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Sailing Towards EMR – Treasure Island or Iceberg?

Posted on August 26, 2009 I Written By

The United States is moving steadily towards Electronic Medical Records (EMR). The HITECH Stimulus Act is like a hurricane-force wind, driving practices towards the electronic age. Many doctors have conflicting opinions about EMRs. Are they a treasure island, full of benefits like increased productivity and revenue, or is it a dangerous iceberg that could sink your practice?

This is going to be XLEMR week with EMRandEHR.com. Another interesting post from Ryan Ricks.

Interoperability, Meaningful Use and Certified EMRs

Posted on August 25, 2009 I Written By

I like reading the weekly newsletters from XLEMR. Ryan Ricks has a way of making complex issues simple. This is a part of his recent newsletter.

Meaningful use has four main functional requirements: computerized order entry, drug interaction checking, maintaining an updated problem list, and generation of transmissible prescriptions. A certified EMR system must provide these functions, and physicians must use them daily for all their patients. In addition, a certified EMR must be capable of sharing information and working with other systems.

The HIT Committee wisely chose existing data standards for their recommendations. Health Level 7 (HL7) is data standard based on the Extensible Markup Language (XML). HL7 was developed for earlier government programs, such as the Doctors Office Quality Information Technology (DOQIT) and Physicians Quality Reporting Initiative (PQRI).

For the full newsletter, go to: http://www.xlemr.com/b2evolution/blogs/index.php

What are your thoughts on the direction that the HIT committee is going?

SRSsoft Brings Doctors Together in Call for Productive EMR Software

Posted on August 21, 2009 I Written By

This is a part of a post on the SRSsoft website. I am a fan of SRSsoft because I think they have it right when they focus on “provider productivity” as a key component of any “good” EMR. See the link below to see the whole blog post, but basically, they went to Washington to advocate for EMRs which improve productivity and enhance the physician-patient relationship.

This is an excerpt from the post:

The signers of this petition are not all SRS clients. Other providers reached out to us and asked that we stand up for them as well. SRS users or not, they are passionate about EHRs, and they speak from positive and negative experience with a variety of EHR products. Three fundamental themes dominated:

*Physicians will not adopt technology that compromises their productivity,
*They will not become data entry clerks, and
*They will not jeopardize the physician-patient relationship.
*No financial incentives or penalties will persuade these physicians to take actions they deem detrimental, or not valuable, to their practices.

Bottom line is that most physicians (if they are smart) will not be induced by incentive or penalties to take on an EMR unless the EMR makes them more productive! I agree with this. Washington needs to make the definition of “meaningful use” and “certified” flexible enough to encompass EMRs that are innovative and enhance our ability to be great doctors and provide excellent care.

Bill Gates Talks About Electronic Medical Records and Healthcare

Posted on August 20, 2009 I Written By

From an Interview with Bill Gates of Microsoft. Some of his views about electronic medical records and healthcare. See complete article.

Mr. Gates was also critical of the United States government’s unwillingness to adopt a national identity card, or allow some businesses, like health care, to centralize data-keeping on individuals. “It has always come back to the idea that ‘The computer knows too much about you,’ ” he said. The United States “got off to a bad start” when it comes to using computers to keep data about its citizens, he said. Doctors are not allowed to share records about an individual patient, and virtual doctor visits are banned, he said, which “wastes a lot of money.” The United States “had better come up with a better model” for health care, he said.

I agree and disagree with Mr. Gates. We need more data sharing and more interoperability BUT confidentiality IS an important issue. Just look at how the drug tests became public about Major League Baseball Players when they were PROMISED it would be strictly confidential!!!! I don’t trust big government or big business. Question: How do you tell an attorney or politician or corporate executive are lying? Answer: Their lips or moving or their fingers are typing!

We have to make sure medical information about individuals remains confidential and remains in the control of the individual.

Simple EMRs and the EMR Backlog

Posted on August 19, 2009 I Written By

The following is from XLEMR. In this Newsletter, Ryan Ricks argues that simple EMRs have many advantages over complex EMRs. They are simpler to learn and install. This may be important if you are going to get your first year HITECH Bonus (if you don’t get it in 2011, you lose it). In my opinion, it is very important that EMRs like this can be certified so Physicians have choice. As long as you can use them in a “meaningful” way, they should be certified. For my definition of “meaningful” see What is “Meaningful Use”, What EMRs should be “Certified” and Who should do the Certifying from July 27, 2009.

This is an excerpt from Mr. Ricks’ post.

Once preliminary certification begins in October, EHR demand should surge. Although the market is currently slow, many vendors have installation backlogs. Preliminary certification may cause those backlogs to increase. Physicians who are in the “wait and see” mode will need to make a decision quickly. Waiting could result in long delays that may jeopardize the ability to qualify for the first year of reimbursements. One alternative is to purchase a simple system. Simple systems take much less time to install, so backlogs are not a problem. Simple systems are also easier to learn, meaning you do not use as much valuable time for training instead of seeing patients. Finally, simple systems are easy to use, giving you more time to qualify for meaningful use. Be sure to ask any EHR vendor if they have any backlogs, and how long it takes to implement their system. Their answer will tell you if their system is simple.

Has anyone seen this backlog? How long do you have to wait?

Evaluations of AllScripts EMR

Posted on August 18, 2009 I Written By

I just ran into a Urologist who purchased an EMR. His group decided to get Allscripts because they knew Urologists who liked it. They also heard that Allscripts had very good support.

I have heard that Allscripts’ EMR is not very user-friendly. Their ePrescribing solution is well liked, but from my reading of the blogs, their EMR is not well liked.

Does anyone use Allscripts EMR? How do you like it?

Top 12 Electronic Medical Record Software Features

Posted on August 17, 2009 I Written By

I just looked at a website of an EMR consultant who posted this blog entry on his Top 10 Electronic Medical Record Software Features for every Physician. This is what he came up with. Take a look.
1) A fully Integrated EMR Software System as opposed to interfaced systems
2) Integration of EMR Software with ePrescription to receive bonus payments
3) Electronic Medical Record Software that supports PQRI Automation
4) Electronic Medical Software with adaptive learning
5) Secure Portability and access to your electronic medical records even without an internet connection
6) Integrated patient portal – Keeping more in-touch with your patients
7) Electronic Medical Record Software that does not box you into rigid templates
8) Document and Image Management
9) Integrated with voice recognition and handwriting recognition
10) Meets all regulatory and compliance requirements (http://www.revenuexl.com/)

My Top Twelve list would go like this:

First of all the EMR has to be: Easy to Use, Simple to Learn, Affordable and it has to make Providers more productive. Without this functionality, none of the other stuff matters!
1. Can document a progress note quickly and efficiently
2. Can ePrescribe
3. Can access medical record information quickly using document management system (lab results, test reports, consultation and hospital reports)
4. Can track Health Maintenance, Chronic Problem Information and Orders
5. Can generate reports for Quality Improvement and Incentive Programs
6. Can connect to other systems via CCD or CCR
7. Allows flexible documentation via typing, dictating, writing and scanning, and drop down menus, templates and pick lists
8. Patient Portal would be nice
9. Interfaces with Scheduling, Billing and Messaging quickly and seamlessly
10. Keeps Patient Medical History Information Stored and Accessible (Allergies, Medications, Past Medical History, Past Surgical History, Habits, Family History and Social History)
11. Quick and Simple ICD-9 and CPT Coding Support
12. Quick and Effective E&M Coding Support

What do you think? Did I miss anything? Is my list better or worse than the list from the EMR Consultant?

EMR Speed, Efficiency and Provider Productivity

Posted on August 14, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

SRSsoft EMR emphasizes speed, efficiency and provider productivity. If your EMR slows you down and makes you less productive, you will lose money and there will be no ROI. More importantly your income will diminish because you will be seeing fewer patients per hour! The $44,000 to $64,000 offered in government incentives (over 5 years) will be insignificant compared to the income you lose due to decreased productivity.

What are your thoughts about provider productivity? For complete post from SRSsoft’s CEO go to: http://blog.srssoft.com/?p=496

IBM vs DEC – XLEMR vs AllScripts

Posted on August 13, 2009 I Written By

The products and services offered in nearly every industry, at their outset, are so complicated and expensive that only people with a lot of money can afford them, and only people with a lot of expertise can provide or use them … At some point, however, these industries were transformed, making their products and services so much more affordable and accessible that a much larger population of could purchase them, and people with less training could competently provide them and use them … To illustrate how these enablers of disruptive innovation (technology enabler, business model innovation, value network) can combine to transform a high-cost, expertise-intensive product into one that is much more affordable and simple, let’s briefly review how it transformed digital computing … By coupling the technological and business model enablers , IBM transformed the computing industry and much of the world with it, while DEC (Digital Equipment Corporation) was swept away. [Dr. Jeff’s Note: read up on computers to see how this will happen with healthcare IT. We don’t have to accept the complex, expensive, unusable systems currently available. They will be replaced by better systems we can all use happily].

(The information above was taken from Clayton M. Christensen’s new book, The Innovator’s Prescription: A Disruptive Solution for Health Care, Introduction pp. xix-xxi. )

I believe that this is happening with EMRs right now! We now have certain EMRs which are easy to use, simple to learn, affordable and effective. These EMRs will sweep away the complex, expensive clunkers put out by most EMR companies.

Your thoughts?

What Did You Like About the EMR You Evaluated?

Posted on August 12, 2009 I Written By

Have you recently evaluated an Electronic Medical Record (EMR)? Tell us one thing you liked about it OR one thing you did not like about it. Which EMR did you evaluate?