Dr. Lucy Hornstein, solo practitioner at Valley Forge Family Practice in Phoenixville, Penn., was not a proponent of electronic health records. An active physician blogger and published writer, she spent quite a few of her words on the technology’s uselessness.
They were expensive, overly complicated and tough to use and provided little return on the investment for users. Besides, most physicians, in her opinion, only implemented them because of meaningful use and the federal incentives they received for using them.
Paper, she had long decided, was good enough for her and during the first 21 years of practice in her own practice, she had no plans to change. It was only after the loss of one of her two staff members that she soon realized that she’d have to re-hire just to maintain her practice at its current load. However, that wasn’t an option for her. Neither, she thought, was adding an EHR to handle the management of the records because other than her perception of the technology, the self-described “dinosaur” didn’t have the budget for such an endeavor. She had zero for such technology.
Even if she had a change of heart and adopted the technology, she had not seen one system that was not cumbersome, not hard to use, intuitive to maneuver and or that offered her the option to meet the needs of her small practice while running the business efficiently.
Are EHRs dead? Well, Healthcare IT News’ Eric Wicklund recently reported that EHR vendors “will have to find a way to modify their products to focus on data that the patient and his or her care team want, or they’ll become obsolete.” Will EHRs become so obsolete so soon after the height of their heyday? When further explained, some of the reasoning makes sense.
According to panelists at the Partners HealthCare’s 10th Annual Connected Health Symposium, we’re in the time of “para-EHR,” defined as all of the phone calls, texts, e-mails and other doctor-doctor and doctor-patient communications that are not entered into the EHR. They could include everything from Skype chats between doctors to Post-It notes to data residing on mobile devices and sensors.
As such, complete records are not being entered into the EHR, and most patient communication takes place outside the EHR setting. But, are EHR’s dead and flat line or do they have some life left in them? I posted the question to Jim Gerrity, director at Ciena.
Are EHRs dead? “The short answer is ‘no,’ however, what is contained in today’s EHR will most likely evolve. Let me expand on this a bit: Paper-based records are still the most widely used method in the healthcare industry, but that’s changing rapidly. EHRs are proving to significantly improve clinical efficiency and coordination and being adopted increasingly by healthcare institutions around the world. A relatively recent example in the U.S. was their great usefulness to provide continued care during and immediately after Superstorm Sandy … e-records backed up and accessible at disaster recovery sites. As one writer put it, EHRs are ‘ushering in a new era in how medical data is stored and shared.’ But is this transition to EHRs required?
The release of the FDA’s final rule requiring most medical devices to carry a unique device identifier (UDI) will allow regulators to track goods and expedite necessary recalls in order to manage quality and promote patient safety. This process will be streamlined with the population of the global unique device identification database (GUDID, pronounced good-I.D.), which will include a standard set of identifying elements for each device given a UDI. The system will allow healthcare providers to look up information about a medical device, then amend the electronic health record of a patient as needed.
GUDID has no mandate in terms of automatic connectivity to EHR; no matter what device is implanted into a patient, his/her healthcare professional must manually input that information cross-referencing the UDI record with his/her EHR. Without this data entry, the point-of-use component leading to better patient safety and monitoring becomes a moot point. Just like manufacturing and design are inexplicably linked, and quality is an essential part of both for safer products, GUDID and EHR must be connected for better patient safety.
According to the FDA, most of the information contained within the GUDID will be made available to the public, meaning individuals can easily look up information about their medical device. The UDI does not indicate, and the database will not contain, any information about who uses a device, including personal privacy information. While the GUDID is a step in the right direction to promoting patient safety, healthcare providers should look to the database as a model for keeping all EHRs.
One of the greatest sources of information that depicts the changes in health IT trends across the industry landscape is from Michael Lake, healthcare technology strategist. Through his monthly reports on the state of health technology, published by his company Circle Square, he provides succinct highlights from throughout the last month. Possibly, what’s best about these reports is that they cover such a diverse segment of the ecosphere.
For example, in one of his most recent reports, the focus was the EHR vendor sphere, cloud EHRs and their importance to independent practices, the use of faxes in hospitals, vendor news and transactions and practice portal insight, among other news.
According to his most recent report, cloud-based EHRs with integrated billing are quickly becoming a key to a practice’s future success as an independent practice. In his report, he cites Black Book as ranking solutions that seamlessly integrate electronic health records (EHR), revenue cycle management (RCM) and practice management (PM). Kareo tops on the list, per KLAS.
However, most practices feel that billing and collections systems and processes need upgrading (87%) and more than 40 percent (42%) are considering an upgrade to RCM software in in the next year . Most practices (71%) are considering a combo of new software and outsourcing services for improvement.
Money magazine offers five things to know about electronic health records. It’s a very high-level overview, mostly for the consumer market, and is a piece designed to get some skin in the healthcare game. The piece pithy and concise, which is good, as the publication is clearly unable to dig into health IT topics like a site like this, but is it worth the ink?
You decide. Let us know. Tell us if it’s a “me too” moment, which I happen to believe is the case. I think the magazine should stick to covering money and leave health IT alone, but that’s a lone opinion.
And so, without further ado, here are five things to know about electronic health records, if you don’t already:
Chances are, patients will see them, if they have not already and will ask about them.
According to Money, “more than half of physicians have started keeping electronic medical records, the federal government announced this year. About 80 percent of hospitals have gone digital, too, with urban institutions leading the way.”
Milton Silva-Craig, president of TransUnion Healthcare, discusses his thoughts for the future of healthcare, payment reform, new patients and financial pressures in the reform era and changes he sees on the horizon.
How has the role of data analytics changed in the healthcare industry, especially in light of the ACA and reform?
It is no longer a nice tool to have at your disposal. It is a requirement. It is the foundation necessary to support the outcomes of reform. Moving forward, reimbursement will be tied directly to outcomes and performance. The only way to measure such performance will be through the use of data. It will be the insights gleamed from the data that will allow providers to be successful in managing the intersection of patient care and a healthy business.
Guest post by John Moynihan, healthcare segment manager, Global Industry Marketing, Siemens Enterprise Communications and Randy Roberts, vice president, mobility portfolio, Siemens Enterprise Communications.
Technology in business today can seem like a zero-sum game. When the employees win, they are able to do whatever it takes to be productive. But doing that tends to tie the hands of IT, keeping them from locking down devices and services well enough to make sure their information is secure. This situation is becoming more common in the medical industry, with clinicians and computing staff often at odds over convenience versus security. Doctors, traditionally reluctant to adopt new technology or take any risks with tried-and-true methods for caring for their patients, have taken to mobility as a duck to water.
Because access to patient information allows them to better do their jobs, doctors in particular are quickly adopting tablets and smartphones. And while they’re not ignorant of the security risks of these devices, particularly the potential for patient information to be lost or stolen, their focus is on caring for their patients. In fact, even if their business doesn’t provide or specifically allow for mobility, they are bringing their own devices into the office.
Fortuneteller Farzad Mostashari said recently that a lull in adoption of EHRs is expected, by him, and that 2014 will be a huge – banner – year for the adoption of the technology to participate in the meaningful use program, since 2014 is the last year to participate and still be eligible for federal incentives.
The penalty phase begins in 2015.
The incentive program is having a clear impact on adoption of the technology, as we all know. Without the “free” federal money and the threat of cuts in reimbursements, motivation to implement the oft described as burdensome technology was lagging.
After having spent several days in a hospital recently caring for a loved one, I can unequivocally say that there is no comparison for patient engagement – in relation to meaningful use and in regard to health IT such as EHRs – between the hospital setting and the ambulatory practice.
Simply put, there is no comparison between the amount of attention given to the topic of patient engagement in ambulatory practice and in hospital care, at least as far as the patient experience is concerned.
Guest post by Girish Kumar Navani, CEO and co-founder, eClinicalWorks.
In a world becoming more and more connected by technology, we have countless resources that fit in the palms of our hands. Thanks to smartphones, we are empowered to shop, bank and manage our social networks and more – whenever and wherever we choose. And companies are working in new ways to meet our needs by building apps and optimized websites that make our lives easier.
This notion of consumerization – the power of the consumer to drive technological innovation – is taking hold in healthcare. It means giving patients tools to track, understand and maintain their health, and meeting their demand for easy access to their doctors and personal health information. Empowering patients in this way could lead to big changes in our healthcare system.