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January 06, 2011
OmniMD™ EHR Version 11.0 Receives ONC-ATCB 2011/2012 Certification
Filed Under (ARRA, CCHIT, EHR, EMR, Electronic Health Records, Electronic Medical Records, Health, Hospital) by admin

FOR IMMEDIATE RELEASE: January 5, 2011
Media Contact:
Ted Dave
pr@omnmd.com
tdave@omnimd.com

January 5, 2011 – Integrated Systems Management Inc announced today that OmniMD™ EHR, Version 11.0 is 2011/2012 compliant and was certified as a Complete EHR on January 4, 2011 by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable (eligible provider) certification criteria adopted by the Secretary of Health and Human Services. The 2011/2012 criteria support the Stage 1 meaningful use measures required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

According to Divan Dave, CEO, of OmniMD™ “This certification is another step in our commitment to provide providers with intuitive, easy-to-use, affordable technologies that help them improve patient care, reduce their costs and qualify for government incentives”.

The ONC-ATCB 2011/2012 certification program tests and certifies that Complete EHRs meet all of the 2011/2012 criteria and EHR Modules meet one or more – but not all – of the criteria approved by the Secretary of Health and Human Services (HHS) for either eligible provider or hospital technology.

“CCHIT is pleased to be testing and certifying products so that companies are now able to offer these products to providers who wish to purchase and implement certified EHR technology and achieve meaningful use in time for the 2011-2012 incentives,” said Karen M. Bell, M.D., M.S.S., Chair, CCHIT.

OmniMD™ EHR, Version 11.0 certification number is CC-1112-484340-1. ONC-ATCB 2011/2012 certification conferred by CCHIT does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

The clinical quality measures to which OmniMD™ has been certified include:

NQF 0421 - Adult Weight Screening & Follow-Up
NQF 0013 - Hypertension: Blood Pressure Measurement
NQF 0028 - Tobacco Use Assessment and Cessation
NQF 0041 - Influenza Immunization
NQF 0024 - Weight Assessment and Counseling
NQF 0038 - Childhood Immunization Status
NQF 0034 - Colorectal Cancer Screening
NQF 0043 - Pneumonia Vaccination Status
NQF 0067 - CAD: Oral Antiplatelet Therapy
NQF 0084 - Heart Failure: Warfarin Therapy

OmniMD™ EHR Version 11.0 is also certified in CCHIT’s separate and independently developed certification program. OmniMD™ Version 11.0 is a pre-market CCHIT Certified® 2011, Ambulatory EHR. Integrated Systems Management Inc. has certified its EHR technology in both programs to provide greater assurance to its customers.

About Integrated Systems Management, Inc

Founded in 2000, OmniMD™ integrated Electronic Health Records and Practice Management (PMS) products and services, offers unparalleled reliability, ease-of-use, efficiency and customizability. OmniMD™ Ambulatory EHR has also earned a designation as a pre-market CCHIT 2011 Certification with the highest 5 Star Usability Rating ensuring OmniMD™ commitment to have a comprehensive, secure, scalable, intuitive and interoperable EHR system. OmniMD™ Ambulatory EHR Version 11.0 is CCHIT 2011 Pre-Market Certified, web-enabled and support devices ranging from Tablet PCs to Smart phones. OmniMD™ offers a comprehensive set of services such as Health Transcriptions, Document Management, Patient Portal, Patient Reminder and Eligibility Verification as part of an integrated solution under one roof helping practices to effectively addressing their financial, administrative, clinical, and regulatory needs. OmniMD™ Ambulatory EHR Version 11.0 is built as a true Software as a Service solution.  It can be deployed as an Enterprise or a Subscription based Service as per the practice requirements.  OmniMD™ is designed to exceed the present and future needs of the healthcare industry. OmniMD™ is robust, scalable, interoperable, secure, intuitive and customizable with rapid deployment model. OmniMD™ EHR has also achieved Surescripts® Gold Solution Provider status, which allows for interoperability with the nation’s community pharmacies - improving the safety, efficiency and quality of the prescribing process. Gold Solution Provider status is granted to vendors whose software products have surpassed Surescripts’ baseline product certification, by demonstrating a higher level of commitment to e-prescribing, enhanced security, excellent customer support and service. OmniMD™ is a division of Integrated Systems Management, Inc. – ISM Inc. - (www.ismnet.com) a leader in Software Development and Information Technology Consulting since 1989.

About CCHIT

The Certification Commission for Health Information Technology (CCHIT®) is an independent, 501(c)3 nonprofit organization with the public mission of accelerating the adoption of robust, interoperable health information technology.  The Commission has been certifying electronic health record technology since 2006 and is approved by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) as an Authorized Testing and Certification Body (ONC-ATCB).  More information on CCHIT, CCHIT Certified® products and ONC-ATCB certified electronic health record technology is available at http://cchit.org.

About ONC-ATCB 2011/2012 certification

The ONC-ATCB 2011/2012 certification program tests and certifies that EHR technology is capable of meeting the 2011/2012 criteria approved by the Secretary of Health and Human Services (HHS). The certifications include Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology and EHR Modules, which meet one or more – but not all – of the criteria. ONC-ATCB certification aligns with Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology published in the Federal Register in July 2010 and strictly adheres to the test procedures published by the National Institute of Standards and Technology (NIST) at the time of testing.   ONC-ATCB 2011/2012 certification conferred by the Certification Commission for Health Information Technology (CCHIT®) does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

“CCHIT®” and “CCHIT Certified®” are registered trademarks of the Certification Commission for Health Information Technology.

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October 27, 2009
Secondary use of EMR data seen reducing costs, improving quality
Filed Under (EHR, EMR, Hospital) by admin

While few practices and hospitals currently use aggregated patient data, the number is expected to increase, and a new study touts the information’s benefits.

By Pamela Lewis Dolan, amednews staff,

One of the biggest untapped benefits of electronic medical record adoption is the secondary uses of the data that are being collected, concludes a study by PricewaterhouseCoopers.

The study, “Transforming Healthcare through Secondary Use of Health Data,” found that practices and hospitals have seen aggregated data from their electronic medical records identify patterns that have allowed them to improve outcomes, reduce errors and increase revenue opportunities.

But the number of institutions using the aggregated, or secondary, data in this way is very small, though it is expected to grow in the next two years.

“Almost every constituent in the [health care] industry that has to make a decision around what type of health care to deliver and when could use this kind of data and the information that aggregating it can produce,” said Dan Garrett, health IT practice leader at PricewaterhouseCoopers.

The report found that among those organizations already using some form of secondary data, 59% have seen quality improvements, 42% have achieved cost savings, 36% have seen patient/member satisfaction improve, and 29% have increased revenue. The biggest users of secondary data are hospitals and physicians, while health plans are the farthest behind.

The survey found that although 95% of physicians are not opposed to using secondary data, many are sensitive to how it should be used. Patients also are concerned.

“We all know we need to use this data, but they also know we can’t risk security,” Garrett said.

The PricewaterhouseCoopers report came from an e-mail survey conducted in June of 732 health care executives, 482 physicians, 136 payers and 114 pharmacy/life sciences organizations.

Above article published on http://www.ama-assn.org/amednews/2009/10/19/bise1023.htm

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September 24, 2009
Blumenthal: More research needed on health IT effectiveness
Filed Under (EHR, EMR, Health, Hospital) by admin

By Neil Versel

Acknowledging that the body of scientific evidence on the efficacy of health IT still is rather scant, national health IT coordinator Dr. David Blumenthal is anticipating a flood of new research as a result of the federal stimulus that encourages wide adoption of electronic health records. To date, most of the research has focused on health IT in specific environments, such as a single hospital, physician office or integrated delivery network, but the stimulus will help put EHRs in new settings that haven’t been studied.

“We are going to be hungry for how to implement health information technology the most efficiently to gain the greatest value for the health IT investment,” Blumenthal told a gathering convened by the Agency for Healthcare Research and Quality last week. “We’re at that transition that we see every time a new technology is moved out from the laboratory.”

Blumenthal advocated clinical decision support technology that encourages continuous quality improvement by delivering research data and new treatment information to the point of care, easily accessible by clinicians. “One thing we haven’t done is apply the scientific method in the practice of healthcare and medicine,” he said.

But he and other health IT experts at the same AHRQ conference cautioned that the road to achieving “meaningful use” of EHRs will be long and fraught with all sorts of danger.

Above article published on

http://www.fiercehealthit.com/story/blumenthal-more-research-needed-health-it-effectiveness/2009-09-21#ixzz0S12KjFSn

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September 21, 2009
Electronic health records open patient privacy questions
Filed Under (CCHIT, EHR, EMR Stimulus Package, Hospital) by admin

Advisory panel considers privacy proposals

By Alice Lipowicz

A federal advisory panel today heard several proposals about how to best protect patient privacy while creating and sharing electronic health records (EHRs).

The Health Information Technology Policy Committee convened to prepare recommendations to the Health and Human Services Department on distributing $19 billion in economic stimulus funding for incentive payments for EHRs and health information exchanges. The bulk of the money will go to doctors and hospitals that buy certified record systems and participate in the exchanges. HHS is expected to issue a rule by year’s end.

Dr. Deborah Peel, founder of the Coalition for Patient Privacy, said the core of privacy is patient control of the information in EHRs.

“The right to privacy and control is the national consensus,” Peel said, “It reflects centuries of medical ethics. We are asking you to set a high bar for privacy to meet with patients’ expectations.”

She suggested patients should be allowed to consent, or not consent, to each disclosure of the information, and for the information to be segmented to maintain different levels of disclosure for different pieces of information. Industry does not want to change its practices, so it is best if regulations are created to enforce patient consent management rules, she added.

However, patient consent, by itself, has not proven to be effective tool, asserted Deven McGraw, a member of the advisory panel and director of the health privacy project at the Center for Democracy and Technology.

“Although the concept of patient control is very appealing, consent does not work the way we want it to,” McGraw said. “Consent does not provide protection.”

That is because health insurers often require blanket consent forms in which patients authorize a very broad variety of uses and disclosures that are not well understood by patient, she said. Patients don’t really have a choice, because if they don’t sign the consent form, the insurer will deny coverage, McGraw said.

The solution is to include patient consent in a comprehensive framework of technical and legal standards for IT systems, networks, practices and training, along with other features, she said.

The committee also heard discussions about the use, disclosure, secondary use and stewardship of the personal health data. It also is considering audits and accountability for the EHR systems and models for data exchange, data storage, data de-identification and re-identification.

In July, a separate advisory committee to HHS, the Health IT Standards Committee, considered specific recommendations for patient privacy that included encryption, strong access controls and audits.

Above article published on

http://fcw.com/Articles/2009/09/18/HHS-panel-considers-patient-consent-for-privacy-in-EHRs.aspx?Page=1

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September 17, 2009
Tips for Ensuring Successful EHR Adoption
Filed Under (EHR, EMR, Electronic Health Records, Electronic Medical Records, Health, Health IT, Hospital) by admin

By Don A. Solberg, MD, Kathryn L Houck and Jim Roberts

Successful electronic health record (EHR) adoption not only improves quality of care by making patient information easily accessible, it also provides valuable clinical decision support. In addition, organizations benefit from streamlined operations — enabling physicians to spend less time on charting and documentation, and more time engaging in face-to-face interactions with patients.

Despite these obvious advantages, however, many physicians are resistant to adopting EHR systems.

A number of factors account for this resistance. First and foremost, organizations are leery of the cost and disruption that can sometimes accompany the conversion from manual to automated processes. Second, a portion of older physicians — who often serve as the leaders in an organization — are typically less comfortable with new technologies than their younger counterparts. And finally, some physicians believe that taking the time to electronically document patient visits will negatively impact patient interaction because it means spending time in front of a computer screen rather than with the patient.

Kittitas Valley Community Health Information Network is an electronic information-sharing partnership linking 30 providers — about 90 percent of all primary care providers in the county — from seven locations. When we implemented our EHR system in 2007, we utilized several strategies that proved instrumental in overcoming anticipated obstacles and ensuring successful adoption:

1) Locate a physician champion. When identifying champions, we looked for those physicians who had a track record of adopting new technologies, were able to maintain positive attitudes despite occasional setbacks and, most importantly, were well-respected by their peers. These champions could clearly articulate the goals and enthusiastically promote the benefits of a fully functioning EHR system to other physicians — helping to encourage even initially skeptical providers to get onboard.

2) Set honest, realistic expectations for physicians and their staffs. The more complex and sophisticated an EHR system, the more challenges a practice might experience in the early stages of implementation. However, we found the potential productivity gains and cost savings ultimately outweighed any inconveniences. By ensuring that everyone understands that there will be a learning curve and that they will experience some growing pains on the front end, you can alleviate frustration and set a positive tone post-implementation.

3) Ask each location to designate a physician, nurse and administrative user to participate in several days of training with the EHR vendor. These “super users” were then available to help others navigate the EHR system, reducing the need for support while building staff camaraderie.

4) Prepare for the transition. In our case, each location went to an abbreviated schedule for two weeks — scaling back patient volume so that physicians and administrative staff would have adequate time to train on the new system. In hindsight, we would recommend that organizations allow a full month for staff to get comfortable and then gradually add back patient visits each week. For example, a practice might take four patient slots out of both the morning and afternoon schedules during the first week, three slots during the second week, two during the third week, and so on. Providing staff members with the opportunity to use the system while performing their daily routines enables them to learn at a comfortable pace.

5) Use a staged rollout. We did not do this during our initial implementation, but have used it several times with processes and changes adopted since. Within each location, two to three physicians, who were committed to the EHR system and willing to work through any stumbling blocks, were selected for initial implementation. Working with fewer physicians at the onset enabled the implementation staff to provide a strong support system, and helped ensure that any issues or concerns were resolved early in the deployment process. Once the first few physicians went live in each location, other providers were added two at a time. That way, each successive group of physicians could seek guidance from colleagues who were already using the system and could witness firsthand the successful utilization of an EHR system.

As an increasing number of health care organizations take advantage of the dollars offered by the American Recovery and Reinvestment Act to deploy EHR systems, it will become even more important to ensure timely and successful adoption of these systems. By setting realistic expectations among key stakeholders, identifying hurdles early and putting plans in place to proactively deal with any challenges that may occur, the likelihood of a smooth transition is significantly increased.

Above article published on

http://health-care-it.advanceweb.com/editorial/content/editorial.aspx?cc=202207&CP=2

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September 10, 2009
CCHIT maps out path to certification with meaningful use focus
Filed Under (Drug, EHR, EMR, Hospital) by admin

Diana Manos, Senior Editor

The Certification Commission for Health Information Technology is expected to release more details on its “modular” certification on Sept. 24, and it is also tentatively planning training sessions in Chicago on Sept. 29 and Oct. 1, to orient vendors and developers to new programs, including updated application processes, certification criteria and test scripts.

The modular approach to certification would tell providers that a healthcare IT product is capable of performing to provide meaningful use, a requirement under the federal stimulus law under which providers could receive bonus payments beginning in 2011.

The certification would be provided in advance of the definition of meaningful use, which is expected out by the end of the year.

Federal officials have said providers would have to make “a business decision” as to whether to go forward in faith with the modular certification ahead of the final rulemaking.

The Certification Commission for Health Information Technology held a “town call” Web conference Thursday to gather input from the vendor and developer communities on the commission’s planned new paths to certification for electronic health record technologies.

CCHIT Chairman Mark Leavitt, MD, said the goal is to achieve more rapid, widespread adoption and meaningful use under the American Recovery and Reinvestment Act of 2009 (ARRA).

“We are concerned that providers could not achieve meaningful EHR use in 2011 if they wait until spring 2010 - the expected date of (the Department of Health and Human Services’)’ final approval of requirements - to begin adopting this technology,” said Leavitt, “CCHIT has analyzed the recommendations of the federal HIT advisory committees and is preparing to offer new paths to certification beginning this October.”

Besides updating and enhancing its certification program for comprehensive EHRs in ambulatory, inpatient and emergency department settings, the commission plans to launch a more limited, modular inspection program for EHR technology, focusing solely on compliance with ARRA-required standards.

In an Aug. 14 meeting, the federal government’s Health IT Policy Committee adopted additional recommendations on meaningful use and proposed expansion of EHR certification to include 10 to 12 certification panels in addition to the existing Certification Commission for Health Information Technology. Physicians, activists, vendors and others warned the committee at a meeting that it was moving too fast.

Above article published on

http://www.healthcareitnews.com/news/cchit-maps-out-path-certification-meaningful-use-focus

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July 02, 2009
Comprehensive EHR system used by only 1.5% of hospitals, says report
Filed Under (EHR, Health, Health IT, Hospital) by admin

By Joseph Conn

Only 1.5% of nonfederal U.S. hospitals use a comprehensive electronic health record system, according to HHS-funded researchers in a report released by the New England Journal of Medicine and mirroring preliminary survey results released by the same researchers this past November.

Lead author Ashish Jha, an associate professor at the Harvard School of Public Health and a staff physician at staff physician at Veterans Affairs and Brigham and Women’s hospitals in Boston, said in a news conference that just 7.6% of hospitals had a “basic” EHR that included the capability to record and store physician and nursing notes. The survey found that 10.9% of hospitals had a basic system without those clinical note-keeping functions.

“Very few hospitals in America have a comprehensive electronic health record,” Jha said. In addition, Jha said, “We didn’t get into effective use of these technologies. And we don’t have information right now with the notion of sharing data with other providers. Just because they have these systems doesn’t mean they are sharing that information with other doctors or hospitals down the street.”

That said, not all was gloom and doom. For one thing, if data from the VA hospitals, which were gathered but excluded from the final survey totals, were added back in, the comprehensive EHR adoption numbers would nearly double to 2.9% and the national numbers for the basic adoption rates would be driven up as well.

“All VA hospitals now have adoption of comprehensive medical records,” said Jha, who is serving as VA advisor. “There are as many VA hospitals with comprehensive medical records as there are non-VA hospitals (with those systems) if you look at it numerically.”

Also, he said, “There is no suggestion here that 90% of hospitals don’t have a computer in the hospital,” Jha said. In fact, some component parts of an EHR are in widespread use. For example, the survey found that 75% of hospitals surveyed reported having electronic lab and radiology systems.

What hospitals don’t have is “a constellation of functionalities” that help doctors and nurses provide the best care possible, Jha said, but the relatively high levels of adoption of some components “suggests we have a good place to start.”

Information about the study was under embargo until Wednesday, but its authors and other healthcare luminaries were available to reporters via a telephone conference Tuesday. One of those was David Blumenthal, the physician founder of the Institute for Health Policy, who spoke briefly about the research report and an article he had written for the New England Journal of Medicine on the federal role for health IT promotion.

Last week, Blumenthal was named as President Barack Obama’s choice to be the national coordinator for health information technology. Blumenthal said he will take over the post in mid-May.

Speaking of the impact the American Recovery and Reinvestment Act of 2009 would have on healthcare information technology, Blumenthal said that for physicians, “This whole project was conceived by the Congress as a building block as a pillar of healthcare reform.”

“One of the key elements is to support behavior change,” he said. “IT is one important and ultimately critical way to do that. I think it would be wrong to see it as a technology that can be adopted on its own, but as a technology to support that.”

The study and Blumenthal’s article are scheduled to appear Thursday in the journal’s online edition.

Above article published on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090325/REG/303259966&AssignSessionID=373357728181706

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May 13, 2009
Should “Meaningful use” include connected devices?
Filed Under (EHR, EMR, Electronic Medical Records, Health IT, Hospital) by admin

e-Patient Dave (right) while on a panel at Health 2.0

As is well known by now, part of the federal stimulus package included $19 billion for electronic medical records (EMR) implementation — and part of those billions include incentives for physicians and hospital groups that implement EMRs by various deadlines. Of course, the implementation also has to meet a criteria referred to as “meaningful use,” however, the legislation purposefully left out just what “meaningful use” meant.

In the past few weeks, health IT thought leaders have sketched out their own takes on what meaningful use should mean, but only the most recent opinion piece includes an analysis that suggests connected devices and smartphones may have a place in that definition.

Dave deBronkart, also known as ePatientDave, has written an eloquent post on the ongoing debate as to what “meaningful use” should mean for EMR implementation. One of deBronkart’s central points is: “The systems we design today will be in use a long time from now, so I suggest we look at the world as it will be in 2020, and how we’ll be using these systems then.”

deBronkart goes on to emphasize that everything and everyone will be ten years older — you, your parents, your children — and even the Internet will have ten more years of innovation behind it. Our oldest doctors today will be retired or deceased by then, and doctors like Fast Company’s “Doctor of the Future” Jay Parkinson (of Hello Health) will be middle-aged, he writes.

“Handheld computers (smartphones) will be ten years more advanced,” deBronkart writes. “(More advanced? Heck, the iPhone was only introduced 28 months ago.) Connected e-health devices will be out of their infancy: WiFi blood pressure monitors, bathroom scales, glucose monitors, you name it. It’s fairly certain that by then we’ll be able to use cheap devices that send routine data to some central storage place, where smart software (your choice of smart software) can send out alarms or reminders, your care team can view it … and you should be able to view it, too. And make notes on it.”

Predicting the future is no easy task, and deBronkart does a nice job of only hinting at the vision of a more connected health environment in 2020, but decisions makers at ARRA need to decide now whether and (then how) technologies like connected devices should be included as part of the definition for meaningful use.

Above article published on

http://mobihealthnews.com/2164/should-meaningful-use-include-connected-devices/

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May 07, 2009
Smart EMR Selection
Filed Under (EHR, EMR, Electronic Medical Records, Health, Hospital) by admin

You’re keen to buy an EMR. But how do you know which one is right for your practice?
By Shirley Grace

The first time North Shore Cardiology invested in an EMR, its vetting process consisted of exactly one issue — seamless integration between its practice management system and the new EMR. Fluent communication across these two major pieces of medical software, the physicians reasoned, was critically important for paperless success. Surely, matching the brand would guarantee that success, with price and functionality fading to the background. “We ‘needed’ seamless,” recalls Jay Alexander, one of North Shore’s cardiologists. Done deal.

A few months later, the EMR lay essentially dead in the electronic water, with only two of the Chicago-based practice’s dozen cardiologists still consenting to use the system, which turned out to be as flexible as a lifetime civil servant at the passport office. Worse, the group lost about a half-million dollars on the failed endeavor.

“Boy, were we dumb,” says Alexander.

We certainly don’t agree with this harsh assessment. In fact, what happened to these “dumb” heart specialists could easily happen to you.

You’re beyond busy treating patients and running your practice. You know that an EMR would help you, but the choices are overwhelming. Your knowledge is piece-meal and rife with buzzwords. Web-based or installed? CCHIT-certified? E-prescribing? PQRI? Finally, you buy one that “looks good,” but the problem is, it doesn’t work right of the box. And you find yourself having a similar experience to the North Shore docs, with a frustrated staff and a seriously depleted bank account.

But it doesn’t have to be that way. North Shore rallied from its mistake, performed all the necessary due diligence, and is now very happy with its second choice, Minimally Invasive EHR by Medical Informatics Engineering. You, too, can learn to navigate through the selection process thoughtfully and logically to maximize your success. Here’s how.

Commit to the project

Going paperless changes your practice at every level. So the first step is to agree as a practice that you’re going to go for it. This in itself can be a challenge, especially in group practices, because you probably have large variations in age, attitude, and aptitude. “We’re like most cardiology groups,” says Alexander. “Young guys who had EMRs in their residencies, and old guys who couldn’t turn a computer on five years ago. We had a guy who couldn’t use a cell phone. You’re only as strong as your weakest person.”

So ask yourself: Why do you want an EMR? Perhaps some pivotal event convinced you of the need, as it did for Jeffrey Hyman, a practicing internist at Treat & Release Walk-in Clinic in Brooklyn, N.Y. (which is part of the 55-physician, multipractice University Physicians Group, of which Hyman is medical director). A few years ago, he needed a specific patient chart. “It was misfiled,” he recalls. “That was after having 5,000 misfiled charts before. That was the chart I needed; the patient was in the ER. It just pushed me over the proverbial cliff, and I said ‘that’s it.’”

And thus began Hyman’s search for the right EMR. He and the two other physicians with Treat & Release spent six months winnowing down all the choices.

Your ah-ha! moment might not be as dramatic as Hyman’s. But whether by calm discussion or a fiery baptism borne out of disaster, you’ll need to be naysayer-free to ensure ultimate success. Make sure all deciders are on board with the idea of going paperless, or at least that they have their tickets in hand, ready to board.

That said, also be sure to temper any über-enthusiastic physicians so you don’t make a snap decision based on incomplete knowledge. Tina Stuart, office manager for Ohio-based Springfield Urology, loved the fact that the three young, computer literate docs at her practice all wanted an EMR, but she found herself pulling on the reigns time and again. “They wanted it to happen yesterday. I kept having to remind them I couldn’t just press a button and make it happen.”

Understand what’s ahead

List everything you hope the system will do for you. What can’t you live without? Is PQRI something you want to participate in? E-prescribing? What are the drop-dead requirements for your specialty? Specialty practices have special needs, such as a pediatrician’s need to have age- and growth-adjusting benchmarks for young patients, for example.

If you’re in a less mainstream specialty, you might have to negotiate with a vendor to modify its EMR to fit your needs. Springfield Urology found that its specialty was a rarity when it comes to off-the-shelf products

Work flow interruptions. There’s one aspect your new EMR will definitely affect, regardless of system choice: “All EMRs impact work flow. Anyone who says otherwise is full of it,” says Alexander. Map out your current work flow to see where certain steps might be eliminated — sometimes literally, such as the time it takes to walk a chart down and put it in the exam door folder-holder. Properly used, an EMR will significantly tighten your intra-office communication. “The back office knows what the front office is doing,” says Stuart. “A doctor can actually see if he has a patient ready. Little things like that sound silly, but people aren’t having to run around the office.”

A paperless work flow also eliminates material waste. Springfield Urology’s surgery scheduler experienced a dramatic change in her workday duties, much to her delight. “She had to make copies and copies of things to prepare for surgeries,” says Stuart. Now, everything the physicians need for the surgeries is instantly accessible. “A piece of paper can get lost; the computer never gets lost.”

Work flow changes also will occur right in the exam room. You’re used to charting by hand. You do it your own way, with abbreviations and symbology that make sense to you and those with whom you work. With an EMR, you’re forced to be more mindful and standardized. You’ll be stepped through the process. The EMR may ask you to make some decisions about how to proceed, depending on your inputs, a patient’s information, and alerts that may pop up suggesting this or that treatment option.

This is all good because you’ll create a more thorough note. But count on it slowing you down while you’re with your patient — a slow-down that may be permanent. “I don’t think you can be as fast on a system as on paper,” says Alexander. “There are so many other advantages, though — the ability to pull data and saving money on not pulling charts are other ways to help your bottom line.”

However, if your EMR is ill-suited for your specialty, then you’ll slow down due to frustration from not being able to navigate the system easily. This was North Shore’s main problem with its first EMR, says Alexander. “The EMR expected us to modify our work flow to the EMR.” Not good.

The money flow. The last preplanning consideration is, of course, the money. Prices vary widely, but “nothing’s cheap,” says Alexander. “You have to believe it’s going to cost you about $30,000 to $40,000 per physician eventually.” Not that you need drop this giant wad all at once. Instead, leverage the cost by investing in a system that offers a modular installation. An EMR so full-blown you suspect it might also whip you up a nice latte sounds great, but you’ll pay dearly if you want it all up front.

Bringing in the system little by little will keep your bookkeeper happy, and it will allow you and your staff time to absorb this paradigm shift gracefully. Don’t tick off your staff with too much change all at once. You’ll get resistance, tension, and money wasted in return.

Take a hard look at your current financial standing, and consult with your accountant about where the money might come from to cover your EMR purchase. This look should include some projection metrics, such as cost-benefit and ROI analyses. Calculate as best you can how your money flow will shift post-EMR. Some metrics to include:

  • Number of patients you see now, and how many you think you can see with the EMR.
  • Staff salaries, and reductions you might make due to increased efficiency in work flow.
  • Cost of handling a chart by hand, including the time it takes to pull it, transport it, lose it, search for it, refile it, etc.
  • Paper, copier maintenance, and other supply costs.
  • New revenue streams from being able to participate in bonus programs, such as PQRI or e-prescribing.
  • Temporary staffing needs to help convert all your paper into a digital form.

Naturally, you’ll want to set a budget. Include implementation, training, hardware, and licensing. This last one can be tricky. One EMR’s licensing may look cheaper at first glance. Find out if said license is “per user” or “per team.” A “per-user” license can significantly drive up cost.

Organize your search

To stay organized and on track when investigating the market:

Set up an EMR selection team. Ideally, the team will have one decider. This will help keep the process from languishing in committee for months. For smaller practices, though, it may make more sense to simply agree by consensus.

But holy cow, there’s so much you need to know. So split up the work. Three-physician Springfield Urology sat down and made lists of what each wanted, says Stuart. From this, they developed a vendor questionnaire. “We each took a point that was important to us, and tried to hit each company with it. I only asked two questions, and each doctor had two questions. That way, we didn’t all have to remember everything.”

Keep your answers in one place. Set up a spreadsheet to house your research, with one column per vendor candidate. Row headers will list aspects for which you need information: vendor history, financial stability, and future plans; certification; system pricing (based on modular installations, hopefully); system functionality and how it fits with your specific needs; technology needs (e.g., desktop/tablet PCs?, wireless vs. wired connection?); and support offerings. Create a separate binder for each vendor to hold any paper-based info each may give you.

Build your candidate list. “When you’re in the hallway doing rounds, or you’re at CME, ask, ‘Which one of you jokers uses an EMR?’” suggests Hyman. “That gives you a scratch list.” Or poll your medical society.

Also, see who’s in the news and what’s being said about this or that vendor. Seek out objective assessments, not just market-speak.

Vet each vendor candidate. Vendors have a product to sell and they’re going to present it in the most positive light possible. It’s your job to ask the right questions so you get a complete picture.

Find out whether you can get to the inner part of the company, says Hyman, because you may discover post-purchase that you need some programming adjustments. “Every doctor charts differently. It’s not standard like banking,” he says. “What’s the accessibility of the engineering team of the company? Too rigid? Stay away. This is not balancing a checkbook. This is how you write.”

Visit other practices. Seeing a product in action at an actual practice is key, but learn from the experience, notes Alexander. “When I went to a cardiology practice, that doctor was more interested in his note, in fitting his info into the note, than he was in the patient. I saw that and I was uncomfortable, but it didn’t hit me; I thought it was him. But it wasn’t.”

Stuart strongly agrees. “It was one of those things that you just have to experience because [all the vendors] say they’re good.”

Test drive each product. There’s nothing like a hands-on experience to tell you whether a product is right for you. “[A vendor] needs to give it to you for a few weeks. It’s like test driving a car. If you don’t do that, you’re making a mistake,” says Alexander.

Be patient

Sure, you’re excited to get rolling with an EMR, and who can blame you? But realistically, your selection process will take six months to a year if you want to end up with a decision you feel good about. It’s much more complicated than, say, a new practice management system. “With EMR it’s a completely different transition,” says Stuart. “There are a lot of little steps that have to be put into place. A lot that can be misunderstood.”

You want to do this right the first time, so take the necessary time to sort out what you want and who you want to do business with to keep you from suffering the same fate as North Shore. “You’re really only allowed a certain number of screw ups,” says Alexander, recalling his own first EMR financial fiasco. “Half a million — that’s the number.”

http://www.physicianspractice.com/index/fuseaction/articles.details&articleID=1335.htm

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April 10, 2009
Obama announces new veterans’ medical records system
Filed Under (EHR, EMR, Hospital) by admin

art.obama33009.gi Obama announces new veterans medical records system
The federal government is establishing a new system for updating medical records of servicemen and women during and after their military careers, President Obama announced Thursday.

The joint virtual lifetime electronic record will, among other things, help ensure a streamlined transition of health care records between the Pentagon and the Veterans Administration.

It will provide “a framework to ensure that all health care providers have all the information they need to deliver high-quality health care while reducing medical errors,” the White House said in a background statement.

“When a member of the armed forces separates from the military, he or she will no longer have to walk paperwork from a [Defense Department] duty station to a local VA health center. Their electronic records will transition along with them and remain with them forever,” Obama said in remarks delivered near the White House.

The system will “cut through red tape” and allow new veterans to start receiving their benefits more quickly, he promised.

During the announcement, Obama was joined by Defense Secretary Robert Gates and Veterans Affairs Secretary Eric Shinseki.

“We welcome this news. … This is a huge day for veterans and troops,” Paul Rieckhoff, head of Iraq and Afghanistan Veterans of America, told CNN.

“This is a good way for [Obama] to come back from Iraq and make a powerful statement.”

The White House recently proposed a significant budget increase for the Veterans Administration, including an 11 percent hike in fiscal year 2010.

In March, however, the administration abandoned a controversial plan to charge private insurers for treatment of veterans’ service-connected ailments.

Veterans’ representatives and members of Congress angrily opposed the proposal, which White House spokesman Robert Gibbs said was never finalized.

Above article published online on www.cnn.com

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