Medical Practice Trends.com » EMR

Five Ways to Scan Your Paper Charts into an EMR System

Peter Polack — Tue, 27 Jul 2010 13:45:17 +0000

We are a little over two years into our electronic medical records implementation at the time of this writing. Since we have been performing a gradual rollout, the entire process has been relatively uneventful. Most of the credit for this goes to our chief information officer (technospeak for the head of our IT department) and our practice administrator.

One of the biggest challenges we have been facing is how to convert all of the paper records into electronic ones. Since we started our EMR implementation with just new patients, we initially were entering brand-new data on those patients and there wasn’t anything to convert. But as we started adding established patients – those patients that had an existing paper chart – we had to deal with two issues: how much of the paper chart do we convert to a digital format and how do we make the majority of the existing clinical history available to the physician? Before I tell you what we did, let’s discuss some options for dealing with conversion of paper records to electronic records.

All patient charts are scanned into the electronic medical records (EMR) system. If your practice is running out of physical office space, as we were, this is an attractive option. Unfortunately, it is easy to

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Post tags: EHR, electronic medical record, EMR, emr conversion, healthcare IT, information technology, medical practice management, records

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CMS Meaningful Use Rules, Part 2

Peter Polack — Thu, 22 Jul 2010 14:06:30 +0000

In part 1, we introduced the different stages of meaningful use criteria as defined by CMS in their final rules, released July 13, 2010. Many practices and hospitals breathed a collective sigh of relief on the one hand, as several criteria had thresholds that were less onerous than were originally proposed. It seems that CMS has been listening.

Thresholds for CPOE and e-Prescribing

For example, as we mentioned earlier, the threshold for meeting criteria for CPOE (computerized physician order entry) is now set at 30%. This means that only 30% of unique patients (not total patient visits) need to have at least one order entered into the electronic medical record system to meet those goals.

Another example is electronically transmitted prescriptions or e-Prescribing. Originally set at 75% of “permissible prescriptions”, this has been dropped to “at least 40%”. This was due in part to objections that (1) some pharmacies are not quite ready to accept e-Prescribing and (2) some patients insist on getting a paper prescription.

Structured Data vs Unstructured Data

Along the subject of prescriptions, an active medication list must be maintained on patients (with the default threshold of at least 80% of unique patients) in the form of “structured data”. Structured data refers to data that can be identified by the EMR system. In other words,

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Post tags: ARRA, EHR, electronic medical record, EMR, meaningful use

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Electronic Medical Records and Liability

Peter Polack — Fri, 09 Jul 2010 13:17:11 +0000

A recent post on the Wall Street Journal’s Health Blog reported on an interview with a professor of law and bioethics who believes that electronic medical records will bring on a whole host of liability issues for medical practitioners. Sharona Hoffman writes in “E-Health Hazards: Provider Liability and Electronic Record Systems,” which appears in the Berkeley Technology Law Journal, that while “the potential benefits of computerization are considerable,” digitized medical systems also “may bring novel responsibilities, burdens and complexities for medical practices,” including a whole new rash of medical malpractice worries.

Some of these worries are legitimate, such as possible “bugs” in software systems which may affect computerized prescriptions or physician orders. Although actual examples of these seem to be hard to find.

Others, on the other hand, sound a little dramatic: “Some systems are so complicated they actually hinder the ability of the doctor [to care for the patient]. Doctors have only about 15 minutes per patient, and more of that time may be spent trying to fiddle with the computer — it can take time away from patient interaction.”

Needless to say, most physicians are bright people. We would expect that they would get a little training before they unleash any device on a patient, whether it is a medical instrument or an EMR system. Professor Hoffman says, “They need to be getting trained if they have an electronic health record system — saying ‘I have a computer so I can figure it out’ [doesn't work]“. This sounds a little bit patronizing. Then again, we all know colleagues who have used something without reading the manual first.

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Post tags: EHR, electronic medical records, EMR, medical liability, Wall Street Journal

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CMS to Publish “Meaningful Use” Final Rule by July 14

Peter Polack — Fri, 02 Jul 2010 14:59:31 +0000

According to a report on FierceEMR.com, the CMS has announced that by July 14 it will release its final ruling on the EMR “meaningful use” standards which will finally spell out just how healthcare providers can become eligible for the HITECH (Healthcare Information for Electronic and Clinical Health) Act financial incentive payments.

In addition, it will presumably unveil its plan for aligning its Physician Quality Reporting Initiative (PQRI) with the EMR financial incentives program.

“We propose to include many ARRA core clinical quality measures in the PQRI program, to demonstrate meaningful use of EHR and quality of care furnished to individuals,” CMS states in an advanced copy of the proposed reg, CMIO magazine reports. “We propose the selection of these measures to meet the requirements of planning the integration of PQRI and EHR reporting.”

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Post tags: ARRA, CMS, EHR, EMR, HITECH, meaningful use, pqri

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Medical Practice Trends Podcast 7: HIPAA, HITECH, and Protecting Your Patients’ Information

Peter Polack — Tue, 08 Jun 2010 12:15:51 +0000

EMR Update 7 – HIPAA, HITECH, and Protecting Your Patients’ Information
This Issue:

What is data-at-rest vs data-in-motion?
What do the new HITECH Act provisions mean to your medical practice?
What are potential penalties for violating the HIPAA regulations?
What proactive measures can you take to protect yourself and your practice?

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Post tags: data at rest, data in motion, EHR, electronic medical records, EMR, HIPAA, HITECH, podcast

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Are EMRs Bad For Your Health?

Peter Polack — Wed, 03 Mar 2010 14:00:49 +0000

In an article on the Huffington Post, the FDA is quoted as saying that errors attributed to the use of electronic medical record systems were responsible for dozens of injuries and six patient deaths. This, say critics of EMR, flies in the face of the assumption that adoption of EMR/EHR will improve patient safety and save lives. Some university studies have looked specifically at hospital-based systems and found that some of them had actually caused more adverse drug events than would have been expected, especially since these systems are supposed to have fail-safe mechanisms against just such occurrences.

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Post tags: EMR, FDA, Huffington Post

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Bonus Resource: EMR Software Checklist

Peter Polack — Thu, 11 Feb 2010 16:22:10 +0000

For those of you who are at the stage of EMR implementation where it is time to decide on the EMR software system, we have a new resource which I think you will find very useful.

Medical Practice Trends has partnered with the folks at SoftwareAdvice.com to give you an EMR Software Checklist. They have a huge database of information from many EMR software vendors and have used this to create a checklist of selection criteria to help medical practices with their EMR system decision-making. Then, one of their consultants will call and walk you through the checklist and explain the best practices for researching EMR software. Software Advice will even provide a “short list” of EMR systems for you to consider based on your unique requirements. Last year, they helped over 10,000 organizations find the right software.

What’s the catch? There isn’t one really. It’s a totally free service for you. SoftwareAdvice receives a “finder’s fee” if they successfully match you with an EMR software company. As an affiliate, Medical Practice Trends gets a cut of that. Hey, we have to pay our electric bills, too.

So, here’s what to do:

First, if you haven’t already started your EMR project, get our free report (located in the right-hand sidebar) “Getting Through the EMR Maze”. This will give you an overview of EMR implementation and help you avoid making costly mistakes.

Next, CLICK HERE to go to the EMR Checklist page. Fill out the information and then you can download a PDF of the checklist so you can get started doing your research right away. Good luck!

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Post tags: EHR, electronic medical record, EMR

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Study: Current EMRs not good for care coordination

Frank Polack — Thu, 07 Jan 2010 20:15:17 +0000

One of the goals of meaningful use and all the related federal spending of health IT is for EMRs to improve care coordination. But the current reimbursement system that’s heavy on fee-for-service encourages software developers and users alike to focus on documentation of billable events rather than coordination of care, a new study finds.

CMS Releases Proposed Meaningful Use Criteria

Peter Polack — Thu, 31 Dec 2009 04:32:51 +0000

The Centers for Medicare and Medicaid Services (CMS) announced today a proposed outline for Meaningful Use criteria, in accordance with EMR implementation provisions under the Health Information Technology for Clinical and Economic Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA) of 2009. These specify some of the guidelines by which physicians can receive incentives of up to $44,000 per provider, over 5 years, beginning as early as 2011.

Stage 1 criteria (the first of 3 total) would cover 25 meaningful use objectives (and 23 for hospitals). These are listed under modules known as Health Outcomes Policy Priorities such as Improving quality and patient safety (use of drug-allergy interaction checks, use of ePrescribing, maintaining active medication list, etc.), Engaging patients and their families in their health care (e.g., provide patients with a copy of their health information), Improving care coordination (e.g., exchanging key clinical information among authorized entities), Improving population and public health (e.g., capability to submit data to immunization registries), and Ensuring adequate privacy and security for personal health information (through the use of appropriate EMR technology).

The implementation of Stage 1 meaningful use standards would begin in 2011. Stage 2 (which would essentially expand upon certain aspects of Stage 1) and Stage 3 (which would deal with achieving improvements in conditions of a national high-priority nature and population health outcomes) would follow later.

While this certainly doesn’t clear things up completely for the individual physician, every piece of information that trickles down from Washington is eventually analyzed and translated for all parties which have a vested interest in the process. Hopefully, resources such as this can help doctors stay informed and as up-to-date as possible.

If you have any comments or questions, please post them here. If we don’t know the answer we’ll certainly try to find someone who does.

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Post tags: ARRA, CMS, electronic medical records, EMR, healthcare IT, HIPAA, HITECH, meaningful use

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Take Our Survey: Are You Using EMR?

Peter Polack — Wed, 23 Dec 2009 01:45:24 +0000

EMR Implementation – How do you stack up against your colleagues?
We’ll post the results in a week or so.
Click the Next button after you answer each question

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Post tags: EHR, electronic medical records, EMR, EMR implementation, EMR training, healthcare IT, medical practice management, practice management software, practice management system, solo practice

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