For years controversy has surrounded whether electronic medical records (EMR) would lead to increased patient safety, cut medical errors, and reduce healthcare costs. Now, researchers at the University of Pennsylvania School of Medicine have discovered a way to get another bonus from the implementation of electronic medical records: testing the efficacy of treatments for disease. In the first study of its kind, Richard Tannen, M.D., Professor of Medicine at the University of Pennsylvania School of Medicine, led a team of researchers to find out if patient data, as captured by EMR databases, could be used to obtain vital information as effectively as randomized clinical trials, when evaluating drug therapies. The study recently appeared online in the British Medical Journal. “Our findings show that if you do studies using EMR databases and you conduct analyses using new biostatistical methods we developed, we get results that are valid,” Tannen says. “That’s the real message of our paper - this can work.” In January 2009, President Barack Obama unveiled plans to implement electronic medical records nationwide within five years, arguing that such a plan was crucial in the fight against rising health care costs. Of the nearly $900 billion in Obama’s planned stimulus package currently before the United States Senate, $20 billion is proposed for electronic health records. Tannen says he and his group recognized that the large EMR databases containing compiled medical information could potentially give researchers the ability to study groups reflective of the total population, not just those who participate in clinical trials, and circumvent studies too costly or unethical for clinical trials. However, such databases contain observational information, which critics argue do not offer the same level of control as randomized trials. “Our study cautiously, yet strongly, suggests that enormous amounts of information within electronic medical records can be used to expand evidence of how we should or shouldn’t manage healthcare,” Tannen says. To address criticisms of observational studies, Tannen’s group had to first determine a way to use EMR databases for insights on therapy efficacy and then prove the results they found were valid. Beginning six years ago, Tannen’s team selected six previously performed randomized trials with 17 measured outcomes and compared them to study data from an electronic database — the UK general practice research database (GPRD), which included the medical records of roughly 8 million patients. Treatment efficacy was determined by the prevalence of cardiovascular outcomes, such as stroke, heart attack and death. After using standard biostatistical methods to adjust for differences in the treated and untreated groups in the analysis of the database information, Tannen found that there were no differences in the database outcomes compared to randomized clinical trials in nine out of 17 outcomes. In the other eight outcomes, Tannen’s group used an additional new biostatistical approach they discovered that controlled for differences between the treated and untreated groups prior to the time the study began. By using the new biostatistical method instead of the standard approach, the researchers showed there were no differences between the outcomes in the EMR database study compared to the randomized clinical trials. Though Tannen warns the ability to use EMR databases from the United States to measure the efficacy of therapies will take more than 10 years of national data, he says the results of his study should serve as a catalyst for more researchers to explore the accuracy of the information that can be obtained using EMR database studies. “An appropriately configured EMR database could offer an invaluable tool, but we need to get to work now on how to configure it properly,” Tannen says. “If we don’t worry about this issue right now and promote a higher investment in the area of EMR research, we’ll lose an opportunity, an enormous health opportunity.” Mark Wiener and Dawei Xie from Penn are co-authors on this study. This research was funded by a grant from the National Institutes of Health. Above article originally published on www.sciencedaily.com

So it looks as if the nation’s taxpayers are going to spend about $20 billion to accelerate the use of computerized medical records. In his press conference Monday night, President Obama went out of his way to explain why that money belonged in the economic stimulus package. It is, he said, a job-creating investment in both the present and the future that will improve the quality of care and save lives.
But in a letter delivered Tuesday to the White House and Congressional offices, 50 of the nation’s leading experts in electronic health records - most of them physicians themselves - warned that “an historic opportunity to achieve quality and efficiency gains through health information technology will be lost,” unless the government channels the spending carefully.
Just throwing money at doctors, they say, is not going to work. “The challenge is going to be all about implementation,” said Dr. Blackford Middleton, chairman of the Center for Information Technology Leadership, a research arm of Partners Healthcare, a big nonprofit medical group in Boston that includes Massachusetts General Hospital. “Where is the money going to flow and what is the mechanism of implementation?”
Dr. Middleton and others who signed the document say the answer lies in replicating a few standout community projects that have had success in offering installation help, technical support, buying power and training to small physician practices. The small group practices will be where the Obama administration’s push succeeds or fails because 75 percent of the nation’s physicians work in offices of 10 doctors or fewer.
The health information technology provisions in the stimulus bill are a step toward the goal of nearly universal electronic health record adoption over the next 10 years (compared with 17 percent today). The central feature of the plan is incentive payments for using electronic records for improvements in health quality, efficiency, prevention and safety.
But the experts’ letter focuses on the importance of properly financing and assigning a significant role to the “Regional Health IT Extension Centers,” which are called for in the bill. The experts see these centers as a critical bridge to success for a nationwide rollout of electronic health records. In their document, they point to two examples of excellence, the Massachusetts eHealth Collaborative and New York City’s Primary Care Information Project.
The New York project began two years ago with $27 million in funding and a commitment to help small practices, especially in disadvantaged neighborhoods, adopt and use electronic health records. It has worked with software suppliers to tailor a health record suited for its purposes. The project’s leaders insisted that the patient information in the electronic records could be shared across a community health network, linking doctors offices, clinics and hospitals. The project provides centralized technical support, education and know-how for doctors and others. It began rolling out its records about a year ago, and they are now used in two hospital outpatient clinics, 10 community health centers, 150 small group physician practices and one women’s jail, serving a total of one million patients.
I asked Dr. Farzad Mostashari, the assistant commissioner in the New York City Department of Health in charge of the primary care information project, what he’s learned. “There is no way that small practices, especially in underserved areas, can effectively implement electronic health records on their own,” he said. “To get a public benefit, and widespread adoption, just giving cash to doctors is not going to work.”
Above Article originally published on http://bits.blogs.nytimes.com/2009/02/10/electronic-health-records-how-to-spend-the-money-wisely/

SCHAUMBURG., The Certification Commission for Healthcare Information Technology (CCHIT)), the federally recognized body for testing and certifying electronic health records (EHRs), has announced it will develop dermatology-specific functionality criteria beginning in 2009. The CCHIT’s decision was in part a response to an application from the American Academy of Dermatology with support from the American Society for Dermatologic Surgery, American Telemedicine Association, the Medical Dermatology Society, and the Society for Investigative Dermatology as well as overwhelming support from the dermatology community and other key stakeholders.

“Beginning in 2006, CCHIT has placed a ’seal of approval’ on physician office-based EHR products to indicate that the system has met rigorous functionality, interoperability and security criteria for primary care, child health, and cardiology. The American Academy of Dermatology is pleased that the unique needs of dermatologists — who use digital images and body mapping to track patient health — will be recognized,” said dermatologist C. William Hanke, MD, MPH, FAAD, president of the American Academy of Dermatology. “This will be a service to the health care community as it continues to transition to a system that relies on electronic health records and the smooth and secure interchange of data. Dermatologists are committed to helping create functional criteria and technical elements that also will help many different physician specialties.”

CCHIT will appoint a work group of volunteer providers, payers, health IT vendors and other stakeholders to define those functions that will best help dermatologists enhance patient care quality and safety, improve practice efficiency, participate in clinical research and maintain board certification. In addition to spurring EHR adoption by dermatologists, developing dermatology-specific certification criteria has the potential to facilitate EHR care coordination between and among dermatologists and non-dermatologist physicians in various practice settings. CCHIT is expected to launch the dermatology-specific EHR certification program in 2010.

EHR systems refer to individual patients’ medical records in a digital format. These systems aid with accessing clinical information that can enhance patient care by helping to prevent medical errors, improve quality and facilitate clinical research. EHRs have grown in popularity amongst all physicians including dermatologists. However, barriers such as affordability, reliability, and whether the product will communicate with other electronic systems have kept many physicians from fully embracing these systems.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential representative of all dermatologic associations. A sister organization to the Academy, the American Academy of Dermatology Association is the resource for government affairs, health policy and practice information for dermatologists, and plays a role in formulating socioeconomic policies that can enhance the quality of dermatologic care. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.

Many dermatology practices, are using OmniMD EMR to increase the efficiencies and reduce their costs

The medical information age.

With the recent explosion in information and technology over the past twenty years come vast changes throughout every industry worldwide. The medical industry itself has not been exempt from the transition from paper forms of data, to computerized electronic forms. The revolution of converting huge amounts of records, x-rays, names and prescriptions is very time consuming but nevertheless, it must be done. The same thing is taking place in the music business with cd’s being phased out of the market to give rise to mp3’s. Even though it hasn’t happened overnight, it is still a necessary step in the progression of human needs. The difference with the medical field is human lives are what’s at stake opposed to human desires.

Controversy.

Many patients are choosing to be implanted with radio frequency identification (RFID) transmitter inside of their body that stores their entire medical background. Some states have made it mandatory for aids and Alzheimer patients to get the implant for their own good. In the event of an emergency where a patient may be unable to respond to health care workers questions, the information regarding the patient may still be obtained. This controversial technique to store information has forced the entire medical structure to re-examine its own information storage and retrieval procedures. Are health care facilities equipped to handle the ever growing amount of patients in an accurate and timely manner? The answer is yes, however the medical field at large has been slow to adapt. The benefits far outweigh privacy issues that are often discussed surrounding electronic storage of medical records. All computer systems as well as communication methods may be vulnerable to attacks but it certainly doesn’t stop their increased use.

Electronic Medical Records (EMR)

It is no secret that clinical physician assistants prefer electronic medical records over out-dated paper documents. The biggest complaint amongst them is being forced to serve as not only an assistant but a secretary as well. There is just too much administrative work to take care of!

Practitioners who use electronic forms of record keeping are able to almost instantly engage their patients covering vast amounts of data from the computer. Digging in file cabinets, verifying past treatments etc. are rendered obsolete by simply using inexpensive powerful software designed for medical professionals. The rampant prescription drug abuses are being eliminated with multifunction safeguards that allow doctors to know conclusively who they are dealing with at any given moment. Forgeries and similar crimes are easily detected and the decrease in illegal activities lowers overall health care insurance cost.

Conclusion.

Regardless of how any of us may feel about the rise of medical technology and information, it is here to stay. The quicker we learn to utilize it for our advantage the better off we will be.

Above article published on http://www.articlesbase.com/computer-forensics-articles/using-emr-software-in-the-information-age-763158.html

Energy has been getting a huge amount of play in President Obama’s stimulus package. But we’d be remiss if we didn’t look at another massive piece of the plan, namely, the modernization of the American healthcare system. It’s getting $189 billion of the total $787 billion. So, what does that mean, and where’s the money going to go?

One element of modernization is to turn paper records into ones and zeroes, with great cost savings expected in the future. It’s a costly proposition to implement, though, which is why many doctors have resisted the switch for years. We’re talking up to hundreds of thousands of dollars per doctor. Included in the stimulus package is some money to make the move less painful.

Sometimes, the decision to switch to e-records is made for the doctor. Take the case of Dr. Regina Benjamin of rural Bayo La Batre in Alabama. Her family practice that treats the poor and uninsured was destroyed by Hurricane Katrina. She was drying out her old paper records and mulling a move to computerized record-keeping, when the partly refurbished clinic burned down.Then it was time. She’s been using electronic records for about two years now, and says “toughest part would be training my gray-haired, 20-year employees how to use a computer when they did not know what a mouse or pointer was.

She says it’s invaluable for improving health care.“When a patient or pharmacy calls at night or on a weekend, I do not have to rely on memory. I can access the chart from any computer, at home, from the hospital, from my hotel room when traveling.

This prevents errors and I can give better care. I can also quickly look at trends and patterns, pick up things earlier than if I had to look thru paper charts.” She was able to fund her conversion through donations and foundation support.

Traveling through Cambridge, Ohio I found a doctor’s office that started using the NextGen electronic system. Dr. Patrick Goggin converted to EMRs about five years ago. It cost about $300,000 to convert. Dr. Goggin did it because of the ease of e-prescriptions (e-mailing prescriptions to patients’ pharmacies) and the shift to “patient-centered” medical care (where a central database lives to serve multiple doctors). Though it’s apparently sometimes hard to retrieve outside information, another tough problem can be converting old paper records. Dr. Goggin found they were only able to transfer the previous six months of records, on average, because by the time they entered everything, it would be obsolete. Dr. Goggin also says it allows him to call up a patient’s record from the road and provide instant care. Another doctor in the office, Dr. David Ray just recently came to the practice, accompanied by his room of thousands of paper files. “Advantages are not quite there as far as outweighing the costs,” he says.

“The technology is probably just not quite there yet for most solo practitioners and small practices to implement such a system.” I shot a few minutes of Dr. Patrick Goggin treating a few patients so you can see how it works in situ.

Article printed from Andy Jordan’s American Journey: http://blogs.wsj.com/american-journey

URL to article: http://blogs.wsj.com/american-journey/2009/02/26/how-doctors-will-use-their-stimulus-mone/