EMR Benefits | EMR and EHR

Bill Gates Puts a New Spin on the Great EMR Debate

I heard an interesting interview on NPR the other day with Bill Gates on the subject of polio eradication. The Bill & Melinda Gates Foundation has been working for a number of years now on the effort, and are intent on seeing that no child ever becomes paralyzed as a result of the disease. The interview got me thinking about money, as NPR host Robert Siegel grilled Gates about the cost of this hopefully final vaccination push in the three countries that still show cases of it each year – Afghanistan, Pakistan and Nigeria.

According to Gates, a nice tidy sum of $5.5 billion will be necessary to vaccinate enough children to finally push out the disease. The question arose as to whether or not this money will be spent wisely. Could it be put to better, more effective use fighting other healthcare conditions, such as malaria, that affect greater numbers of people? Gates made the point that once polio is eradicated, the enormous amount of money already being spent on fighting it can then be spent on these other issues – a statement that to me didn’t seem to sit well with Siegel.

Now, if you’re in healthcare, chances are money crosses your mind a few times a day. And if you use an EMR, you’ve likely voiced an opinion or two on whether it has lived up to its promised value. I think Gates’ point above on cost effectiveness of disease eradication – the most expensive disease gets eradicated first to free up its funds for other healthcare causes – can be applied to the EMR ROI debate.

Yes, healthcare is expensive. Yes, current and possibly future EMRs may not have the best interfaces or give the ideal user experience. But, given time (perhaps a lot of time), they will ultimately help springboard immense cost savings throughout the industry. I consider them the backbone of interoperability, especially when it comes to health information exchange and accountable care – two notions that might just become the norm once EMR utilization finally reaches critical mass.

Stage 2 Meaningful Use will likely see a shift in the market, and from what I’ve read thus far, is causing providers to think about Meaningful Use in a new way. It might be a hiccup in this journey to cost savings, but it will likely separate the wheat from the chaff as far as vendors go. Hopefully, only effective products will be left standing, which will in turn make it easier for providers to use EMRs in the most effective way.

Money will of course be on everyone’s minds at the upcoming HFMA ANI show in Orlando. This has got to be one of my favorite events as it is smaller than HIMSS but still has that bustling, breaking news vibe. I’ll be interested to hear from providers their opinions on the recent push for greater price transparency when it comes to hospital costs, and how they are feeling about EMRs as of late. It will also be interesting to see how vendors are helping these providers meet Stage 2 and patient engagement head on.

Will you be at the ANI show? Drop me a line in the comments below and let me know what you’re looking forward to learning about or seeing the most.

EMR A Disappointment In The US?

Twitter has been circulating tweets discussing whether EMR is a disappointment in the USA. I find the question really intriguing. I’m sure the doctors who have their EMR and love the benefits they’ve gotten from EMR think its far from a disappointment. The doctors that have an EMR forced on them or select one that kills their workflow likely see EMR as a huge disappointment. Whether EMR is a disappointment in the US starts with which group you think is larger.

My personal gut feeling is that it’s likely split somewhere down the middle. About half of doctors are satisfied with their EMR, and half of doctors are unsatisfied (some might use a much harsher word) with their EMR software.

Does that mean that EMR is a disppointment in the US? I’d have to say it does.

Although, I think that disappointment is the right word. It’s not that I think we shouldn’t be doing EMR. We absolutely should be making physician documentation electronic. As I’ve been starting to highlight in my EMR Benefit Series on EMR and HIPAA, there are some major issues with paper charts that are easily solved with EMR.

The reason EMR has a been a disappointment to date is that EMR implementations can be so much better than they are today.

I believe we are sitting on so much possibility when it comes to how healthcare IT can transform healthcare. For a myriad of reasons, we’re not seeing that potential and quite frankly that’s disappointing.

Study: EMRs Improve Ambulatory Care

A new study done by researchers from the Weill Cornell Medical College has concluded that community-based physicians who move to EMRs can improve care meaningfully.

The study, which was done in collaboration with New York’s Health Information Technology Collaborative, gathered baseline year data gathered from 500+ physicians in ambulatory practices and 75,000 patients with five different health plans in New York’s Hudson Valley. They then compared quality scores for EMR-using physicians and those without EMRs.

Researchers concluded that 56 percent of physicians who were using EMRs scored significantly higher on quality of care provided, particularly in managing chlamydia, diabetes, colorectal cancer and breast cancer. A combined score across nine quality measures also also suggested that EMRs helped generated better care than paper-based records overall.

What made the study results particularly interesting, researchers said, was that the physicians using EMRs used off-the-shelf systems which hadn’t been specialized to achieve these kind of results.

Researchers seem to think that the improved ambulatory results are just the tip of the iceberg:

“EHRs may improve the quality of care by making information more accessible to physicians, providing medical decision-making support in real time and allowing patients and providers to communicate regularly and securely,” says Dr. Rainu Kaushal, director of the Center for Healthcare Informatics and Policy and the Frances and John L. Loeb Professor of Medical Informatics at Weill Cornell. ”However, the real value of these systems is their ability to organize data and to allow transformative models of health care delivery, such as the patient-centered medical home, to be layered on top.”

Interesting. I would have assumed that reminders and warnings had generated , as they certainly help doctors make sure overworked doctors are on target with tests, avoid drug interactions and the like. But researchers like Dr. Kaushal and her colleagues seem to think that the big EMR payoff will come as EMR systems change the core models doctors use to deliver care.

Given that new models are all but inevitable at this point, I guess we’ll get to find out!

Costs of Healthcare, Benefits of Healthcare IT and Health Tracking at #chs11

Seems like people really liked my tweets from yesterday at the Connected Health Symposium. So, I thought I’d do it again today. Here’s some of the interesting tweets I saw and wrote during the Connected Health Symposium.

Information matters when patients are paying for their healthcare. #HighDeductiblePlanMember #chs11

October 21, 2011 11:18 am via webReply RetweetFavorite

@techguy

John Lynn

The cost of healthcare was a major theme throughout the entire conference. I agree completely that as patients start to pay more of their healthcare, they need more information and make better decisions.

RT @perficient_hc: Dr Tippet: If #healthit was as strong as IT in Finance we’d save money and live longer #chs11

October 21, 2011 11:30 am via HootSuite ReplyRetweetFavorite

@Independa4U

Independa, Inc.

I found this really interesting. Twitter (and even this blog) doesn’t quite capture the irony of the statement. Basically, Dr. Tippets from Verizon really highlights how if we did IT right in healthcare we have the potential of saving lives and live longer. Both noble goals.

“The literature is overwhelmingly positive on the benefits of EHR, but the negative gets more attention.” -Blumenthal at #chs11

October 21, 2011 10:22 am via webReply RetweetFavorite

@techguy

John Lynn

I think Blumenthal might have actually said Healthcare IT instead of EHR, but there’s a lot of overlap in this. I agree with Blumenthal that the media and even blogs like mine love to write about the negative more than the positive. It makes for a compelling headline. Maybe the people behind the good research studies need to promote themselves more too.

15% of Internet users track weight diet or exercise routinely online but h/c is not using this #CHS11

October 21, 2011 11:31 am via TweetDeck ReplyRetweetFavorite

@drnic1

Nick van Terheyden

This kind of hit me on multiple levels. First, I found it interesting that 15% are tracking their weight and exercise. Is that too low? It’s probably the highest level of any other healthcare data tracking app. I wonder where the rest of the apps stand. The second thing that hit me was the fact that doctors aren’t using this data. Finding some way to make it easy and useful for doctors to use all this collected information is going to be a challenging, but important next step. I’ll be interested to see how EHR companies work through the process of taking that data and integrating it into their EHR software. It won’t be easy, but I believe patients will love this type of integration. Plus, it would encourage many others to start using these medical devices.

Does an EMR Improve Patient Care?

Everyone probably realizes by now that I love to read first hand experiences with EMR and EHR. I guess I’ve always loved stories and I’ve always loved to tell stories, so maybe that’s where that comes from. I guess this is why I loved Katherine Rourke’s post called “Would An EMR Have Improved My Son’s ED Care?” on the Hospital EMR and EHR website. It’s a great read if you love first hand experiences with EMR as I do.

Katherine does raise a challenging question, “Does an EMR improve patient care?”

In past presentations, I’ve always put the idea of an EMR improving patient care under the “possible EHR benefits.” (See a full list of EMR and EHR Benefits) As many things in life there’s a big “Depends!” that is the b est answer to that question. The answer to this question depends on what kind of care you were offering previously, the type of care you offer, the EMR you chose, the features you chose to employ in that EMR, the match between your workflow and the EMR workflow, and I’m sure another dozen other depends as well.

What’s more important to point out is that an EMR can improve patient care. I certainly can’t guarantee that an EMR will improve patient care in your clinic, but I’ve seen many cases where it has improved patient care and so I know it’s possible. The biggest determining factor in whether an EMR will improve patient care in your clinic is your desire to have it do so.

Many times in life, you get what you want. Do you want an EMR to improve your patient care? Or were you too focused on wanting to get the EHR Incentive money? Not that these and other benefits are mutually exclusive, but the focus of your EHR implementation matters a lot. Make sure you’re focused on the right things and your EMR selection and implementation will go 100 times better. In fact, it will even improve patient care if you want it to.

Will EMR Vendors Cut Through The Noise This Year?

Folks, as an editor covering this industry I’ve read more EMR vendor news, pored over more of their press releases and taken in more their advertising pitches than most. Despite that, I’ve seldom walked away with a clear sense of why that vendor was truly special.

While that’s never a good thing for any vendor, it’s a particularly bad problem in 2011, which, I predict, will make or break many smaller EMR developers. If it was hard to get buyers’ attention over the last two years — especially that of fearful physicians — it’s going to be a Herculean challenge this year. The noise level is higher than a pack of screaming fans at a Metallica concert.

I’m not suggesting that EMRs have become a commodity like John suggested was a possibility (the real problem is how diverse they are, in fact!) but I am saying that many are still doing a terrible job of setting themselves apart. Too much of the content churned out by EMR vendors makes appallingly broad generalizations or strings together a list of “me-too” features.

I do sympathize, tremendously, with the struggle health IT marketers go through in trying to sell such a complex product in a way which clearly communicates:

* Affordability
* Easy maintenance
* Easy-to-establish productivity
* Reliability

and in the case of selling to larger entities like hospitals:

* Interoperability
* Data integrity
* Intelligently designed infrastructure
* Scalability
* And much, much more!

Still, there’s no getting around the fact that they’ve got to get the job done. This year, if an EMR vendor seems like a me-too, they’ll be history in 18 months, tops. Like it or not, the time has come to put up (a clear message) or shut up.

What are the Benefits of EMR?

I’ve always loved the discussion on benefits of an EMR. There are a lot of interesting possibilities. It’s certainly a hard thing to measure since you’re often comparing apples and organes, but there’s certainly some interesting possible benefits. Looks like the video got most of my list of EMR benefits. Enjoy!

EMR Stimulus Concerns

I just read one of the best posts I’ve read in quite a while by Marc Holland, CEO of System Research Services about HI(TECH) Anxiety. One of the best parts of the post was a list he did of the concerns physicians and their staff have about the EMR stimulus:

I don’t have enough Medicare revenues to qualify
I don’t have enough of a Medicaid patient volume to qualify
I’m reluctant to shop, let alone buy, until I know what criteria I must meet for my usage to be considered “meaningful”
The vendors I have spoken with don’t offer a version suitable to my specialty; a general purpose EMR simply doesn’t meet my needs
I have no personal capability or interest in becoming my own IT department and I don’t have the luxury of staff with the necessary skills
I haven’t begun to shop and don’t know where to start
The software I have seen doesn’t match my needs; usability is a key concern
I’m concerned about sharing my patient information with competitors and with the government, how do I preserve the confidentiality of my patient information?
How do I obtain and manage patient permissions?
I need help; lots of help

These concerns really aren’t new. Plus, none of them are really all that significant. It’s just the learning curve that’s required to implement an EMR. Sadly, I think that far too much focus has been on shoving the EMR down people’s throats instead of educating them properly on EMR and the inherent benefits of those EMR.

The Advantages of EMR Systems

We’re always happy to welcome people interested in doing quality guest posts on this blog. So, when I got this in my email, I thought it was an important subject to cover on this blog. The following guest post looks at some of the advantages of an EMR system. This is a good start for those looking at an EMR system. I think there are a number of other advantages that aren’t listed below. I’d love to hear about other advantages of an EMR system in the comments.

The Advantages of EMR Systems

There’s talk of every public hospital in the USA being equipped with electronic medical record systems in a year or two; that’s how popular and necessary these information technology systems have become. And why not, considering the various advantages they hold. EMR systems:

Lower costs in the long term: While the initial cost may be high, over a period of time, the average cost of the system becomes much less than a similar manual system. When records are maintained electronically, there is less room for error. Security is also enhanced leading to patient confidentiality and privacy.
Eliminate repetitive and unnecessary testing: EMR systems help prevent repetitive testing and thus save both patients and hospitals a lot of money. They can be transferred via email to any hospital or medical practitioner in an instant thus avoiding the need for tests that have already been performed.
Provide accurate medical information: Information that’s stored in the electronic format is not prone to human error and can be retrieved easily at the touch of a button or the click of a mouse. Search and retrieval times are a fraction of what they would be in manual systems.
Allow information to be available anytime, anywhere: Doctors and other medical personnel can access medical records from anywhere using handheld devices like the iPhone and related software. This allows them to continue treatment no matter where they are and also to pass on information so that other physicians can also provide emergency care when needed.
Allow for streamlined information: The information is stored in such a way so that retrieval of select data based on certain criteria and filters can be accessed. Besides this, physicians can also use the system to prescribe medicines for their patients from pharmacies that are part of the program. This allows patients to get refills directly without having to go to the doctor or the pharmacist. EMR systems also allow physicians to order diagnostic tests and view the results online.

This article is written by Kat Sanders, who regularly blogs on the topic of phlebotomist school at her blog Health Zone Blog. She welcomes your comments and questions at her email address:katsanders25@gmail.com.

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Bill Gates Puts a New Spin on the Great EMR Debate

EMR A Disappointment In The US?

Study: EMRs Improve Ambulatory Care

Costs of Healthcare, Benefits of Healthcare IT and Health Tracking at #chs11

Does an EMR Improve Patient Care?

Will EMR Vendors Cut Through The Noise This Year?

What are the Benefits of EMR?

EMR Stimulus Concerns

The Advantages of EMR Systems

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