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.
Guest post by Laura Kreofsky, Principal Advisor at Impact Advisors.
It is no surprise many hospitals and eligible professionals are “heads down” on meaningful use Stage 2 preparations. EHR upgrades, evaluating performance against increased thresholds for carry-over objectives from Stage 1, and delving into the technical, procedural and workflow complexities of many new objectives has caught many providers off guard, particularly those for whom meeting Stage 1 was a relatively easy goal.
Two very challenging areas for Stage 2 for most eligible hospitals (EHs) and eligible professionals (EPs) are the objective “Summary of Care Record at Transitions of Care (ToC)” and those that relate to Public Health reporting.
For these objectives, it is not necessarily the performance thresholds that present the challenge, rather the EHR functional requirements, the requirements-behind-the-requirements, or the workflows that are the cause of consternation. These objectives and their unique challenges are described below:
Summary of Care Record at Transitions of Care (ToC).
This objective is challenging on two fronts. First, the population and generation of the Summary of Care Record (the “Record”), and second, the actual transmission of that document at transitions of care to intended recipients.
CIOs in healthcare face the constant challenge of doing more with less. Most are being asked to dramatically cut costs while continually tackling an ambitious list of responsibilities, including maintaining their organizations’ ability to demonstrate meaningful use, making the transition to ICD-10, sharing information through healthcare information exchanges (HIEs) and maintaining stringent patient privacy and HIPAA compliance programs.
Three key and often overlooked elements can help to address these tasks: document scanning, clinical language understanding and integration standards. Mastery of this electronic health record (EHR) trifecta can significantly simplify the healthcare CIO’s challenge.
Document scanning
Electronic health record adoption levels are steadily increasing, but ongoing interoperability issues result in high volumes of paper-based communications between providers. In fact, a survey conducted by the Bipartisan Policy Center in Washington, D.C., found that 71 percent of physicians identified lack of EHR interoperability and exchange infrastructure as major barriers to HIE.
Kareo, a company I have come to quietly respect (the company does not sponsor this site in any way) issued the following graphic (something else I have come to really like). I’m a visual person and there’s often no better way to convey complicated information like that found in health IT and I find the following graphic filled with much telling information, and seems to beg whether small practices are served well by EHRs.
This graphic seems to speak to a bigger picture of what’s going on currently in the space. This information tells the story of how it is becoming more difficult to maintain autonomy in private practice, but not impossible. With technology, small practices can thrive. But, is there enough focus on the small practices for technology to make the difference Kareo says it can?
Kareo has skin in this game, after all, and makes its position clear: “The solution is technology, and not just one piece of software but a fully-integrated seamless package of solutions from a single vendor … most physician practices know that to remain independent they will have to make changes.
“The willingness to change is important because success may rely on seeing your practice as a business and carefully considering and evaluating your bottom line. While many physicians in practices with five providers or fewer are still hesitant to adopt an EHR, the potential benefits are indisputable.”
Guest post byJason Thomas, CIO and IT director of Green Clinic Health System, and Dell Software solutions user.
Across the healthcare landscape, organizations are expected be in complete compliance with all security and privacy policies on all devices – even personal devices brought in by doctors, nurses, clinicians and administrators.
Being compliant involves many things, including training staff, revising business agreements, modifying policies, staying up-to-date on the newest technologies and updating notices of privacy practices as new regulations go into effect – such as the HIPAA Omnibus Final Rule.
While most of the industry’s current compliance strategies are focused on maintaining privacy and protecting patient data, the more recent addition of bring-your-own-device (BYOD) brings a whole new level of complexity into the compliancy equation.
David Willis, vice president and distinguished analyst at Gartner, recently stated, “BYOD strategies are the most radical change to the economics and the culture of client computing in business in decades.” He added that the benefits of BYOD include creating new mobile workforce opportunities, increasing employee satisfaction and reducing or avoiding costs.
Like the adaption and implementation of every new and innovative technology, it takes time to get used to it. Therefore, with electronic health records, being ready for change is key.
Previously, physicians were comfortable with a paper-based system because its usage had been a norm since and before they started studying medicine. The way they had to learn and adopt to a working environment when they started practicing, they will have to do the same with innovative technologies such as EHRs, built to make their lives easier.
In the initial stages, EHR documentation is likely to be cumbersome as physicians familiarize themselves with the new system.
ONC’s HealthIT.gov published the following graphic aimed directly at consumers, expanding on its education strategy. For those that live in health IT, much of the information included here has been seen multiple times. Perhaps there is little new here.
However, there are a few nuggets that I personally find of interest that are worth sharing. According to the the feds, “between 2001 and 2011, the number of doctors using an EHR system grew about 57 percent, making it easier for you and all of your doctors to coordinate your care, and often reducing the chance of medical errors.”
Now that studies have suggested that about 66 percent of the population would switch to a doctor using an EHR versus one not using one, we’re going to see this stat is every piece of collateral in support of the effort; in fact, that same story has been reported here at this twice (this makes the third time). That detail is included here, too, as we would expect.
The Accenture Consumer Survey on Patient Engagement explores whether doctors are delivering on the growing patient demand for access to EHRs and other electronic capabilities.
According to the info below, more than half of global users would switch to a doctor using EHRs with Brazil, France, Singapore and Spain registering well more than 50 percent of all patients willing to switch. In the US, the number of switchers hoovers at around 41 percent.
Kareo, a company I have come to quietly respect (the company does not sponsor this site in any way) issued the following 
Accenture released the following infographic that illustrates the key findings of its recent survey (also featured in a recent post: