Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

EMR, HIE Use Up Sharply In U.S.

A new survey by Accenture has concluded that the number of U.S. doctors using EMRs — either in their practice or at a hospital — has climbed to over 90 percent, and that almost half are using HIEs. More than half of doctors surveyed (60%) report using an EMR in their own medical practice.

The Accenture survey reached out to 3,700 doctors in eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.  Data showed a spike in healthcare IT usage across all of the countries surveyed.

In the U.S., doctors had the biggest increase in adoption demonstrated in the survey, up 32 percent in routine use of health IT capabilities, as opposed to an average increase of 15 percent among non-U.S. clinicians, reports HealthcareIT News.

Other standout activities were e-prescribing (65 percent using) and entering patient notes into EMRs (78 percent), a 34 percent annual increase between 2011 and 2012. Forty-five percent of physicians also use IT for basic clinical tasks such as getting alerts while seeing patients (45 percent), according to Healthcare IT News.

Healthcare IT News also caught an interesting detail around lab orders. The magazine notes that 57 percent of U.S. doctors said they regularly use electronic lab orders  (a 21 percent annual increase) the volume of physicians doing so internationally dropped 6 percent.

Globally, the number of doctors who “routinely” access clinical data on patients seen by different health organizations has climbed by 42 percent, from 33 percent of doctors in 2011 to 47 percent in 2012. Spain was the leader by a significant margin, with 69 percent of doctors routinely accessing such data.

The study also concluded that internationally, almost 60 percent of doctors customarily enter patient notes electronically either during or after consults.

On the other hand, so-called “digital doctors” are still unlikely to connect or transact electronically with outside organizations. Accenture found that only 10 percent of physicians communicate electronically to support remote consults/diagnostics, and that roughly 20 percent e-prescribe, receive notifications of patients’ interactions with other health organizations and communicate electronically with clinicians in other organizations.

Post a Comment(4)
May 10, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Adoption  ePrescribing  Healthcare IT  HIE  Hospitals  Research
Tags:        

Upcoding, Presidential Debates, and MU Incentives– #HITsm Chat Highlights

Every week, HL7 Standards, hosts a #HITsm Tweet Chat and poses four questions “on current topics that are influencing healthcare technology, health IT, and the use of social media in healthcare.” It’s always a great discussion and also a great chance to meet a wide variety of people that are passionate about healthcare IT.

In case you missed it, or are curious about what went on this week, we’ve put together the list of topics with some of the best responses for each topic. There were some interesting topics this week, as well as some great responses. If you have any opinions on any of these topics, feel free to continue the discussion in the comments. This chats take place every Friday at 11AM CST. You’ll find members of Healthcare Scene regularly participating in the chat under some of the following Twitter accounts: @techguy, @ehrandhit, @hospitalEHR, and @smyrnagirl.

Topic One: Big debate now about EHRs sparking upcoding if not fraud. What’s your take? Will inverse be true with digitized health system?

 

 

 

Topics Two: 59% of IT execs say staff shortages harm earning of MU incentives. What is long-term impact if feds HIT education lag demand?

 

 

 

 

Topic Three: What would you ask Obama or Romney about HealthIT, reform law, or healthcare in general during the Oct. 3 debate? 

 

 

 

 

Topic Four: Health IT projects: Which ones are you postponing until after the election? 

 

Post a Comment(0)
September 29, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Technology  ePrescribing  Health IT Jobs  Healthcare  Healthcare IT  Healthcare Social Media  Meaningful Use  mHealth  PHR
Tags:          

Can Health IT Reduce Readmissions?

We who work around health IT know it can do some great tricks, but it’s always nice to see examples of how it can actually save money.  One example of how health IT can be a cost-saver is in helping to reduce readmissions, according to a new study from CSC.  Here’s a summary of how it might work, courtesy of CMIO magazine:

Reducing readmissions will require identifying patients at risk for readmission, carefully orchestrated care management programs and patient-specific transition pathways. While this type of patient tracking, collaboration and patient-centeredness has been historically difficult to achieve, health IT should enable more organized care management through tools such as e-prescribing, master patient indexes and electronic clinical communication.

The report notes, however, that this works much better if hospitals and health systems have integrated EMRs that extend from the facility into community medical practices.  And that’s just common sense. After all, hospitals aren’t equipped to check on patients regularly once they’re discharged, aside perhaps from a few that are experimenting with remote monitoring.

The thing is, given that hospitals and medical practices are seldom running the same systems, it’s unlikely (OK, almost impossible) that they’ll be able to share much in the way of digital information. Sure, they’ll get faxes galore, but if that was an efficient way to share docs we wouldn’t be having these conversations.

Oh well. It’s always good for deep thinker types to point the way ahead. Unfortunately, I think we’ll have to wait a while for coordinated care planning via health IT to really find its place. Maybe John’s predictions for Direct Project will help us get part of the way there.

Post a Comment(0)
August 15, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Adoption  ePrescribing  Healthcare  Hospitals
Tags:            

What’s Next For Physician Tablet Use?

Not long ago, Manhattan Research released a study offering details on how doctors’ consumption of digital devices and media is progressing.  The survey, which surveyed 3,015 physicians in 25 specialties, looked at doctors who were online in the first quarter of 2012.

Among the most interesting — if not surprising — findings was that tablets have more or less officially hit the medical mainstream. According to the research firm, tablet use among doctors has nearly doubled since last year, hitting a whopping 62 percent in this year’s study.  You also won’t be shocked to learn that iPads dominate medical tablet use, in part due to their high-res screen and ease of  use.

Why the greater rush to adoption?  I think the following comment, which Monique Levy of Manhattan Research made to InformationWeek, offers a nice insight:   ”It used to be that you had to solve the problems of security access, validation, and data security first and then adopt,  (but) what’s happened is that the system has turned upside down. We’re now at adoption first and solve the problem later.”

As Levy notes, the first wave of adoption has been driven largely by access to lower-risk information, and less for patient data. We can expect to another round of resistance when physicians are tethered to EMRs largely by tablets, she predicts.  I’d add that as long as there’s no native client physicians can use to access EMRs on the iPad, it will make things worse.

Given that resistance, maybe medical use of tablets will expand in other areas first. According to IT prognosticators and researchers at the Gartner Group, top medical uses of tablets also include waiting rooms, e-prescribing, diagnostic image viewing and appointment scheduling. (I’m amazed more practices aren’t doing the waiting room check-in thing.) Maybe one of these other areas will evolve breakout apps before doctors are really hooked up with patient data on their tablet.

Post a Comment(0)
July 23, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Filed Under: EHR  EHR Market  Electronic Health Record  Electronic Medical Record  EMR  EMR Adoption  EMR Technology  ePrescribing  Health IT Jobs  Healthcare  Healthcare IT  mHealth
Tags:              

Cutting EMR Training Budget Can Create Serious Problems

Not long ago, American Medical News ran an article on training up medical practice staffers for EMR use. The piece concluded that while practices may save some bucks on the front end, they generally end up regretting it later.  An anecdote from the piece:

Nine months after All Island Gastroenterology and Liver Associates in Malverne, N.Y., went live with its electronic medical record system, practice administrator Michaela Faella realized things had not gone as smoothly as planned.

Even though the staff had used other health information technology systems for many years and considered itself tech-savvy, it had taken everyone six months to learn how to use the new EMR system. Several months later, the staff still had not become proficient at it.

The problem was not with the staff, but that the practice cut training short to save time and money. “Training was not placed high on the priority list, and we paid the price for it,” Faella said.

As the piece notes, many practices assume that the training bundled into the cost of their new EMR will meet their needs, and find out to their regret that this isn’t the case.  (In fact, I’d argue that this is more the rule than the exception, based on anecdotes I hear in the field and in conversations with physicians.)

A consultant quoted in the piece suggests that practices should consider three main issues when planning for training:

1) How much data they’ll be dealing with, which can vary greatly depending on whether all data is imported in advance or done patient by patient

2) Whether the practice will be integrating new systems into the EMR, such as e-prescribing, or conversely, adding an EMR to existing systems

3) Whether using the EMR will call for using new hardware such as tablet computers

Personally, I’m not satisfied by that list at all.

What about, first and foremost, assessing the staff’s existing skills more precisely, walking staffers through the various layers of the EMR on a daily basis, forming teams of superusers within the organization to help the less skilled and taking steps to be sure EMR problems don’t interrupt critical functions (a backup/workaround plan for the short term)?

What do you think?  Does the list above cover the critical EMR practice integration issues?  Am I just being testy?

Post a Comment(2)
April 17, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Filed Under: Electronic Health Record  Electronic Medical Record  EMR  EMR Adoption  EMR Technology  ePrescribing  Healthcare  Healthcare IT
Tags:                        

e-Prescribing: Some Considerations

I’m always in the mood for stories, which is why I love the Cases and Commentaries section on the AHRQ WebM&M site. There’re a bunch of February posts up there but the one that caught my eye was one titled E-prescribing: E for Error?

The case involved a 63 year old man who went in to see his primary care physician. He was receiving psychotherapy, but was still prone to anxiety. The PCP prescribed him alprazolam for the anxiety. Since the clinic had just implemented a new e-prescribing system, the doctor assured the patient that he didn’t need a paper prescription and just needed to show up at pharmacy and pick up his order.

So far so good.

Back at the doctor’s office, a nurse entered the presribed medication into the practice’s shiny new system, except that she inadvertently added an order of atenolol, intended for a different patient, to this patient’s order. She soon realized her mistake and deleted the atenolol order.

When the patient went to the pharmacy, he was given both the alprazolam and the atenolol, which he thought was odd, since he had been prescribed only one medication. However, he just went ahead with taking both medications per the directions handed to him by the pharmacist, and it was only a few days later, during an appointment with a cardiologist that the mistaken atenolol addition was finally identified.

Fortunately, the patient lived to tell the tale, which we all know is not the outcome in some sad cases. Elisa W. Ashton, the author of this Cases and Commentaries piece, has some great points listed as her takeaways from this case. Here are mine:

- It’s too soon to say goodbye to paper. I worry about trees more than the average Jane, but if there’s a ever a case to be made for a paper prescription, here it is. A paper prescription would’ve shown up the double prescription both to the nurse, as well as the patient, making it less likely to make it to the pharmacy.

- It’s not clear who/what failed. Did the nurse realize delete the wrong entry only after she transmitted the patient’s prescription? Did the prescription software trule delete the medication or simply mark it as flagged for deletion?

- This accident happened on a newish system, perhaps users were not as familiar with it as they should have been.

- If you think something’s odd about your prescription, speak up. As patients many of us tend to assume that doctors know best. However, doctors are as human as everyone else, no matter how many initials tag along before or after their names. You don’t have to be obnoxious about it, it’s perfectly fine to verify politely with your doctor’s office if the additional (or missing) medications are necessary.

- Bravo to the eagle-eyed cardiologist! It was great someone caught this error in time, though I would much prefer that some kind of check system be built into the e-prescription system to prevent errors of this sort.

Go check out the post on AHRQ.

Post a Comment(7)
February 13, 2012 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  ePrescribing  Healthcare  Healthcare IT
Tags:                

A Report on ePrescribing Challenges

From the Center for Studying Health System Change (hschange.com) comes a study on e-prescriptions, and how providers and pharmacies work together to electronically transmit and fulfill prescriptions. Now, I don’t know how reliable this organization or its research is (the .com in its name, for example, is something that bothers me. Also the report focuses almost exclusively on SureScripts). But the study is interesting to me for what it reveals statistically.

HSChange.com conducted 114 phone interviews with 24 physician practices, 48 community pharmacies, divided between local and national companies. The national respondents included 3 mail-order pharmacies, and 3 chain pharmacy headquarters. Those of you who are interested in the numbers, the methodology and other sundries, go ahead and read the report in its entirety. Here’s a quick summary from the report’s results the rest of us. My comments are bolded.

According to the report:
Two-thirds of the practices sent at least 70% of their prescriptions electronically. Which means about 46.2% of the prescriptions are e-prescribed. Plenty of room for growth, methinks.

Pharmacists at more than 50% of Community said their pharmacies received less than 15% of their prescriptions electronically. The reasons: providers didn’t transmit electronically, or sent out computer-generated prescriptions by fax or mail. Interesting – could be indicative of either lack of knowhow, or infrastructure that allows for e-transmission.
New prescriptions are more likely to be e-prescribed than prescription refills (renewals). The report states that many pharmacies don’t use this feature in order to avoid SureScripts fees for renewals.

There are plenty of inefficiencies. E.g. a) multiple requests for the same prescription were sent (say by phone, fax and through SureScripts) by pharmacies b) providers mistakenly deny prescriptions and then re-send the same prescription as a new one.

E-prescribing to mail order pharmacies is a different process – (apparently providers need to be Surescripts certified to e-prescribe with community pharmacies, and also need to be certified to e-prescribe to mail order pharmacies. So, even when a provider selects a mail order pharmacy to fulfill an e-prescription, the prescription is delivered by fax to the the mail order pharmacy by Surescripts.)
Prescription specificity falls on the provider – tablets, capsules, and liquid formulations might have different costs. Pharmacists can’t change the prescription from a capsule to a tablet on their own, without consulting with the prescribing provider. This might result in unexpected costs.
Providers’ patient instructions are still incomprehensible! Pharmacists often have to play translator (maybe because as the report alludes to, the instructions are intended for pharmacist eyes, not the patient.)

an independent pharmacist explained, ‘A lot of times we can’t copy the directions word for word because the patient doesn’t understand them, just like with paper prescriptions. We have to go in and erase ‘t.i.d.’ and put in, ‘One tablet three times a day’.’

 

Post a Comment(0)
November 28, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  ePrescribing  Healthcare  Healthcare IT
Tags:          

Who Will Police EMRs and EHRs?

Amid all the dog-bites-man type health IT news, here are some not-so-positive EMR/EHR stories that have been reported:

- An EMR in Lifespan hospital group gave incorrect prescriptions to some 2000 patients. The article in the Providence Journal says that

The hospitals have placed calls to nearly all the affected patients, although not all have called back, Cooper said. Most patients reached had already obtained the correct medication because the error was noticed by someone at the hospital, or a pharmacist or doctor outside, she said. So far, Cooper said, there is no evidence that any- one was harmed.

Thank goodness for that.

- Incorrectly calculated MU thresholds (GE Centricity). I’m not going to rehash the story, but you can check out Neil Versel’s article in InformationWeek, the spirited discussion on my previous EMR and EHR blog post and John’s EMR and HIPAA blog post.

It might be just be my skewed viewpoint, but GE Centricity related issues are nowhere on par with people being prescribed the wrong prescription. In one case, a few practices may not be able to demonstrate Meaningful Use. Wrong medication could actually be life-threatening to you. So if I had to rank my problems, I’d rather be short by 44K than worry about my EMR inadvertently killing my patients off.

What we need is a governing body, similar to the National Transportation Safety Board, to police EMRs, says Paul Cerrato in a recent InformationWeek Healthcare article.

Cerrato writes:

“An NTSB-like organization for EHRs would at the very least provide a reporting mechanism to keep track of incidents and life-threatening consequences of misusing e-records. More importantly, it could police vendors and healthcare providers who repeatedly ignore these dangers.”

Cerrato goes on to say there are only 120 EHR-specific problems reported to the FDA over the last 18 years. That figure, if correct, to me shows:

  • EMR users don’t know how/where they can report EMR related errors or don’t expect any action to be taken – this certainly is credible, because from all quarters, it seems as if the focus is just to get the healthcare field into electronic data capture, not on whether the experience delivers any tangible and useful benefits
  • Maybe they’re willing to give EMRs a pass assuming the healthcare IT to be in infancy
  • They’re too overwhelmed with the EMRs’ capabilities/inabilities to really see what’s going on

For a national database of EMR problems to be truly relevant, here’s the information I would look for, on problems I’m facing:

  • How critical was the error? How many people did it affect, and in what ways – medically, financially?
  • How was it handled?
  • How common is it – are there others who’ve faced similar problems?
  • If the problem was not sorted, what raps on the fingers did the vendors face?

Read the article here.

Post a Comment(9)
November 7, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Adoption  EMR Technology  ePrescribing  Healthcare  Healthcare IT  HIE  Meaningful Use
Tags:                          

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 31-35

Time for the next entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I hope you’re enjoying the series.

35. CPOE is important, but every EMR will have it.
I think that the CPOE discussion hit a head for me when I saw the CPOE requirements that were baked into meaningful use. Then, I heard someone from the often lauded (appropriately so) IHC in Utah who said that IHC didn’t have CPOE and it would be hard for them to meet that benchmark. Ok, so I’m more of an ambulatory guy than I am hospital, but this surprised me. In the clinics I’ve helped with EHR, CPOE is one of the first things we implemented. No doubt that every EMR has CPOE capabilities.

34. Make sure adverse drug events reporting is comprehensive
Yes, not all drug to drug, drug to allergy, etc databases are created equal. Not to mention some EHR vendors haven’t actually implemented these features (although, MU is changing that). I’d really love for a doctor and an EMR company to go through and rate the various drug database companies. How comprehensive are they? How good can you integrate them into your EHR? etc etc etc.

33. Make certain drug interactions are easy to manage for the physician
I won’t go into all the details of alert fatigue in detail. Let’s just summarize it this way: You must find the balance between when to alert, what to alert, how to alert and how to ignore the alert. Plus, all of the opposites of when not to alert, what not to alert, and how to not ignore the alert.

32. Ensure integration to other products is possible
Is it possible that you could buy an EMR with no integration? Possibly, but I have yet to see it. At a bare minimum clinics are going to want to have integration with lab software and ePrescribing (pharmacies). That doesn’t include many of the other common interfaces such as integration with practice management systems, hospitals, radiology, etc. How well your EMR handles these integration situations can really impact the enjoyment of your EHR.

31. Ensure information sharing is easy
This tip could definitely be argued, but I believe we’re headed down the road of information sharing. It’s going to still take a while to get to the nirvana of information sharing, but we’ve started down the road and there’s no turning back. Kind of reminds me of Splash Mountain at Disneyland where the rabbit has a sign that says there’s no turning back now. My son didn’t like that sign so much and I’m sure many people won’t like that there’s no turning back on data sharing either. However, it’s going to happen.

If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other EMR tips.

Post a Comment(0)
October 12, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  ePrescribing  Healthcare IT  Meaningful Use
Tags:                                          

Mobile Makes the Difference in Emergencies … or on Vacation

My family and I have escaped this week to our favorite vacation destination, Pensacola Beach. And so I sit here writing in the cozy confines of the condo that we call home for close to a week nearly every summer. I gave barely a thought to how I was going to transmit this blog to the HealthcareScene.com servers while here. As it turns out, there is no WiFi, which means I’m relying on my iPhone to do a bit of online research, my laptop for Word, and the hotel across the street’s business center with which to cobble it all together.

My connectivity issues pale, of course, in comparison to those of providers working outside of their hospital’s four walls – be it in emergency situations such as the aftermath of a hurricanes like Ivan and Dennis, which hit Pensacola back in 2004 and 2005, respectively, or as part of a routine provider/patient encounter in telehealth programs. I wonder how providers at Pensacola’s Sacred Heart Hospital, where I was born (and no, I’m not telling you what year), handled patient care in the aftermath of Ivan, which devastated the town and outlying beach communities, and how mobile health solutions might better enable them should Mother Nature pay the same sort of visit today.

Well timed for this blog was the recent news that Epocrates has released the first phase of its EHR system, including an iPhone app, targeted to primary care practices with 10 physicians or less. The EHR, according to a recent report at MobiHealthNews.com, “is initially available as a Web-based SaaS product, includes patient encounter notes, electronic lab integration, e-prescribing and Epocrates’ flagship drug database.”

The iPhone version should be available in a few weeks, and is likely to include remote patient record look-up and schedule access, and e-prescribing. The iPad version, which is in development, will focus on point-of-care data capture. MobiHealthNews.com also reports that an Android app is in the works, but will be rolled out in later versions of the EHR.

It will be interesting to see if later versions also target larger physician practices, which would surely also benefit from mobile technology like this. Perhaps most interesting, at least to providers in places like Pensacola that see their fair share of hurricane-induced on-site emergency care, is that the Epocrates mobile EHR app will “be a native app and it will store patient data on the device,” according to the company, which means that “the device will not need a signal to access the EHR. Any new data will be synched with the record once the phone finds a signal.”

Hopefully that signal will not be as elusive in a community’s time of need as the WiFi seems to be at my vacation destination.

Post a Comment(0)
August 3, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company’s social media strategies for its three key properties – Billian’s HealthDATA, Porter Research and HITR.com. She is a regular contributor to a number of healthcare blogs, and currently manages the Technology Association of Georgia Health Society’s social media channels. You can find her on Twitter @SmyrnaGirl.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  ePrescribing  Healthcare  Healthcare IT  Hospitals  Personal Musings
Tags:                    




    • Next