The following is a fascinating infographic from UC Berkeley School of Information highlighting, very nicely, the information contained in an EHR; the difference between an EMR and an EHR; top specialties to adopt electronic health records, as well as top (and not top) states to adopt the technology.
The information here clearly speaks for itself. According to Berkeley’s School of Information, “data science holds great promise for patient health, but patient data is only actionable in so far as it is digital. This is where EHRs come in. By 2019, the majority of physicians will have adopted a basic EHR system, and with good reason, too. EHRs may reduce outpatient care costs by 3 percent.
This “Electronic Health Records & the Data of Health Care” infographic from datascience@berkeley explores the health data revolution; if nothing else, I thought it was worth a share.
No one will argue that there are not benefits to EHRs (electronic health records). They eliminate paper, enable providers to track data efficiently over a period of time, create a clearinghouse of patient health information in one place, just to name a few. Some argue EHRs improve the overall quality of patient care and business management. However, with so many EHRs on the market, hospitals and doctors’ offices face the daunting task of selecting the right system. Like the general population, most healthcare professionals’ exposure to technology has been limited to that of a consumer, making the selection of the right EHR system a process out of their comfort zone. Then getting trained on how to efficiently use the system while maintaining a high level of patient care comes into play. This has proven to be frustrating, ineffective and possibly dangerous in extreme cases when information is incorrect and/or cannot be accessed. This situation has put healthcare providers in a challenging position, to say the least.
Since 2009 when the federal government rolled out the $30 billion American Recovery and Reinvestment Act as an incentive program for the healthcare industry to go digital with its records, the landscape has changed. One of the first things that happened was the huge influx of technology vendors who decided to make their foray into the healthcare space. Unfortunately, most of these companies did not understand how the industry operated, no pun intended. In fact, the average vendor just launched its first product to the industry in the last year so that does not provide a lot of industry longevity/credibility. Many vendors were focused on getting the peace of $30 billion pie at the cost of their client not getting what the system they needed. Established technology vendors, who shifted their focus on solving the industry’s problems, were outnumbered by the new players who entered the market chasing government grants. The availability of these grants actually created an EHR technology bubble in very short period of time. To make matter worse, well-intended government rules only focused on the end users’ ability to implement technology correctly instead of the technology producers.
With the overwhelming amount of information out there about EHR technology and the providers, healthcare professionals must do thorough due diligence to find the best system that fits their needs. This will take both a time and resource commitment. Let’s look using a metaphor that most people understand or at least have had some experience with, dating. The same principles used in dating can apply when selecting the right EHR technology. Here are four simple rules that can help any healthcare provider make a good business decision when looking for an EHR solution.
Guest post by John Squire, president and COO, Amazing Charts.
According to the 2014 Exclusive EHR Study conducted by the MPI Group and Medical Economics, 70 percent of clinicians said their EHR investment has not been worth the effort, resources and costs. Widespread dissatisfaction with electronic records systems is casting an unfortunate shadow over the great potential they hold for making today’s medical practices more efficient and for improving healthcare delivery. However, practices can help avoid future disappointment with their EHR decision and save time and resources by understanding how to avoid common implementation pitfalls.
1. Choosing the wrong EHR
The intuitiveness and ease of use of your EHR will affect every area of your practice. If you don’t consider yourself to be technologically savvy, finding an intuitive solution should be at the top of your list. (After all, presumably you’re a clinician, not an IT expert.) Was a clinician was involved with the development of the EHR system? If a clinician wasn’t involved, chances are your idea of “usable” won’t line up with that of the vendor’s.
Another aspect to consider is cost, which can vary across a wide spectrum from free to several thousand dollars a month. Decide on the maximum price that you are willing to pay. This will reduce the list of vendors for consideration. Oh by the way, beware of the word “free.” Your biggest hidden cost is not the dollars spent on software, but the hours of lost productivity from a system that impedes you with banner ads and other annoying distractions.
To be certain that the EHR you choose is the right one for your practice, do everything in your power to expose yourself to the software prior to purchasing. It is worth asking the vendor whether they offer free trials. If not, consider watching video tutorials, attending webinars and shadowing another clinician using the EHR.
2. Underestimating the importance of an implementation plan
To ensure the smoothest transition possible, develop an implementation plan that will introduce you to your new EHR and also help you identify specific questions to ask the vendor. Your EHR vendor will likely have one to give you – just ask.
At a minimum, a useful implementation guide should tell you how to do the following:
Electronic health record (EHR) technology has become truly transformative for the healthcare industry; prepared or not, healthcare teams are increasingly relying on new information technologies to improve the delivery and management of care. EHRs have enabled faster and easier access to patient information, and hold the promises of improved workflows, efficient sharing of information across communities and reduced costs for many physicians and hospitals.
But now that nearly 80 percent of physician practices in the U.S. today have EHR systems in place and the Centers for Medicare & Medicaid Services’ (CMS) meaningful use program is well underway, it is time to look to the next stage of health care technology and innovation. Health care teams must now move beyond the first step of digitizing patient records to transforming this valuable data into meaningful and actionable knowledge that will help care teams make more informed decisions at the point of care and ultimately, improve outcomes.
For this impact to take place at both the individual level and at the population level, care teams need to leverage clinical analytics that will provide visibility into important clinical trends across the entire population. For example, being able to review trends in diabetes care or readmission rates across a population represents an opportunity for specific, meaningful change to improve care delivery and outcomes.
For a practicing clinician, “population health management” means being able to see where an individual patient is within the clinician’s or clinic’s population (e.g., whether the individual’s chronic condition is above or below population benchmarks) and to take action at the point of care, as well as being able to refer to relevant population health metrics.
For a patient, clinical analytics presumes trust, not only in the competency and care of the physician, but also in the security of his or her information. Population health management and analytics tools must ensure that patient information can be gathered, stored, and used in a way that is demonstrably secure.
Care teams should consider four key elements when exploring clinical analytics tools for population health management:
On the first day of HIMSS 2014 in Orlando, I stepped into a bewildering echo chamber. “We’re doing population health,” repeated everyone, be they physicians at a hospital whose EHR system my company implemented, the IT directors of other hospitals looking to update their EHR system or competing EHR experts. Everyone was interested in buying it, and everyone was interested in selling it. On one particular walk of the floor a colleague quipped, “Will there be a prize for the one millionth person to say ‘population health?’”
Despite this obsessive buzz nobody seemed able to define what population health is. It’s the proverbial elephant described by touch rather than sight. Is it a concept of health or a study of the various factors that affect health? Is it a course of action for the treatment of the population in its entirety or individual patients only?
The Affordable Care Act, which cites population health as an essential component of its mandate, aims to expand access to the healthcare delivery system, improve the quality of care, enhance prevention, make healthcare providers responsible for outcomes, and promote disease prevention at the community level.
All of this is commendable, but, in the end, what is population health? What does it look like? Will we recognize it if we achieve it? A friend of mine on the payer side observes that vendors claim it’s everything and providers don’t know exactly what they want it to be. Put those together and the term becomes meaningless.
There are additional questions about population health that remain unanswered. Is it an outcome, as the ACA approach suggests, or is it a foundation built on big data, analytics, ACO tools, bundled payments, systems consolidations or something else? At every HIMSS booth, the answer to these questions was a resounding “Yes.”
Today, healthcare organizations are being challenged to provide quality care while improving accuracy, efficiency and accountability. With the additional strain of staff reductions, space constraints, budget cuts and technological advancements all competing with new regulations, there is almost a perfect storm of workflow changes for clinicians to address and adopt. While most focus on the immediate challenges of electronic health records, they may not think through all the implications when implementing the technology used to access it.
Amid the widespread adoption of EHRs, caregivers are equipped with a multitude of devices to access electronic reports – including tablets, handhelds, wall mounts and mobile carts. Furthermore, the logistics governing electrical, phone and network cabling, not to mention physical “real estate,” can stretch the ability to cope for some facilities. It’s not surprising to find cutting-edge IT equipment being used in cramped, stuffy rooms with inadequate furniture, mounting surfaces and storage. At the recent HIMSS conference, we presented to dozens of clinicians and explored how the enterprise-wide application of ergonomic principles within a hospital setting can help manage and sustain all of the often overlooked aspects of clinical workflow.
Ergonomic Factors
Ergonomics is the application of scientific knowledge to a workplace to improve the well-being and efficiency of workers. Ergonomic design considerations begin with human abilities and limitations and how they affect the work process. An ergonomic workplace increases workers’ efficiency and productivity, while helping to reduce fatigue, exertion, and musculoskeletal disorders.
Studies have shown that a good ergonomics program also favorably influences reduction of workplace injuries and absenteeism, and contributes to overall employee wellness.
Received the following study recently that is quite interesting; thought it worthy of sharing:
Emergency department physicians are less likely to admit patients to the hospital when they have readily available electronic access to those patients’ health records, Weill Cornell Medical College researchers have found.
Its study, published March 12 in Applied Clinical Informatics, illustrates the value of combining multiple providers’ digital patient charts into a single source for health care providers – particularly in an urgent setting like the emergency department. With information such as previous test results, prescriptions and other patient history immediately accessible, providers are able to treat patients more efficiently and effectively than when they lack that data.
“New York State has made significant investments in health information exchange,” said Dr. Joshua Vest, an assistant professor at Weill Cornell and the lead author on the study. “Our study shows that providing physicians, nurses and allied health care professionals such as physician assistants real-time access to community-wide, longitudinal health records does in fact benefit patients.”
With federal and New York State government backing, hospitals and medical practices across the state are investing millions of dollars to make health records sharable among physicians when they need the information. The digitized charts contain doctors’ notes from every patient visit; family medical history; immunization records; lab results; medication history; allergies; reminders for preventative care and more.
Garth Graham, M.D., M.P.H., specializing in cardiology, is the current president of the Aetna Foundation and former deputy assistant secretary at the U.S. Department of Health and Human Services (HHS) during both the Bush and Obama administrations. Here he discusses the Aetna Foundation, improving quality of care, how the health IT community continues to change, how can it best be used as a positive tool for better health outcomes, even at the individual level.
Tell me about the Aetna Foundation and your role within the organization? How does the Foundation impact healthcare community?
The Aetna Foundation is the philanthropic arm of Aetna, Inc. funding a number of activities across the country that promote thought-leadership and community-based impact as well as research around improving health outcomes. As the Foundation’s president, I oversee the philanthropic work, including grant-making strategies aimed at improving the health of people from underserved communities.
Overall, at the Aetna Foundation we seek to impact the healthcare community by supporting research and organizations focused on improving the health and wellness of individuals throughout the United States.
How do you go about working to improve the health status and quality of care of the individual and community?
Our Digital Health Initiative is the most recent example of our efforts to fund both national and local programs that are striving to limit healthcare disparities among vulnerable populations, as well as increase positive health and wellness outcomes for individuals. Through this initiative, we are supporting technology that can empower individuals with the convenience and control to meet their personal health and wellness goals.
We hope that by arming individuals with the best possible tools to improve their health, we can ultimately build healthier communities.
Received the following study recently that is quite interesting; thought it worthy of sharing: