OmniMD EHR Earns Surescripts White Coat of Quality for 2012

TARRYTOWN, NY, January 3, 2013--OmniMD™, a division of Integrated Systems Management Inc., announced that its OmniMD electronic health record (EHR) has earned the Surescripts® White Coat of Quality distinction for technology vendors for 2012.

"Earning the Surescripts White Coat of Quality for 2012 for OmniMD EHR is an important recognition that we uphold the highest standards of quality in e-prescribing," said Divan Da've, CEO. "Very few EHRs have achieved this distinction. We are dedicated to continuous improvement of our products, and the White Coat of Quality for 2012 is a tribute to our team's work."

OmniMD serves more than 11,000 users with complete electronic medical record (EMR)/EHR software, cloud-based or enterprise. Surescripts is an important component of OmniMD's complete EHR, Da've said.

OmniMD's EHR previously completed Surescripts Gold certification. The resulting Gold Solution Provider status is granted to vendors with software products that surpass Surescripts' baseline product certification to meet criteria that demonstrate a higher level of commitment to e-prescribing. OmniMD was one of only nine vendors to attain that status in 2010.

The Surescripts White Coat of Quality distinction for technology vendors is a critical part of Surescripts' continuous quality improvement program. The White Coat recognizes technology vendors that uphold the highest standards of clinical quality in e-prescribing. E-prescribing saves lives, improves efficiency and reduces the cost of healthcare for all.

About OmniMD
OmniMD, headquartered in Tarrytown, NY, is a division of Integrated Systems Management, Inc., which is a leader in software development and information technology consulting since 1989. OmniEHR™, OmniPM™ and OmniMD Services offer unparalleled reliability, ease-of-use, efficiency, interoperability, and customizability. OmniMD v.11.2 is ONC-ATCB 2011/2012 certified as a Complete EHR and is also CCHIT Certified® 2011 for Ambulatory EHR with a 5-Star usability rating.

OmniMD offers a comprehensive set of services such as Revenue Cycle Management (RCM), medical transcription, document scanning and indexing, a patient portal, patient reminders, IT and networking, and eligibility verification as part of an integrated solution to help practices effectively address their financial, administrative, clinical, and regulatory needs. For more information, please visit http://www.omnimd.com.

Contact:
Connie Jones
Marketing Manager, OmniMD
914-332-5590 x116
cjones@omnimd.com

EMR Market Expected To Increase Growth

While the sales growth in electronic medical record (EMR) systems has been slower than anticipated due to confusion over vendor qualifications and federal guidelines, the EMR market did grow in 2010 and it should see much better years ahead, according to a report from Kalorama Information.

The value of the market for EMRs was about $15.7 billion in 2010, according to the New York-based healthcare market research company in its latest report, “EMR 2011: The Market for Electronic Medical Record Systems.”

The EMR growth rate in 2010 was 13.6 percent–just above the rate in 2009 (10 percent). These rates were less, though, than predicted by Kalorama researchers (it had predicted about a 15 percent growth for both years). However, the rates may be improving as physician adoption improves and more incentive checks for EMR adoption under meaningful use guidelines are sent out.

Kalorama is predicting that adoption and upgrading activities will be “brisk” in coming years. As new systems are sold, companies will earn revenues from existing clients in servicing and consulting–resulting in a market growth rate of 18 to 20 percent for the next two years.

“We think that while progress was made in physician adoption and in vendor sales, there is still a lot more potential,” said Bruce Carlson, publisher of Kalorama Information, in a statement. “There are still a considerable number of physicians who need to be fully functional and hospitals that have to improve their stage ranking.”

Source : http://www.emrspecialists.com/2011/03/emr-market-expected-to-increase-growth/

Study: Most Americans support EMRs

CHICAGO – Seventy-eight percent of Americans favor the use of electronic medical records, according to a recent study by NORC at the University of Chicago, an independent research organization.

The study was published in the February edition of the journal HSR: Health Services Research.

Researchers say this report is different because most previous studies of EMRs have focused on the attitudes of clinicians or health organizations. Surprisingly few have focused on the attitudes of consumers toward health IT and, of those, none were based on a sample that fully represents the American people.

Key findings of the study are:

* Fifty-nine percent believe EMRs could reduce health costs
* Seventy-two percent support sharing of health care information among providers
* Eighty percent favored use of e-prescribing
* Seventy-nine percent thought that personal health records would help patients to be better informed about their health.
* Despite the fact that 48 percent of Americans are concerned about the privacy of medical records, fully 64 percent said that the benefits of EMRs outweigh privacy concerns
* The study also found that Americans aren’t without their reservations. Forty-four percent said they are not willing to pay to increase the use of health IT, and 57 percent said that use of health IT would make no difference in their choice of a physician.

Individuals with lower income and those who have less familiarity with electronic technology have less favorable attitudes towards health IT, the study found. Researchers say this implies that some of the populations that are most likely to benefit from health IT may be least open-minded about it.

“Our core finding is that a large majority of Americans support use of health IT to improve healthcare and safety, and reduce costs, which suggests that government and industry efforts to increase the effectiveness and use of health IT are generally consistent with the public’s wishes,” said Dan Gaylin, NORC’s executive vice president for Research, and the lead author of the study. “But there is still room for efforts to demonstrate the advantages of health IT among some important demographic groups.”

Source : http://www.emrspecialists.com/2011/02/study-most-americans-support-emrs/

Patient-Centered Medical Home Requires an EMR System

Patient-centered medical homes have become all the rage in the healthcare industry these days. The big push is coming from payers who want to cut costs and provider organizations who want primary care physicians to have a bigger say in the care of their patients. No matter who is driving the financial and clinical model, the train isn’t leaving the station, so to speak, without health IT to power it.

At a primary-care practice in St. Louis, Mo., both patients and their families are seeing firsthand how an electronic medical record (EMR) system documents patient treatment and applies clinical decision support and analytics to tailor a patient’s treatment plan.

PCMHs are not all the same, and the Des Peres Internal Medicine office further personalizes treatment by having a nurse practitioner and social worker as part of the PCMH team. One of the Des Peres Internal Medicine physicians said that one of the goals of the PCMH is to increase patient access to care. That could mean access to the social worker via telephone. It also gives patients the extra channel of communicating or completing tasks such as making an appointment, filling a prescription or entering patient vitals via a patient portal.

One of the best benefits of an EMR in a PCMH is the streamlining of care delivery, which includes the elimination of duplicative tests. Most patients in a PCMH likely have multiple chronic conditions that a care team must manage. If patients see multiple specialists on their own, who is coordinating the care? Even if the coordination is done through a primary-care physician, without an EMR to aggregate data and document what happens in every specialist office, the amount of administrative and clinical paperwork would be overwhelming.

Another benefit is empowering patients, which can often translate into taking better care of themselves, especially when they have their up-to-date patient information available to them via the patient portal and clinical decision support and analytics to support their entire care team.

Source : http://www.emrspecialists.com/2011/02/patient-centered-medical-home-requires-an-emr-system/

EMR Spending Expected to Double in 4 years

Government incentives for using electronic medical records will result in spending on systems doubling by 2015, according to a report by IDC Health Insights. However, the study notes that much of that growth will come closer to end of that projected period, because vendors are having trouble keeping up with the orders.

Total EMR spending, which is expected to grow from $1.9 billion in 2009 to $3.8 billion by 2015, is about twice the growth rate analysts are seeing over the health information technology market and the general IT market, said Judy Hanover, research director of provider IT strategies for the Framingham, Mass.-based market research company and co-author of the report.

The report notes that a separate IDC survey in August 2010 found that 44% of health care organizations plan to accelerate or aggressively accelerate their plans to deploy EMRs because of financial incentives in the 2009 economic stimulus package. The stimulus provided incentives of up to $44,000 under Medicare and nearly $64,000 under Medicaid for meaningful use of an EMR.

But this rapid deployment is causing a vendor backlog that has resulted in unanticipated delays of up to six months for some practices and hospitals. Hanover said this has been a bigger issue for inpatient system deployments, but analysts are starting to see it on the ambulatory side as well.

The authors of the report predicted that the largest chunk of EMR investments will come in 2015. Not only is the backlog expected to cause delays, but some physicians will put off purchasing until it gets closer to 2015, when incentives turn to penalties.

The forecast shows clinics and physician practices will spend $335 million on EMRs in 2011 and $490 million in 2015. Ambulatory EMR spending overall was $633 million in 2009 and is expected to reach $1.4 billion in 2015.

Making an early decision on an EMR will help ensure that staff members are available for its installation, Hanover said. Practices might want to consider looking at third-party vendors if their primary vendors are experiencing a backlog, she said. Many third parties can provide installation and training services with the help of the vendor, she said.

After 2015, vendors are expected to enter a “maintenance cycle” in which revenue will come mostly from replacement systems or upgrades. Not only could the government require EMRs to perform more functions than they do today to qualify for incentives, health system reform may have an impact.

“We do expect to see, as health care reform goes into effect, a massive consolidation in the provider community in terms of acquisitions and reductions in the total number of providers,” Hanover said. “And that will drive some replacements and upgrading and reinvestment in EMRs.”

Source : http://www.emrspecialists.com/2011/02/emr-spending-expected-to-double-in-4-years/

Medicare EMR Incentive Program Begins Registration

Washington — Starting Jan. 3, eligible physicians and hospitals will be able to register for the Medicare electronic medical record incentive program, a prerequisite for obtaining billions in available federal bonuses, the Centers for Medicare & Medicaid Services announced Dec. 22, 2010.

Also starting Jan. 3, registration for the Medicaid EMR incentive program will launch for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. In February, registration will open in California, Missouri and North Dakota. The remaining states probably will launch their Medicaid EMR incentive program sign-ups in the spring and summer, CMS said.

Officials with CMS and the National Coordinator for Health Information Technology said they hope for broad registration by doctors and hospitals. To prepare for the process, health professionals are encouraged to visit the CMS website (www.cms.gov/ehrincentiveprograms/).

“With the start of registration, these landmark programs get under way, and patients, providers and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” said CMS Administrator Donald M. Berwick, MD.

David Blumenthal, MD, the national health IT coordinator, said, “It’s time to get connected.”

He added that his office and CMS have numerous resources to help physicians and hospitals enroll in the program. They include a website that lists more than 130 certified EMR systems (onc-chpl.force.com/ehrcert/).

Another site lists the 62 regional extension centers that can assist physicians in obtaining the bonuses (healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495/).

Physicians who want to participate must register in either the Medicare or Medicaid EMR incentive programs. Participants must choose only one program — they cannot receive payments from both. However, after receiving a bonus for a given year, they may change their program selection once before 2015.

In 2010, CMS finalized standards that doctors and hospitals must meet to demonstrate meaningful use of their EMR systems. Physicians can receive as much as $44,000 over a five-year period through Medicare, and up to $63,750 over six years through Medicaid.

CMS on Dec. 22, 2010, announced several additional key 2011 dates for the EMR physician incentive program:

• January — Some state agencies begin issuing Medicaid EMR incentive payments.
• April — Participants begin to attest eligibility for Medicare bonuses.
• May — CMS begins issuing Medicare bonuses.
• Oct. 3 — Physicians have a final chance to begin their 90-day reporting period to demonstrate meaningful use in 2011.
• Dec. 31 — 2011 bonus payment year ends for eligible professionals.
  

Source : http://www.emrspecialists.com/2011/01/medicare-emr-incentive-program-begins-registration/

Hospitals Integrating Their Medical Devices and EMRs

A third of hospitals have integration between medical devices and electronic medical records, allowing data recorded on the devices to be uploaded automatically into EMR, according to a survey released Dec. 1 by HIMSS Analytics.

Most hospitals that have linked devices and EMRs said they believe it saves staff time by eliminating manual documentation.

HIMSS Analytics, part of the Chicago-based Healthcare Information and Management Systems Society, surveyed 825 U.S. hospitals on their use of medical device utilization. It found the devices most likely to be interfaced are intelligent medical device hubs (networked diagnostic equipment that provide data streams) and physiological monitors.

Recording and charting vital signs is one of the core measurements of stage 1 meaningful use. The Centers for Medicare & Medicaid Services meaningful use incentives offer hospitals a base payment of $2 million each from Medicare and Medicaid. Although the stage 1 meaningful use criteria do not require the charting to be done automatically, many believe integration between medical devices and EMRs will be required later.

“The transfer of data directly from a medical device to the EMR can reduce potential medical errors and improve patient care, because no manual transfer of data takes place,” said John Daniels, vice president of health care organizational services for HIMSS. “Such data integration also improves workflow by saving time for clinical staff, a valuable benefit when looking at nursing shortages in health care.”

The report notes that hospitals are not yet conducting return-on-investment studies on the integration of the monitoring devices to EMRs. But some hospitals have reported that integration has saved time. St. John’s Medical Center in Jackson, Wyo., reports that integration of vital sign monitors to its EMRs has yielded a 60% time savings, because staff do not have to enter the data manually.

The report said a critical factor hospitals face is determining how to connect an intelligent medical device to an EMR.

For those that integrate some devices to an EMR, about half use a wired local area network to provide the connectivity. Only 8% rely solely on wireless LAN connections for the integration.

The report says hospitals will place more importance on integrating medical devices to EMRs when more is known about the stage 2 and stage 3 meaningful use requirements. The Office of the National Coordinator for Health Information Technology is working on stage 2 criteria.

Source : http://www.emrspecialists.com/2011/01/hospitals-integrating-their-medical-devices-and-emrs/

Healthcare iPad Deployment To Approach 70% In 2011

Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicates that iPad deployments are accelerating in large part due to the mobile device’s compelling point-of-care applications and uses.

Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey’s results were released earlier this month.

Data showed that nearly 70% of the attendees were from hospitals or healthcare organizations with more than 1,500 employees, and 15% of attendees were executive-level staff or physicians.

More than 25% of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70% plan to deploy the devices within the next year.

One-third of respondents identified point-of-care applications — including lab order visualization and results, clinical decision support, and medical image viewing applications — as top priorities, while 18% identified general administration, including billing, coding, and claims applications, as top priorities.

Nearly 75% identified secure configuration and deployment as the number one iPad IT management challenge, and 53% identified mobile application deployment as a key issue.

Lynne Dunbrack, analyst with IDC Health Insights, said security will remain a top concern for healthcare CIOs, especially if clinicians bring in their own devices to access the hospital’s healthcare information systems, such as electronic medical records (EMRs) and computerized physician order entry (CPOE) systems.

“As more patient information is moved into EMRs and made accessible both inside and outside the organization via a range of devices, including mobile devices and tablets, the risk of a privacy breach rises. Organized deployment and virtualized clients will help to mitigate this concern,” Dunbrack said.

Dunbrack also noted that the iPad, which has a sleek design, an intuitive user interface, and a large screen (relative to a smartphone), is becoming increasingly popular among clinicians. As the iPad gains traction among healthcare providers, EMR vendors will develop bidirectional integration between their EMR applications and clinicians’ mobile point-of-care devices such as smartphones and tablets.

Vendors are also developing EMR applications specifically for the iPad, Dunbrack observed. One example is St. Louis-based ClearPractice, a company that develops Web-based ambulatory EMR and revenue cycle management applications. ClearPractice recently launched Nimble, a comprehensive EMR application designed and developed specifically for the iPad.

Alan Snyder, BoxTone’s CEO, said in a statement that the iPad is redefining how organizations leverage mobile technology in the enterprise and the healthcare community is leading this paradigm shift.

“As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity,” Snyder said.

Source : http://www.emrspecialists.com/2010/12/healthcare-ipad-deployment-to-approach-70-in-2011/

Officials Preparing Adjustments to Meaningful Use Final Rule

CMS soon will release modifications for certain provisions in the final rule for Stage 1 of the meaningful use ehr incentive program, Government Health IT reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for incentive payments through Medicaid and Medicare.

Tony Trenkle — director of the Office of e-Health Standards and Services at CMS — said the adjustments to the meaningful use criteria currently are undergoing a federal clearance process, which is the final step before publication. Trenkle spoke on Wednesday during a Health IT Policy Committee meeting.

Trenkle added that CMS also will release guidance for health care providers on how to meet quality measures in the incentive program.

Discussion of Stages 2, 3

During the meeting, the Policy Committee also considered what incentive requirements to include in the next stages of the meaningful use program.

Committee members discussed whether Stage 2 meaningful use requirements — which are expected to go into effect in 2013 — should be incrementally built on requirements from Stage 1, or if there should be a set of larger steps framed around measuring and improving patient outcomes.

Paul Tang — chair of the meaningful use work group and chief medical information officer at the Palo Alto Medical Foundation — said the committee would prefer to establish the Stage 3 goals for 2015 first and then backtrack to form Stage 2 requirements.

Committee member Latanya Sweeney — director of the data privacy lab at Carnegie Mellon University — said future meaningful use criteria should incorporate privacy regulations (Mosquera, Government Health IT, 10/20).

National Coordinator for Health IT David Blumenthal said that the rollout of Stage 1 of the meaningful use criteria “was very rushed” (Conn, Modern Healthcare, 10/21). He added that the next stages should focus on infrastructure and interoperability.

Time Frame

Tang said that the meaningful use work group aims to have draft requirements for Stages 2 and 3 by Nov. 19, adding that it will revise the draft after taking comments from the full Policy Committee.

He said final recommendations could be submitted to the Office of the National Coordinator for Health IT by the third quarter of 2011, while CMS could release a notice of proposed rulemaking on the next stages by the fourth quarter of next year (Manos, Healthcare IT News, 10/21).

Source : http://www.myemrstimulus.com/officials-preparing-adjustments-to-meaningful-use-final-rule/

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/

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/

Wound EMR Could Reduce Amputation Rates For Diabetics

EMR (Electronic medical records) specifically for wounds could substantially cut amputation rates for diabetes patients with foot ulcers, a study recently presented at the American College of Surgeons 96th Annual Clinical Congress determined.

Records pulled from an online wound EMR (OWEMR) system set up at by Dr. Jason Maggi at New York University Langone Medical Center’s Department of Surgery over a six-month span showed that there were up to 137 variables for each record, reports Medscape Medical News. Automated alerts sent out to all doctors involved with a particular patient’s care help doctors to sort through that information and integrate quantitative measures like healing rates in real time, according to Maggi, the study’s senior author.

“Effective management of this information and analysis of data in a timely fashion can mean the difference between limb salvage and amputation,” Maggi said, according to Medscape.

The OWEMR combined information like medications, medical history and lab results with digital photos of patient progress to help doctors “centralize information” onto a single page.

Dr. Danielle Katz, an associate professor of orthopedic surgery at SUNY Upstate Medical University who moderated Maggi’s presentation, hailed the study as potentially being “the future of medicine.”

Said Katz, “I think more and more there will be a push to have applicable practice guidelines [and] methods for tracking outcomes, and I think this really demonstrates a very potentially useful tool.”

Source : http://www.emrspecialists.com/2010/10/wound-emr-could-reduce-amputation-rates-for-diabetics/

EMR Development Debate Focuses On Standards, Competition

Lest anyone think the issue has been settled, national health IT coordinator Dr. David Blumenthal says there is a “raging debate” in scientific and policy circles about whether standards or competition should drive EMR development, MassDevice reports.

“There is a raging debate in the computer science world, which I have only lifted the lid on because I’m not a computer scientist, but it goes basically like this: Do we want a world where somebody sets very detailed standards for what computers have to do in order to create interoperability? Or do we want a world that’s a little bit more like the Internet, where a minimal set of standards was created and an enormous, vibrant competition and spontaneous growth occurred?” Blumenthal reportedly said at a gala for the Lucian Leape Institute of the National Patient Safety Foundation.

“I hear both sides of that argument, constantly, and even those people who believe in the minimal set of standards aren’t really sure what that minimal set is, but we’re working on precisely that,” Blumenthal added.

He was responding to a question from former U.S. Treasury Secretary Paul O’Neill about EMR standardization.

“Why is it that we’re reluctant to declare that we are going to design the best prototype that we can with an idea that we will have [iterative versions] as we learn more and we identify more needs?” wondered O’Neill, himself now a patient-safety advocate. “Why is it that we can’t call to question and get on with what’s a clear and apparent need for a national standard that’s a work in progress?”

“It’s not that it has to be perfect from day one, but your office basically says, ‘We’re going to do this now’?” O’Neill asked. O’Neill noted that he had seen the “travesty” of a $500 million investment in a proprietary EMR that was not interoperable with competitive systems, something that’s “not worth a damn” when a patient travels outside the local service area, and he does not want to see others waste money like that.

Blumenthal also addressed the recent news that medical licensing boards may require health IT competency for physicians to keep up their licensure. “Information is the lifeblood of medicine, and unless physicians and other healthcare professionals are capable of using the most modern technology available for managing information, I think they will have trouble claiming, in the 21st century, the unique competence that entitles them to being licensed and board certified,” Blumenthal reportedly said at the NPSF event. “I think they’ll have trouble holding up their heads as professionals and claiming that they are at the top of their game and capable of providing the best care that technology allows.”

Source : http://www.emrspecialists.com/2010/10/emr-development-debate-focuses-on-standards-competition/

Making Meaningful Transition To EMR

With the publication of the meaningful use guidelines on July 13, it is now clear what hospitals and doctors must demonstrate in their adoption of electronic medical records to grab a share of the billions of dollars available in federal incentives. Not as obvious, however, are the steps to take in negotiating this transition.
More than just the right technology, there must be a plan for preparing paper records and workflow processes for a “new normal,” where doctors will utilize both paper and electronic records to treat patients. The need for this “EMR enablement” work has been mostly lost amid the discussion of what technology milestones hospitals must hit and by when.

Hospitals that correctly complete this preparatory stage will realize three benefits: a more efficient records management program that returns cost savings to apply toward EMR; a better-organized records system that makes EMR implementation easier; and improved workflows for treating patients with hardcopy and digital records. Below are key EMR-enablement steps:

Centralize paper records for better access and lower costs
Today, most hospitals have patient records and films bottled up in specific departments, with no ability to share this information across the entire organization. In many cases, this produces unnecessary duplication of records and inconsistent management processes. Consolidating hardcopy patient records and films and then re-engineering how the organization stores and uses them can save time, cut costs and improve the quality of care through faster access to patient data. These new workflows need to account for how organizations archive, use and protect patient records in paper and electronic form. 
Stop saving – and paying for – outdated and duplicate records

Going digital does not mean digitizing every patient record. A thoughtful approach – what to digitize versus what can remain paper-based or securely destroyed – is required to reduce costs and improve care. A study from the American Health Information Management Association found that more than half of U.S. hospitals keep medical records forever, a behavior driven by the twin forces of industry regulations like HIPPA and state retention laws. Hospitals should comb through their records and destroy duplicates as well as those records past state-mandated retention periods. Destroying these outdated files and redundant copies cuts storage costs and makes digitization more cost-effective.
Begin your EMR journey with the right records

Make no mistake: paper records are not going to disappear any time soon. A portion of the physical patient record will continue to exist and grow at least in the near term. Information technology will certainly change how records are accessed and stored, but paper will continue to coexist with electronic information in a so-called “hybrid” record environment for many years to come. An intelligent approach to digitizing records will control costs and change how documents are shared and protected, improving workflow-based functions like billing, coding, and chart completion. Records can be shared simultaneously by many different departments instead of being handed off piece-by-piece to complete these functions. Scanning only what is needed as it is needed – and not just scanning every record, or even the entire record – ensures that the investment in an EMR is on par with treatment requirements, using patient history and clinical needs as criteria for conversion.

The opportunities of moving to the EMR are great. By addressing the core issues of what (and how) information needs to be stored, accessed and protected, healthcare providers can develop a more efficient pathway to the EMR and, in the process, deliver the patient care and cost savings benefits promised by this transition.

Source : http://www.emrspecialists.com/2010/10/making-meaningful-transition-to-emr/

Mayo Clinic Using EMRs To Reveal Genetic Predisposition To Disease

EMRs are moving into genomics, at least at the Mayo Clinic.

In a study published in the Journal of the American Medical Informatics Association, Mayo physicians showed how EMRs were able to help them determine the genetic variants that make certain people more likely to develop peripheral artery disease.

With consent of patients, researchers tapped the Mayo database of more than 8 million Electronic Medical Records to pinpoint clinical variables that could indicate a predisposition to PAD, a task that would be difficult if not impossible with paper records, Healthcare IT News reports. The physicians were able to confirm several cases of the disease and to identify phenocopies–traits found in confirmed cases–of atherosclerotic PAD.

“Although manual abstraction of medical records can provide high-quality data, for large studies such as genetic association studies, manual review of medical records can be prohibitively expensive and time-consuming,” the study says. “Our study demonstrates … several significant advantages over traditional approaches to genomic medicine research by simplifying logistics, reducing timelines and overall costs through efficient data acquisition.”

The team, from Mayo’s Divisions of Cardiovascular Diseases and Biomedical Informatics and Statistics, said that structured EMR data from large institutions “offer great potential for diverse research studies, including those related to understanding the genetic bases of common diseases.”

Source : http://www.emrspecialists.com/2010/09/mayo-clinic-using-emrs-to-reveal-genetic-predisposition-to-disease/

HIMSS Analytics Europe to award wired hospitals

BRUSSELS – HIMSS Analytics Europe will introduce awards for European Hospitals that have achieved the highest scores on the EMR Adoption Model (EMRAM). They’ll be unveiled at the upcoming HIMSS Europe Health IT Leadership Summit in Rome from September 29 to October 1.

HIMSS Analytics Europe recently launched the European EMR Adoption Model and is currently surveying hospitals across 12 European countries. Initial findings will be presented at the upcoming Leadership Summit, alongside the announcement of the criteria needed to achieve the highest level of EMR adoption.

HIMSS officials explained that the European EMR Adoption Model has been adapted to meet the unique needs of European Healthcare Institutions and draws on the HIMSS Analytics US EMR Adoption Model which was developed in 2005 as a methodology for evaluating the progress and impact of electronic medical record systems for hospitals in the HIMSS Analytics Database. Tracking their progress in completing eight stages (0-7), hospitals can review the implementation and utilization of information technology applications with the intent of reaching Stage 7, which represents an advanced electronic patient record environment.

Stage 7 hospitals:

* Deliver patient care without the use of paper charts
* Are able to share patient information by sending secure standardized summary record transactions to other care providers
* Use their vast database of clinical information to drive improved care delivery performance, patient safety clinical decision support, and outcomes using business intelligence solutions
* Are best practice examples of how to implement sophisticated EMR environments that fully engage their clinicians.

The validation process that confirms a hospital has reached Stage 7 includes a site visit conducted by an executive from HIMSS Analytics Europe and two current chief information officers to ensure an unbiased evaluation of the Stage 7 environments.

“Stage 7 hospitals provide best practices that other healthcare organizations can study and emulate as they strive to use EMR applications to improve patient safety, clinical outcomes and patient care delivery efficiency,” said Uwe Buddrus, General Manager, HIMSS Analytics Europe. “The accomplishments of Stage 7 hospitals serve as important indicators of high quality patient care with the interoperable electronic medical record in place.”

Source : http://www.emrspecialists.com/2010/09/himss-analytics-europe-to-award-wired-hospitals/

Should physicians nearing retirement deploy EHRs?

One of the lesser discussed factors determining whether to adopt EHRs or not is the number of years that a physician who owns his or her practice has left before retirement.

This is a complicated issue, and the advice will vary from physician to physician, given his or her specific circumstances. There are, however, a few common facts that need to be taken into consideration.

As one healthcare consultant noted, putting in an EHR system in the office doesn’t instantly deliver value. It’s – rightly – what you do with the system. And that will require time, likely years, to reap the benefits of improved clinical outcomes of patients and perhaps derive new sources of revenues (such as charging agencies to send out data, etc.). The question is whether the physician has the time to develop value or meaningful use out of the EHRs.

There will be immediate benefits, such as data retrieval automation, which can cut down on office staff time doing low-priority tasks. Intangible benefits may surface in the form of increased patient satisfaction when appointments can be scheduled via e-mail or test results received electronically without staff intervention and time.

Another benefit is the elimination of duplicative tests, but until the fee-for-service model is replaced, this particular benefit is lost revenue for physicians. Although the industry is beginning to embrace such models as bundled payments and payments tied in with medical homes, the timeline for when we are completely rid of fee for service is fuzzy at best. Will the physician retire before that happens? If retirement is less than five years away, I’d say it’s unlikely we’ll see payment reform.

Choosing the most cost-efficient system and a vendor that guarantees achieving meaningful use criteria may remove some of the discomfort and uncertainty over the major changes. Certainly physicians should reach out to their local regional extension centers (RECs) to help with implementation and workflow and office reengineering.

The healthcare consultant made a number of good points. It’s not the end of the world if the physician’s practice does not have an EHR since many larger organizations have their own and simply have that acquired practice implement the system that they use. That’s what happened to my physician’s office, although the acquisition occurred more than five years ago, which was at a time when EHRs weren’t a hot issue, as they are now.

At any rate, David Blumenthal, MD, said that in the near future adopting health IT will be part of the cost of doing business and part of the profession. Who knows when that will be? But when that time does arrive, it may just matter who is fully using EHRs and who is not.

Source : http://www.ehrexperts.us/should-physicians-nearing-retirement-deploy-ehrs/

Detroit Medical Center pegs EMR savings at $5M a year

DETROIT – Detroit Medical Center executives say they have achieved improved patient safety and saved $5 million to boot, thanks to DMC’s system-wide electronic medical system.

It is the second year in a row in which computer-based healthcare information processing created major improvements in quality of care and cost-savings for DMC’s eight hospitals, officials said.

The windfall in savings - triggered by highly effective electronic monitoring of critical tasks such as treating pressure ulcers and preventing medication errors - resulted in a healthy return on investment, they said.

The $50 million system powered by Kansas City, Mo-based Cerner Corp, has gone online throughout the DMC in gradual stages over a 12-year period, starting in 1998.

“The latest numbers are in, and we continue to see great strides in improving quality, treating patients more quickly and preventing error, which translates to dollar savings as well,” said Chief Nursing Officer Patricia Natale. “This work with these results is very exciting.”

“The savings are only part of the story,” she added, “because EMR is also a major step forward on the road to better quality of patient care. Thanks to EMR, we’re now seeing a dramatic reduction in the length of hospital stays due to pressure sores, along with a dramatic reduction of drug errors through EMR-enabled medication scanning.”

“The latest surveys show that EMR has helped to reduce medication errors by up to 75 percent,” said DMC Chief Medical Information Officer Leland Babitch, MD. “Obviously, that’s a major gain for patients - especially given the fact that medication errors account for the majority of accidental deaths and injuries at U.S. hospitals.”

The U.S. Institute of Medicine has estimated that up to 100,000 patients die as a result of hospital errors annually.

Treating pressure ulcers

The impact of the electronic medical record system on the treatment of pressure ulcers was especially noticeable, said DMC quality-of-care administrators.

They noted that the chronic sores often require extended hospital stays and thus drive up costs. But the most recent DMC Patient Care Services study of severe pressure ulcer cases showed that close EMR monitoring of bedsores reduced the average length of stay required to treat them by nearly three full days last year, compared with the average length of ulcer-triggered stays before EMR monitoring began in 2008.

The DMC study concluded that the reduction in the length of pressure ulcer-related hospital stays - in a system that admits more than 75,000 patients each year - was now helping to generate more than $4.5 million in yearly cost savings.

“The data on electronic medical records and patient safety and quality of care are clear and convincing by now,” said DMC Vice President for Quality and Safety Michelle Schreiber, MD. “Those data demonstrate beyond a reasonable doubt that EMR is an extremely powerful tool when it comes to protecting patients from hospital errors.

“But EMR is also proving to be an effective method for promoting quality of care - and the new numbers on bedsores and length of stays show how computer-based recordkeeping helps caregivers to take better care of patients day in and day out.”

In spite of the savings to be had from hospital-based EMR, however, recent studies show that the majority of U.S. hospitals have either failed to implement top-to-bottom EMR systems - or are cutting back on information technology (IT) programs already in place.

As of August 2010, fewer than 4 percent of U.S. hospitals had implemented the level of system-wide electronic patient recordkeeping that is now in place at the DMC. In addition, a recent study at the University of Michigan School of Medicine showed that more than one-fourth of the nation’s recession-affected hospitals have been cutting back on their already existing IT programs.

The cash-strapped hospitals were slashing IT budgets, reported the study in the Journal of Hospital Medicine, in spite of the fact that the Obama administration has recently made available more than $2.73 billion in Medicare/Medicaid bonuses for clinicians and hospitals that spend to improve their electronic medical records systems.

“The DMC has spent $50 million on building a powerful EMR system over the past five or six years, said Michael Duggan, president and CEO of the Detroit Medical Center, “and we did it because we like to think of ourselves as the ‘hospital of the future’ - as a state-of-the-art healing center where patients know they can get the best healthcare available anywhere today. ”

“At the same time, the ability to greatly reduce healthcare costs via electronic medical records is an added bonus - which makes implementing EMR a win-win situation for everyone involved.”

Source : http://www.emrspecialists.com/2010/09/detroit-medical-center-pegs-emr-savings-at-5m-a-year/