Government incentives for using electronic medical records will result in spending on systems doubling by 2015, according to a report by IDC Health Insights. However, the study notes that much of that growth will come closer to end of that projected period, because vendors are having trouble keeping up with the orders.

Total EMR spending, which is expected to grow from $1.9 billion in 2009 to $3.8 billion by 2015, is about twice the growth rate analysts are seeing over the health information technology market and the general IT market, said Judy Hanover, research director of provider IT strategies for the Framingham, Mass.-based market research company and co-author of the report.

The report notes that a separate IDC survey in August 2010 found that 44% of health care organizations plan to accelerate or aggressively accelerate their plans to deploy EMRs because of financial incentives in the 2009 economic stimulus package. The stimulus provided incentives of up to $44,000 under Medicare and nearly $64,000 under Medicaid for meaningful use of an EMR.

But this rapid deployment is causing a vendor backlog that has resulted in unanticipated delays of up to six months for some practices and hospitals. Hanover said this has been a bigger issue for inpatient system deployments, but analysts are starting to see it on the ambulatory side as well.

The authors of the report predicted that the largest chunk of EMR investments will come in 2015. Not only is the backlog expected to cause delays, but some physicians will put off purchasing until it gets closer to 2015, when incentives turn to penalties.

The forecast shows clinics and physician practices will spend $335 million on EMRs in 2011 and $490 million in 2015. Ambulatory EMR spending overall was $633 million in 2009 and is expected to reach $1.4 billion in 2015.

Making an early decision on an EMR will help ensure that staff members are available for its installation, Hanover said. Practices might want to consider looking at third-party vendors if their primary vendors are experiencing a backlog, she said. Many third parties can provide installation and training services with the help of the vendor, she said.

After 2015, vendors are expected to enter a “maintenance cycle” in which revenue will come mostly from replacement systems or upgrades. Not only could the government require EMRs to perform more functions than they do today to qualify for incentives, health system reform may have an impact.

“We do expect to see, as health care reform goes into effect, a massive consolidation in the provider community in terms of acquisitions and reductions in the total number of providers,” Hanover said. “And that will drive some replacements and upgrading and reinvestment in EMRs.”

Source    :    http://www.ama-assn.org/amednews/2011/01/31/bisd0201.htm

Washington — Starting Jan. 3, eligible physicians and hospitals will be able to register for the Medicare electronic medical record incentive program, a prerequisite for obtaining billions in available federal bonuses, the Centers for Medicare & Medicaid Services announced Dec. 22, 2010.

Also starting Jan. 3, registration for the Medicaid EMR incentive program will launch for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. In February, registration will open in California, Missouri and North Dakota. The remaining states probably will launch their Medicaid EMR incentive program sign-ups in the spring and summer, CMS said.

Officials with CMS and the National Coordinator for Health Information Technology said they hope for broad registration by doctors and hospitals. To prepare for the process, health professionals are encouraged to visit the CMS website (www.cms.gov/ehrincentiveprograms/).

“With the start of registration, these landmark programs get under way, and patients, providers and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” said CMS Administrator Donald M. Berwick, MD.

David Blumenthal, MD, the national health IT coordinator, said, “It’s time to get connected.”

He added that his office and CMS have numerous resources to help physicians and hospitals enroll in the program. They include a website that lists more than 130 certified EMR systems (onc-chpl.force.com/ehrcert/).

Another site lists the 62 regional extension centers that can assist physicians in obtaining the bonuses (healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495/).

Physicians who want to participate must register in either the Medicare or Medicaid EMR incentive programs. Participants must choose only one program — they cannot receive payments from both. However, after receiving a bonus for a given year, they may change their program selection once before 2015.

In 2010, CMS finalized standards that doctors and hospitals must meet to demonstrate meaningful use of their EMR systems. Physicians can receive as much as $44,000 over a five-year period through Medicare, and up to $63,750 over six years through Medicaid.

CMS on Dec. 22, 2010, announced several additional key 2011 dates for the EMR physician incentive program:

• January — Some state agencies begin issuing Medicaid EMR incentive payments.
• April — Participants begin to attest eligibility for Medicare bonuses.
• May — CMS begins issuing Medicare bonuses.
• Oct. 3 — Physicians have a final chance to begin their 90-day reporting period to demonstrate meaningful use in 2011.
• Dec. 31 — 2011 bonus payment year ends for eligible professionals.

Source     :     http://www.ama-assn.org/amednews/2011/01/03/gvse0106.htm

A third of hospitals have integration between medical devices and electronic medical records, allowing data recorded on the devices to be uploaded automatically into EMR, according to a survey released Dec. 1 by HIMSS Analytics.

Most hospitals that have linked devices and EMRs said they believe it saves staff time by eliminating manual documentation.

HIMSS Analytics, part of the Chicago-based Healthcare Information and Management Systems Society, surveyed 825 U.S. hospitals on their use of medical device utilization. It found the devices most likely to be interfaced are intelligent medical device hubs (networked diagnostic equipment that provide data streams) and physiological monitors.

Recording and charting vital signs is one of the core measurements of stage 1 meaningful use. The Centers for Medicare & Medicaid Services meaningful use incentives offer hospitals a base payment of $2 million each from Medicare and Medicaid. Although the stage 1 meaningful use criteria do not require the charting to be done automatically, many believe integration between medical devices and EMRs will be required later.

“The transfer of data directly from a medical device to the EMR can reduce potential medical errors and improve patient care, because no manual transfer of data takes place,” said John Daniels, vice president of health care organizational services for HIMSS. “Such data integration also improves workflow by saving time for clinical staff, a valuable benefit when looking at nursing shortages in health care.”

The report notes that hospitals are not yet conducting return-on-investment studies on the integration of the monitoring devices to EMRs. But some hospitals have reported that integration has saved time. St. John’s Medical Center in Jackson, Wyo., reports that integration of vital sign monitors to its EMRs has yielded a 60% time savings, because staff do not have to enter the data manually.

The report said a critical factor hospitals face is determining how to connect an intelligent medical device to an EMR.

For those that integrate some devices to an EMR, about half use a wired local area network to provide the connectivity. Only 8% rely solely on wireless LAN connections for the integration.

The report says hospitals will place more importance on integrating medical devices to EMRs when more is known about the stage 2 and stage 3 meaningful use requirements. The Office of the National Coordinator for Health Information Technology is working on stage 2 criteria.

Source    :     http://www.ama-assn.org/amednews/2010/12/20/bisc1220.htm

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.

Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicates that iPad deployments are accelerating in large part due to the mobile device’s compelling point-of-care applications and uses.

Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey’s results were released earlier this month.

Data showed that nearly 70% of the attendees were from hospitals or healthcare organizations with more than 1,500 employees, and 15% of attendees were executive-level staff or physicians.

More than 25% of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70% plan to deploy the devices within the next year.

One-third of respondents identified point-of-care applications — including lab order visualization and results, clinical decision support, and medical image viewing applications — as top priorities, while 18% identified general administration, including billing, coding, and claims applications, as top priorities.

Nearly 75% identified secure configuration and deployment as the number one iPad IT management challenge, and 53% identified mobile application deployment as a key issue.

Lynne Dunbrack, analyst with IDC Health Insights, said security will remain a top concern for healthcare CIOs, especially if clinicians bring in their own devices to access the hospital’s healthcare information systems, such as electronic medical records (EMRs) and computerized physician order entry (CPOE) systems.

“As more patient information is moved into EMRs and made accessible both inside and outside the organization via a range of devices, including mobile devices and tablets, the risk of a privacy breach rises. Organized deployment and virtualized clients will help to mitigate this concern,” Dunbrack said.

Dunbrack also noted that the iPad, which has a sleek design, an intuitive user interface, and a large screen (relative to a smartphone), is becoming increasingly popular among clinicians. As the iPad gains traction among healthcare providers, EMR vendors will develop bidirectional integration between their EMR applications and clinicians’ mobile point-of-care devices such as smartphones and tablets.

Vendors are also developing EMR applications specifically for the iPad, Dunbrack observed. One example is St. Louis-based ClearPractice, a company that develops Web-based ambulatory EMR and revenue cycle management applications. ClearPractice recently launched Nimble, a comprehensive EMR application designed and developed specifically for the iPad.

Alan Snyder, BoxTone’s CEO, said in a statement that the iPad is redefining how organizations leverage mobile technology in the enterprise and the healthcare community is leading this paradigm shift.

“As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity,” Snyder said.

Source     :     http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=228800929&queryText=electronic%20medical%20records

SEOUL, South Korea – Seoul National University Bundang Hospital (SNUBH) has reached Stage 7 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) scale.  It is the first hospital outside of the United States to achieve the Stage 7 designation, and the only hospital in Asia to do so.

The EMR Adoption Model provides a leadership guide for IT adoption in healthcare. The higher the stage, the more advanced the IT application coverts to. Stage 7 represents a totally paperless environment.

Only 1 percent of US hospitals rank at the Stage 7 achievement level on the EMRAM. At this stage, care coordination across the hospital is improved using EMR, developing better health information exchanges, and data warehousing for population health improvement.

The Seoul National University Bundang Hospital reached Stage 7 with:

• Almost all medical orders entered by physicians.
• Ninety percent of physicians enter patient health information into the EHR, using structured templates that generate data, allowing clinical decision support for clinical guidance.
• Efficiency gained through automation, such as relying on only four transcriptionists to support 910 inpatient beds and over 4,000 outpatient visits per day.
• The Medical Imaging department is fully digitized producing 1.2 terabytes of data per month for 70,000 radiologic exams per month.
• The Closed-Loop Medication Administration (CLMA) process has the highest level of patient safety for bar-coded medications through RFID technology
• The hospital uses clinical data warehousing for developing over 250 quality clinical indicators and 98 critical pathways.
• A Health Information Exchange exists between the hospital and 36 private clinics in its region.

“The Seoul National University Bundang Hospital is an excellent example of healthcare IT adoption to improve the quality and efficiency of care while improving patient and employee satisfaction,” said John P. Hoyt, executive vice president of Organizational Services at HIMSS. “We congratulate the hospital and its information technology team for creating this environment for its patients, employees and medical staff.”

HIMSS Analytics is beginning to collect data on electronic health record implementation from all hospitals in Korea. More information on Stage 7 recognition is available on the HIMSS Analytics website.

Source    :     http://www.healthcareitnews.com/news/himss-analytics-names-first-korean-stage-7-hospital

PORTLAND, MAINE – “What do you really hold dear to you that you want to preserve into the future as you transition to an electronic medical record?” That’s the question consulting firm Innovation Partners International posed to Maine providers attending a regional extension center (REC) educational forum this week.

Bernard Mohr, a partner at the firm, said he grew up next to a farm with milking cows. The stools the farmers used to milk the cows were three-legged. He explained that they found that a stool with three legs was actually “much more stable on uneven ground than a four-legged stool.”

The stool, Mohr said, is a metaphor for a different model for managing the transition to an EMR.

According to Mohr and Robert (Bob) Laliberte, who teaches the UNE Project Management Program and is also a partner at Innovation Partners International, the three legs of the “stool” of an EMR implementation are: life-giving properties, hopes and aspirations and first steps. If you can identify those three components then you’ll have a better chance at having a successful transition to your EMR, they said.

Mohr and Laliberte asked the 30 providers in attendance to pair up in groups and identify the life-giving properties or the core values that give their practices vitality and that, “if not retained during the transition to their EMR, would irreparably worsen the situation.”

“Autonomy is important for me,” said one doctor. “And feeling like I am doing something that matters – helping people. If I end up just playing with medical records that would be the pits for me.” I don’t want to spend more time with a machine than the people I am trying to help.”

Laliberte told attendees they had to think of an EMR as a possibility rather than a burden. He asked providers to think about “exciting possibilities” that the technology could bring to their practices.

Providers agreed that improved quality of care and patient satisfaction were at the top of the list. They also said it was important that providers have improved satisfaction as well.

“In the end, the most important thing is that you are making a difference for your patients, that is what it is all about,” said one attendee.

The last question attendees had to answer was, “what is the smallest step you could take in the next week to start moving toward your desired future?”

Attendees said identifying their goals and visions for the technology as well as talking to other providers about their experience could be possible action items for them.

Remember, said Laliberte in closing: “the EMR is at the service of the patient.”

The session was part of regional forum series being held by The Maine Regional Extension Center (MEREC), overseen by HealthInfoNet, and Quality Counts, a regional healthcare collaborative committed to improving health and healthcare for the people of Maine.

Source :  http://www.healthcareitnews.com/news/three-legged-stool-model-emr-transition

NEW YORK – The New York Department of Health (DOH) and the public-private partnership New York eHealth Collaborative (NYeC) on Tuesday submitted a plan to ONC outlining a proposal to spend $129 million in state and federal funds to build and implement a statewide medical records network.

The network is being touted by officials as the country’s largest – connecting hundreds of hospitals, thousands of medical practitioners and up to 20 million patients a year. Once completed, New York doctors anywhere in the state will have instant access to critical Electronic Medical Records (EMR) of every patient.

“Better information helps doctors do a better job,” said David Whitlinger, executive director of NYeC. “This statewide network will empower healthcare providers by giving them access to a wealth of patient data that they didn’t always have at their fingertips. While cutting edge technology plays a tremendous role in modern medicine, in many respects medical records are still stuck in the past. We look forward to helping create a system that will greatly improve the quality of medical care and therefore people’s lives.”

The proposed statewide network will link together several existing regional electronic medical records networks with new infrastructure and programming, and state agencies will set policies to govern the system’s implementation and maintenance. Currently, healthcare providers can share some electronic records with certain neighboring medical institutions.

The Statewide Health Information Network for NY (SHIN-NY) will allow patients and healthcare providers to have immediate access to histories, prescriptions, test results, medical analysis and diagnoses, and more, anywhere in the state.

“Having this information can mean the difference between life and death,” said Eugene Heslin, a practicing New York physician who serves on the Board of NYeC. Heslin says having quick access to patients’ information such, as their medication history, can be life-saving in an emergency.

While several other states and the Veterans Administration have set up large networks for medical records, officials say New York’s system will ultimately dwarf them when completed given the scope of the state’s medical facilities. The proposal establishes a preliminary timeline for the implementation of many of the core services the network can provide – ranking them in priority – and foresees new services being added every several months between mid-2011 and 2014.

“New York is once again leading the nation in healthcare initiatives that will provide better treatment to the millions of patients treated in the state every year,” said New York State Department of Health Deputy Commissioner of Health Information Technology Transformation Rachel Block. “We feel it is our responsibility to help all patients and healthcare providers across the state have access to the same vital information that can help save lives. We look forward to working with NYeC and other state programs to create this network and establish rules that will make electronic medical records secure, accessible and helpful to the many stakeholders all around the state.”

Source  :  http://www.healthcareitnews.com/news/new-york-emr-network-set-be-largest-country

EMRs keep on proving their mettle in the area of care coordination.

The latest evidence comes from Kaiser Permanente Colorado, which improved outcomes by mining its EMR and electronic disease registries to match patients with heart disease to clinical pharmacy specialists and “personalized” nurses. In a study published in the November edition of the journal Pharmacotherapy, Kaiser researchers reported an 89 percent reduction in mortality, as well as cost reductions of $60 per day for cardiac patients enrolled in a disease management program, as compared to a control group.

The program, called the Kaiser Permanente Collaborative Cardiac Care Service, can notify pharmacy specialists if a patient doesn’t pick up a prescription or if a cholesterol test reveals a need to change medications, for example. The pharmacists or nurses then can contact individual patients to help them make the necessary adjustments to their treatment.

Rather than seeing costs increase due to the extra service, healthcare expenditures declined significantly for patients in the program. Hospitalization costs averaged $19 per day for participants, vs. $69 per day for those receiving standard treatment. Kaiser also reported small cost savings on physician office visits and medications due to the better coordination.

“This program works because it is a team approach,” study co-author Dr. John Merenich, medical director of the Clinical Pharmacy Cardiac Risk Service at KP Colorado, tells Healthcare IT News. “Our teams of nurses and clinical pharmacists, as well as our health information technology, require significant investment. We always knew it was the right investment because it saved lives. Now we know it’s also the right investment because it provides the highest quality care at a lower cost. This is the value people have been looking for in health care.”

Source     :     http://www.fierceemr.com/story/emr-driven-disease-management-reduces-mortality-costs/2010-10-28

Electronic medical records specifically for wounds could substantially cut amputation rates for diabetes patients with foot ulcers, a study recently presented at the American College of Surgeons 96th Annual Clinical Congress determined.

Records pulled from an online wound EMR (OWEMR) system set up at by Dr. Jason Maggi at New York University Langone Medical Center’s Department of Surgery over a six-month span showed that there were up to 137 variables for each record, reports Medscape Medical News. Automated alerts sent out to all doctors involved with a particular patient’s care help doctors to sort through that information and integrate quantitative measures like healing rates in real time, according to Maggi, the study’s senior author.

“Effective management of this information and analysis of data in a timely fashion can mean the difference between limb salvage and amputation,” Maggi said, according to Medscape.

The OWEMR combined information like medications, medical history and lab results with digital photos of patient progress to help doctors “centralize information” onto a single page.

Dr. Danielle Katz, an associate professor of orthopedic surgery at SUNY Upstate Medical University who moderated Maggi’s presentation, hailed the study as potentially being “the future of medicine.”

Said Katz, “I think more and more there will be a push to have applicable practice guidelines [and] methods for tracking outcomes, and I think this really demonstrates a very potentially useful tool.”

Source    :      http://www.fierceemr.com/story/wound-emr-could-reduce-amputation-rates-diabetics/2010-10-21