Physician champions speak out

As we head into the next stage of EHR adoption, now that the meaningful use criteria have been finalized, it’s time for health IT advocates to start rallying their physician colleagues to get serious about implementing and deriving value from EHRs.

Eugene Heslin, MD, lead physician at Bridge Street Medical Group in the New York Hudson Valley, is one such physician champion. There’s an interesting element about Heslin’s story. His six-physician practice has been using EHRs since 2006. In 2009, it joined 10 other practices totaling 237 primary care physicians across 51 sites in the Hudson Valley region in adopting the patient-centered medical home model. Here’s the thing: Health IT was used to support the PCMH’s approach to care, which required physician office redesign.

The PCMH model is all about coordination of care and communication among a patient’s multiple healthcare providers, which could include inpatient, PCP, specialist, skilled nursing facility, and home healthcare. Try getting all the visits and results updated in real time for each provider by paper. If you succeed, no doubt you’ve expended a lot of time and resources.

There will be other new models of care that will require a more efficient means of communication and sharing of information. Health IT will be the infrastructure that enables that sharing and communication.

Heslin said that the federal incentives can help drive critical mass among his colleagues and create widespread adoption at the community level. Many say that health information exchange is what will make EHRs valuable. Once there’s widespread adoption, connectivity is the next step. So it’s important to get to critical mass.

Heslin was spot on when he said that we need “to develop efficiencies and logic systems that allow us to rationalize care – to care for our patients using more intelligent tools, more efficiently – and not ration care. Meaningful use moves us in that direction.” At a time when demand will far outstrip demand, the industry needs to be more efficient – not at the expense of the patient. Any time you can deliver clinical decision support, a comprehensive view of the patient, just to name a few, you are indeed rationalizing care. Important difference.

The industry needs more advocates such as Heslin to speak concisely and eloquently of the value of EHRs.

Source : http://www.healthcareitnews.com/blog/physician-champions-speak-out

EHR developed for long-term care holds promise

By Molly Merrill

COLUMBIA, MO – Researchers from the University of Missouri are developing an electronic health record system aimed at meeting the needs of a population of older adults that’s expected to almost double in the next 20 years.

According to the U.S. Administration on Aging, there will be about 72 million older adults living in the U.S. who will require care from a workforce that is already projected to be lacking.

Researchers from MU are currently working on a solution they say may help alleviate some of the burden. They’re developing an EHR system that encompasses standard health assessments and those obtained through new technologies. The goal, they say, is to increase efficiency and accuracy, improve patient outcomes and reduce costs for long-term care.

“As the use of emerging technologies increases along with the older population, maintaining complete and accurate patient information can be overwhelming,” said Marilyn Rantz, professor in the MU Sinclair School of Nursing. “A comprehensive system that encompasses all measures, old and new, is the key to enhance and efficient clinical decision making.”

The EHR is being tested at TigerPlace, an independent senior-living facility in Columbia, Mo. According to the researchers’ initial findings, use of the EHR system can enhance nursing care coordination and advance technology use and clinical research.

“New technologies to passively monitor older adults’ health are being developed and are increasingly commercially available,” Rantz said. “The challenge remains to integrate clinical information systems with passive monitoring data, especially in long-term care and home health settings, in order to improve clinical decision making and ensure patient records are complete.”

Effective EHR systems display data in ways that are meaningful and quickly assessable for clinicians, Rantz said. With access to comprehensive data, clinicians can make more informed clinical decisions, better perform risk assessments and provide risk-reducing interventions.

Source :- http://www.ehrexperts.us/ehr-developed-for-long-term-care-holds-promise/

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/

Flexibility built into final rule on meaningful use EHR

WASHINGTON – Federal officials released the final rule on meaningful use Tuesday, which will allow physicians and hospitals to qualify for thousands of dollars in stimulus funding incentives for the adoption of electronic health records.

The 864-page final rule, several weeks late from its anticipated delivery before June 21, outlines the specific qualifications providers must meet to achieve the meaningful use of electronic health records.

At a news conference Tuesday morning, federal healthcare officials praised the advance of electronic health records, while acknowledging the difficulties providers face at the onset of adoption.

According to David Blumenthal, MD, national coordinator for health information technology, the final rule differs from the proposed rule issued last January: It allows providers more flexibility in choosing which measures to use for qualifications.

According to Blumenthal, the proposed rule required doctors to comply with 23 measures, and hospitals 25 measures. The government received more than 2,000 comments on the rule, many of them asking for more flexibility in allowing clinicians to qualify.

Blumenthal said the final rule took those comments into account. The final rule requires doctors to comply with a set of 15 core objectives during the first year - or Stage 1- of adoption. Hospitals are required to comply with 14 core objectives. In addition to the core objectives, both hospitals and doctors will have to choose five more objectives from a “menu” of 10, he said. The remaining objectives will be deferred to Stage 2 of adoption.

The final rule also reduced the number of electronic prescriptions a doctor is required to make from 75 percent to 40 percent, Blumenthal said.

Kathleen Sebelius, Department of Health and Human Services Secretary, said the Federation of American Hospitals is an “enthusiastic supporter” of the new rule. The federal government hopes other groups will join them, she said.

Blumenthal, a physician, said he is confident the use of electronic health records will become a core professional competency among physicians, who will eventually lead the way in adoption. Until then, the government will encourage healthcare IT adoption through financial incentives, such as these set up under the meaningful use rule. The government will also supply “shoulder-to-shoulder” support for providers through the regional extension centers.

Key changes in the final CMS rule include:

• Greater flexibility with respect to eligible professionals and hospitals in meeting and reporting certain objectives for demonstrating meaningful use. The final rule divides the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer in 2011-2012. This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.
• An objective of providing condition-specific patient education resources for both EPs (eligible providers) and eligible hospitals and the objective of recording advance directives for eligible hospitals, in line with recommendations from the Health Information Technology Policy Committee.
• A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, which conforms to the Continuing Extension Act of 2010
• CAHs (critical access hospitals) within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.

A CMS/ONC fact sheet on the rules is available on the CMS Web site.

Source : http://www.myemrstimulus.com/flexibility-built-into-final-rule-on-meaningful-use/

EMR use inches up in physician offices

By Neil Versel

The first anniversary of the enactment of the American Recovery and Reinvestment Act–Irvine, Calif.-based research firm SK&A published a report saying that 36.1 percent of physician offices have some form of electronic medical record. That’s 3.2 percentage points greater than the 32.9 percent adoption rate reported in February 2009.

Those numbers may seem high, based on studies in esteemed academic publications such as the New England Journal of Medicine, but they are in line with the findings from recent Centers for Disease Control and Prevention report. It’s also worth noting that SK&A had a huge sample size of 180,000 physician offices in the U.S.

It’s no surprise that adoption rates seem to be related to number of physicians, number of exam rooms in the office and daily patient volume, with larger practices more likely to have EMRs. Practices owned by integrated health systems tend to have greater EMR usage as well, slightly above 50 percent. Given that primary care is increasingly burdened with high patient loads and starved for cash, general practice was near the bottom in terms of EMR adoption, SK&A reports. Dialysis, critical care and radiology reported the highest EMR usage rates.

Source: http://www.emrspecialists.com/2010/07/emr-use-inches-up-in-physician-offices/

Federal panel wants national reporting on EMR software, data errors

By Neil Versel

The Adoption/Certification Workgroup of the federal Health IT Policy Committee wants to require hospitals and physicians to report “hazards and near-misses” as a result of software malfunctions, beginning in 2013. Reporting would become part of demonstrating “meaningful use” of EMRs and thus a condition for receiving Medicare and Medicaid bonus payments.

While some would like to see a database on EMR and data glitches up and running sooner than that, some patient-safety advocates believe 2013 is unrealistic. “I think it will take a while to do this right,” UCSF physician Dr. Robert M. Wachter tells the Huffington Post Investigative Fund. “The problem here is that there are potentially dangerous systems and we have no mechanism to figure out what they are or to force them to improve,” he adds.

The database could help pull together an uncoordinated group of existing public and private data repositories, such as the voluntary reporting system the FDA runs to track issues with devices it regulates. However, that system, like many others, has limited public access and redacts any fields that could identify the reporting organization.

The workgroup envisions a reporting system in which patients are encouraged to report errors and omissions in their own medical records and recommends that vendors include “feedback” buttons so they can report problems with a single click.

To learn more:
- see this Huffington Post Investigative Fund story
- check out this take from Federal Computer Week

Source:http://www.emrspecialists.com/2010/07/federal-panel-wants-national-reporting-on-emr-software-data-errors/