Three EHR Software Trends to Watch for in the New Year

January 21st, 2013 Amanda Guerrero

EHR softwareThough many providers have yet to adopt an electronic health record system, EHR implementation rates are rising steadily; and the Centers for Medicare and Medicaid Services’ EHR Incentive Program continues to attract participants. With Meaningful Use stage 2 kicking off in 2014 – and providers facing penalties for not having meaningfully used certified EHR software by 2015 – these trends are not likely to taper off any time soon. In fact, 2013 is positioned to be a big year for EHRs and health IT.

Here are three of the topics that are sure to be all the buzz in 2013:

1. Data security. Data breaches made headlines often in 2012, leading countless healthcare organizations to promise to focus on tighter security protocols and provide training for employees on security best practices. With more and more information being stored digitally in electronic health record systems, it is only natural that data security be of the utmost importance. Otherwise, data breaches will only become more common, compromising patient privacy and the integrity of stored medical data.

2. Replacement EHRs. Many early EHR adopters knew little about the software and how it might affect their organization’s day to day; but now, providers are much more informed. This is leading healthcare organizations to rethink their current software system and look for other EHR solutions that better meet their needs. EHR vendors that want to survive will need to step up their game to avoid getting replaced or becoming obsolete. This means focusing on ROI, usability and design, and truly understanding their target user’s needs.

3. Patient portal integration. Providers who want to start attesting to Meaningful Use stage 2 in 2014 will need to start getting ready this year. This means implementing an online portal and actually getting patients to use it, particularly to access their clinical summaries and to send their doctors secure electronic messages. Providers integrating a portal with their EHR software will also likely be looking for other ways to make the most of their patient portal technology, meaning that remote patient monitoring, televists and e-consults might also see a spike this year.

What other EHR or health IT-related topics do you think will trend in 2013?

Infographic – The Past, Present and Future of EHRs

January 16th, 2013 Amanda Guerrero

Shared via HealthIT.gov

AMA Offers Concerns, Recommendations for Meaningful Use Stage 3

January 15th, 2013 Amanda Guerrero

Meaningful Use Stage 3The American Medical Association (AMA) has long supported electronic health record adoption, but it has also been a voice of criticism, opposing many of the measures that physicians are required to meet in order to qualify for EHR incentives. Yesterday, the AMA expressed their most recent meaningful use concerns by submitting comments to the Office of the National Coordinator for Health Information Technology (ONC) regarding the proposed guidelines for stage 3.

“While the AMA shares the Administration’s goal of widespread EHR adoption and use, we are extremely concerned with the recommended approach to move full speed ahead without a comprehensive evaluation of the program and resolving existing barriers, including Health IT infrastructure flaws,” the AMA stated in a letter to Dr. Farzad Mostashari, the ONC’s National Coordinator for Health IT.

The letter then goes on to offer physicians’ main concerns about meaningful use, as well as recommendations for improving the EHR Incentive Program. These are some of the AMA’s key recommendations:

  • Complete the evaluations of stages 1 and 2 before developing stage 3 rules.
  • Modify the meaningful use program to eliminate the regulatory requirement that physicians must meet all measures in order to qualify for incentives.
  • Allow more leeway during the penalty years, requiring that physicians meet just ten of the core and menu set measures.
  • Factor in relevancy and include exclusions, such as exempting physicians at or nearing retirement age from participating in the program.
  • Make measures outside a physician’s control optional to meet (i.e. having patients view their information online or send secure message electronically).
  • Survey EHR vendors about their ability to incorporate the capabilities necessary for meaningful use into their software within the proposed timeframes.
  • Require that certified EHR systems be capable of producing reports that inform physicians whether they have met each of the meaningful use measures.
  • Place additional emphasis on usability and patient safety criteria during the EHR certification process.
  • Develop uniform standards on interoperability and secure HIEs.

The AMA’s principal recommendation mentioned throughout the letter, however, is its suggestion that stage 3 guidelines be put on hold until the prior two stages have been evaluated and a nationwide interoperable network is fully developed and operating properly.

This is not the first time the AMA has offered recommendations for meaningful use. Last May, on behalf of nearly 100 healthcare organizations and medical societies, the AMA submitted comments to the Centers for Medicare and Medicaid Services for improvements to proposed stage 2 rules.

Why Healthcare Should Embrace Criticism on Social Media – and How to Handle It

January 11th, 2013 Amanda Guerrero

Healthcare social media

Social media has revolutionized how we communicate, interact and make decisions – and it is an essential part of any business’ marketing strategy. Yet, healthcare organizations have long been wary of joining the social media conversation. The good news is that many hospitals and healthcare systems are finally starting to put their differences with social networks aside and are building online communities to connect patients and providers.

Having an online presence allows medical practices to:

  • Find out what their patients are saying
  • Manage customer relations
  • Identify areas for improvement
  • Increase patient engagement
  • Grow their brand

Of course, establishing social media profiles can also have its drawbacks. Social networks serve as effective patient communication tools, but they can also be venues for patients to post criticisms and complaints. Knowing how to manage these types of comments can mean the difference between a marketing success and a social media flop. Here are two steps for handling criticism with care and using negative social media comments to your advantage:

1. Identify the problem.

Not every negative comment posted on your organization’s Facebook wall or mentioned in a tweet on Twitter will be true. Patients often post things out of anger and sometimes due to a lack of knowledge. However, your job is to take every piece of criticism seriously and try to get to the root of the problem.

Hospital waiting room

For example, imagine your social media team is monitoring Twitter and sees the following message: “I’ve been waiting in the ER at @hospitalX for hours. Longest waiting times ever!” What would you do? One course of action would be to find out who the patient is, how long they have been waiting and why, as there could be several reasons for the patient’s extended wait. Perhaps they forgot to check in. Maybe the patient was called when they stepped outside to make a phone call. Front desk could have misplaced their registration packet. Or maybe your hospital really does have long wait times.

Whatever the problem is, it is important to identify it. This will allow you to address it.

2. Fix it.

After you have identified the problem, take the necessary steps to fix it. This can include acknowledging that a mistake was made (i.e. misplaced paperwork) and apologizing for the oversight, or thanking patients for helping you to identify an area that needs improvement. Other patients will see that you take comments and criticism seriously, and they will feel a greater sense of satisfaction with your organization.

Using Ophthalmology EHR to Spot Early Signs of Glaucoma

January 8th, 2013 Amanda Guerrero

Ophthalmology EHRThere are many types of glaucoma and not all of them present with early warning signs or symptoms, meaning that patients often become aware of the disease once it has already advanced and caused optical damage. This has contributed to glaucoma becoming the second leading cause of blindness worldwide. Now, however, according to the results from a University of Sydney study, physicians might be able to detect glaucoma early on by monitoring changes in patients’ eye blood vessels through their ophthalmology EHR.

For the study, published in the journal Ophthalmology, researchers tracked more than 2,400 patients (none of them initially presenting with glaucoma) over the course of ten years. During that time, 82 patients developed open-angle glaucoma in at least one eye. The patients who were diagnosed with the disease tended to be older than the group as a whole and were more likely to be women and have higher blood pressure. Researchers also concluded that patients with narrower vessels at the start of the study were more likely to have developed glaucoma ten years later.

This is positive news for at-risk patients, as they might have a fighting chance against the disease by undergoing routine eye examinations. During these exams, doctors can check for vascular changes in the eye, including retinal arteriolar narrowing, which researchers found to be associated with open-angle glaucoma. Detecting changes when comparing results to prior entries in a patient’s electronic medical record will allow ophthalmologists to treat the disease before vision loss occurs.

Other ophthalmology EHR features allow caregivers to easily track disease progression and intraocular pressure over time, as well as monitoring medication compliance and which patients are regularly canceling follow-up appointments.

Who is at risk for glaucoma?

Though patients of all ages and races can develop glaucoma, there are certain groups that have a higher chance of developing the disease. They include:Glaucoma eye exam

  • People over the age of 60
  • People with a family history of the disease
  • People with high internal eye pressure
  • People with certain medical conditions such as diabetes and high blood pressure
  • People of African-American, Hispanic and Asian descent

The American Optometric Association recommends yearly dilated eye exams for at-risk patients and those over the age of 61. Healthy adults aged 18 to 60 should have an eye exam at least once every other year.

A Look Back at PwC’s Healthcare Predictions for 2012

January 2nd, 2013 Amanda Guerrero

healthcare_2012In November 2011, PwC’s Health Research Institute (HRI) released a report outlining what they believed would be the top issues facing the healthcare industry in 2012. Here’s a look at some of those predictions and how they panned out over the last twelve months.

Value-Based Care. The HRI predicted that healthcare organizations would need to adapt to new performance and value-based payment metrics in 2012 – and this actually happened. In the past year, hospitals and healthcare organizations have worked hard to demonstrate that they are delivery higher-quality care to patients in order to avoid being penalized and to attest to Meaningful Use.

The HRI also predicted that employers would “demand performance-based pricing structures with provider, insurance and wellness partners, tying payment to improvements in employee health or reductions in absenteeism.” In the past year, we have seen employers implement workplace wellness programs as a way to reduce absenteeism and employee turnover. Starting in 2014, the Affordable Care Act will allow employers to reward employees who meet health goals through participation in wellness programs. This essentially means that employees who fail to meet these goals (or refuse to participate in a wellness program), could end up paying more for their employer-sponsored health coverage.

Population Health. Heading into 2012, the HRI predicted an increase in payer-provider relationships and greater participation in shared savings programs. A survey they conducted backed this prediction, as nearly three-fourths of consumers reported wanting integrated care models – 38 percent believed it would lead to lower costs and 36 percent said it would increase quality of care. Again, the HRI was right. Accountable care organizations became much more commonplace in 2012, and we even saw big players outside the health industry partner with healthcare providers to improve patient health. We are sure to see more of this in 2013.

Data securityPrivacy and Security. Also on the forecast for 2012 was the privacy and security of patient data. The HRI predicted that healthcare organizations would have to make this a priority in order to reduce security threats and protect sensitive patient information. While this has been a top concern for the healthcare industry, 2012 was a bad year for data breaches. In fact, the security breach at the Utah Department of Health, which took place in April, is reported to be one of the largest data breaches ever recorded by the Department of Health and Human Services. This means that privacy and security will surely be a major issue in 2013 as well.

What are your predictions for 2013?

Proposed Bill Could Lead to Prizes and Grants for Health IT Innovators

December 18th, 2012 Amanda Guerrero

Electronic medical record software innvation prizeThe introduction of electronic medical record software in the healthcare industry has allowed software developers to create additional technologies than can interface with an EMR. With patients and providers increasingly using new devices and applications for health-related reasons, it is important that they meet federal privacy regulations and safety requirements. For this reason, Representative Mike Honda, a Democrat from California, has introduced a bill in Congress that would create an Office of Wireless Health at the Food and Drug Administration (FDA).

According to a press release by Honda’s office, the purpose of the new FDA unit would be “to provide recommendations to the FDA Commissioner on how to develop and maintain a consistent, reasonable, and predictable regulatory framework on wireless health issues.” In addition to the Office of Wireless Health, the bill proposes establishing a mobile health developer support program at the Department of Health and Human Services to advise developers on privacy regulations.

The bill also calls for the creation of a Disruptive Technologies Prize Program to promote and reward health IT innovation. Developers submitting entries for the national prize would need to demonstrate that their technology significantly improves quality of care, reduces costs, and is viable to the market.

The bill would also:

  • Establish a challenge grant program to provide funding to small innovators
  • Provide low-interest loans for physicians to purchase health IT products and services
  • Provide grants to allow medical professionals to retrain employees for new health IT positions
  • Create a tax incentive program so that providers can deduct costs related to electronic medical record software and other health IT products and services

More Physicians Using EMR Software, But Still Lacking Timely Access to Patient Data

December 14th, 2012 Amanda Guerrero

Doctor using EMR softwarePrimary care doctors (PCP) have implemented electronic medical record software at a higher rate than many other physician specialties, with 69 percent of providers using EMR software in 2012 compared with just 46 percent in 2009. The fact that EMR adoption rates have doubled in a three year period shows that PCPs understand the value of the software in improving care delivery and reducing costs. However, there are still improvements to be made. According to a Commonwealth Fund survey of primary care doctors in ten different countries, many providers still complain about not getting patient data on time from hospitals and specialists, hindering their ability to provide comprehensive care.

For the survey, researchers polled general internists, family practice physicians and pediatricians in the following countries:

  • Australia
  • Canada
  • France
  • Germany
  • the Netherlands
  • New Zealand
  • Norway
  • Switzerland
  • the United Kingdom
  • the United States

Results were then compared to data collected from a similar survey in 2009. What researchers found is that, despite more doctors using EMR software, most physicians do not receive timely access to patient data after they are seen by a specialist, nor are they informed by a hospital when a patient of theirs is discharged.

Physicians in Switzerland were most likely to receive information from specialists when needed (27 percent), while those in the Netherlands were least likely to (1 percent). The U.S. landed in the middle of the spectrum and tied with Canada with 11 percent of doctors receiving timely access to patient information. “Lack of integration between primary care, specialty care, and hospitals can put patients at risk and result in duplicative care, particularly for patients with complex chronic illnesses,” said the paper published about the study in the journal Health Affairs.

As far as receiving notification from a hospital following a patient’s discharge, the average for the ten countries was 36 percent. The U.S. fell below the international average, with only 26 percent of physicians reporting that they always receive notification of discharge from hospitals.

This shows that there is still a lot of progress to be made with regards to the U.S. healthcare industry’s goal toward greater care coordination and patient-centered care. While EMR software can help physicians meet this goal, there are still some barriers, such as a lack of interoperability between electronic medical record systems. Vendors and health IT technicians will need to continue working on this flaw to ensure that the electronic exchange of patient information becomes an everyday occurrence.

Study: Most EMR Software-Related Data Entry Errors Involve No Harm to Patients

December 13th, 2012 Amanda Guerrero

Doctor using EMR softwareIt is easy to imagine how a glitch in an electronic medical record system could be detrimental to patient care, but we often fail to think about how human error could be just as damaging. As part of a study related to safety issues with EMR software, the Pennsylvania Patient Safety Authority found that the vast majority of EMR-related problems are not the result of software bugs but of human-induced factors. Still, despite the large number of problems reported, most do not result in adverse outcomes for patients.

For the Authority’s study, 3,099 EMR software-related events were analyzed to determine the error that caused the event and whether patient health was affected by it. What researchers found is that 89 percent of EMR-related problems caused no harm to patients and 10 percent resulted in unsafe conditions. Only 1 percent of events – a total of 16 altogether – involved either temporary or significant harm. This was due to:

  • The wrong medication data being entered (6 cases)
  • The wrong medication being administered (3 cases)
  • A documented allergy being ignored (2 cases)
  • A lab test result not being entered (2 cases)
  • Data not being documented (2 cases)
  • A patient allergy not being documented properly (1 case)

Despite the majority of patients not being harmed by data entry errors in physicians’ electronic medical record software, it is important that further studies be conducted to determine what steps should be taken to prevent mistakes from being made. This is particularly the case with events involving medication errors, as they make up the majority of EMR software-related events (81 percent).

“When most people talk about the safety of health IT, they’re thinking of software bugs, hardware failures, or network problems. But our data show issues that are much more about the human-computer interface or the ways healthcare providers interact with the technology,” said William Marella, program director for the Authority, according to an article on EMR Daily News.

Using Tablets to Access Medical Practice Management Software and Improve Charge Capture

December 11th, 2012 Amanda Guerrero

Doctor viewing medical practice management softwareTechnology is transforming the healthcare industry, with IT solutions such as electronic medical record software slowly finding their way into hospitals and physician practices across the United States. Providers are relying increasingly on electronic processes; yet, in many medical organizations – including those that have implemented medical practice management software – parts of the billing process remain largely paper-based. This is due to the fact that physicians have had a hard time finding an efficient way to capture charges while seeing patients. Now, however, doctors are finding that entering charges on their tablets or smartphones can eliminate billing and coding inefficiencies.

Instead of capturing charges on a paper superbill and having billing and coding staff transfer the information to the EMR or practice management system, doctors can enter the data directly into the billing software themselves. This streamlines the billing process, helps physicians capture charges more efficiently, and reduces the risk of data being lost or entered incorrectly. Plus, by accessing the medical practice management software on their tablets, physicians can access ICD and CPT coding information to ensure that the right codes are being selected, and that patients are being billed correctly for the services they received.

Doctors that treat patients at multiple locations can also benefit from using tablet devices, as tablets are easier to transport and provide access to billing and electronic medical record software outside the physician’s office. This reduces the need for extra paperwork, which can easily be misplaced, as well as discrepancies between the EMR data and information on the paper billing slips. The mobility of a tablet also allows physicians to capture charges quickly and efficiently even while seeing a high volume of patients. This allows medical organizations to get paid faster and to prevent setbacks in the revenue cycle.

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