Tag: electronic health records

Pediatricians May Be the Only Group of Physicians Who Can Create Life-long Electronic Health Record Users and Advocates

Perhaps creating an opportunity is nothing more than observing the details and taking action once one has been identified.

Lack of opportunity, on the other hand, might be the opposite – keeping your head down and barreling through life without taking an adequate measure of the terrain in which you are navigating.

The feds missed an opportunity. During their planning and roll out of meaningful use, in their effort to collect the health data of this country’s population, specialists, in many cases, were not considered as recipients of their meaningful use incentives.

For many specialties, this might not apply. But pediatrics are different entirely. Not so much for the physicians’ sake, but for the patients they serve.

Given the direct marketing plan that the federal government has undertaken with its latest healthcare pet project, Blue Button, I’m surprised by its lack of foresight related to patient involvement to this group when it comes to meaningful use.

As the feds work desperately to change the perception of electronic data collection, and to move the most information into electronic records as possible, one might think the best way to ensure absolute adoption is by requiring the one group of physicians who might be able to affect the longest term change to participate in the incentive program.

Pediatricians, like it or not, have not been given special treatment as far as meaningful use is concerned. They, like another large group of physicians, OBGYNs, are left to fend for themselves. You can read more about OBs and their fierce independence in my recent interview with digiChart’s CEO Phil Suiter. The reason is well known and obvious: these groups of caregivers don’t necessarily rely on the government (Medicare/Medicaid) to keep their doors open.

The nature of pediatric practice is such that Medicare is not a significant part of their practice so meaningful use incentives don’t apply here. Therefore, the only avenue left for pediatrics is the Medicaid option – and it only works for practices that have more than 20 percent of their volume as Medicaid. In most cases, these groups of physicians don’t meet the minimum requirements of serving Medicare and Medicaid recipients to qualify, and, also in most cases, they don’t go out of their way to do so.

Therefore, given the logic that A+B=C, they are not lining up to get their share of the incentive checks.

But, one would think the feds would try to find some way to make an exception for pediatricians to participate in meaningful use without having to meet the minimum requirement that 20 percent of their population participate in Medicare. I’m not trying to re-open an issue that I know has been discussed countless times; I’m trying to make a different point.

That is, given the new push for patient engagement and the social media-like approach being taken through the Blue Button movement, I believe the importance of pediatricians has been overlooked.

Why? Well, it’s obvious to me that to engage a population, it’s best to change the population’s behavior. To do so, you have to catch them young; so young that they never knew a difference otherwise.

For example, children today will never know what life was prior to the web. They won’t be able to imagine life before mobile devices turned us into an always on society. There’s a lot they’ll never know.

Thus, if they are exposed to electronic health records in their doctor’s office as they grow up, by the time they reach adulthood, they’ll expect their doctors to use nothing but electronic health records. In fact, they won’t even know what to do with a paper record – how to read and understand it – and, therefore, won’t give their money to doctors without the systems.

It’s really the most direct route to changing a population’s behavior.

Indoctrination.

Sure, engaging the adult population through a service like Blue Button is important, and will certainly help fill the gap currently experience in healthcare’s ownership issue, but as we’ve seen in every other area of life, true change won’t come until those who know no other way become the majority and know no other way.

Is the ONC Blue Button a Lot Like Staples’ “Easy Button”?

Staples’ “Easy Button”

As the self-proclaimed ONC Blue Button movement gains steam and more members of the public sign up to make sure their data gets downloaded, it seems the Office of the National Coordinator, among others in the fold, have borrowed a marketing campaign from office supply chain, Staples.

The “Easy Button” is vernacular for something that get done at the press of a button, even if said task isn’t necessarily as easy as just pushing as button. Obviously, that’s the point.

Same goes for the Blue Button. From a marketing perspective, the concept is genius. With the simple push of a button, you too (read: “consumer/patient”) can have instant access to every last bit of your media records and personal health information like never before.

With the campaign just getting started, there are already more than one million people who have signed up for the Blue Button service (sounds sort of like “black tie event” when I read it like this). Eventually, the movement will take hold, no doubt, and the consuming public will be on board like never before. I anticipate Blue Button will grow enormously, similar in nature to the culture that social sites the likes of Facebook and Twitter have become. Not that we’ll sit around sharing our records with those who “like” us or posting comments about each others ailments and conditions, I think people will perceive blue button to have the same value.

It’s about access to information – information that until now many people have not realized they owned or had access to – instantly, as long as Blue Button is available to them.

That’s the catch after all, isn’t it? Blue Button has to be available to consumers for them to be able to push that little easy button. Seems like there are only a couple things that might keep someone from it. The most obvious is that a patient’s physician must have a meaningful use EHR in place. Another is that the practice must choose to offer the service.

It goes without saying, then, that consumers without insurance most likely won’t have access to Blue Button as they’ll likely not have access to a regular physician with a certified EHR. The current healthcare reform may change this slightly as more people will be “encouraged” to insure themselves. And, as practices move to EHR, access to Blue Button will increase.

All of these details are beside the point. Right now, it’s about the marketing. Making sure patients know that the health information that is rightfully theirs can be in the palm of their hands as easily as pushing a little button.

As we know, or so we’ve hypothesized, that the more you can engage patients in their care, the better care they’ll take of themselves.

And you’ve got to hand it to the ONC. Creating a message that directly engages the public rather than hoping that physicians and their vendors will carry the task is something I have long advocated for.

So getting us, as patient consumers, to engage in and to own our care really took little more effort than developing an app and marketing it directly to the people.

“That was easy.”

A 12-step Program to Ensuring the Secure Data in Your EHR Stays That Way

This line pretty much sums it up: Improve quality of care through electronic health records.

Apparently, it’s a motto of sorts for the New York City Department of Health and Mental Hygiene. Not bad when you think about it. Sort of has a “I-love-health-IT” ring to it.

As cool as the organization’s unofficial motto, it features a wealth of great information about the benefits of EHRs, how they can improve healthcare and patient outcomes and steps practice leaders need to take when working to protect the data contained in the records.

As such, NYC’s health department site is filled with great advice for practice administrators to take to create proper procedures and practices to maintain data security.

Here’s a nice, 12-step program for you, courtesy of the NYC:

1. Continue following the rules and regulations set forth by HIPAA. Do not leave printed patient health information where others have access to it. When scanning information into a patient’s EHR, destroy the paper copy when it is no longer needed. Unlike paper charts, it is easy to see a computer screen from across the room. Computer screens should not be visible from the waiting room, check-in area or any place an unauthorized person may be able to see a patient’s EHR. Install privacy filters on monitors to block anyone from viewing the computer from a side view.

2. Install antivirus, intrusion detection and firewall software.

3. Do not use social security numbers as a unique patient identifier. This is something I’d like to see adopted universally in healthcare. There’s no need for my SSN to be sitting on the top of my new patient forms for all the world to see.

4. Patients have the right to control who sees their information. Whether or not an EHR system is in place, do not share patients’ health information with anyone unless the patient has personally authorized it or such disclosure is authorized by law (e.g., mandated disease reporting). Ensure that employers,marketers and law enforcement or immigration officers do not have access to patient records. If your practice is part of a Health Information Exchange network, patients have the right to choose whether or not they will participate. Patients have the right to revoke their consent for sharing information.

5. Patients should understand their rights to consent, as listed in #4 above.

6. Always log out of the EHR system when leaving the computer. If EHRs are left open on the screen, other people can access and/or modify patient information. This activity will be logged as the user’s and he/she may be held accountable for any privacy violations.

For more about this subject, take a look at this insightful article by Dean Wiech of Tools4ever.

7. Keep all passwords safe and secret. Create a password carefully. Passwords should not be obvious, such as birthdays, pets’ names or favorite sports teams. Think of something that is easy for you to remember, but impossible for anyone else to guess. Never share passwords. If anyone asks a staff member for his/her password, the staff member should report that person immediately to the practice administrator. Passwords should not be posted or written down near the staff members’ desks. Change passwords every three months.

8. Ensure hardware is safe and secure. Portable computers are easy to steal. Computers, servers and other equipment that contain data should be locked in a secure place when not being used.

9. Be careful when accessing EHRs from outside of the office. When opening a patient’s EHR in public, make sure no one can see the computer screen. Only access EHRs from a secure Internet connection.

10. Train all staff members on data security policies and procedures. Make sure everyone in the practice understands and observes the policies and procedures for protecting patient health information.

11. Keep up with staffing changes. If an employee leaves the practice, change the user’s status to inactive. This means they can no longer sign in with their old password.

12. Review audit trails periodically. Reviewing audit trails can alert practices to potential system abuse or misuse. Some staff members forget to log out of their system, as well as access parts of the EHRs that are beyond their practice function. Audit trails can let practice administrators know when this occurs and take appropriate action.

So, as the old saying goes, “The more you know,  the further you’ll go.”

One-on-one with digiChart’s CEO Phil Suiter