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?
Guest post by Mohan Ponnudurai, director at Sparta Systems.
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.[1] 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.
Guest post by Garrett Taylor CEO of Uplift Comprehensive Services.
My organization, Uplift Comprehensive Services (residential services) is fully involved in “mhealth.” We use mobile high-definition video conferencing, which allows our doctors and clinicians to care for patients in geographically remote areas of North Carolina, and gives them full access to electronic health records and an easy way to collaborate each other. Along the way, we’ve improved patient service, enhanced productivity, and cut travel and office costs.
By combining video conferencing technology with a bring your own device (BYOD) mobile strategy, Uplift saves at least $500 for each scheduled physician visit. The thousands of dollars we save each year can be used instead to find grant opportunities for better patient care.
It’s not as hard as you might think to use video conferencing in a mhealth strategy. What follows is an explanation of Uplift’s mobile video conferencing approach.
Uplift Comprehensive Services has been in business for 12 years, covering 15 counties across North Carolina. We offer community-based assistance for children, adolescents and adults, with services substance abuse prevention to mental health treatment. Our treatment options include multi-systemic therapy, outpatient therapy, and medication management, among others. Continue Reading
Guest post by Greg Link, co-author with Stephen M. R. Covey of the national bestseller Smart Trust: The Defining Skill that Transforms Managers into Leaders.
As the name implies, patient satisfaction scores are nothing more than a measure of a patient’s healthcare experience. Like customers in any other industry, healthcare patients expect good, old-fashioned, caring customer service and to have their expectations met. Unfortunately, due largely to the extreme complexity of the healthcare experience, patients have historically lowered their expectations and defined extraordinary service as merely having their health issue ultimately resolved. That’s like ignoring all of the service aspects of a hotel stay as long as you slept through the night.
Now, in response to the Affordable Care Act, which links hospitals’ government reimbursement payments to how well they score in the Hospital Consumer Assessment (HCAHPS) on patient care, hospitals across the country are scrambling to improve their scores.
Stephen M.R. Covey
“The reality is, hospitals can’t talk themselves out of a problem they behaved themselves into,” Stephen M. R. Covey said, author of The Speed of Trust and Smart Trust.
Covey suggests that the patient experience is not a campaign or a department; it is a function of a high-trust culture generated by good, old-fashioned, common-sense behaviors demonstrated by all stakeholders. These behaviors are common to trusted people and organizations throughout history – behaviors like listening first, clarifying expectations, talking straight, creating transparency, extending trust, and demonstrating respect. One compelling example of a remarkable extension of trust is the Cleveland Clinic, where they are so transparent they give patients online access to their own charts and medical records, including doctors’ notes.
Vitera and Greenway merge. Goodbye, “Vitera.” The company is now officially known as Greenway Medical Technologies, Inc. According to a press release on the subject, the two “leading providers of clinical, financial and administrative solutions to healthcare providers, today announced the completion of a previously announced merger resulting in the combination of the two companies into an innovative leader in health information technology.”
The two are one, the marriage underway.
Vista Equity Partners, owner of Vitera, acquired all outstanding Greenway common stock for $20.35 per share in a transaction valued at approximately $644 million.
The combined company will be privately held and operate under the Greenway brand. Tee Green, Greenway’s CEO, will maintain that position. Vitera’s CEO, Matthew J. Hawkins, will serve as President. Both will serve on Greenway’s board of directors.
The combined company will maintain headquarters and principal operations in Carrollton, GA, Tampa, FL, and Birmingham, AL, serving 100,000 providers across nearly 13,000 medical organizations nationwide — including healthcare enterprises, ambulatory practices, public health, retail and other clinics.
Vitera, through Vista, bought Success EHS earlier this year, which is located in Alabama.
Despite the enormous amount of knowledge that was imparted upon you during your education, perhaps one of the most important elements of maintaining a successful practice was, most likely, barely touched upon. The concept of quality health care is not complete without a rigorous discussion of patient satisfaction. A good physician/patient relationship is a crucial element of a successful practice. The fact that patients do not complain does not necessarily mean they are satisfied with the care they are receiving.
The Necessity for a Patient Satisfaction Survey
Let’s face it: In the big picture, seemingly no matter which profession, a majority of complaints to licensing boards does not revolve around specific ‘practice-based’ issues. Instead, those complaints tend to be based on “client-expectation” issues. From this, we can make the claim that happy clients do not tend to complain. If your practice can meet your patients’ expectations then your patients will more than likely react favorably by continuing their relationship with your practice, and perhaps even recommend your practice to a friend. The best method to gauge your patients’ opinion of their experience is to ask them, and by far the most cost effective method of achieving that is by a properly constructed and thoroughly analyzed patient satisfaction survey.
The Objections to a Patient Satisfaction Survey
Certainly, there are what some see as “legitimate” objections to the patient satisfaction survey. Certainly high on that list would be the issue of cost. If your practice is a member of a medical malpractice insurance organization, it’s possible that the administration and analysis of a patient satisfaction survey is a member service, available to the practice for no additional cost. If not, there are independent consulting firms that can work with your practice to design and analyze a survey. Additional costs that would be incurred would include staff time necessary to distribute and collect the survey.
The Brookdale University Hospital and Medical Center is one of New York’s most innovative hospitals on the forefront of health IT. As one of Brooklyn’s largest voluntary nonprofit teaching hospitals with 530 inpatient beds and a regional tertiary care center, Brookdale provides general and specialized inpatient care to hundreds of thousands of people every year. In addition, the medical center provides 24-hour emergency services, numerous outpatient programs, and long-term specialty care. Brookdale is one of Brooklyn’s largest, and most experienced full-service emergency departments and a regionally recognized Level I Trauma Center that receives more than 100,000 visits a year.
Brookdale University Hospital and Medical Center has come to rely on two main resources to seamlessly and securely access patient data and medical history.
Brooklyn Health Information Exchange (BHIX) is a Regional Health Information Organization (RHIO) devoted to developing, deploying, operating and promoting innovative uses of health information technology to facilitate patient-centric care in Brooklyn and surrounding areas. BHIX was established in 2007 as a community-driven collaboration between providers and payers interested in improving patient care across healthcare settings.
RHIOs, such as BHIX, maintain medical records that are continually updated by participating healthcare providers, who can then access the accumulated data with a patient’s consent.
As one of the largest and busiest full-service emergency departments in Brooklyn and a regionally recognized Level I Trauma Center with more than 100,000 visits a year, Brookdale University Hospital and Medical Center has a demonstrable need to instantly and securely access accurate patient data from a multitude of sources. In an emergency situation, access to critical patient data such as medical history, medication usage, and allergies can often make the difference between life and death.
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.
Vitera and 
The two are one, the marriage underway.