Implementation Process for an Electronic Medical Record

By Eric Fishman, MD

It is unlikely that you will find the process of implementing an Electronic Medical Record in your office to be an easy one. However, there are a variety of activities that you can do to simplify and streamline the process, and increase the probability of success.

First, please understand that not only do you need to learn a new complicated and sophisticated software program, but you also need to undertake a significant modification of your current workflow.

We believe that we have realized a mechanism to split these two processes, thereby significantly increasing the probability of a successful implementation.

Assuming that you have made a decision that you will be implementing an EMR in the ‘not too distant future’, but are not ready to purchase one immediately, we have found that modifying your workflow to one which will more closely model the workflow that will be imposed upon you by the EMR can be very helpful during the extended implementation process.

Our current recommendations are that, again assuming you have not yet chosen which EMR you will be utilizing, are that you start to modify your workflow by utilizing a Tablet PC, and voice recognition software, so that you can get used to the process of keeping a portable computer by your side, and completing as much of the patient documentation as possible during the actual encounter.

Our current specific recommendations in this regard are that you utilize a Motion Computing LE1600 Tablet PC, with 1 GB of RAM. If you know that you will be utilizing an ASP model EMR eventually, you can save a few dollars by purchasing one with a 30 GB hard drive. If you are unsure, or if you know that you’ll be utilizing a client server model, we would then recommend that you purchase the tablet with a 60 GB hard drive.

It is our opinion that this hardware / software combination will be compatible with the overwhelming majority of EMR software packages that you are likely considering as your final choice.

There are a number of advantages to utilizing this model during the extended implementation procedure. You will have spread out the costs associated with implementing an EMR by months. The above configuration is likely to cost less than $6000.00, and you will start saving money from the onset, as your transcription costs will either be significantly diminished or altogether eliminated, thereby allowing you to save toward what will be the larger expense of the software licenses and implementation fees.

Above article publish on http://www.emrspecialists.com/2010/03/implementation-process-electronic-medical-record/

Massachusetts Receives $24 Million in HIT Funding

By, Rich Silverman

Massachusetts, long a leader in the delivery of quality medical care to its citizens, has just received more than $24 million from the federal government to speed the adoption of electronic medical records (EMRs) throughout the Commonwealth.

According to a report in govmonitor .com, the Office of the National Coordinator (ONC) has authorized the release of the $24 million, the maximum that Massachusetts is entitled to under the American Recovery and Reinvestment Act (ARRA) of 2009. According to the report, $13.4 million will go to support the adoption of EMRs throughout the Commonwealth, and another $1.6 million will go toward creating a statewide high-speed communications system for medical data and records.

According to Massachusetts Governor Deval Patrick, “This federal funding will help reduce health care costs and improve patient care using proven technologies, many of which are developed right here in Massachusetts.” Lieutenant Governor Timothy Murray added that in addition to streamlining health care, the money would help create jobs.

The grants, given in furtherance of the adoption of EMRs, will be administered by the Massachusetts e-Health Institute, the state agency created for that purpose. One if its key goals, according to an article in MassHighTech.com, will be to ensure the privacy of all medical records in the state.

Couple the release of this funding with recent news that meaningful use has finally been defined and that ONC is taking definitive steps to develop a certification, and it looks like providers in Massachusetts are finally getting the tools they need to fully implement EMRs.

Above article publish on http://www.myemrstimulus.com/massachusetts-receives-24-million-hit-funding/

Study: E-prescribing greatly improves accuracy, less so for safety

By Neil Versel

It’s a small study group, but the results are eye-opening nonetheless: Primary-care practices cut their prescription error rates from 42.5 percent to 6.6 percent in a one-year period by adopting e-prescribing technology.

That’s the finding of researchers at Weill Cornell Medical College in New York City, as reported in the Journal of General Internal Medicine, who studied the prescribing accuracy of 12 primary-care practices in New York state. Six of the practices wrote prescriptions electronically, resulting in the major reduction in errors, while the half-dozen practices in the control group that stuck with paper prescription pads had a small uptick in their error rate, from 37 percent to 38 percent.

Not surprisingly, e-prescribing had an immediate impact on legibility, as the researchers found at the beginning of the study period that 88 percent of handwritten prescriptions at the practices that adopted the technology had some question about the prescriber’s intentions. What e-prescribing did not do, however, is reduce the rate of potentially adverse drug events. But near misses actually increased at practices that did not switch to e-prescribing.

Above article publish on http://www.eprescriptionservices.com/study-eprescribing-greatly-improves-accuracy-safety/

Surescripts Announces Significant Price Reduction for E-Prescribing

Surescripts, The Nation’s E-Prescription Network, today announced that it has lowered the cost of e-prescribing services used millions of times each day by physicians, pharmacists and payers nationwide. After six years of no price increases, the announcement illustrates how replacing a manual, paper-based process with health information technology creates a more efficient and, ultimately, lower-cost means of providing care.

Surescripts operates the nation’s largest e-prescription network and supports a rapidly expanding ecosystem of healthcare organizations nationwide. Surescripts was founded on the principles of neutrality, transparency, interoperability, education, collaboration and quality. Surescripts’ e-prescribing services allow physicians to electronically send prescriptions from their offices to any of 52,000 retail pharmacies and six of the largest mail-order pharmacies. In addition, Surescripts provides physicians with electronic access to their patients’ prescription benefit and prescription history, which helps to improve safety and enables doctors to prescribe medications with the lowest out-of-pocket cost to the patient. Beginning Jan. 1, 2010, Surescripts reduced what pharmacies, pharmacy vendors and pharmacy benefit managers pay for e-prescribing.

“Our decision to lower prices fulfills a public promise made when legacy SureScripts and RxHub were founded,” said Harry Totonis, president and CEO of Surescripts. “Three things have enabled us to keep this promise: Surescripts’ ongoing commitment to its own operational efficiency; the economies of scale resulting from the merger; and Surescripts’ success in working with healthcare organizations across the country to create and meet the growing demand for e-prescribing.

“And stay tuned — we are not done yet. With this price reduction, we are focused on the opportunity to connect even more physicians, pharmacies, payers and patients. As we add more participants to the network, this will continue to drive down the cost of e-prescribing, as our efficiency, scale and economics improve. As this occurs, we will again pass those savings along to the industry.”

“The widespread adoption of e-prescribing is clearly the right thing for all of us to support,” said Stanton McComb, president of McKesson Pharmacy Systems. “In these times, we are especially sensitive to the economic pressures that our customers are under. We recognize that most everyone wants to support e-prescribing, but there is a real cost to doing so for pharmacies. MPS felt that it was important to support and extend Surescripts’ price reductions as quickly as possible to our software customers to support this advancement in pharmacy care and also support our customers economically.”

“Surescripts’ overall efforts — which go well beyond operating a network and certifying software vendors — have helped create unprecedented demand for e-prescribing,” said Bruce Roberts, RPh, National Community Pharmacists Association (NCPA) executive vice president and CEO. “Today, nearly 25 percent of all U.S. office-based physicians, nurse practitioners, and physician assistants are now e-prescribing. That accounts for more than 150,000 prescribers nationwide — more than double the number from one year ago. For community pharmacies, this growth not only lowers the cost of e-prescribing, but begins to realize the gains in efficiency that we all envisioned from the beginning.”

Building The Network, Creating a Market for Paperless Prescriptions

In 2001, the nation’s retail pharmacies and leading pharmacy benefit managers embarked on a shared vision — to create a national network to facilitate the secure transmission of prescription information between prescribers, pharmacies and health plans.

Today, PBMs and health plans providing prescription drug coverage for two-thirds of all Americans are active users of The Nation’s E-Prescription Network. Together with 85 percent of all retail pharmacies and the nation’s leading mail-order pharmacies, they have created the first and only network to allow an entire segment of the nation’s healthcare system — the $254 billion prescription care segment — to electronically share clinical health information on a nationwide basis. However, these organizations have gone far beyond building and electronically linking to a network.

With an eye toward safer, more efficient and lower-cost prescribing, these organizations have worked closely with the state governments, medical associations, technology vendors and various non-governmental organizations focused on standards, health IT adoption, quality, privacy and security to create a sustainable market for e-prescribing. As a result, more than 150,000 (nearly 25 percent) of all U.S. office-based physicians, nurse practitioners, and physician assistants use more than 200 types of e-prescribing and electronic medical record (EMR) systems to e-prescribe today.

Above article publish on http://www.eprescriptionservices.com/surescripts-announces-significant-price-reduction-eprescribing/

CMS Aims To Coordinate ‘Meaningful Use’ Rules With Other Regulations

CMS must pay special attention to ensure that the final version of the proposed “meaningful use” rule for electronic health records fits with other rules for standards and certification, as well at the interim final rule for the certification of EHRs, Government Health IT reports.

Earlier this year, CMS published a notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified EHRs to qualify for incentive payments under the 2009 federal economic stimulus package.

The Office of the National Coordinator for Health IT also published an interim final rule describing required certification standards for EHR technology.

Tony Trenkle, CMS director of e-health and standards, recently stressed how the interplay between different regulations will be important in determining what health care providers will need to demonstrate to qualify for the incentive payments.

ONC policy analyst Steve Posnack said that CMS and ONC are coordinating their regulations to ensure that the standards set for determining meaningful use are in step with rules governing certification of EHRs (Mosquera, Government Health IT, 3/18).


Above article publish on http://www.myemrstimulus.com/cms-aims-coordinate-meaningful-use-rules-regulations/

Medical Billing Service – HIPAA Compliance

Medical Billing Services ensure compliance of The Health Insurance Portability and Accountability Act (HIPAA) of 1996. HIPAA regulation protocols are issued to protect client’s information safely. It also encourages the use of electronic processing and data transferring through multiplexer, router or modem which ensure high degree of privacy. HIPAA has issued laws to release information confidentially. HIPAA complaint medical billing service is unique feature of medical billing company. Specialized billing procedures are:

• Insurance authorization and verification

• Cash posting and reconciliation

• Weekly or monthly evaluation

• Billing and enrollment

• Coding

• Updating anti-virus soft ware

HIPAA complaint software packages

HIPAA complaint medical billing software ensures easy way of sending electronic claims at a faster and cost effective way. It reduces claim rejection, increase collection and avoids delays. It provides a variety of functions like:

• Electronic medical billing

• Preparing patients ledger

• Processing billing information and insurance payments

• Claim submission electronically

• Rebilling of insurance claims

• Electronic medical records

• Covering patience insurance authorization

• Recording patients notes

• Medical coding

• Statement cycle billing

Hiring HIPAA Compliant Medical Billing Service

HIPAA compliant medical billing service provides track for patient statistics and diagnoses with security of health details. It provides medical billing and coding services, quick turn around time and high level of security. Those medical billing companies following HIPAA regulation protocols can assure services confidentially. So it’s better to hire a company that strictly follows all HIPAA protocols prescribed for medical industry. Such a medical company reduces work load and improve cash flow.

Above article publish on http://www.mymedicalbillingoutsourcing.com/medical-billing-service-hipaa-compliance/

Dermatologist’s Guide To Electronic Medical Records Systems

The medical community has had quite a challenge to convert to entirely medical records and, in many ways, is still in transition. Dermatologists frequently enjoy straightforward practice settings that integrate patient data on surgical procedures, patients’ historical data, and newer technologies that continue to emerge. Any more, the accuracy and reliability of these data systems are improving and high quality dermatology care is being increasingly streamlined. The sophisticated technology is undermined, however, if each piece of the dermatologist’s arsenal isn’t integrated into a comprehensive Electronic Medical Records (EMR) system.

DERMATOLOGY-SPECIFIC WORKFLOW

The term “workflow” refers here to an EMR that adapts to the way you conduct your office activities. Instead of being a cumbersome addition to your workload, the right EMR System for you can and should easily integrate into your unique office setting. For example, if you do physical exams, laser treatments and phlebotomy all in different rooms, you need your EMR to be able to automatically migrate all of the patient’s data so that it is accessible from any computer throughout your office. The days of manually scanning, uploading, and transferring patient data are over. Therefore, we will begin here with the assumption that all patient records will be easily accessible from one user interface, not multiple software programs for different types of records. This includes drawings you use to identify the locations of lesions with respect to anatomy. As you will read in a moment, all of this information can be housed within one EMR System.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

Many dermatologists acquire new patients from a host of community referral locations, with physicians that use different machines and software than they own in their office. You need to be able to verify their previous imaging for the best possible patient care and to avoid repeating any tests, particularly for staging various cancers. The problem is that trying to choose an EMR based on the myriad of consultant’s equipment is difficult at best. For example, if you use the DicomWorks viewer for viewing radiographic images, but a patient brings you a CD-ROM from a consultant that used CT Scanner from Toshiba, the Aquilion 16-Slice, you need to make sure that the EMR you choose to grow your practice will be compatible.

If you consult on patients in the hospital or another setting separate from your primary office, the right EMR can really help increase your efficiency. First, being able to view the patient’s record remotely while your taking the consulting physician’s phone call can be extremely helpful. Second, you can synchronize the data on your laptop or handheld device directly into your EMR. Taking your laptop of portable digital assistant with you on your visit to the away patient can save you time by not having to type notes a second time after the consult is finished.

DRAWING DERMATOLOGIC IMAGES IN YOUR EMR

A growing trend is for physicians to use tablet PC’s at bedside. This lends itself very easily to using EMR’s that allow you to draw on anatomical diagrams directly in the patient’s record. Traditional desktop computers also allow this feature. For example, you can outline a nevus and the EMR software will convert that to an image file that is saved with the patient record. This can be particularly useful when tracking growth. You will need to put specific notes in the text areas of the EMR for it to be searchable later.

BUILDING TRUST IN YOUR EMR SYSTEM

Dermatologists are known to conduct rather extensive excisions of carcinomas in the clinic setting. Your EMR should record vital signs in real time and trigger audible and visual notifications in the event of abnormal readings. You shouldn’t have to watch the monitor continually; rather you can control all the parameters and alarms exactly how you want them to behave.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

Appointment reminders and recurring laboratory studies frequently require valuable time from your staff. An EMR System that could integrate automatic emails or phone calls one week prior to an appointment would improve efficiency.

In addition, your EMR should timestamp and track every authorized user’s activities. From ordering special materials prior to nuclear studies, to tracking who logs into the EMR, a lot of repetitive tasks can be integrated into an office system that curbs human error and improves your practice’s measurable outcomes.

Above article publish on http://www.emrspecialists.com/2010/03/dermatologists-guide-electronic-medical-records-systems/

Efficiency Rates of Medical Billing Rise With Electronic Medical Billing Services

With the emergence of electronic medical billing, mistakes in medical billing have drastically reduced. Now that many if not most insurance carriers file claims electronically as do many hospitals, the paper trail of claims and bills is reduced or eliminated all together. Personal security and confidentiality is better protected this way too. Instead of doing medical billing and claims in-house, many physicians are outsourcing their billing to third party medical billers for better medical practice management. When physicians outsource their medical billing, they are reducing the stress and the work load of their staff. The front office waiting room personnel already have a lot of their plate, putting out fires in various ways from emergency care to basic office maintenance. Unburdening them from a stack of medical claims to enter into the system as well as file and mail gives them hours of extra time to dedicated to other important tasks. Outsourcing doesn’t mean physicians suddenly lose control of all of their patient’s billing- now with the Internet; anyone who is certified can log into the electronic medical billing system and watch the progress of a client’s claim from beginning to end. Here Are Other Benefits to Outsourcing Your Medical Billing HIPPA laws are automatically updated for you, so you can feel confident about new updates and requirements. Less paper handling mean fewer errors and more efficient billing Consistent legible handwriting because claims are typed in rather than written When bills are sent electronically, it is sent within seconds which means bills are being paid faster, physicians are collecting more money faster When physicians invest in an electronic medical billing service, they are also getting the other tools and products that come with the service. Physicians can run reports, set schedules, email and maintain an overall more efficient medical practice management with everything being accessed electronically. Even more, several physicians and or nurses can log onto the practice at one time and all have access to reports, claims and patient files.

Above article publish on http://www.mymedicalbillingoutsourcing.com/efficiency-rates-medical-billing-rise-electronic-medical-billing-services-2/

Standards Panel Calls for Increased Monitoring of Security in EHR Modules

Vendors and users of electronic health record modules should monitor them closely for potential data security breaches, according to the Health IT Standards Committee, Government Health IT reports.

The suggestion was included in a summary of the committee’s recommendations on the interim final rule on standards and certification criteria for health IT under the 2009 federal economic stimulus package. The rule describes the requirements for certified EHR systems that physicians and hospitals must use to qualify for health IT adoption incentives.

John Halamka — vice chair of the committee, who published a summary of the recommendations in a March 9 blog post — said the committee “recommended that a list of acceptable technology standards be included in the certification process” in part because IT security standards change quickly, particularly for those strengthening encryption.

According to Halamka, the committee also recommended that the interim final rule “specify broad families of standards” for clinical operations, such as a major version of each standard that also includes a “detailed implementation guide that serves as a floor.”

The Office of the National Coordinator for Health IT has offered the interim final rule for public comment until Monday (Mosquera, Government Health IT, 3/11).

Above article publish on http://www.myemrstimulus.com/standards-panel-calls-increased-monitoring-security-ehr-modules/

The Importance of Voice Recognition in an EMR

In the beginning there was memory. The physician’s memory was the original repository of the patient medical record. Memory was supplemented by handwritten notes on papyri in ancient Egypt and Babylon and on paper from medieval times to the 20th century. With the advent of recording devices in the 20th century, handwritten notes gave way to the infinitely more time effective practice of dictating patient notes into a recorder which were then transcribed into a typewritten or word processed document. Of course, that practice introduced an extraneous third party into the medical record keeping process: the transcriptionist with the attendant additional expense to the physician and loss of privacy for the patient.

At the current time, 21st Century technology offers physicians and health care providers a medical record paradigm that will not only vastly upgrade the process of producing, maintaining and safeguarding medical records but will, in a direct and fundamental way, actually improve the quality of medical care. The technology is Electronic Medical Records (EMRs). EMRs produce the most accurate and complete patient health record possible to date and help physicians practice better medicine as well. EMR technology is available in a plethora of shapes and sizes with a great variety of possible features. The technology can change the way you interact with your patients, from before they make their first appointment to after they’ve left your office, and have questions about their visit in your office.

As a practicing physician you are aware of the repetitive nature of some aspects of your practice, specifically with regard to patient diagnosis. It is very likely that you and/or your staff have asked the same or at least very similar questions to each of the thousands of patients you have treated. Unless you are practicing in a tertiary referral center, and never see the same condition twice, the patient answers likewise tend to be repetitive. Similarly, physical examination findings fit into certain categories that are seen over and over again. For this reason, most of the current high-end Electronic Medical Record products very capably utilize ‘pick lists’ or ‘click and point’ methodology to complete large portions of the patient medical record.

These point and click systems are particularly adept at documenting, for instance, allergies to medications, medications that are currently being taken, past medical history, family history, social history, and major portions of the physical exam. This is the case because of the narrow range of options which are available as patient responses. For instance, your patient either smokes or doesn’t smoke. And if he/she smokes, it is probably 1 ppd, or 2 ppd, or some other value that can reasonably easily be foreseen by the experts who have designed the point and click system for your office.

However, the historical portion of the patient medical record typically has a great deal of information that cannot be easily foreseen by the developers of the point and click templates. For instance, as an Orthopedic Surgeon, my patients frequently find themselves in automobile accidents. It is not likely that the author of whichever EMR may find its way into my office has contemplated the various street names and intersections in my community. Therefore, in a typical point and click system, there will be a scarcity of relevant information concerning the specifics of the accident. And I find that these specifics are important for a wide variety of reasons, not least of which is that they remind me of the particulars regarding this patient when they return to the office. Utilizing templates for the historical portion of the report, while feasible, tends to produce extraordinarily repetitive reports, each of which sounds not only vaguely similar to the previous patients, but in many cases essentially identical to other patients. This certainly makes it difficult to recall the characteristics of this particular patient.

One of the advantages of an EMR is that it allows physicians, hospitals, insurance companies, pharmaceutical companies, medical societies, and other parties entitled to view the patient data for legitimate, permissible purposes, to do so. Legitimate, permissible purposes include coordinating patient treatment, accessing diagnostic procedures and results, preventing adverse drug reactions, and ensuring medical practice within clinical practice guidelines. One particularly high priority purpose from the physician’s standpoint is that the data be accessed by third party payors to streamline reimbursement for services.

Above article publish on http://www.emrspecialists.com/2010/03/importance-voice-recognition-emr/

Single Specialty vs. Multi-Specialty EMR

By Eric Fishman, MD

There is a lot of discussion concerning which is the “best” Electronic Health Record for any individual entity. There are a variety of parameters which should be considered prior to embarking upon what will undoubtedly be one of the most important decisions in the life of a healthcare organization.

One of the most important issues is “Should I purchase an EMR designed for my specific specialty?” We will attempt to address some of the pros and cons of each option.

If you are involved in a multi-specialty clinic I would strongly advise against purchasing multiple different EMRs, one for each specialty. One of the major difficulties with this plan, and it may be all but insurmountable, is the interconnectivity between the various programs. Yes, they may all be HL7 compatible, but you will find yourself in an almost endless quagmire of interfaces.

The question is a bit more difficult to answer if you practice in a single specialty environment. There are a large number of specialty specific EMRs for a variety of specialists, including Oncology, Ophthalmology, Orthopedics, Cardiology, etc. In this instance, if you have a very sophisticated workflow, often seen in larger single specialty medical groups, then a specialty specific EMR may be most appropriate. I find that Oncologists, in particular, do well with EMRs designed specifically for their specialty. This is, in part, because many of their workflow issues are entirely foreign to almost all other specialties. This would include, of course, dosing issues concerning their cancer curing pharmaceuticals.

At the other end of the spectrum would be Internal Medicine and/or Family Practice. Most “general” EMRs are fully capable of handling most of the workflow and reporting issues found in those practices, and therefore a more general EMR would be most appropriate.

Cardiology, Ophthalmology and Orthopedics, and many others, fall somewhere in the middle. If you find yourself using a substantial number of activities that are not performed by any other specialists, such as in office arthroscopy for Orthopedists, you’ll likely find generic EMRs to be lacking in functionality. If, however, your office based practice is more standardized, by which I mean closer to the activities performed by other specialists, then the problems which may be associated with single specialty EMRs may not be worth encountering.

What are some of these problems? First of all, many single specialty EMRs are provided by companies which are both small and unlikely to grow much larger because of their limited potential user base. Certainly this is not the case of all single specialty EMRs, and there are some multi-billion dollar companies producing fine software in this arena. However, many of them are products which were started by a physician in that specialty. Their longevity in the marketplace must be considered when acquiring software of that nature.

So, in short summary, I would encourage you to take a careful look at the workflow in your office and consider how similar or different it is to other physicians of different specialties. If it is not extraordinarily different, I would go with a more general EMR. For your specific installation, that of a multi-specialty clinic, I would strongly recommend purchasing a general EMR from a company which is large enough to have developed the different workflows for each relevant specialty.

Above article publish on http://www.emrspecialists.com/2010/03/single-specialty-multispecialty-emr/

E-prescribing gains momentum in Europe

There is increasing acceptance of e-prescribing in Europe and system sales should more than triple in the next six years, according to a report on the technology by market research firm Frost & Sullivan.

According to the analysis, the European market for e-prescription systems, including integrated and stand-alone e-prescription systems, was worth $95.4 million in 2008 and should reach $449.7 million by 2015.

“Having experienced tremendous growth in the United States, e-prescription is on course to be accepted by the healthcare system in Europe,” notes Frost & Sullivan Research Analyst Jayapradha T. E. “With an increase in the acceptance of integrated healthcare solutions, government initiatives and the need to reduce medical errors caused by paper prescriptions, the e-prescription market is expected to carve a niche for itself in the global healthcare arena.”

The drive to ensure greater mobility for patients and health professionals has resulted in attempts to modernize healthcare IT systems, which requires the effective integration of economic, organizational and clinical information across the healthcare spectrum.

“The drive towards enhanced healthcare mobility, reduced costs and improved efficiency, paralleled by an emphasis on patient safety and service quality, is having a direct positive impact on the e-prescription systems market in Europe,” Jayapradha said.

According to the Jayapradha, prescriber resistance to e-prescription technology still needs to be overcome. In addition, there is a dearth of empirical evidence demonstrating the advantages of e-prescription. Prescribers also seem to believe that they need a substantial amount of training to use e-prescription technology—training that will take up a considerable amount of their time.

“Good change management and stakeholder engagement are vital to overcoming the reluctance of health professionals to shift from paper-based to electronic-based prescriptions,” Jayapradha noted. “There is also a need for more empirical data through research to prove the benefits reaped by existing users of e-prescription.”

Above article publish on http://www.eprescriptionservices.com/eprescribing-gains-momentum-europe/

Global Market for MT Services Set to Skyrocket

The global market for medical transcription services is expected to approach $49 billion worldwide by the year 2015, according to a recent report from Global Industry Analysts, Inc.

Growth in the industry is primarily triggered by efforts to prune down healthcare costs. Health maintenance organizations, healthcare providers, and hospitals, primarily in developed countries, are increasingly turning towards the maintenance of digital records of patient encounter, which is contributing for rapid proliferation of medical transcription services.

The United States is the largest market worldwide for medical transcription services followed by the UK, Australia and Canada, as stated by the new market research report on medical transcription services. The increasing complexity of the health care sector, coupled with heightened demand for reliable health care documentation for insurance claims, have been the two major factors driving the United States’ medical transcription industry.

Above article publish on http://www.medicaltranscriptionoutsource.com/global-market-mt-services-set-skyrocket/

10 Steps to Selecting the Right EHR Solution For Your Practice

By Reda Chouffani

As many medical practices shift gears toward a paperless environment, it’s clear to many they must first investigate what potential incentives will be available to them if they participated in the Stimulus healthcare information technology HITECH. Additionally they will need to identify which product would be the most cost effective and offers the highest return on investment.

In selecting an EHR, most healthcare organizations face conflicting reports on products they are evaluating, some of which can be based on lack of proper product implementations. Others failed products that did not fit the practice’s workflow. As an example; by knowing how to select an EHR product, and examining how some of the previewed products compare, the medical practice will be able to properly identify its need and which products can successfully meet its challenges.

Practices have had plenty of time to make paper charts work for them since the early 20s, when the US saw the spike in private group practices grow. This provided ample time to perfect the efficiency of using paper based workflows. While several software vendors come with a promise of a new world where no paper exists and practice’s revenues increase, it would be very naïve for any Practice Administrator to take their word for it.

Today’s technology is fully capable of automating and streamlining many clinical workflows, as long as it is the right solution with the right planning and readiness.

To avoid being just another statistic in the failed world of EHR, there are a few critical objectives that should be met to ensure a thorough assessment, smart selection and careful planning for an EHR selection.

The following are the ten steps that can help you during your EHR selection stage:

1. What are Your SMART EHR Goals?

It is critical to define what the practice’s EHR goals are. This will enable the practice to ensure that providers, practice administrators and other stakeholders are on the same page. Document the top 10 goals everyone needs this EHR to accomplish.

The goals can be further divided into financial and or operational objectives. Each goal must document using the S.M.A.R.T. methodology (Specific Measurable Attainable Realistic Time Bound). By doing so, everyone will have a clear understanding of what to gain and expect from the adoption of an EHR system.

2. Current State Analysis

Since every practice differs in workflows, you will need to consider that there are different EHR’s. We recommend that all major workflows must be reviewed, and establish which can be automated and streamlined through an EHR and which will require additional resources to properly document electronically.

Example:

• Physician completes visit, and marks on the encounter
• Physician writes a prescription for some medication
• Patient takes the paper encounter and gives it to Check-out staff
• Check-out staff enters data in the billing system
• Check-out staff collects the co-pay / balance.
• Patient gets receipt and takes the prescription to the pharmacy

Future State Analysis:

• Patient pays at the time they come in for any balance or co-pay requirement
• Physician completes visit electronically and selects the procedures performed
• Physician creates an electronic prescription for the patient and submits it online
• Patient leaves the practice without one piece of paper
• Patient picks up their medication at the local pharmacy

3. Define What Devices You Are Planning on Utilizing

During this assessment phase, it is critical to identify the proper set of devices, interfaces and hardware that you will need as part of your paperless endeavors. There are several aspects to identify so you have a clear understanding of the complete scope of the project:

• Does the current Ultrasound machine allow you to submit studies electronically? If yes, how much for licensing from the vendor?
• Does the Dexa machine support imaging export? How much is the cost for that?
• Are insurance card scanners needed? Are they double sided?
• How many high speed scanners are required?
• Are the providers going to need tablets or plain laptops?
• Do you need wireless set up at the practice?
• Are the lab interfaces included in the EHR package or is the lab company willing to pay for them?
• Do you need signature pads to eliminate form printing?
• Does the transcription company support interfacing with EHR?
• Does your router allow for remote connectivity, and do you have redundancy on the connection?

4. Create a Comprehensive Vendor Questionnaire

This should include questions about company history and certifications.

Currently, there is no finalized decision on certification body for the ARRA, financial viability, business agreement, system cost, post-implementation maintenance costs, system functionality, system technology and most importantly references.

Some examples are:

• What is the cost per physician?
• Total cost of ownership, yearly fees, support costs and upgrades
• Can you design and modify the current system templates?
• Is your system true client/server or it is web based?
• How many installations do you have that are current?
• Is support local or outsourced overseas?
• Is your product a certified product (certification body to be determined)? If not, do you plan on it?
• Can your product interface with another PMS application?

5. Narrow Down the Vendor List

Creating a list of vendors based on product specialty, reputation, and references will help you tremendously. This list should consist of 3 to 5 vendors at most.

There are several web sites such as KLAS that will provide you with some additional reviews of software packages that are available, and may further assist you in narrowing down your list.

6. Request System Demonstrations

During this stage, it is highly recommended that the practice provide the implementation and project manager with a number of scenarios. These workflows should be performed during the demonstration.

Examples can be:

• Documenting review of systems and adding family history
• Documenting initial prenatal visit
• Documenting requesting/scheduling and post surgery notes
• Documenting colonoscopy procedure and viewing clinical imaging

7. Request References From Vendors of Practices Such as Yours

At this step, a list of practices using the product that you can contact would be advisable. This would shed some light on several components.

Questions to ask are:

• How long before the practice was seeing the same volume of patients?
• What specific items do the providers see as value with this package?
• What items does your clinical staff say is slowing them down?
• How would you rate the company support?
• Has this impacted your billing cycle?

There are several questions you should ask, but the main focus is to be specific. Get facts which will help you determine whether or not this package is a good investment.

8. Review the Business Case

Whether the vendor provides you with a strong business case to justify the investment you are about to embark on or you take it upon yourself to create a financial analysis, it is a must to have some financial measurements such as return of investment (ROI), total cost of ownership (TCO), net present value (NPV) and discounted cash flows (DCF). This will enable you to have a clear understanding on whether this solution will pay for itself or drain your practice of income during these difficult economic times.

Some of the items to review are:

Soft ROI: This is the element of your business that will have soft savings. For example: First begin to perform time and motion studies. This is where you measure the time it takes for the physicians to document a visit, prescribe or record the diagnosis and procedures on the encounter. Then measure the time it will take for the same activity but with the EHR package (s) you are evaluating. The difference in time gained will be one of the practice’s soft ROI.

Hard ROI: This can be associated with the cost savings from eliminating things like paper charts, folders, material, filling cabinets, and space leased for storing paper charts, transcription costs and such.

Risk Mitigation: The final section will cover the risks of using such a product. It is clear that by digitizing paper charts, practices reduce the risk on misplacing or losing patient charts. With the proper backups in place, a healthcare organization can rest assured that no matter what, the patient charts are protected. In addition, some of the prescription modules enable drug interaction and allergy alerts. This reduces the patient’s health risks dramatically.

9. Visit Local or Remote Client’s Site

Being exposed to a live site using the product(s) you are evaluating is key. This can help you get candid feedback, and will demonstrate how it is being utilized.

10. Decision Time

When you have considered your goals and challenges, what to resolve and what products to select, reviewed their existing install and had everyone on the same page, it’s time to evaluate your findings and use the attached checklist to assess which of the products will fit your need.

As the market and healthcare regulatory changes continue to affect medical organizations, executives are under pressure to reduce IT costs, automate current processes and increase revenue. Some of the changes can also determine if current implemented EHR will be a source of incentives or penalties.

Above article publish on http://www.healthcareitinsider.com/business-process/10-steps-to-selecting-the-right-ehr-solution-for-your-practice/

Survey: Many Non-EHR Users Plan To Purchase Systems Within 2 Years

Fifty-eight percent of physicians who currently do not use electronic health records say they plan to introduce new systems in the next two years, according to a survey released Tuesday at the Healthcare Information and Management Systems Society’s 2010 conference, HealthLeaders Media reports.

For the study, Accenture’s Innovation Center for Health and Institute for Health & Public Service Value and Harris Interactive surveyed 1,000 physicians in practices with fewer than 10 practitioners.

Of the survey respondents, 15% were currently using EHRs and 85% were not.

Of the respondents younger than age 55, 80% said that they plan to purchase EHR systems within two years (Johnson, HealthLeaders Media, 3/2).

Motivations for EHR Purchasing

When asked about major factors driving EHR adoption:

• 61% cited federal penalties for non-adoption; and
• 51% cited federal incentive payments (Mearian, Computerworld, 3/2).

The survey also found that 75% of non-users said they would be interested in purchasing an EHR system from a local hospital if the facility partially subsidized the purchase. Most non-users expect a hospital or health network to subsidize about 50% of the cost for an EHR system.

EHR Expectations

The survey also found that physicians have high expectations for EHR systems. According to the survey:

• 67% expect EHRs to improve billing and other administrative processes;
• 62% expect EHRs to make it easier to order and view imaging and test results;
• 59% expect EHRs to facilitate medication management;
• 55% expect EHRs to boost care coordination with other clinicians; and
• 51% expect EHRs to improve patient care (HealthLeaders Media, 3/2).

Above article publish on http://www.ehrexperts.us/survey-many-non-ehr-users-plan-to-purchase-systems-within-2-years/