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February 05, 2010
Filed Under (EMR, Electronic Medical Records) by admin
By: Michael Young
The medical industry has changed significantly over the past decade. One of the major changes is that many medical offices are moving from paper to electronic medical records. There are also a number of practice management software packages available to medical practitioners. This makes their lives easier, but what does it mean for patients? To understand the answer to that question, it is first important to understand what an electronic medical records system is.
Generally EMRs, electronic medical records, and EHRs, electronic health records, are synonymous. These systems keep track of medical information. These systems keep medical records stored in a central location so that they can be made available to pharmacies, specialists and other providers. What this means for the patient is that medical care is becoming more portable.
President Bush created the Office of the National Coordinator for Health Information Technology (ONC) in 2004. This office was headed by David Brailer in the beginning. Brailer addressed interoperability issues and established a National Health Information Network (NHIN). Regional Health Information Organizations (RHIOs) have been established under the ONC in many states for the purpose of promoting the sharing of health information. Currently, Congress continues to create legislation to increase funding for these programs and programs like them.
Moving from paper systems to EMRs is a process that is still in the beginning stages within the medical community. It is a work in progress. Many concerns exist, and privacy is one of those concerns. While a moving to an EMR would potentially give many providers, pharmacists and other medical professionals access to a patient’s records, these records are kept very secure. The adoption of electronic medical records systems is clearly what the future holds, from a technology as well as legislative standpoint. In the end, the patient benefits because it is easier to fill prescriptions, transfer records and receive consistent care than with paper systems.
As medical records systems continue to move from paper to electronic, look for the ability of systems to communicate with each other to also become important. As the patient, you will benefit because of the portability of electronic health records and you will no doubt benefit from the increased continuity-of-care that they can offer.
Above article publish on http://www.sooperarticles.com/health-fitness-articles/general-health-articles/electronic-medical-records-more-prevalent-now-2926.html
January 11, 2010
Filed Under (EMR, Electronic Medical Records) by admin
By Peter Polack
A good electronic medical records system must be able to demonstrate a process for maintaining the legal integrity of its records. Here we cover some of the top considerations when moving your practice from paper to digital.
As a practice makes the transition from paper to electronic medical records, they may encounter a variety of legal concerns. Some important decisions must be made to ensure the legal integrity of digital records. Additionally, there will be some surprises in store regarding compliance, privacy, and security. In matters of electronic medical records, the best offense is a good defense. Here are some issues to consider:
When you write a medical exam on a piece of paper and sign it, you’ve created a legal document. By now you are probably well aware of the importance of documentation, and the dangers which alterations to medical records invite. A paper chart’s integrity is usually rather simple to determine. However, an electronic chart is often more complicated. According to the Healthcare Information and Management Systems Society, an electronic record must be stored in a legally correct manner - otherwise it may be considered hearsay, challenged as legally invalid.
So, why is this important? Well, if your electronic medical records don’t meet the Federal or State requirements for a medical record, payors can deny a claim. Or, even worse, you may subject your practice to an increased risk of an adverse outcome in litigation. It’s not only important to be sure your electronic medical records are not altered, but you also need the ability to demonstrate the procedures which prove this fact.
How do you make sure an electronic record cannot be altered? The ideal system must balance the user’s desires, including ability to correct mistakes and make changes, with the legal integrity of the record itself.
- Does your EMR system “time stamp” each entry to produce an audit trail? This could include an unalterable record of every entry and event in order to prove the validity of the record.
- Does it restrict access to certain templates or features? You wouldn’t want a front desk employee changing patients’ intraocular pressures, for example.
- Does the system keep track of which person documented what? You wouldn’t want your name associated with another user’s entry.
- Does it have a strict but not too time-consuming security protocol? Some solutions include alphanumeric passwords that are changed periodically, biometric access, and automatic logout after a period of inactivity.
- Does it have a secure yet practical “lock-out” feature? A typical one might allow the doctor to make changes at the end of the day, but after 24 hours the record locks. This may seem a bit harsh, but it could actually serve to protect you by preventing unauthorized changes.
Above article publish on http://www.buzzle.com/articles/some-of-the-legal-issues-with-electronic-medical-records.html
November 13, 2009
By Kenneth Corbin
Sen. John Kerry is continuing his push to accelerate the adoption of electronic medical records.
The Massachusetts Democrat on Tuesday introduced legislation to spur family doctors and small-scale practitioners to migrate their paper records to digital format, a goal that most everyone agrees would improve care and lower costs, but one that entails a significant initial expense.
“Electronic medical records and prescriptions are the common sense solution to restricting costs, reducing errors and reforming a broken system,” Kerry said in a statement. “Doctors don’t need convincing — they’ve seen the results.”
Kerry’s bill, the Small Business Health Information Technology Financing Act, would make small-scale doctors eligible for grants from the Small Business Administration to move to electronic records.
“This legislation helps small practices acquire the technology that will allow them to be more efficient and to focus on patient care,” Kerry said.
The federal government has already made it clear that digital records are a priority, earmarking $19 billion for the cause in the February stimulus bill.
In 2007, Kerry introduced legislation to push doctors use digital systems when issuing prescriptions. The 2008 Medicare bill passed with provisions establishing a timetable offering bonus payments to early adopters of the technology, and eventually phasing in penalties for the laggards who continue issuing paper prescriptions.
Above article published on http://blog.internetnews.com/kcorbin/2009/11/kerry-backing-bill-to-boost-el.html
November 10, 2009
BY DR. SCOTT RANSOM
When Dr. Henry Plummer developed the concept of the “unit record” nearly 100 years ago, his idea was to place all of a patient’s records in a single file that traveled with the patient and could be stored in a central repository. His concept of medical care continuity quickly became the standard for medical record keeping worldwide.
I wonder what Dr. Plummer would make of today’s adoption of electronic medical records (EMR) by U.S. health care providers? After all, the concept is basically the same, just expanded to take advantage of today’s capacious electronic storage and retrieval methods.
Even the federal government has gotten into the act, defining a complete EMR system as containing four basic functions: computerized orders for prescriptions, computerized orders for tests, reporting of test results and physician notes.
In a perfect world, an EMR system tracks a patient’s entire health and medical history in a computerized, electronic format that is accessible wherever the patient is. These records are more easily retrievable than manual systems, and can make a patient’s navigation through the health care system much safer and more efficient.
But it’s hardly a perfect world. Even though the American Recovery and Reinvestment Act of 2009 has made the promotion of a national, interoperable health information system a priority, EMRs have not been adopted nearly as quickly in the U.S. as one might expect. Issues, including the high cost, lack of standardization, security and privacy have stood in the way of implementation.
A recent study from the New England Journal of Medicine points out that hospital EMR adoption rates are still abysmal, concluding that only about 8 percent of the 3,000 hospitals studied by researchers used even a basic EMR in a single unit, which included nurse or physician notes. And only 1.5 percent of non-federal U.S. facilities use a comprehensive EMR.
This seems counter-intuitive, especially when one considers the numerous advantages of EMRs, starting with efficiency. Information stored in an electronic format can be retrieved easily at the touch of a button or the click of a mouse. Search and retrieval times are a fraction of what they would be in manual systems. At the very least, this saves time by eliminating the need to complete the old manual medical history forms at a new physician’s office. This also reduces the chance for error when a patient forgets to list certain prescribed medications or supplements. It’s all there in one easily accessible record.
But efficiency isn’t the only benefit. For patients, access to good care becomes easier and safer when records can easily be shared. Important information — such as blood type, prescribed drugs, medical conditions and other medical history aspects — can be accounted for much more quickly. Doctors and other medical personnel can retrieve these medical records from anywhere using handheld devices like an iPhone, which allows them to continue treatment no matter where they are. And, in case of emergency, information can be shared with emergency room physicians who can then order diagnostic tests and share results online.
Another benefit is safety. It’s estimated that nearly 98,000 patients die annually by preventable medical errors of some type. It’s entirely possible that these numbers could be greatly reduced by a comprehensive medical history information generated through an EMR system.
The Mayo Clinic is setting the standard for EMR implementation. With one of the largest such systems in the world, all medical documentation relating to a patient’s care – physician notes, laboratory reports, surgical dictations, copies of correspondence, appointment schedules, X-rays, ultrasounds, CT and MRI scans, echocardiograms – is instantly available to caregivers via more than 16,000 computer terminals on Mayo’s three campuses. The efficiencies created by simply typing a few identifying keystrokes to retrieve a patient’s record saves a doctor’s practice or a hospital many thousands of dollars. That’s even taking the cost of the electronic system into account.
Even the federal government thinks electronic record keeping is important. Veterans’ hospitals across the country share an electronic system called VistA, which shares records of veterans in its health system. Should a patient find him or herself in a VA hospital, even away from home, the hospital will have the same access to his or her records that the hometown hospital does.
It’s interesting to note that a recent report from PricewaterhouseCoopers’ Health Research Institute contends that Medicaid penalties might do more to boost EMR adoption than incentives, like available funding to physicians to purchase and implement EMRs. According to the report, “Provisions in the stimulus law that call for cuts in Medicare reimbursements, rather than a multibillion-dollar incentive program, will do more to push the adoption of electronic medical records among hospitals and doctor practices by 2015.”
However EMR adoption happens, it’s critical that it happen sooner rather than later. The health care industry’s ability to provide efficient, coordinated, safe and high-quality care is only enhanced by the rapid availability of accurate data. And with the availability of solid data, researchers can also use the EMR to analyze large amounts of patient information more efficiently, speeding the application of new research findings and vastly improving patient care in the future.
Just as Dr. Plummer saw beyond the information exchange limitations of his era, we can see the benefits of using the latest technologies for the practice of continuity in 21st century medicine. But the goal, just as it was in Dr. Plummer’s time, or even going as far back as Hippocrates and his famous oath, is still nobly laudable: “First, do no harm.”
Above article published on http://www.fwbusinesspress.com/display.php?id=11302
November 04, 2009
The health care industry is trying to catch up when it comes to technology.
“Other businesses have been able to figure out how to make it work, such as the finance business. You can get money wherever you go. Health care is really behind,” said Helen Connors, executive director for Kansas University Center for Health Informatics.
Connors said it is unreasonable to ask patients to recall their medications and past history every time they see a doctor.
“Why are we asking the patient for that information? We can’t rely on the patients or providers to remember everything, so it’s got to change,” she said. “I think eventually consumers are going to drive it because they are not going to put up with it.”
The federal government has earmarked $34 billion in stimulus funds to address the issue.
“That’s a lot of money,” said Dave Garets, CEO and president of HIMSS Analytics, which collects and analyzes health care data related to information technology. “The federal government has never allocated much of any money to provide incentives to hospitals and doctors to get in gear. But boy, they did this time.”
The goal is to offer incentives for health care providers to move from paper charts to computers during the next five years, and after 2015 penalize those who don’t by, for example, providing lower reimbursements for Medicare patients.
Congress is working on the details with some preliminary regulations expected by year’s end, Garets said.
High-tech advantages
The ultimate goal is for doctors, hospitals and pharmacies to be able to access any patient’s information in a more efficient and timely manner by using electronic medical records, commonly called EMRs.
For example, if an out-of-town patient is taken to an emergency room and has allergies, an EMR would immediately alert the physician. EMRs also allow doctors to order and see lab results at the click of a button. Research has shown that EMRs significantly reduce medical errors.
For example, they can alert a doctor if he or she prescribes a medication that would not interact well with a current medication. EMR prescriptions also are more legible than their hand-written counterparts. Dr. Jon White, health information technology director of the Agency for Healthcare Research and Quality, said EMRs can help doctors manage more information better and more quickly. An EMR can contain patients’ medical information, lab work, the latest research in health, insurance information, pharmaceutical data and messages from other office workers, to name a few applications. “You can still practice without those tools, and in fact, people do every day. It just becomes more challenging to do it as time goes by,” he said.
High-cost process
White said doctors and hospitals have been dragging their heels on changing over to EMRs primarily because of costs. “They are expensive. But, we think that they will get back the money that they put into it,” he said. “Ultimately, everyone who successfully implements electronic medical records say they would never go back, but that’s a big hurdle to get over.”
The agency estimates that it costs about $30,000 for a provider that isn’t in a hospital setting.
Lawrence Memorial Hospital and Kansas University both started moving to an electronic system several years ago. LMH has spent more than $12 million just for software. KU Hospital has budgeted $52 million for the entire process.
“It’s probably one of the largest single activities that any hospital will pursue,” said Chris Hansen, chief information officer at KU Hospital. “It’s monumental, which is why there haven’t been a lot of hospitals that have gotten there.”
According to a 2008 survey in the New England Journal of Medicine, only 4 percent of physicians reported having an extensive, fully functional electronic records system and 13 percent had a basic system.
Hospitals are doing better.
Garets, of HIMSS Analytics, said 83 percent of hospitals nationwide have a basic system, but in Kansas, only 62 percent of the 132 hospitals do. More startling, he said, is that 29 percent — or 38 — of the state’s hospitals have no basic system and have no plans to purchase one, compared with 12 percent nationally.
“That is craziness,” Garets said, laughing. “It’s like what, ‘Are you living under a rock?’”
Connors, of KU’s Center for Health Informatics, is chairwoman of the state’s new e-Health Advisory Council, which is working to recommend a health information exchange plan for the state. She said some states already have a plan and are applying for federal money to begin implementing those plans. However, Kansas is applying for funding to develop a plan.
“Right now, we are fact-finding, looking at what other states have done, what do we need and what is going to be best for Kansas,” she said.
The first mission is to help health professionals get electronic systems and then figure out how they can exchange that information. Ultimately, the state’s systems will plug into a national one.
Learning curve
But, change isn’t easy.
“Almost every single one of us that is out there now grew up writing words on charts, writing notes on charts and using a pen,” White said. “Until not too long ago, we were taught that the pen was the mightiest instrument available to a doctor.”
Dr. Sabrina Prewett, 54, medical director in the LMH Emergency Department, would agree. In January, the emergency room will be one of few nationwide that is paperless.
“It was very challenging,” Prewett said of the five-year process. She worked alongside IT personnel to implement the software and then helped train staff.
“That’s why I became the one that helped develop it because if I can do it — anybody can do it,” she said, laughing.
But, Prewett said it has been worthwhile. It is safer, quicker and the information is legible.
“The impetus is for patient safety,” she said.
Above article published on http://www2.ljworld.com/news/2009/nov/02/health-industry-finally-moving-toward-computerized/?city_local
November 02, 2009
BY DR. SCOTT RANSOM
When Dr. Henry Plummer developed the concept of the “unit record” nearly 100 years ago, his idea was to place all of a patient’s records in a single file that traveled with the patient and could be stored in a central repository. His concept of medical care continuity quickly became the standard for medical record keeping worldwide.
I wonder what Dr. Plummer would make of today’s adoption of electronic medical records (EMR) by U.S. health care providers? After all, the concept is basically the same, just expanded to take advantage of today’s capacious electronic storage and retrieval methods.
Even the federal government has gotten into the act, defining a complete EMR system as containing four basic functions: computerized orders for prescriptions, computerized orders for tests, reporting of test results and physician notes.
In a perfect world, an EMR system tracks a patient’s entire health and medical history in a computerized, electronic format that is accessible wherever the patient is. These records are more easily retrievable than manual systems, and can make a patient’s navigation through the health care system much safer and more efficient.
But it’s hardly a perfect world. Even though the American Recovery and Reinvestment Act of 2009 has made the promotion of a national, interoperable health information system a priority, EMRs have not been adopted nearly as quickly in the U.S. as one might expect. Issues, including the high cost, lack of standardization, security and privacy have stood in the way of implementation.
A recent study from the New England Journal of Medicine points out that hospital EMR adoption rates are still abysmal, concluding that only about 8 percent of the 3,000 hospitals studied by researchers used even a basic EMR in a single unit, which included nurse or physician notes. And only 1.5 percent of non-federal U.S. facilities use a comprehensive EMR.
This seems counter-intuitive, especially when one considers the numerous advantages of EMRs, starting with efficiency. Information stored in an electronic format can be retrieved easily at the touch of a button or the click of a mouse. Search and retrieval times are a fraction of what they would be in manual systems. At the very least, this saves time by eliminating the need to complete the old manual medical history forms at a new physician’s office. This also reduces the chance for error when a patient forgets to list certain prescribed medications or supplements. It’s all there in one easily accessible record.
But efficiency isn’t the only benefit. For patients, access to good care becomes easier and safer when records can easily be shared. Important information — such as blood type, prescribed drugs, medical conditions and other medical history aspects — can be accounted for much more quickly. Doctors and other medical personnel can retrieve these medical records from anywhere using handheld devices like an iPhone, which allows them to continue treatment no matter where they are. And, in case of emergency, information can be shared with emergency room physicians who can then order diagnostic tests and share results online.
Another benefit is safety. It’s estimated that nearly 98,000 patients die annually by preventable medical errors of some type. It’s entirely possible that these numbers could be greatly reduced by a comprehensive medical history information generated through an EMR system.
The Mayo Clinic is setting the standard for EMR implementation. With one of the largest such systems in the world, all medical documentation relating to a patient’s care – physician notes, laboratory reports, surgical dictations, copies of correspondence, appointment schedules, X-rays, ultrasounds, CT and MRI scans, echocardiograms – is instantly available to caregivers via more than 16,000 computer terminals on Mayo’s three campuses. The efficiencies created by simply typing a few identifying keystrokes to retrieve a patient’s record saves a doctor’s practice or a hospital many thousands of dollars. That’s even taking the cost of the electronic system into account.
Even the federal government thinks electronic record keeping is important. Veterans’ hospitals across the country share an electronic system called VistA, which shares records of veterans in its health system. Should a patient find him or herself in a VA hospital, even away from home, the hospital will have the same access to his or her records that the hometown hospital does.
It’s interesting to note that a recent report from PricewaterhouseCoopers’ Health Research Institute contends that Medicaid penalties might do more to boost EMR adoption than incentives, like available funding to physicians to purchase and implement EMRs. According to the report, “Provisions in the stimulus law that call for cuts in Medicare reimbursements, rather than a multibillion-dollar incentive program, will do more to push the adoption of electronic medical records among hospitals and doctor practices by 2015.”
However EMR adoption happens, it’s critical that it happen sooner rather than later. The health care industry’s ability to provide efficient, coordinated, safe and high-quality care is only enhanced by the rapid availability of accurate data. And with the availability of solid data, researchers can also use the EMR to analyze large amounts of patient information more efficiently, speeding the application of new research findings and vastly improving patient care in the future.
Just as Dr. Plummer saw beyond the information exchange limitations of his era, we can see the benefits of using the latest technologies for the practice of continuity in 21st century medicine. But the goal, just as it was in Dr. Plummer’s time, or even going as far back as Hippocrates and his famous oath, is still nobly laudable: “First, do no harm.”
Dr. Scott Ransom is president and professor in obstetrics, gynecology, health management and policy at the University of North Texas Health Science Center at Fort Worth.
Above article published on http://www.fwbusinesspress.com/display.php?id=11302
October 30, 2009
By Dr. Raj Bhandari and Terry L. Austen
Special to the Mercury News
Patients in the Kaiser Permanente San Jose Hospital are seeing something new when a physician or nurse visits their rooms. The doctors and nurses themselves aren’t different; they continue to provide their patients with superior care and service.
But a piece of equipment they bring with them — a wheeled cart with a computer screen on top — is a significant difference, and it’s an example of what will help dramatically improve health care in America.
The cart-borne computer is wirelessly connected to a huge database containing the medical history of our members, as well as the latest recommended treatments for a wide range of medical conditions. The database contains all outpatient and inpatient visit information, diagnostic images such as X-rays and mammograms, allergies, specialists’ notes, lab tests and prescriptions. And it is all part of KP HealthConnect, the largest nongovernmental electronic medical record (EMR) system in the United States.
Electronic medical records are a cornerstone of President Barack Obama’s health reform effort, and as part of his effort to stimulate the economy, he has dedicated some $19 billion to make EMRs a national reality.
Why? Electronic medical records improve the quality of care. A fully functional EMR system gives physicians, nurses and technicians a patient’s comprehensive medical history at the point of care, whether it’s in the doctor’s office, the emergency room or in a skilled nursing facility. It is also remotely accessible for specialists and others who are on call, allowing them to make informed decisions that expedite patient care.
EMRs have the potential to increase efficiency and contain costs by reducing duplication and improving patient safety, and they do this by harnessing the incredible power of computers — their ability to calculate, to network, to automatically check facts and to provide targeted research results — and applying that power to medical care.
In health care systems with fully implemented electronic medical records, physicians and nurses no longer need to spend valuable time looking through several files for paper records that are often incomplete.
Now, for example, emergency department physicians with a fully functional EMR system can see a patient’s previous hospitalizations, medications and diagnoses when that patient shows up complaining of chest pains. That means treatment can begin more quickly and success is more likely.
Medication is safer, too: Prescriptions written by physicians using the EMR system are spell-checked and legible, and the computer automatically combs the patient’s history for potentially dangerous drug interactions and alerts the doctor.
In the hospital, medications are bar-coded and scanned at bedside to help ensure the right patient is getting the right drug in the right dose at the right time.
Of course, EMRs should not be a one-way street. In integrated health care systems, patients can use their home computers to increase convenience by making appointments online, ordering prescription refills that are delivered to their home, viewing their lab results through secure Web pages, and e-mailing their physicians — all at no additional cost.
Last year, thanks to these online tools tied to EMRs, Kaiser Permanente members had 6 million e-visits without using a gallon of gas.
Notes jotted on paper and placed in multiple files where doctors rarely see them are a remnant of a fragmented, inefficient model of medical care. In the 21st century, Americans expect — and deserve — more.
Dr. Raj Bhandari is physician-in-chief and Terry L. Austen is senior vice president and area manager for Kaiser Permanente San Jose Medical Center. They wrote this article for the Mercury News
Above article published on http://www.mercurynews.com/opinion/ci_13534802
September 18, 2009
Diana Manos, Senior Editor
Social Security administrators have set aside $24 million for contracts to provide electronic medical records to improve the efficiency of its disability programs.
Michael Astrue, Commissioner of Social Security, said the agency is looking for healthcare providers, provider networks and health information exchanges to participate in its Medical Evidence Gathering and Analysis through Health Information Technology program.
Astrue said health IT will improve the efficiency of a process which is largely paper-bound. For nearly a year, he said, Social Security has been testing health IT to obtain electronic medical records. Disability applications processed with electronic medical records from test sites in Massachusetts and Virginia have significantly reduced processing times, he said.
“With these competitive contracts, Social Security continues to be a leader in the use of health IT to improve service to the American public,” Astrue said. “This technology will greatly improve the speed and consistency of our disability decisions.”
The contract opportunities announced Friday are funded through the American Recovery and Reinvestment Act. They will require awardees, with a patient’s authorization, to send Social Security electronic medical records through the Nationwide Health Information Network. The NHIN, considered by the federal government to be a safe and secure method for receiving instantaneous access to electronic medical records, is an initiative of the Department of Health and Human Services and is supported by multiple government agencies and private sector entities.
Social Security reports a significant increase in disability applications as a result of the current recession. The agency expects to receive more than 3.3 million applications in fiscal year 2010, a 27 percent increase over FY 2008. To process these applications, the agency sends more than 15 million requests for medical records to healthcare providers.
Above article published on http://www.healthcareitnews.com/news/social-security-fund-24-million-contracts-emrs
September 09, 2009
ScienceDaily — A new framework of recommendations created by health informatics researchers may help doctors and hospitals prepare for a federal initiative to expand the use of electronic health records (EHRs).
The recommendations from faculty at The University of Texas Health Science Center at Houston, the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine appear in a commentary in the Sept. 9 edition of JAMA, the Journal of the American Medical Association.
“With high-quality, well-designed, and carefully implemented systems, highly-reliable, safe health care will be achieved,” said Dean Sittig, Ph.D., commentary author, associate professor at The University of Texas School of Health Information Sciences at Houston and member of The University of Texas - Memorial Hermann Center for Healthcare Quality and Safety.
The American Recovery and Reinvestment Act of 2009 created approximately $20 billion in incentives for individuals and organizations to “meaningfully” use electronic health records beginning next year. Previous studies report that 4 percent of physicians in the outpatient setting and 1.5 percent of U.S. hospitals have a comprehensive electronic health record system.
“This framework can help make sure that electronic health records are used safely and effectively as doctors continue to adopt them,” said Hardeep Singh, M.D., M.P.H. co-author and assistant professor of medicine and health services research at the VA Health Services Research and Development Center of Excellence and Baylor in Houston.
This framework of recommendations proposed by Sittig and Singh provides guidance for key stakeholders who are either currently involved or who will soon be involved with electronic health records.
“While using electronic health records, we not only have to consider issues related to technology, but also issues related to people who use them, how they interact with technology and how the electronic health record fits with the work flow of the clinic or organization that adopts it,” said Singh, who noted that if the Computerized Patient Record System developed by the Department of Veterans Affairs was included in the EHR-use study, the percentage of U.S. hospitals with a comprehensive electronic health record system would nearly double to 2.9 percent.
VA’s electronic health record system covers many aspects of patient care, including reminders for preventive health care, electronic entry of orders, display of laboratory test results, consultation requests, and pathology and imaging studies.
“The American Recovery and Reinvestment Act stipulates that clinicians and healthcare organizations can receive incentive payments for ‘meaningful use’ of EHRs. Depending on the definition and timeline for ‘meaningful use,’ this legislation could result in a rush to implement sub-optimal systems,” said Sittig, co-author of a new book that addresses EHR issues and is titled “Clinical Information Systems: Overcoming Adverse Consequences.”
For Americans to realize the full potential of electronic health records, which include reduced cost, less duplication and greater quality, Sittig and Singh believe all eight essentials, which are based on a systems engineering model for patient safety, should be followed.
“These issues are essential to maximize patient care benefits and minimize unintended errors from technology,” Singh said.
The commentary is titled “Eight rights of safe electronic health record use.” The authors received support from the National Library of Medicine, the VA National Center of Patient Safety, the Houston VA Health Services Research and Development Center of Excellence and the Agency for Health Care Research and Quality.
Above article published on http://www.sciencedaily.com/releases/2009/09/090908193440.htm
August 27, 2009
By Brian Smith / Register News Writer The days of a white-coated doctor taking a pen from his pocket and making notations in a file are long gone.
With computers becoming smaller, cheaper and more portable, health care professionals are replacing paper records with electronic records that can be instantly accessed.
The Madison County Health Department’s home health division, MEPCO Home Health, is in the process of implementing an electronic medical records (EMR) system, department spokesperson Christie Green said, and will begin using the system on Sept. 1.
“EMRs will make things faster, more efficient and will provide a huge space savings,” Green said. “For example, MEPCO will be moving from nearly 200 square feet of filing space to electronic records housed in a server room of less than 40 feet.”
Federal health care reform efforts have focused on transitioning health care providers to EMR systems to increase efficiency and reduce spending.
Local public health director Jim Rousey said that an EMR system frees personnel to spend more time treating patients instead of making records.
“Every year, our home health nurses were spending more and more time fulfilling documentation requirements for patient care,” Rousey said.
“This interfered with what nurses really wanted to be doing, which was taking care of patients.
“Employing an electronic medical record system should reduce the amount of time it takes to document the care and ultimately provide more time with the patients,” he said.
Rousey said that using an EMR can take some adjustment for practitioners experienced in maintaining paper records.
“At the beginning, there is a steep learning curve for everyone. Sometimes it actually takes longer to use the EMR in the beginning, but the efficiency becomes apparent as everyone gets accustomed to the system,” Rousey said.
At Pattie A. Clay Regional Medical Center, which switched to an EMR system in 2004, the system has paid large benefits, said Joy Barnes, information technology director.
“The nurse at the bedside may need to spend more time to initially gather and document patient information, but the administration and reporting side of nursing has seen efficiency improvements in both time and accuracy of the patient chart,” Barnes said.
Cost is still a concern when transitioning to an EMR system, Green said, despite the decrease in equipment costs over the past few years.
“Less than a tenth of our total outlay for an electronic medical records system in MEPCO was for the hardware,” Green said. “The cost of installing, licensing, and maintaining a quality system is still extremely high — in the 100s of thousands of dollars, even for a small family practice.”
Security can be another concern, said Martin Hensley, information technology specialist for the health department.
“Controlling access and ensuring security is a problem that exists on a bigger scale than it did in the past,” Hensley said. “In the past, we could just lock a file room and the charts would be secure. Now, everyone in the agency must be more conscious of security. Each computer terminal or laptop can be a doorway to confidential medical information.”
Barnes and Green also both pointed to making wise choices about the systems that are implemented as a key component of implementing an EMR system.
“In the past, we used carts with laptop computers that were wheeled into each patient room,” Barnes said. “The carts were cumbersome and not the best option, especially in a semi-private room with two patients.
“With the new renovations in place, the nursing staff are testing hand-held computers developed specifically for the health care environment,” Barnes said.
“We have to be aware of the potential for the computer to come between the provider and the patient,” Green said. “For example, large screens may block a patient’s view, or a computer’s location in the room may cause the provider to turn her back to the patient.”
Despite the costs and concerns, Green said EMRs and other health technology have a benefit to patients.
“In the long run, electronic records will increase the speed and accuracy of the flow of information between providers,” Green said.
“This translates into improved quality of care for patients, as various providers can communicate about an individual’s health needs.”
Above article published on http://www.richmondregister.com/localnews/local_story_236085613.html?keyword=secondarystory
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