By Neil Versel

Plenty has been said about the potential for EMRs and telemedicine to improve the woeful state of care in America’s prisons, but juvenile detention facilities often get left out of the discussion.

On Tuesday, Los Angeles County supervisors approved $17 million in funding for an EMR system to manage the medical records of the more than 1,500 youngsters being held in county juvenile camps and halls. The EMR is intended to improve record keeping in the county’s Probation Department, which federal authorities have cited multiple times in recent years for keeping inadequate medical records on youths in custody.

The Los Angeles Times reports that the U.S. Department of Justice has said the poor record-keeping has resulted in “inconsistent or inappropriate treatment and medication.” Los Angeles County currently faces the threat of a civil-rights lawsuit that could strip county officials of some of their control over the Probation Department, the newspaper says.

Though juvenile detainees often get moved between facilities in Los Angeles County, paper records don’t always follow them. The EMR is intended to rectify that problem. The Probation Department’s CIO says the unspecified system should be in place in 15 to 18 months.

Source:http://www.fierceemr.com/story/l-county-approves-17m-emr-juvenile-detention-facilities/2010-06-03

Selecting electronic medical records software is notoriously difficult. The EMR market is flooded with several hundred vendors that cover the full spectrum of pricing and functionality, and clinics often have trouble cutting through the marketing noise.

Federal qualified health centers (FQHCs) are certainly not exempt from this predicament. They too will be required to use electronic medical records by 2015. Since most are using paper charts, the transition to electronic can be especially challenging for them.

When beginning the search for an EMR, we recommend that buyers assemble a list of their key requirements. Specialty-specific templates, lab integration, e-prescribing, and device integration are commonly required features. FQHCs, however, need to consider additional functionality due to their unique offering.

These requirements include:

• The ability to serve a wide range of specialties. Most FQHCs will need a system that supports a broad range of care – primary care, pediatrics, women’s health, behavioral health, physical therapy, dental, etc. While many vendors can address primary care and related specialties, very few can also address mental/behavioral health, therapy, and dental care in a single system.
• FQHC reports. As you know, FQHCs are required to track detailed patient information and provide Universal Services Data (USD) reports on patient demographics, statistics, and trends. Most software vendors on the market will have basic reports for patient demographics and sometimes PQRI, but most will not offer specific FQHC reports out of the box.
• Support for sliding fee scale adjustments. Systems built for FQHCs will allow administrators to apply discounts based on family size and income. Most vendors will not offer this functionality, requiring users to complete adjustments manually. This process can become very labor-intensive and increase the room for human error.
• Efficient workflows for high-volume centers. FQHCs are notoriously busy, with many providers seeing 30-40 patients per day. This large patient load will require a system that allows users to complete notes quickly, calculate charges efficiently, and generate claims automatically. Wasting time with redundant tasks can quickly lower an FQHC’s ability to support high patient volumes.

Although the EMR software market is large and complex, FQHCs can begin their EMR search processes effectively by focusing on software vendors that offer these four features. They will further benefit from the simple fact that fewer software vendors can serve their specialized needs. This smaller universe of potential vendors will help them quickly identify potential options and make the research process that much easier.

Source: http://www.softwareadvice.com/articles/medical/emr-selection-primer-four-essential-features-for-fqhcs-1061510/#ixzz0r6HUnpcG

By, Mike Miliard

NEW YORK – The worldwide market for hospital information systems is positioned for significant growth in the coming years, according to a new study from GlobalData.

The global market is forecast to exceed $18 billion by 2016, after growing at a compound annual rate of 13 percent from its $7.8 billion valuation in 2009.

That growth is primarily driven by hospitals that stand to receive government reimbursements as they try to improve care and increase workflow efficiency with information technology. Overall, the study shows, hospital officials strongly believe that adopting HIS will greatly increase efficiency and reduce medical errors, thus improving quality of care.

The electronic medical records segment is by far the largest segment in the HIS market – valued at $3.4 billion in 2009 and expected to increase at a compound annual growth rate (CAGR) of 15.3 percent over the next seven years.

Practice management is the second largest segment, valued at $1.2 billion in 2009 and growing at a CAGR of 10.8 percent over the same period. Computerized physician order entry (CPOE), pharmacy information systems (PIS) and laboratory information systems (LIS) are projected to grow at a CAGR of 12.1 percent, 9.7 percent and 10.6 percent, respectively.

Current hospital systems are not delivering sufficiently safe, high-quality, efficient and cost-effective healthcare, according to the study, and computerization, with EMR at the center, is effectively the only way forward.

Physicians and healthcare organizations around the world looking to adopt more EMR technologies, and major companies in the market are vying for various collaborations to reach office-based physicians.

Governments in the United States, the United Kingdom, Canada, France, Australia, New Zealand, Denmark and Finland are implementing plans to build integrated computer-based national healthcare infrastructures based around the deployment of interoperable EMR systems. Many of these countries aim to have EMR systems deployed for their populations within the next 10 years.

The HIS market in the United States was valued at $2.6 billion in 2009 and is expected to grow at a CAGR of 19.3 percent over the next seven years. Economic stimulus provided by the American Recovery and Reinvestment Act is expected to increase the adoption rates to 90 percent for physicians and 70 percent for hospitals in the United States.

Source: http://www.healthcarefinancenews.com/news/global-his-market-grow-18b-2016

Urology is a surgical specialty where the doctor focuses on the urinary tract of humans and the reproductive organs of specifically males. EMR is an electronic medical record which has been developed to replace old school medical records. Urology EMR software has been developed to specifically assist doctors in this field.

EMR stands for Electronic Medical Record and is a computerized version of the old paper records and filing system.

The reason that many doctors are switching to electronic versions of medical records is mainly due to the amount of space they take up and the financial implications which come with old school paper records take up. In most places it is common law that medical records need to be held for at least seven years, this can become extremely costly to a doctors office if you add up the various materials it takes to create and upkeep medical records over that period of time.

Paper files can often require an art and some skill to locate and keep tract of. A busy doctors office accumulates hundreds of records and this can become complicated when you need to pull a certain patients file. By switching to EMR, you and your staff will be able to easily locate any file with one simple online search and a few clicks of a mouse.

Above are listed but a few of the many advantages of going online and switching to the electronic method of doing things. There are of course many more benefits that any office can experience such as increased legibility and less room for error, room is allowed for the standardization of medical terminology and abbreviations. These can also be used in medical research for data collection and storage.

One possible downfall of EMR software is that as with any technology it can be accessed by anyone with the power, will and know how. This can result in a problem with patient confidentiality. There are various laws which have been put in place to protect patient privacy so this should not be seen as too big of a concern. All current leading Urology EMR software solutions will have the best security measures in place.

Urology EMR or urology electronic medical records represent computer software available to capture access and store information in busy hospitals and clinics. Urology EMR focuses directly on those records related to urology specialists and patients.

Source: http://www.bmi-resources.com/why-is-urology-emr-so-important-to-urologists/

By Pamela Lewis Dolan,

The technology you adopt for your practice, including electronic medical record systems and smartphones, could become subject to Food and Drug Administration scrutiny. Experts are trying to discern what that level of examination might look like, and what specific technology would be affected.

So far, there’s no clear answer.

The FDA might get involved, experts say, because some kinds of health information technology could be considered medical devices — which the FDA regulates.

Sen. Charles Grassley (R, Iowa) started the high-level discussion about the FDA’s role in health IT in the context of meaningful use of EMRs and the push to get physicians to adopt technology. He sent a letter on Feb. 24 to Health and Human Services Secretary Kathleen Sebelius asking what her agency intended to do to ensure the safety of EMRs, and the role the FDA should play in monitoring them.

The next day, an FDA director stated flatly: “Under the Federal Food, Drug and Cosmetic Act, HIT software is a medical device.”

Jeffrey Shuren, MD, director of the FDA Center for Devices and Radiological Health, made that statement as he reported that his agency had received 260 reports over the past two years of health IT-related malfunctions causing 44 injuries and six deaths. Dr. Shuren’s statement was made to the Health Information Technology Policy Committee, an advisory panel under the auspices of the HHS Office of the National Coordinator, which oversees health technology.

Steve Nitenson, RN, PhD, an adjunct professor in the information technology management division at Golden Gate University in San Francisco, said the FDA has a history of stepping up scrutiny after problems occur. Many believe that the number of deaths and complications Dr. Shuren detailed in his testimony to the advisory committee was an indication that the FDA now feels it is necessary to exercise its authority.

The discussion of FDA oversight has prompted a debate over what is considered a medical device, and what should and shouldn’t fall under FDA regulation.

Experts generally divide health-related applications into three categories — those that clearly could be considered a medical device, those that clearly are not, and those that could go either way.

Nitenson said the FDA already monitors EMR functionalities that involve contact with patients, such as interpreting lab results, for example. Most experts agree that even smartphone applications that are an extension of those systems fall under the medical device category and are thus open to FDA scrutiny.

But when it comes to other uses of technology, “It’s more like the wild, wild West,” Nitenson said. This is the area that would include a combination of systems that would transmit data from one source to another, and the various devices used to store and transmit the data, including mobile devices such as smartphones.

Michael Zeinfeld, founder and president of Complemedia, a Chicago-based company that builds targeted media channels for branding purposes, said one reason the FDA is taking another look at many of these devices is that their mobile counterparts are making applications easier to adopt, and thus the mobile devices are used more widely.

Kyle Heppenstall is the managing director of CompassX Group, a life sciences management consulting firm in Irvine, Calif., that helps clients get systems validated with various federal agencies. His clients include corporations, health care firms, and biotech and pharmaceutical companies that are building technology systems for the consumer market. He advises them that those systems need to be validated, even when they are mobile extensions of existing systems that already are monitored by the government.

Heppenstall said the cost of developing a regulated system could be up to three times more expensive than developing systems that are not regulated. “That is an additional burden that would have to be [paid for] by the owner of the system,” he said.

Particularly with smartphone applications — many of which are inexpensive to develop and cost nothing to download — most experts agree that the cost of developing FDA-compliant applications and software would stifle innovation.

“Finally there’s a place where doctors can go, and health care professionals can go, to get these tools and resources, and you don’t want to make it more difficult for innovation to happen,” Zeinfeld said. “And you shouldn’t have to make it more difficult. Certainly, there’s got to be some middle ground.”

On the other hand, Nitenson, who has worked clinically in emergency and intensive care departments, said, “I would never use, nor would I recommend, [that] a physician use software technology that is specifically designed around a smartphone device that is not strong enough to endure both the HHS mandates and the FDA’s mandate of data security and integrity for medical devices.”

Most experts agree that full oversight of all health information systems likely never would happen. The cost would be too high, and the scope of regulation would be too vast.

But Dr. Shuren did lay out some possible scenarios, most of which would involve tracking problems after a device or software has hit the market. For example, there could be a database of adverse effects, or a registration list of devices. Another option might be a requirement that developers adhere to the FDA’s Quality Systems Regulation, a list of specific guidelines manufacturers must follow.

Nintenson thinks there must be consequences if FDA oversight is to have an impact.

“As long as there is no consequence, people who write software don’t necessarily do things in a more secure manner,” he said.

Above article publish on

http://www.ama-assn.org/amednews/2010/05/24/bica0524.htm

By Marianne Kolbasuk McGee

CIOs rank electronic medical records projects higher than IT managers and directors, who are focused on PC refreshes.

With $20 billion-plus worth of meaningful use bonuses from the government at stake for their organizations, E-medical records and electronic ordering systems are the top IT priorities for hospital CIOs over the next two years, according to a survey.

However, among hospital IT managers and directors, EMR projects ranked further down on the IT priority list, with only 25% naming those initiatives as “most important” for their organization over the next two years.

The survey of 178 respondents, including 36 CIOs and 142 IT directors and managers at hospitals with 200 or more beds, was commissioned by HP and conducted earlier this year by research firm NewGrowth Consulting.

The survey was designed to ask about hospital IT leaders’ IT priorities and plans, especially those initiatives involving PCs.

Among CIOs surveyed, 58% named EMR systems as their most important IT project over the next 24 months, while computerized physician order entry came in at a close second, named by 56%.

Respondents could choose more than one answer.

The CIO results are in synch with the biggest theme in healthcare IT today — the federal government’s push for hospitals and doctor practices to implement EMR, CPOE, and other e-health systems over the next several years.

Under the HITECH portion of the American Recovery and Reinvestment Act signed into law in February 2009, the federal government plans to begin in 2011 rewarding healthcare providers with more than $20 billion over the next several years for their meaningful use of health IT systems such as EMR and CPOE.

Coming in third among top IT priorities of hospital CIOs was security initiatives, named by 47% of respondents, followed by database initiatives, with 42%. Other IT projects on the CIO priority list include bar-coded medication administration (36%); hospital expansion (33%); PC refresh (31%); and thin client/PC virtualization (31%).

However, further down the hospital IT leadership totem pole, IT management priorities — where PCs were involved — differed somewhat from those of CIOs.

Hospital IT managers and directors named PC refresh (51%); security initiatives (42%); and CPOE (37%) as their top IT projects for the next 24 months. That was followed by hospital expansion (34%); BCMA (33%); and database initiatives (30%).

Among hospital IT managers and directors surveyed, EMR ranked 7th, being named by 25% of the respondents. The survey also found that nearly two-thirds of hospital CIOs planned PC virtualization for some of their client hardware.

Also, nearly six in 10 hospital CIOs said their organizations did not have a telemedicine program, while 41% said their hospitals did have such initiatives underway. Most CIOs with telemedicine programs plan to expand those efforts in the next 24 months.

Above article publish on http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=224700871

I always love to hear clinics talk about the challenges they face in implementing an EMR. For the most part, they are completely predictable. Especially when it comes to the small versus large clinic challenges.

For example, small clinics will complain that they don’t have the resources that large clinics have to implement an EMR. Large clinics will complain that they have too much bureaucracy, red tape and stakeholders that they have to get on board an EMR implementation. They wish they were like smaller clinics who could quickly make decisions and had a much more focused need.

Of course, the reality is that both of these point of views are accurate. It’s not news that small clinics can make decisions easier and that larger clinics have more resources at their disposal. Certainly a generalization, but the reason it’s a generalization is because it’s generally true.

Since both small clinics and large clinics both face major challenges of resources and red tape respectively, then how does any clinic get over them and implement an EMR? Let’s be honest, it’s really more a matter of the priority EMR is given than anything else. So far many doctors offices haven’t decided to make their EMR implementation a priority. Once a clinic makes EMR a priority, it’s really quite amazing to see what happens.

The good news is that for many clinics, the EMR stimulus money has changed this fact and bumped EMR adoption up on their priority list. Plus, in the 4+ years I’ve been writing about EMR software, EMR software has come a really long way. Sure, they still have a ways to go, but the EMR software of today is much improved and can provide some real value to a clinic if implemented correctly.

It’s time to address the excuses for why you can’t do an EMR and start focusing on the benefits you can receive from an EMR. Notice I didn’t say “ignore” or “hide” the excuses. We need to address the excuses people are giving and see what benefits you might be missing because you’re not using an EMR. I know very very few people who use an EMR and would ever want to go back to paper. There’s a reason for this.

Above article publish on

http://www.healthrotate.com/emr-implementation-in-small-and-large-clinics/

By Jonathan G Ponting

Latest technology has simplified our lives to a great extent. Internet is helping to simplify many complicated procedures and few examples of the same are exchanging messages, contacting people in distant places using chat and emails, online shopping, reading information of latest events and happenings across the world and collecting information required related to any topic.

One of the most benefited industries from internet is the field of medicine. The latest innovation of medical technology is online patient portals. It is designed to increase communication and relation between patient and health care providers.

Online patient portal helps in efficiently managing the available resources with the local physician or provider to reduce the cost of treatment for both patient and the provider that uses advanced technology. It also enables doctors and providers in transmission of everything that is related to treatment of the patients like medical images for diagnosis, reports, medical date related to patient etc. It is also helpful in educating local physicians online on preventing development of chronic diseases via video conferences.

Online portals are also helping physicians to easily schedule appointment with patients as there is increase in demand for health care services which helps patients in avoiding to stand in lengthy lines. Patient portal helps patients to have better understanding of the disease they are suffering from, with the help of information provided and can also request for renewal of prescriptions at these portals. Patients are also offered to join various groups where other members also suffer from similar chronic diseases which help in lifting of spirits.

Patient portals not only help patients to directly contact with physicians but also to have remote access to mobile tools. Online patient portals are helping to improve quality of health care in remote and rural areas.

Patient portals are best and easy way of contacting doctors for various ailments and getting them treated without waiting for long time. They are best sources of getting advanced treatment for patients’ condition at affordable prices. They are highly beneficial for both patient and the health care provider in offering and availing best of treatments irrespective of geographic location.

Above article publish on http://healthcareblog01.wordpress.com/2010/05/04/online-patient-portal-another-innovation-of-medical-technology/

By Rich Silverman

We talk a lot in this blog about the financial aspects of Electronic Medical Records (EMRs), and with good reason – they can entail a substantial investment in time and money. But it’s sometimes easy to lose sight of the purpose of all that investment – to save lives.

There has been a great deal of research conducted into how much it will cost to implement an EMR, yet there has not been a lot of research into their impact on patient outcomes. A recent study shows that the adoption of Electronic Medical Records and Radiology Information Systems (RISs) in hospitals in the U.S. actually lowers infant mortality in this country. Research conducted by Amalia Miller of the University of Virginia and Catherine Ticker of MIT’s Sloan School of Business showed that when hospitals adopt EMRs and RISs, their infant mortality rates drop.

Using data on births and infant mortality already collected by the U.S. Government, and statistics on health care information technology adoption provided by the Health Information Management Systems Society (HIMSS), the researchers compared infant mortality in selected areas of the country where data was available (privacy laws limited that data pool) with the adoption of EMRs and RISs in those same areas.

After correcting for a wide range of variables, the researchers came to the following conclusions:

The adoption of EMRs by one additional hospital in a county reduces infant mortality by 13%.

The average cost of the HIT used to save that baby is about $450,000.

The reduction of infant mortality is twice as great for African-Americans than non-African-Americans.

The median cost to implement EMR in a hospital, according to a 2007 America Hospital Association study was $5,556 in capital costs per bed and $12,060 per bed per year in maintenance costs.

The authors studied “bare-bones” HIT implementations of EMRs, and only looked at the impact on neonatal and infant health outcomes. They suggest that more robust implementations of HIT, including decision-support and computerized physician order entry, as examples, will extend the beneficial effects of HIT to other classes of patients.

This research serves as a gentle reminder that the HITECH Act was intended to provide incentives for physicians and hospitals to implement and use Electronic Medical Records because EMRs will improve patient outcomes and save lives. This research shows that they do.

Above article publish on http://blog.pchealthstop.com/?p=985

Between 75-85 percent of physicians with EHRs are already using functions that meet some of the proposed criteria for demonstrating meaningful use, according to analysis from Seth O. Hogan, survey director, and Stephanie M. Kissam, health services research associate, at RTI International in Chicago.

The authors of the survey, published in the April edition of Health Affairs, said their analysis contributes new information about the rates at which primary care physicians, medical specialists and surgical specialists who had a basic EHR system used specific functions before the passage of the stimulus law, compared to the level of expected meaningful use of EHRs set forth in the proposed federal regulations.

“Among physicians who had key functions available to them, 75-85 percent reported using functions in the patient record category. These functions included organizing patient information such as sex and date of birth, lists of medications taken by the patient, problem lists or the current diagnoses of patients and clinical notes,” wrote the authors.

A stratified random sample of 5,000 U.S. office-based physicians was drawn from the American Medical Association’s Physicians Masterfile where, after 516 were determined as ineligible, 2,758 of the 4,484 eligible physicians completed the surveys during a data collection period from August 2007 to February 2008, yielding a 62 percent response rate.

The authors sorted completed interviews by whether physicians reported having a basic EHR system, meaning that it offers practitioners, at minimum, the following functions: the ability to record patient demographics, including name, address and sex, inclusion of patient problem lists, clinical notes, patient medication lists, and orders for prescriptions and electronic viewing of laboratory and imaging results. “Applying these criteria resulted in a sample of 485 physicians eligible for analysis,” the authors noted.

Fewer than one in five physicians reported having at least a basic EHR system, the survey found. Of those who did, primary care physicians were the most likely to report having a basic EHR system (19.4 percent). Medical specialists were the next group most likely to have a basic EHR system (17.1 percent) followed by surgeons (16.7 percent). “Availability of additional EHR functions, beyond those defined in a basic system, varied across all physician groups,” the authors wrote.

The use of these basic functions did not differ significantly by broad medical specialty yet the authors reported these data to provide baselines for tracking changes by specialty groups over time.

According to the survey, 79 percent of 306 responding physicians whose EHR systems had warnings for drug-to-drug interactions used this function. For information exchange functions, the authors also reported on the use of sending prescriptions electronically (79 percent of 265 respondents whose records had this function) and submitting laboratory orders electronically (used by 64 percent of 256 respondents whose records had this function).

“Public health reporting functions were less commonly used among the small number of physicians who had those functions available to them,” the authors wrote. In addition, only 27.6 percent of the 128 responding physicians said they could provide at least 10 percent of unique patients with timely electronic access to their health information, the authors found.

“To qualify for new federal funds intended to promote the widespread adoption and use of EHRs, U.S. physician practices must meet the government’s meaningful use benchmarks,” concluded the authors. “Tracking the use of EHRs across different types of providers will be a critical component in evaluating how their use affects healthcare costs, quality and safety and overall population health measures.”

Above article publish on http://www.healthimaging.com/index.php?option=com_articles&view=article&id=21577:healthaffairs-about-80-of-emr-users-meet-some-meaningful-use-criteria