On Tuesday, the Health IT Standards Committee approved quality measures and standards for how health care providers can demonstrate “meaningful use” of electronic health records by 2011, Government Health IT reports.

Under the federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs will qualify for Medicaid and Medicare incentive payments.

The standards panel endorsed a matrix of 27 quality measures and 12 standards that build on each other to improve patient outcomes. The standards call for health care providers to use health IT tools for transmitting:

• Continuity of care documents;
• Discharge summaries;
• Inpatient and outpatient prescriptions;
• Laboratory test results; and
• Other structured health data.

The committee said health providers who have not yet adopted EHR technology could use certain unstructured data for 2011, provided that they work to eventually meet structured data standards.

John Halamka, co-chair of the Standards Committee, said the panel attempted to provide “comfort levels” to encourage physician compliance with the standards and quality measures. He said future criteria will require health care providers to meet stricter standards.

The standards panel also suggested that meaningful use criteria require health care providers to fully comply with HIPAA privacy and security rules by 2011 (Government Health IT, 7/22).

Above article published on http://www.ihealthbeat.org/Articles/2009/7/23/
Standards-Panel-Backs-Quality-Measures-for-Meaningful-Use.aspx

Molly Merrill, Associate Editor

CHICAGO – The Healthcare Information and Management Systems Society has published two definitions of “meaningful use” as it applies to certified electronic health record technologies and hospital’s use.

HIMSS officials announced the definitions Tuesday as the National Committee on Vital and Health Statistics Executive Subcommittee began hearings to define “meaningful use.”

According to HIMSS officials, EHR technology is “meaningful” when it has capabilities including e-prescribing, exchanging electronic health information to improve the quality of care, having the capacity to provide clinical decision support to support practitioner order entry and submitting clinical quality measures - and other measures - as selected by the Secretary of Health and Human Services.

Officials say physicians must meet the definition within a specified time frame, which as described in the American Recovery and Reinvestment Act of 2009.

In order for hospitals to have a reasonable chance of achieving the definition, HIMSS officials say the requirements must be introduced in incremental stages. In order for hospitals to meet each stage, milestones must be achieved in phases of not less than two years each, commencing in FY11. In the final phase, which must commence in FY15, HIMSS officials believe the mature definition of “meaningful use of certified EHR technology” includes at least four attributes:

1. A functional EHR certified by the Certification Commission for Healthcare Information Technology (CCHIT);
2. Electronic exchange of standardized patient data with clinical and administrative stakeholders using the Healthcare Information Technology Standards Panel’s (HITSP) interoperability specifications and Integrating the Healthcare Enterprise’s (IHE) frameworks;
3. Clinical decision support providing clinicians with clinical knowledge and intelligently-filtered patient information to enhance patient care; and
4. Capabilities to support process and care measurement that drive improvements in patient safety, quality outcomes and cost reductions.

HIMSS officials have urged that CCHIT be named as the certifying body for EHR technology.

HIMSS developed its recommendation by drawing up an initial draft of meaningful users of certified EHR technologies in March. The draft was publicly posted with a discussion forum for a three-week period commencing April 1, 2009. The draft was then reviewed by the HIMSS membership community, which consists of more than 3,000 volunteers organized into nearly 80 groups

Above article published on http://www.healthcareitnews.com/news/himss-publishes-meaningful-use-definitions

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

The medical information age.

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

Controversy.

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

Electronic Medical Records (EMR)

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

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

Conclusion.

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

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

Electronic medical records are the wave of the future, and Chicago area hospitals are already on board.

Hospitals with more advanced record-keeping technology have fewer complications, lower mortality rates, and lower costs, according to a study released last week by Johns Hopkins University. The study looked at more than 40 hospitals with digital record systems and more than 160,000 patients in a six-month period.

“It’s the right thing to do and we’re going to see a lot of studies like this in the next 5-10 years that attempt to measure the benefits of electronic medical records,” said Dr. Mike Kelleher, chief medical information oficer at Children’s Memorial Hospital.

Most of Chicago’s top medical institutions including Northwestern Memorial Hospital, NorthShore University HealthSystem–Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, Skokie Hospital, and 75 doctor’s offices–, University of Illinois Medical Center at Chicago, Rush University Medical Center and Children’s Memorial Hospital have either already made the leap to digital records, or are in the process.

Former President George W. Bush laid out the goal of having electronic records nationwide by 2014, a goal that was quickly adopted by President Barack Obama.

Wired In

The study findings are no surprise to Chicago-area hospitals, well versed in digital technology.

“What we did was transformational–it changed the way we do things and the way we think,” says Mark Neaman, president and chief executive officer of NorthShore University HealthSystem.

“Patients can even have a Blackberry conversation with their physician or order a prescription online,” Neaman said.

NorthShore University HealthSystem, one of the pioneers in digital records, went completely digital in 2004.

Digital records can even prevent mistakes from being made.

“We have seen measurable improvements in the quality of our outcomes, reduced medication errors and become generally more efficient,” Neaman said.

The complete transition at NortthShore $took 15 months from launch to finish in April of 2004 and cost an estimated $42 million, according to Neaman.

“We applied the big bang theory,” Neaman said. “We wanted to have everything up and running quickly.”

Almost all Chicago-area hospitals have some digital record keeping system in place or are in the process of implementing one.

Security, however, becomes a major concern with personal information in digital form.

With electronic records, it is much easier to track who has accessed a file—an important security feature—but making sure the right people have access can be time consuming.

“It’s a big concern,” Kelleher said. “You have to make sure that the people you give access to are properly vetted.”

“Before electronic medical records, files were continually being misplaced,” said Dr. David S. Channin, radiologist at Northwestern Memorial Hospital and chief of imaging informatics at Northwestern University Medical School. “We relied on loose pieces of paper with illegible writing, and human memory.”

Northwestern Memorial has used electronic records for more than a decade now for nearly all of their services.

More Benefits

The benefits of digital records aid in many different aspects of patient care.

One key benefit is allowing doctors to find information on patients more easily.

While it may take physicians or nurses more time to enter information into the system, the ability to find it and search for it with ease is invaluable according to Kelleher.

Patients and doctors can also have their information readily available at the touch of a keyboard without having to dig through extensive files.

Digital Divide

Despite the many advantages there are still countless hospitals that are falling behind with this technology.
After years of recording information manually, some doctors are hesitant to change to a new electronic system.

“The older physicians are more likely to be unwilling or uncertain about using the computer system,” said Kelleher.

“The catch is that there are tradeoffs between quality and efficiency and independent tradeoffs within each one,” says Dr. Channin.

There is also a steep cost of investment as far as equipment and training.

NorthShore University HealthSystem invested an estimated $42 million in the new technology, $5 million of which went to training staff, according to Neaman.

They are foreseeing an estimated return of 17 million dollars per year in savings related to the new system, but the return is very long-term and small in comparison.

Originally Published by Vanessa Handand and Chris Kelly, Northwestern University.