Knowledge Networks says half of docs now use EMRs

By Neil Versel

Hard to believe, but 52 percent of specialists and 50 percent of primary-care physicians claim to be using EMRs, up from 42 percent and 38 percent, respectively, two years earlier, a new survey indicates. The survey does not specify what EMR usage means.

“While use of this technology will soon be mandated, these ‘early adopter’ levels suggest a desire for digital convenience at a time when patient record keeping promises to become exponentially more complex,” reports New York-based survey firm Knowledge Networks. The company conducted the study of nearly 11,000 healthcare professionals through the Physicians Consulting Network, which maintains a research panel of physicians and other caregivers.

(We quibble with whether 50 percent is “early adopter” level–or even accurate–and that technology will “soon be mandated.” CMS will penalize those that haven’t gotten to “meaningful use” by 2015, but won’t exclude non-compliant providers. For that matter, participation in Medicare and Medicaid is voluntary.)

One possible explanation for the increased EMR use is the fact that physicians continue to be crunched for time, a situation that will only get worse as 32 million newly insured patients enter the healthcare system in coming years, thanks to the Patient Protection and Affordable Care Act. Supporting this theory is the finding in the survey that 14 percent of primary-care docs and 12 percent of specialists expect to spend less time with pharmaceutical sales representatives in the next six months. Those numbers compare with 9 percent (PCP) and 8 percent (specialists) in the 2008 survey.

Meanwhile, physicians seem to be embracing smartphones to improve their efficiency. The survey found that 62 percent of specialists and 55 percent of primary-care physicians have such devices, and that at least 17 percent of these smartphone owners are using their phones for e-detailing from pharma reps.

“Healthcare professionals are embracing new technologies that promise more control and convenience; we cannot help but see a connection between the use of smartphones for e-detailing and an anticipated drop in time spent with sales reps,” Knowledge Networks Senior VP Jim Vielee tells Healthcare IT News. “These trends seem destined to magnify as healthcare reform takes effect, creating dramatic upswings in doctors’ case loads.”

Source :- http://www.emrspecialists.com/2010/07/knowledge-networks-says-half-of-docs-now-use-emrs/

Doctors Increase EMR Use

By Nicole Lewis

A growing number of primary care physicians (PCPs) and specialist doctors are using electronic medical records and other technologies as they adopt health information technology to streamline their workflow processes, a new study shows.

The survey, conducted by Knowledge Networks in conjunction with the Physicians Consulting Network (PCN) and its panel of specialists and other health care professionals, shows that 52 percent of specialists and 50 percent of PCPs said they are already keeping their patient records in an electronic format — up 10 percentage points for specialists and 12 points for PCPs since 2008.

Published last week, the study of nearly 11,000 health care professionals also shows that more than half of PCPs and specialists already have smartphones, and that many are using them for email, shopping, e-detailing and to participate in surveys.

The report reveals that smartphones, such as iPhones and BlackBerries, are quickly becoming a way of life for medical professionals. Sixty two percent of specialists and 55 percent of PCPs report having one, and roughly 85 percent to 90 percent of those who have them are using them for Internet and for email.

Other findings were that 17 percent of PCPs and 18 percent of specialists who have smartphones are using them for e-detailing, which refers to the use of technology to bypass sales calls from pharmaceutical representative. Higher proportions — 29 percent of PCPs and 24 percent of specialists — use smartphones to participate in on-line surveys.

Executives at Knowledge Networks say the research reflects the way digital technology and other factors are transforming doctors’ attitudes and habits.

“Marketers must adjust to the needs of plugged-in, increasingly busy doctors in everything they do - from the platforms they use for messaging to the time they expect to have with prescribers,” Jim Vielee, senior vice president at Knowledge Networks, said in a statement. “Health care professionals are embracing new technologies that promise more control and convenience; we cannot help but see a connection between the use of smartphones for e-detailing and an anticipated drop in time spent with sales reps. These trends seem destined to magnify as health care reform takes effect, creating dramatic upswings in doctors’ case loads.”

Knowledge Networks is a company that works closely with clients to create, effective marketing, advertising, public policies, and social science research.

Source :- http://www.emrspecialists.com/2010/07/doctors-increase-emr-use/

EMR Implementation in Small and Large Clinics

I always love to hear clinics talk about the challenges they face in implementing an EMR. For the most part, they are completely predictable. Especially when it comes to the small versus large clinic challenges.

For example, small clinics will complain that they don’t have the resources that large clinics have to implement an EMR. Large clinics will complain that they have too much bureaucracy, red tape and stakeholders that they have to get on board an EMR implementation. They wish they were like smaller clinics who could quickly make decisions and had a much more focused need.

Of course, the reality is that both of these point of views are accurate. It’s not news that small clinics can make decisions easier and that larger clinics have more resources at their disposal. Certainly a generalization, but the reason it’s a generalization is because it’s generally true.

Since both small clinics and large clinics both face major challenges of resources and red tape respectively, then how does any clinic get over them and implement an EMR? Let’s be honest, it’s really more a matter of the priority EMR is given than anything else. So far many doctors offices haven’t decided to make their EMR implementation a priority. Once a clinic makes EMR a priority, it’s really quite amazing to see what happens.

The good news is that for many clinics, the EMR stimulus money has changed this fact and bumped EMR adoption up on their priority list. Plus, in the 4+ years I’ve been writing about EMR software, EMR software has come a really long way. Sure, they still have a ways to go, but the EMR software of today is much improved and can provide some real value to a clinic if implemented correctly.

It’s time to address the excuses for why you can’t do an EMR and start focusing on the benefits you can receive from an EMR. Notice I didn’t say “ignore” or “hide” the excuses. We need to address the excuses people are giving and see what benefits you might be missing because you’re not using an EMR. I know very very few people who use an EMR and would ever want to go back to paper. There’s a reason for this.

Above article publish on http://www.emrspecialists.com/2010/05/emr-implementation-small-large-clinics/

Online Patient Portal – Another Innovation of Medical Technology

By Jonathan G Ponting

Latest technology has simplified our lives to a great extent. Internet is helping to simplify many complicated procedures and few examples of the same are exchanging messages, contacting people in distant places using chat and emails, online shopping, reading information of latest events and happenings across the world and collecting information required related to any topic.

One of the most benefited industries from internet is the field of medicine. The latest innovation of medical technology is online patient portals. It is designed to increase communication and relation between patient and health care providers.

Online patient portal helps in efficiently managing the available resources with the local physician or provider to reduce the cost of treatment for both patient and the provider that uses advanced technology. It also enables doctors and providers in transmission of everything that is related to treatment of the patients like medical images for diagnosis, reports, medical date related to patient etc. It is also helpful in educating local physicians online on preventing development of chronic diseases via video conferences.

Online portals are also helping physicians to easily schedule appointment with patients as there is increase in demand for health care services which helps patients in avoiding to stand in lengthy lines. Patient portal helps patients to have better understanding of the disease they are suffering from, with the help of information provided and can also request for renewal of prescriptions at these portals. Patients are also offered to join various groups where other members also suffer from similar chronic diseases which help in lifting of spirits.

Patient portals not only help patients to directly contact with physicians but also to have remote access to mobile tools. Online patient portals are helping to improve quality of health care in remote and rural areas.

Patient portals are best and easy way of contacting doctors for various ailments and getting them treated without waiting for long time. They are best sources of getting advanced treatment for patients’ condition at affordable prices. They are highly beneficial for both patient and the health care provider in offering and availing best of treatments irrespective of geographic location.

Above article publish on http://www.emrspecialists.com/2010/05/online-patient-portal-innovation-medical-technology/

Research Shows That Electronic Medical Records Save Babies’ Lives

By Rich Silverman

We talk a lot in this blog about the financial aspects of Electronic Medical Records (EMRs), and with good reason – they can entail a substantial investment in time and money. But it’s sometimes easy to lose sight of the purpose of all that investment – to save lives.

There has been a great deal of research conducted into how much it will cost to implement an EMR, yet there has not been a lot of research into their impact on patient outcomes. A recent study shows that the adoption of Electronic Medical Records and Radiology Information Systems (RISs) in hospitals in the U.S. actually lowers infant mortality in this country. Research conducted by Amalia Miller of the University of Virginia and Catherine Ticker of MIT’s Sloan School of Business showed that when hospitals adopt EMRs and RISs, their infant mortality rates drop.

Using data on births and infant mortality already collected by the U.S. Government, and statistics on health care information technology adoption provided by the Health Information Management Systems Society (HIMSS), the researchers compared infant mortality in selected areas of the country where data was available (privacy laws limited that data pool) with the adoption of EMRs and RISs in those same areas.

After correcting for a wide range of variables, the researchers came to the following conclusions:

The adoption of EMRs by one additional hospital in a county reduces infant mortality by 13%.

The average cost of the HIT used to save that baby is about $450,000.

The reduction of infant mortality is twice as great for African-Americans than non-African-Americans.

The median cost to implement EMR in a hospital, according to a 2007 America Hospital Association study was $5,556 in capital costs per bed and $12,060 per bed per year in maintenance costs.

The authors studied “bare-bones” HIT implementations of EMRs, and only looked at the impact on neonatal and infant health outcomes. They suggest that more robust implementations of HIT, including decision-support and computerized physician order entry, as examples, will extend the beneficial effects of HIT to other classes of patients.

This research serves as a gentle reminder that the HITECH Act was intended to provide incentives for physicians and hospitals to implement and use Electronic Medical Records because EMRs will improve patient outcomes and save lives. This research shows that they do.

Above article publish on http://www.emrspecialists.com/2010/04/research-shows-electronic-medical-records-save-babies-lives/

Relaxing Meaningful Use Key to EMR Industry Growth, Kalorama Notes

By Chip Means

Relaxing the meaningful use standards, as some physician organizations and members of Congress are urging HHS to do, would be a boon to the EMR industry, according to market research firm Kalorama Information, which completed its market research report “EMR 2010 (Market Analysis, ARRA Incentives, Key Players, and Important Trends)” earlier this year. The report predicts a $13.8 billion market that if properly driven by incentives and encouragement of health systems, could grow in double digits.

“Requiring physicians to undergo 25 mandates by next year may not be effective given the kind of real-world usage among physicians we see today,” said Bruce Carlson, publisher of Kalorama Information. “Getting physicians used to these systems is the challenge to a totally paperless healthcare system in the United States and we think gradual, achievable goals would be preferable.”

Kalorama notes that the objectives of the HSS meaningful use requirements, in order for physicians to receive incentives in 2011, include some that would be expected, such as a requirement that physicians must submit a percentage of claims electronically, use an established diagnostic list such as ICD-9, and have common medications entered for each patient. The firm notes that some sort of requirement for computerized physician order entry (CPOE) on a percentage of orders should also be expected to increase EMR use. But Kalorama believes that requiring 80% of orders via CPOE by 2011, or that half of patients get auto-reminders through an EMR system, is a possible limiter to sales of EMR systems.

Thirty-seven U.S. Senators, led by Senate Finance Committee Chairman Max Baucus, D-Montana, and Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, D-Iowa, wrote a letter requesting improvements in a proposed rule for distributing stimulus funds for health IT that was published by the Centers for Medicare & Medicaid Services which would increase flexibility and encourage participation among providers. 235 members of the U.S. House of Representatives urged CMS to modify its proposed definition and requirements for hospitals to qualify for the meaningful use of health IT incentive payments.

Kalorama’s market research study was conducted before the release of ‘meaningful use’ standards by HHS, but it did note that the largest barrier to EMR use in the United States is physician compliance. Kalorama has also noted that for EMR to grow in the way the federal government envisions, healthcare systems will have to develop incentives of their own, something that might be in jeopardy if standards are not easier to follow.

“It’s not just about encouraging physicians directly, though that’s part of it,” notes Carlson. “It’s about encouraging healthcare systems to develop ‘matching’ programs to encourage EMR among their affiliated physicians. Unless there’s a clear road to incentive money they won’t do that.”

Above article publish on http://www.emrspecialists.com/2010/04/relaxing-meaningful-key-emr-industry-growth-kalorama-notes/

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/

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/