HIMSS Analytics Names First Korean Stage 7 Hospital

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

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

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

The Seoul National University Bundang Hospital reached Stage 7 with:

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

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

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

Source : http://www.emrspecialists.com/2010/12/himss-analytics-names-first-korean-stage-7-hospital/

The ‘Three-Legged Stool’ Model For EMR Transition

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

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

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

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

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

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

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

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

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

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

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

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

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

Source : http://www.emrspecialists.com/2010/11/the-three-legged-stool-model-for-emr-transition/

Meaningful use final rule to see minor revisions

BALTIMORE – The Centers for Medicare and Medicaid Services plans to correct a few inconsistencies in the meaningful use final rule it published in July and will post on its web site more detailed guidance for providers on how to meet quality measures required by the health IT incentive program.

The minor revisions, including more detailed descriptions of each of the meaningful use objectives and measures, “should help clarify issues and help the (Health IT Policy Committee) plan for recommendations for future stages,” said Tony Trenkle, director of CMS’s Office of e-Health Standards and Services.

Trenkle, who spoke at a Sept. 22 meeting of the policy committee’s meaningful use workgroup, did not offer further information on the clarifications. They would be released “shortly,” he said.

The panel met to propose preliminary requirements for the second stage of meaningful use in 2013, such as raising the level of performance required for computerized physician orders, electronic prescribing and other measures that were begun in the first stage.

In doing so, Paul Tang, chairman of the meaningful use work group, reminded the panel of its main goal: to move clinical practices operating without EHRs into the digital age.

“We want to pay particular attention to smaller practices and hospitals,” said Tang, who is also chief medical information officer of the Palo Alto Medical Foundation. “We want to raise the tides but not sink the boats.”

To set preliminary requirements for stage 2 in 2013, the panel is taking a ‘backfilling’ approach by splitting the difference between existing stage 1 requirements and where it wants to end up by 2015 for stage 3 of meaningful use of ehr.

For example, to set the stage 2 requirement that physicians should use e-prescribing for 60 percent of their prescriptions in 2013, it picked the midpoint between the current stage 1 requirement of 30 percent and the stage 3 goal that 90 percent of prescriptions should be ordered electronically.

Compared with the first set of meaningful use requirements, stage 2 should also incorporate more standard and coded data from EHRs, which should reduce the reporting burden on providers. “We hope that they are capturing the information as part of patient care and not a separate activity,” Tang said.

Staking out new ground, the group introduced objectives for a glide path to care coordination, starting with a measure that calls for providers to link members of their care teams electronically with at least 20 percent of their patients.

The work group will present its preliminary recommendations on stage 2 meaningful use measure in October. In December, the panel will put out a request for comments on the proposals.

In April, the panel will be able to get indications of the number of providers reporting stage one measures and a sense of the market, Tang said. The policy committee wants to make final recommendations by April to give vendors sufficient time to add functionality to EHRs.

Source : http://www.myemrstimulus.com/meaningful-use-final-rule-to-see-minor-revisions/

New York EMR Network Set To Be The Largest In The Country

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

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

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

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

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

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

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

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

Source : http://www.emrspecialists.com/2010/11/new-york-emr-network-set-to-be-the-largest-in-the-country/

EMR-Driven Disease Management Reduces Mortality, Costs

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

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

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

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

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

Source : http://www.emrspecialists.com/2010/11/emr-driven-disease-management-reduces-mortality-costs/