Tuesday, December 14, 2010

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/

Monday, December 6, 2010

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/

Friday, November 26, 2010

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/

Thursday, November 25, 2010

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/

Thursday, November 11, 2010

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/

Monday, October 11, 2010

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/

Wednesday, September 15, 2010

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/