pressure, HbA1c, weight ... the list goes on. An EMR/EHR system also puts thousands of procedure and diagnostic codes at your fingertips.
Electronic Medical Records Improve Care Management
Use an electronic medical records system to track pending orders for lab tests and diagnostic imaging. Those that are long overdue may signal lost reports or patient noncompliance. In many cases, you can use your EMR system to spot trouble before it's really trouble.
Affordable EMR Software Options: Is ASP Right For You?
Use your EMR to receive automatic reminders in the exam room when a patient is due for preventive or disease-management services. Even the best physicians won't remember everything. Let the software help you. For that matter, use the EMR to remind you of evidence-based guidelines for diagnosing and treating conditions while you talk to the patient. With most electronic medical record systems, you'll be able to quickly produce a list of all patients due for a preventive test; in some cases, the EMR software will print reminder letters that can be mailed to patients.
Print a copy of the progress note and give it to the patient at the end of the visit. Or put his entire record on a mini "thumb" drive that he can take home. Don't want to get this advanced with your software system? Use it to print patient education handouts in the exam room, or before the patient leaves your office.
Better Prescribing with EMR Software
Almost every EMR software system includes an e-prescription function. E-prescribing means less time talking to pharmacists and answering questions about what you've written. Use the extra time however you please - spend more time with your patients, or more time with your family.
Does Your E-Prescribing Software Pass the Test?
E-prescribing software also lets you fax prescriptions from your computer to the pharmacy. This EMR function minimizes the chances a patient will lose or alter the prescription you've written. When it's time to reissue a script, simply give the mouse a few clicks and move on to the next patient.
Electronic medical record (EMR) software systems also tends to reduce the number of prescribing mistakes, alerting physicians to potential drug interactions, allergies or other situations that require extra caution. In the event of a drug recall, your EMR will let you immediately identify all patients taking the recalled drug. Many electronic medical records systems will print our reminder letters, and some will even telephone patients and play a pre-recorded message!
Boost Efficiency with an Electronic Medical Records System
No more flipping through pages upon pages of written notes. Use your EHR to review a concise (and real-time updated) summary of the patient's health information at a glance. Less time in the chart means more time with the patient.
The Most Important Questions to Ask EMR or EHR Vendors
Stay on top of your work with an electronic to-do list that includes incoming lab, radiology, and pathology reports. Most EMRs also collect and triage your in-office messages and telephone calls.
Don't like a good old game of phone tag? When patients call, answer their questions right away by pulling their record from the software. No more pulling the paper chart and calling them back.
Produce referral letters, school and work excuses, and other documents with a few clicks. You can also send messages to your nurse(s) without leaving the exam room.
Reduce staff downtime at the copy machine. When you need to share records with someone, transmit them electronically using your EMR software. Your copy machine will thank you.
Send claims faster by sending encounter information, including diagnostic and CPT codes, straight to your practice-management software.
Use an EHR to Lower Costs
How might you use an extra $10,000? That's how much you could save (per doctor, per year) on dictation and transcription costs. Let your electronic medical records system do the work for you at no additional charge.
Save several thousand dollars a year on paper chart supplies, not to mention several hundred trees, with your electronic medical records software system. While you're at it, save your stamps and use your EMR to electronically transmit charts.
Higher Income with Electronic Health Records
Qualify for "pay for performance" bonuses by tracking the care you provide and the outcomes you achieve for various groups of patients. True, those pay for performance incentives aren't particularly generous, but they'll help you pay for your electronic medical records software.
Automatically capture all your charges while you record what you do. While you're at it, reassign your transcriptionist and file clerks to help collect accounts receivable. You won't need a full time transcriptionist or file clerk with a decent EMR.
Medical Billing Software Option Includes Free EMR System
No more defensive coding! Confidently code for higher levels of service based on thorough EMR documentation. Use the software system's automatic E&M coding suggestions that are based on your documentation.
Of course, we'd be remiss if we didn't give thanks to Medical Economics for many of the ideas cited here.
Note: On this blog, the terms "electronic medical records" and "electronic health records" are used interchangeably.
EMRs Give You Better Access to Data
Pull a patient chart within seconds, not minutes. Even the most basic electronic medical records systems mean no more wasting time searching for charts.
Open a patient's chart on any computer in your office. With many EMR systems, you'll be able to open a patient's chart from anywhere in the world! Medicine isn't always practiced in the office. Duty sometimes calls at home or on vacation - usually late at night, right?
It helps that more than one person can work with a chart at the same time. In most cases, that means greater efficiency and reduced costs.
An EMR Facilitates Better Charting
With an EMR, you'll stop worrying about chicken-scratch handwriting. You might be able to read what you wrote, but your local pharmacist (and your malpractice carrier!) will appreciate the improvement in your notes.
Let your patients complete a computer guided medical history at home or in your office. Many EMR or EHR systems facilitate this process, and allow the information to be automatically uploaded into the electronic medical record.
Effortlessly (well, relatively effortlessly) import diagnostic images, lab results and hospital discharge summaries into the patient record. Almost all EMR software systems will also let you update medication and problem lists with every visit.
Build flow sheets and create graphs for all kinds of data. Visually analyze blood pressure, HbA1c, weight ... the list goes on. An EMR/EHR system also puts thousands of procedure and diagnostic codes at your fingertips.
Electronic Medical Records Improve Care Management
Use an electronic medical records system to track pending orders for lab tests and diagnostic imaging. Those that are long overdue may signal lost reports or patient noncompliance. In many cases, you can use your EMR system to spot trouble before it's really trouble.
Affordable EMR Software Options: Is ASP Right For You?
Use your EMR to receive automatic reminders in the exam room when a patient is due for preventive or disease-management services. Even the best physicians won't remember everything. Let the software help you. For that matter, use the EMR to remind you of evidence-based guidelines for diagnosing and treating conditions while you talk to the patient. With most electronic medical record systems, you'll be able to quickly produce a list of all patients due for a preventive test; in some cases, the EMR software will print reminder letters that can be mailed to patients.
Print a copy of the progress note and give it to the patient at the end of the visit. Or put his entire record on a mini "thumb" drive that he can take home. Don't want to get this advanced with your software system? Use it to print patient education handouts in the exam room, or before the patient leaves your office.
Better Prescribing with EMR Software
Almost every EMR software system includes an e-prescription function. E-prescribing means less time talking to pharmacists and answering questions about what you've written. Use the extra time however you please - spend more time with your patients, or more time with your family.
Does Your E-Prescribing Software Pass the Test?
E-prescribing software also lets you fax prescriptions from your computer to the pharmacy. This EMR function minimizes the chances a patient will lose or alter the prescription you've written. When it's time to reissue a script, simply give the mouse a few clicks and move on to the next patient.
Electronic medical record (EMR) software systems also tends to reduce the number of prescribing mistakes, alerting physicians to potential drug interactions, allergies or other situations that require extra caution. In the event of a drug recall, your EMR will let you immediately identify all patients taking the recalled drug. Many electronic medical records systems will print our reminder letters, and some will even telephone patients and play a pre-recorded message!
Boost Efficiency with an Electronic Medical Records System
No more flipping through pages upon pages of written notes. Use your EHR to review a concise (and real-time updated) summary of the patient's health information at a glance. Less time in the chart means more time with the patient.
The Most Important Questions to Ask EMR or EHR Vendors
Stay on top of your work with an electronic to-do list that includes incoming lab, radiology, and pathology reports. Most EMRs also collect and triage your in-office messages and telephone calls.
Don't like a good old game of phone tag? When patients call, answer their questions right away by pulling their record from the software. No more pulling the paper chart and calling them back.
Produce referral letters, school and work excuses, and other documents with a few clicks. You can also send messages to your nurse(s) without leaving the exam room.
Reduce staff downtime at the copy machine. When you need to share records with someone, transmit them electronically using your EMR software. Your copy machine will thank you.
Send claims faster by sending encounter information, including diagnostic and CPT codes, straight to your practice-management software.
Use an EHR to Lower Costs
How might you use an extra $10,000? That's how much you could save (per doctor, per year) on dictation and transcription costs. Let your electronic medical records system do the work for you at no additional charge.
Save several thousand dollars a year on paper chart supplies, not to mention several hundred trees, with your electronic medical records software system. While you're at it, save your stamps and use your EMR to electronically transmit charts.
Higher Income with Electronic Health Records
Qualify for "pay for performance" bonuses by tracking the care you provide and the outcomes you achieve for various groups of patients. True, those pay for performance incentives aren't particularly generous, but they'll help you pay for your electronic medical records software.
Automatically capture all your charges while you record what you do. While you're at it, reassign your transcriptionist and file clerks to help collect accounts receivable. You won't need a full time transcriptionist or file clerk with a decent EMR.
Medical Billing Software Option Includes Free EMR System
No more defensive coding! Confidently code for higher levels of service based on thorough EMR documentation. Use the software system's automatic E&M coding suggestions that are based on your documentation.
Of course, we'd be remiss if we didn't give thanks to Medical Economics for many of the ideas cited here.
Note: On this blog, the terms "electronic medical records" and "electronic health records" are used interchangeably.
Thursday, September 6, 2007
Most Important Features of Payer-Offered Electronic Medical Records
A new survey by the Healthcare Information and Management Systems Society (HIMSS) finds a majority of respondents believe electronic medical records systems (EMRs) offered by health insurance plans should have robust privacy and security features.
Survey respondents were most likely to believe that EMRs (also known as electronic health records, or EHRs) offered by insurance plans should include insurance company data, such as claims data. However, about two-thirds of respondents also said they believed that payer-offered EMR systems should include clinical data derived from hospital and ambulatory visits, as well as consumer-generated data, writes iHealthBeat.org
Twenty-four percent of survey respondents said they thought payer-offered EHRs would boost patient safety, while 21 percent said they expected them to verify insurance eligibility and benefits. Improved billing collections and improved quality of care each were selected by 18 percent of respondents.
The results were based on a survey of 101 physicians in July, 2007, by HIMSS.
Survey respondents were most likely to believe that EMRs (also known as electronic health records, or EHRs) offered by insurance plans should include insurance company data, such as claims data. However, about two-thirds of respondents also said they believed that payer-offered EMR systems should include clinical data derived from hospital and ambulatory visits, as well as consumer-generated data, writes iHealthBeat.org
Twenty-four percent of survey respondents said they thought payer-offered EHRs would boost patient safety, while 21 percent said they expected them to verify insurance eligibility and benefits. Improved billing collections and improved quality of care each were selected by 18 percent of respondents.
The results were based on a survey of 101 physicians in July, 2007, by HIMSS.
Tuesday, August 21, 2007
EMR Cost Savings Tool: Use This Tool to Estimate the Expected Cost Savings from an Electronic Medical Records System
If you're concerned about the cost of an electronic medical records software system (EMR system), or want to accurately estimate your return on investment (ROI) of your EMR, this cost savings tool should help.
It was designed by a Medicare Quality Improvement Organization under the DOQ-IT program. The spreadsheet helps quantify potential monthly savings as a result of an EMR or EHR implementation. Simply answer a few questions and see whether or not your electronic health records software is worth the initial investment.
Additional benefits associated with improved clinical care process and efficiencies may or may not be represented by a dollar amount in this tool. The worksheet represents the areas of EHR or EMR use where common efficiencies and saving are realized. A full ROI request should be performed with your electronic medical records EMR vendor during the contracting phase of your EHR implementation.
It was designed by a Medicare Quality Improvement Organization under the DOQ-IT program. The spreadsheet helps quantify potential monthly savings as a result of an EMR or EHR implementation. Simply answer a few questions and see whether or not your electronic health records software is worth the initial investment.
Additional benefits associated with improved clinical care process and efficiencies may or may not be represented by a dollar amount in this tool. The worksheet represents the areas of EHR or EMR use where common efficiencies and saving are realized. A full ROI request should be performed with your electronic medical records EMR vendor during the contracting phase of your EHR implementation.
Monday, August 20, 2007
Study: When it Comes to Electronic Medical Records, Osteopathic Physicians Say Cost is Biggest Hurdle
A new research study by the American Osteopathic Association and the Medical Group Management Association finds the cost of an electronic medical records (EMR) software keeps doctors of osteopathic medicine (DOs) from transitioning to electronic medical records. In some cases, the costs kept physicians from fully utilizing EMRs they had already installed.
The study shows larger medical groups (at least 51 full-time doctors) tend to have more funds available for information technology investment, and adopt electronic health or medical records systems at a rate of 55.1 percent. The rate was much lower (25 percent) in solo physician practices.
What's keeping physicians from adopting EMR or EHR systems? According to this study, a “lack of capital resources to invest in an EHR”. Researchers found that the median EHR/EMR purchase and implementation cost was $20,000 per physician, with an additional $250 per month per physician for maintenance.
Affordable EMR Software Options: Is ASP Right for You?
Of those that had moved to an electronic medical records system, nine out of ten respondents said they would not go back to paper medical records. Among AOA members, “improved access to medical record information” ranked highest as a potential benefit to their medical practices. Other high-ranking benefits with more direct impact on practice financials were “improved accuracy for coding evaluation and management procedures” and “improved charge capture.”
Overcoming Financial Fears Important When Considering an Electronic Medical Records System
This research also seems to support the theory that although these software systems can be expensive, they lower practice costs in the long run. Of those with systems, 22.3 percent said their practice costs had decreased. To be fair, an almost identical percentage of DOs claimed their practice costs had increased. The balance wasn't sure.
Is There a Business Case for Electronic Medical Records?
MGMA conducted the study of AOA members in spring 2006, although the results were released in August 2007.
The study shows larger medical groups (at least 51 full-time doctors) tend to have more funds available for information technology investment, and adopt electronic health or medical records systems at a rate of 55.1 percent. The rate was much lower (25 percent) in solo physician practices.
What's keeping physicians from adopting EMR or EHR systems? According to this study, a “lack of capital resources to invest in an EHR”. Researchers found that the median EHR/EMR purchase and implementation cost was $20,000 per physician, with an additional $250 per month per physician for maintenance.
Affordable EMR Software Options: Is ASP Right for You?
Of those that had moved to an electronic medical records system, nine out of ten respondents said they would not go back to paper medical records. Among AOA members, “improved access to medical record information” ranked highest as a potential benefit to their medical practices. Other high-ranking benefits with more direct impact on practice financials were “improved accuracy for coding evaluation and management procedures” and “improved charge capture.”
Overcoming Financial Fears Important When Considering an Electronic Medical Records System
This research also seems to support the theory that although these software systems can be expensive, they lower practice costs in the long run. Of those with systems, 22.3 percent said their practice costs had decreased. To be fair, an almost identical percentage of DOs claimed their practice costs had increased. The balance wasn't sure.
Is There a Business Case for Electronic Medical Records?
MGMA conducted the study of AOA members in spring 2006, although the results were released in August 2007.
Wednesday, July 25, 2007
When Adopting an Electronic Health Record (EHR), Overcoming Financial Fears is Important
It's no secret that the majority of U.S. physicians practice medicine with paper and a pencil, and that transition to an electronic medical record (EMR) or electronic health record (EHR) system has the potential to boost efficiency and quality of care.
Why the slow rate of adoption? Many physician practices think they cannot afford an electronic medical record or practice management software system. These offices are overwhelmed by the traditionally high initial costs, including computer hardware and EMR software, installation, training, space, maintenance, support and system upgrades.
But an EMR or a practice management system can be affordable, no matter the size of the physician practice. Here are a few suggestions for how to affordably implement an electronic health record EHR in your office.
Go modular. A modular EHR system enables incremental implementation of an EHR system with a smaller up-front investment. Some physician offices are using online tools for chronic disease, e-prescribing, and registries as starting points for building a full-scale EHR or EMR. [24]
Opt for phased implementation. Purchase or rent more complex EHR components (e.g., data exchange interfaces) and hardware (e.g., notebook computers) later in the implementation phase. [13] Implement incrementally by patient, provider, module, or function.
Ditch the traditional, embrace the ASP model. Consider obtaining an Application Service Provider (ASP) based electronic health record software system. Users “rent” access to software, and vendors provide access to data applications. ASP has the potential to reduce costs associated with EHRs, specifically hardware and maintenance. [13,14]
If you're a physician, you've probably also heard horror stories about lost productivity on the heels of an EMR adoption. Many of these stories are exaggerated, although it will take some time (generally 4-12 weeks) to bring you and your staff up to speed with the new medical software system. That's the case with any change.
Physician Offices Slowly Adopt Electronic Medical Record Systems
Time savings from electronic medical records are realized in long-run. Research shows that EHR systems have the potential to save physicians time over time by enhancing clinical processes and workflow; by improving clinicians’ abilities to make sound clinical decisions in a timely manner; by decreasing documentation and dictation time; by improving patient tracking and follow up; by improving the legibility, accuracy, and accessibility of progress notes; by reducing time spent on filing, finding, and pulling charts; by using e-mail messaging; by increasing full integration and documentation of clinical information; and by reducing the time spent writing new and refill prescriptions.
Sources:
[13] Meyer, M. (2004). Physician use of e-mail: The telephone of the 21st century. Journal of Medical Practice Manager, 19(5): 247– 51.
[14] Miller, R. H., & Sim, I. (2004). Physicians’ use of electronic medical records: Barriers and solutions. Health Affairs, 23(2): 116– 26.
[24] Working Group on Financial, Organizational, and Legal Sustainability of Health Information. (2004). Connecting for health: Achieving electronic connectivity in healthcare. New York: Markle Foundation. Retrieved September 30, 2005, from http://www.hsrnet.net/nhii/materials/CFH_Incentives_Summary.doc
Why the slow rate of adoption? Many physician practices think they cannot afford an electronic medical record or practice management software system. These offices are overwhelmed by the traditionally high initial costs, including computer hardware and EMR software, installation, training, space, maintenance, support and system upgrades.
But an EMR or a practice management system can be affordable, no matter the size of the physician practice. Here are a few suggestions for how to affordably implement an electronic health record EHR in your office.
Go modular. A modular EHR system enables incremental implementation of an EHR system with a smaller up-front investment. Some physician offices are using online tools for chronic disease, e-prescribing, and registries as starting points for building a full-scale EHR or EMR. [24]
Opt for phased implementation. Purchase or rent more complex EHR components (e.g., data exchange interfaces) and hardware (e.g., notebook computers) later in the implementation phase. [13] Implement incrementally by patient, provider, module, or function.
Ditch the traditional, embrace the ASP model. Consider obtaining an Application Service Provider (ASP) based electronic health record software system. Users “rent” access to software, and vendors provide access to data applications. ASP has the potential to reduce costs associated with EHRs, specifically hardware and maintenance. [13,14]
If you're a physician, you've probably also heard horror stories about lost productivity on the heels of an EMR adoption. Many of these stories are exaggerated, although it will take some time (generally 4-12 weeks) to bring you and your staff up to speed with the new medical software system. That's the case with any change.
Physician Offices Slowly Adopt Electronic Medical Record Systems
Time savings from electronic medical records are realized in long-run. Research shows that EHR systems have the potential to save physicians time over time by enhancing clinical processes and workflow; by improving clinicians’ abilities to make sound clinical decisions in a timely manner; by decreasing documentation and dictation time; by improving patient tracking and follow up; by improving the legibility, accuracy, and accessibility of progress notes; by reducing time spent on filing, finding, and pulling charts; by using e-mail messaging; by increasing full integration and documentation of clinical information; and by reducing the time spent writing new and refill prescriptions.
Sources:
[13] Meyer, M. (2004). Physician use of e-mail: The telephone of the 21st century. Journal of Medical Practice Manager, 19(5): 247– 51.
[14] Miller, R. H., & Sim, I. (2004). Physicians’ use of electronic medical records: Barriers and solutions. Health Affairs, 23(2): 116– 26.
[24] Working Group on Financial, Organizational, and Legal Sustainability of Health Information. (2004). Connecting for health: Achieving electronic connectivity in healthcare. New York: Markle Foundation. Retrieved September 30, 2005, from http://www.hsrnet.net/nhii/materials/CFH_Incentives_Summary.doc
Friday, July 20, 2007
Doctors: When Did You Adopt an Electronic Health Record System?
Of the 36% of physicians with an electronic health record (EHR) system surveyed by Medical Economics, more than half (58%) have had their EHRs for more than two years. Only a small group (6%) of respondents said their practice had adopted an EHR within the past six months.
The survey also found that of the 65% of physicians without an EHR system in place, approximately one in three (30%) said they planned to adopt an EHR system within the next year.
What were the top three reasons for adopting an EHR system? Physician respondents cited better documentation, improved access to records and enhanced quality of care, according to the survey. The ability to defend a malpractice suit was ranked as the least important reason by survey respondents.
The results are based on a December 2006 survey of 548 physicians, and were published in Medical Economics.
The survey also found that of the 65% of physicians without an EHR system in place, approximately one in three (30%) said they planned to adopt an EHR system within the next year.
What were the top three reasons for adopting an EHR system? Physician respondents cited better documentation, improved access to records and enhanced quality of care, according to the survey. The ability to defend a malpractice suit was ranked as the least important reason by survey respondents.
The results are based on a December 2006 survey of 548 physicians, and were published in Medical Economics.
Thursday, July 19, 2007
Helpful Advice When Choosing an EMR
There are many electronic health records and electronic medical records software packages on the market, and in some cases, the variety of software options makes the selection process overwhelming. Here's some advice: Don't choose an electronic medical record (EMR) software system before reviewing these helpful tips!
Vendor Software Licenses: When you purchase an EMR or EHR system, part of the price almost always includes a software license. These licenses usually take one of two forms - concurrent or named-based. If your EMR is one of the new ASP (monthly rental agreement) based systems, you don't really purchase a software license. Instead, you rent the license, usually for a low fee. However, the same issues exist for determining the number of ASP licenses as with a traditional EHR license purchase.
Possible Red Flags:
1. The EMR software vendor doesn't specify the type of license ini the quote.
2. Software functionality is not specified.
3. The EHR company doesn't specify the period of time the license is in force.
Interfaces: Software programs that allow data from the electronic health record system to flow back and forth between external applications. These applications can either reside outside the physician practice (think lab applications) or can be
another system within the doctor's office, such as a medical billing system.
Possible Red Flags:
1. One-way or two-way interface is not specified.
2. The EHR's data format is not specified (structured or non-structured).
3. Additional license costs, if any, not specified.
4. The EMR company promises an interface, but it is not currently available.
Clinical Documentation Features to Consider When Selecting an EMR or EHR System
Implementation Services: Consulting services offered by the electronic medical record vendor. These services will provide planning and actual implementation of an EHR software system for the physician practice.
Possible Red Flags:
1. The EMR vendor can’t commit to a project plan with milestones.
2. Only the EHR vendor can customize templates.
3. Software implementation is not broken into small enough tasks.
Training Services: Consulting services offered by the electronic health record company. They provide hands on training for how to use the EMR in the physician office.
Possible Red Flags:
1. There is no cost listed for future EHR training.
2. The EMR vendor offers no formal training plan.
3. There is no definition of what training expenses will be reimbursed, along with limits.
Support and Maintenance: EHR support and maintenance costs typically represent 15-20% of the software license fee. Where the actual license are often a one-time fee, the support and maintenance costs are renewed on a yearly basis. This yearly fee
basically covers two areas: 1)any upgrades or new releases; and 2)customer service and support. If you select an ASP-based (web-based) electronic medical record system, you don't usually pay a yearly support fee because those services are built into the monthly rental fee you pay for the medical software.
It should be noted that both vendor EHR software and third party EMR software will need support, so it is important to determine which components the support costs cover. Also, some EMR/EHR vendors might have more than one service level agreement representing different support options at different costs.
Potential Red Flags:
1. No support agreement from the electronic health record company.
2. No guarantees of service or reliability.
3. No cap on renewal percentage increases.
4. No software escrow costs offered.
5. The EMR company charges extra for database schema.
6. There are added maintenance costs for third party products.
7. The EHR company will not offer support for third party products.
8. No support offered for previous EHR/EMR software versions or releases.
Payment Terms: EHR implementation typically involves a number of phases and takes time. Things can go wrong. Therefore, the payment terms should reflect milestone-based payments. This means should pay the EMR vendor percentages of the total as major parts of the project plan are successfully completed.
Potential Red Flags:
1. The electronic medical records company wants all or most of the payment up front.
2. The EMR vendor is not willing to agree to final payment when system is accepted.
3. The EHR company has no policy or process for payment refunds or reductions.
A Business Case for Electronic Health Records
Service Level, Hours of Support: Most EMR or EHR companies will offer several ways to communicate and resolve software problems. Typical methods include email, telephone, and online chat. In some cases, a specialist will visit the physician office to help resolve an issue with the electronic health records software. Ask whether remote diagnostics and/or on site visits by support analysts are available.
Potential Red Flags:
1. “Normal business hours” are specified instead of detailed days and hours.
2. The company offers no "after hours" support to physicians.
Financing Alternatives: Electronic medical record or electronic health record systems can be expensive, depending on the type of medical software system you choose. (The exception is when you buy an ASP (web-based or online-based) EMR, where the physician user pays a monthly fee instead of an up-front license fee.) EHR or EMR vendors should offer you the option of leasing or financing your system.
Potential Red Flags:
1. The EMR company passes you off to a third-party finance partner and is not involved in the process.
Editor's Note: The terms "Electronic Medical Records", "Electronic Health Records", "EHR" and "EMR" are used interchangeably in this article. For more information like this, click here.
Vendor Software Licenses: When you purchase an EMR or EHR system, part of the price almost always includes a software license. These licenses usually take one of two forms - concurrent or named-based. If your EMR is one of the new ASP (monthly rental agreement) based systems, you don't really purchase a software license. Instead, you rent the license, usually for a low fee. However, the same issues exist for determining the number of ASP licenses as with a traditional EHR license purchase.
Possible Red Flags:
1. The EMR software vendor doesn't specify the type of license ini the quote.
2. Software functionality is not specified.
3. The EHR company doesn't specify the period of time the license is in force.
Interfaces: Software programs that allow data from the electronic health record system to flow back and forth between external applications. These applications can either reside outside the physician practice (think lab applications) or can be
another system within the doctor's office, such as a medical billing system.
Possible Red Flags:
1. One-way or two-way interface is not specified.
2. The EHR's data format is not specified (structured or non-structured).
3. Additional license costs, if any, not specified.
4. The EMR company promises an interface, but it is not currently available.
Clinical Documentation Features to Consider When Selecting an EMR or EHR System
Implementation Services: Consulting services offered by the electronic medical record vendor. These services will provide planning and actual implementation of an EHR software system for the physician practice.
Possible Red Flags:
1. The EMR vendor can’t commit to a project plan with milestones.
2. Only the EHR vendor can customize templates.
3. Software implementation is not broken into small enough tasks.
Training Services: Consulting services offered by the electronic health record company. They provide hands on training for how to use the EMR in the physician office.
Possible Red Flags:
1. There is no cost listed for future EHR training.
2. The EMR vendor offers no formal training plan.
3. There is no definition of what training expenses will be reimbursed, along with limits.
Support and Maintenance: EHR support and maintenance costs typically represent 15-20% of the software license fee. Where the actual license are often a one-time fee, the support and maintenance costs are renewed on a yearly basis. This yearly fee
basically covers two areas: 1)any upgrades or new releases; and 2)customer service and support. If you select an ASP-based (web-based) electronic medical record system, you don't usually pay a yearly support fee because those services are built into the monthly rental fee you pay for the medical software.
It should be noted that both vendor EHR software and third party EMR software will need support, so it is important to determine which components the support costs cover. Also, some EMR/EHR vendors might have more than one service level agreement representing different support options at different costs.
Potential Red Flags:
1. No support agreement from the electronic health record company.
2. No guarantees of service or reliability.
3. No cap on renewal percentage increases.
4. No software escrow costs offered.
5. The EMR company charges extra for database schema.
6. There are added maintenance costs for third party products.
7. The EHR company will not offer support for third party products.
8. No support offered for previous EHR/EMR software versions or releases.
Payment Terms: EHR implementation typically involves a number of phases and takes time. Things can go wrong. Therefore, the payment terms should reflect milestone-based payments. This means should pay the EMR vendor percentages of the total as major parts of the project plan are successfully completed.
Potential Red Flags:
1. The electronic medical records company wants all or most of the payment up front.
2. The EMR vendor is not willing to agree to final payment when system is accepted.
3. The EHR company has no policy or process for payment refunds or reductions.
A Business Case for Electronic Health Records
Service Level, Hours of Support: Most EMR or EHR companies will offer several ways to communicate and resolve software problems. Typical methods include email, telephone, and online chat. In some cases, a specialist will visit the physician office to help resolve an issue with the electronic health records software. Ask whether remote diagnostics and/or on site visits by support analysts are available.
Potential Red Flags:
1. “Normal business hours” are specified instead of detailed days and hours.
2. The company offers no "after hours" support to physicians.
Financing Alternatives: Electronic medical record or electronic health record systems can be expensive, depending on the type of medical software system you choose. (The exception is when you buy an ASP (web-based or online-based) EMR, where the physician user pays a monthly fee instead of an up-front license fee.) EHR or EMR vendors should offer you the option of leasing or financing your system.
Potential Red Flags:
1. The EMR company passes you off to a third-party finance partner and is not involved in the process.
Editor's Note: The terms "Electronic Medical Records", "Electronic Health Records", "EHR" and "EMR" are used interchangeably in this article. For more information like this, click here.
Friday, July 13, 2007
Electronic Medical Records: Physician Offices Slowly Adopt EMR Systems
How many physician offices use electronic medical record (EMR) systems in the United States? Data from the National Ambulatory Medical Care Survey suggest EMR medical software systems are growing in popularity, but that most physicians still practice medicine with paper and pencil.
One-quarter of office-based physicians report using full or partial electronic medical record systems in 2005, a 31% increase from the 18.2% reported in the 2001 survey, but suggesting the race to computerize physician offices has a long way to go before the finish line is in sight.
EMR use did not vary by physician age, gender or specialty type, according to the NAMCS. The data also show physicians in the Midwest and West are more likely to use EMRs than those in the Northeast.
Wrote the researchers, "Although these estimates show that progress has been made toward the goal of universal electronic health records, there is still a long way to go. Solo practitioners are the least likely to use EMRs, whether measured generally or for an EMR system with four specific features. Although solo practitioners make up about one-third of physicians, they comprise about two-thirds of medical practices. Additionally, the features of EMRs vary widely; clinical reminders and public health reporting lag behind the other features of systems in current use."
For more information, see National Center for Health Statistics.
One-quarter of office-based physicians report using full or partial electronic medical record systems in 2005, a 31% increase from the 18.2% reported in the 2001 survey, but suggesting the race to computerize physician offices has a long way to go before the finish line is in sight.
EMR use did not vary by physician age, gender or specialty type, according to the NAMCS. The data also show physicians in the Midwest and West are more likely to use EMRs than those in the Northeast.
Wrote the researchers, "Although these estimates show that progress has been made toward the goal of universal electronic health records, there is still a long way to go. Solo practitioners are the least likely to use EMRs, whether measured generally or for an EMR system with four specific features. Although solo practitioners make up about one-third of physicians, they comprise about two-thirds of medical practices. Additionally, the features of EMRs vary widely; clinical reminders and public health reporting lag behind the other features of systems in current use."
For more information, see National Center for Health Statistics.
Wednesday, July 11, 2007
Common EMR Terms, Glossary Part 2
Here are some more of the most common terms (and definitions) you'll run across when evaluating an electronic medical record or electronic health record software system.
Client Server: A form of distributed computing where a dedicated heavy-duty server computer handles most of the processing tasks while less powerful client computers access and share files, programs and computing power. A network located at the customer's site connects the server (the big computer) and the "clients" (the smaller computers). Client server systems are commonly found in larger physician office practices and hospitals.
Clinical Information System: Relating exclusively to the information regarding the clinical care of a patient, instead of the administrative data. Most EMRs/EHRs contain clinical information systems, whereas most practice management software systems contain administrative data. Many vendor solutions integrate the two types of data together for physicians.
Computerized Patient Record: The previous name for an EMR or EHR.
Data compression: A method that reduces the volume of data by more efficiently encoding the information. This process could save the user time and money by lowering transmission times, minimizing bandwidth requirements and reducing storage space.
Data Warehouse: A large database that stores information like a data repository, but also allows the user to access data for population analysis. Such a warehouse is most often used by physicians and policymakers to identify trends and support the
creation of knowledge - for example, to show a physician how many of his patients have received a flu shot in the past 12 months. Reports from the data warehouse are normally generated at scheduled intervals.
Electronic Data Exchange: A direct exchange of data between two computers via the internet or other network, using shared data formats and standards. In healthcare, the most common frames of reference of EDI are electronic claims processing and electronic prescribing (e-prescribe).
Integration: The task of ensuring that all of the elements of an information system (EHR/EMR) communicate and act as a uniform entity. An integrated system maintains one database, stores data in the same format, and utilizes the same processing features. Be wary of electronic medical record systems with poor integration features!
Operating System: The software program that controls the power and logics of all operations of a computer system. Examples include Microsoft Windows and MacOS for Macintosh.
Portal/Patient Portal: The entry point for authorized persons to access secure data using the Internet. A patient portal allows a patient to access the physician practice via the Internet for the purposes of communication, scheduling, and/or accessing health information.
Redundancy: Two computer servers that simultaneously and automatically store identical information. Each server can be used as a back-up for the other in the event of system failure. In an EHR or EMR, redundancy is a GOOD thing. Look for medical software systems that have some sort of built-in redundancy.
Registry: A software application that allows a physician to record and track information for subpopulations of patients, especially those with chronic diseases or requiring preventive care.
Workflow Automation: A type of medical software that automates workflow and re-engineers processes such that productivity gains and improved customer service are realized. Look for EMRs with robust workflow automation - that's the feature that promises to save physicians lots of time and money.
Client Server: A form of distributed computing where a dedicated heavy-duty server computer handles most of the processing tasks while less powerful client computers access and share files, programs and computing power. A network located at the customer's site connects the server (the big computer) and the "clients" (the smaller computers). Client server systems are commonly found in larger physician office practices and hospitals.
Clinical Information System: Relating exclusively to the information regarding the clinical care of a patient, instead of the administrative data. Most EMRs/EHRs contain clinical information systems, whereas most practice management software systems contain administrative data. Many vendor solutions integrate the two types of data together for physicians.
Computerized Patient Record: The previous name for an EMR or EHR.
Data compression: A method that reduces the volume of data by more efficiently encoding the information. This process could save the user time and money by lowering transmission times, minimizing bandwidth requirements and reducing storage space.
Data Warehouse: A large database that stores information like a data repository, but also allows the user to access data for population analysis. Such a warehouse is most often used by physicians and policymakers to identify trends and support the
creation of knowledge - for example, to show a physician how many of his patients have received a flu shot in the past 12 months. Reports from the data warehouse are normally generated at scheduled intervals.
Electronic Data Exchange: A direct exchange of data between two computers via the internet or other network, using shared data formats and standards. In healthcare, the most common frames of reference of EDI are electronic claims processing and electronic prescribing (e-prescribe).
Integration: The task of ensuring that all of the elements of an information system (EHR/EMR) communicate and act as a uniform entity. An integrated system maintains one database, stores data in the same format, and utilizes the same processing features. Be wary of electronic medical record systems with poor integration features!
Operating System: The software program that controls the power and logics of all operations of a computer system. Examples include Microsoft Windows and MacOS for Macintosh.
Portal/Patient Portal: The entry point for authorized persons to access secure data using the Internet. A patient portal allows a patient to access the physician practice via the Internet for the purposes of communication, scheduling, and/or accessing health information.
Redundancy: Two computer servers that simultaneously and automatically store identical information. Each server can be used as a back-up for the other in the event of system failure. In an EHR or EMR, redundancy is a GOOD thing. Look for medical software systems that have some sort of built-in redundancy.
Registry: A software application that allows a physician to record and track information for subpopulations of patients, especially those with chronic diseases or requiring preventive care.
Workflow Automation: A type of medical software that automates workflow and re-engineers processes such that productivity gains and improved customer service are realized. Look for EMRs with robust workflow automation - that's the feature that promises to save physicians lots of time and money.
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