Guest Post: Diane Matthews, MHA, is a the CEO of Laser Logics and Suitemed Solutions.  Laser Logics focuses on providing comprehensive IT services to healthcare.  SuiteMed Solutions helps doctors looking for comprehensive EHR Solutions.

Rural healthcare providers seem to be facing more obsticles with the following issues regarding EHR: cost, functionality to cost, effective training, implementation, support, IT hardware backend.

Strengthening the rural areas with technology advances in healthcare increases positive healthcare outcomes and reduces associated costly risks attributable to chronic diseases. I have lived in rural farm country side nearly all my life and I see the struggles of these rural healthcare providers. But, I also see the impact of lack of healthcare to children and elderly persons who simply have no means to travel 90 miles round trip for a doctor’s appointment. This is a crisis!

If we do not empower our rural healthcare providers with usable beneficial technology that is cost advantageous, then combined with reduced healthcare reimbursements and higher out of pocket costs that most rural families simply cannot afford, we are going to be losing our rural healthcare providers simply because they can afford to keep the doors open.

Cost is a huge factor. But a good healthcare EHR consultant not only focuses on the EHR software itself it is showing healthcare providers a wealth of avenues that can be effectively leveraged together to bring those implementation costs significantly down. Depending upon the healthcare facility this could be Section 179, American Disabilities Act, Green Tax Incentives, Federal 340B programs – it isn’t just one stimulus program – it is leveraging them all collectively and effectively together to yield the most advantageous outcome for the rural healthcare provider.

Something else I am seeing is a lot of rural healthcare providers are going with brand well known names in commercial EHR.  However, once the check is written the interest and commitment to the rural healthcare providers dwindles to non-existent. Then, what has happened is money that couldn’t afford to be thrown away in essence has possibly leaving no room to try again.

Rural healthcare providers need to invest their research into not EHR vendors but EHR consultants who look at the bigger picture of the healthcare entity and the community at large with focus on their unique needs. Organize group on-site training to reduce costs. An outstanding EHR consultant is going to view this as an opportunity to bring cutting technology to the hands of those who might not otherwise have an opportunity to receive it. Done right, while the EHR consultant may not have a high profit margin, the payoff will be seen with positive referrals from happy rural health entities, development of long term professional relationships, and being a responsible source in narrowing the gap in rural America between technology and healthcare.

What specific challenges do rural healthcare providers face with EHR?

What proposed resolutions to these challenges can be had to reduce EHR barriers for the rural healthcare providers?

I was passing through my LinkedIn account and saw this message from @GrandRounds4ODs which seems to have come from his Twitter account:

Appoint a single point of contact for project/contract compliance. Keep the consultants + vendors honest!

This is some great advice. One point of contact can really help to cut through the lies…err…EMR sales mis communications.

I’ve been working really hard on an EMR book that focuses on EMR selection. My goal is to have it out in the next week or so before I head off to HIMSS. It’s really coming along quite well and I think it will be a valuable e-book for physicians selecting an EMR vendor.

As I was writing, one section that I don’t have as much experience with is the EMR contract negotiation. I’ve found a couple nice resources online, but I thought I’d reach out to all you smart readers to get some more feedback on EMR contract negotiation.

Here’s some questions about it to get you thinking:
What’s the best advice for negotiating an EMR contract?
Which items should you make sure are in an EMR contract?
How much negotiating room do you have in an EMR contract?
Is it worth finding an EMR consultant to help with the negotiations?

Ok, that should get you started. Let me hear your experiences and knowledge with the EMR contract.

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
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?