BEI HIT Blog
EMR & HIPAA
Most providers think their productivity will go down if they implement an EHR. Trouble is that most providers don’t really measure productivity and don’t think about how to improve it. Using an EMR is a great way to start because the measurement tools are available. If these tools are used properly, productivity measurement and improvement can be attained.
The most recent EMR adoption numbers I’ve seen are putting EMR adoption at about 60% of doctors. When I think about the other 40% of doctors that have yet to adopt an EMR, my guess is that the biggest reason they haven’t adopted an EMR is based on their fear that an EMR will negatively impact their practice and their productivity. They fear that a change to EMR is going to be negative rather than a positive that it could be.
A whitepaper called Getting Lean with Your Practice: Five Tips for Improving Provider Productivity with an EHR does a good job looking at the issues of productivity in a practice and how to improve that productivity. One thing it points out is that if you can’t measure it, then you don’t really know how you’re doing. Turns out, an EMR is a great way to measure productivity. Read More
EMR & HIPAA
BEI Commentary: The jury is out on email versus text, but it is important to think about what communications method is best to interact with patients. While we are not there from a HIPAA compliance standpoint, it is helpful to think about this now.
The idea of improving communication in healthcare is always a hot one. For fear of HIPAA and other factors, healthcare seems to lag behind when adopting the latest communication technologies. The most simple examples are email and text message. Both are simple and widely adopted communication technologies and most in healthcare are afraid to use them.
At the core of why people are afraid is because native email is not HIPAA secure and native SMS is not HIPAA secure either. Although, there are a whole suite of communication products that are working to solve the healthcare communication security challenges while still keeping the simplicity of an email or text message. In fact, both of the other companies I’ve started or advise, Physia and docBeat, are focused on the problems of secure email and secure text. Plus, there are dozens of other companies working to improve healthcare communication and hundreds of EMR, PHR, and HIE applications that are integrating these forms of communication into their systems. Read More
Life as a CIO Blog, March 13, 2013
BEI Commentary: Some of our practices use scribes to assist with clinical documentation. What is the best practice for using scribes? What about workflows? Credentials? Dr. John Halamka has a few good points to make about this in his blog.
Given the rigors of documentation required for Meaningful Use, quality measurement, and ICD10, some organizations are adding dedicated scribes to rounding and evaluation teams.
I was recently asked two questions about scribes.
Does Meaningful Use allow the use of scribes?
Meaningful Use does not specify who does the documentation, as long as the thresholds for data capture are exceeded. Read More
Annals of Internal Medicine, March 5, 2013
BEI Commentary: Part of the promise of EHRs is to improve healthcare over all in general, which includes population health. One clinical intervention that is known to be effective is the use of a colonoscopy to screen for colon cancer for adults aged 50 and over. In a recent, controlled study published by the Annals of Internal Medicine, colonoscopy screening rates improved from 26% to over 65% when EHRs were used to assist in the process of identifying and getting patients in for their procedures.
Background: Screening decreases colorectal cancer (CRC) incidence and mortality, yet almost half of age-eligible patients are not screened at recommended intervals.
Objective: To determine whether interventions using electronic health records (EHRs), automated mailings, and stepped increases in support improve CRC screening adherence over 2 years. Read More
Accenture Newsroom, March 4, 2013
BEI Commentary: A key to reforming healthcare is patient engagement and patient access to their own medical records. But there is a question of how much access a patient should have. Accenture published a survey that show the current state of physician opinions. What do you think?
A new Accenture (NYSE:ACN) survey shows that most U.S. doctors surveyed (82 percent) want patients to actively participate in their own healthcare by updating their electronic health records. However, only a third of physicians (31 percent) believe a patient should have full access to his or her own record, 65 percent believe patients should have limited access and 4 percent say they should have no access (See figure 1). These findings were consistent among 3,700 doctors surveyed by Accenture in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States. Read More
Healthcare Informatics, February 6, 2013
BEI Commentary: Consider enlisting your patients’ help in making sure their medical records are accurate. This has the side benefit of involving them further in their care, and showing them that you care!
Backed by a study from the Office for the National Coordinator of Health IT (ONC), researchers at the Danville, Pa.-based Geisinger Health System and the National Organization for Research at the University of Chicago (NORC) recently discovered that patients can help make the information in their EHR more accurate. These results were touted in a recent webinar from the National eHealth Collaborative (NeHC).
According to Prashila Dullabh, M.D., project lead at NORC, the researchers assessed the need for patient feedback in improving the quality of their EHRs through a pilot project at Geisinger. Users of the Geisinger patient portal, MyGeisinger, were encouraged to provide feedback on their medication list within their medical record prior to an office visit. Dullabh says 1500 patients received the feedback form, and approximately 30 percent responded to this offer to update. Read More
Healthcare IT News, October 25, 2012
BEI Commentary: CMS has announced the CQMs for 2014 – a change compared to what is being reported today.
The Centers for Medicare & Medicaid Services (CMS) has published the final 2014 clinical quality measures (CQMs) for eligible professionals and eligible hospitals seeking to attest for meaningful use.
Beginning in 2014, the reporting of clinical quality measures will change for all providers. Electronic health record (EHR) technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria. Read More
New York Times, September 25, 2012
BEI Commentary: Please make sure you are billing the correct amount – not too much and not too little.
The Obama administration has issued a strong and much-needed warning to hospitals and doctors about the fraudulent use of electronic medical records to illegally inflate their billings to Medicare. Attorney General Eric Holder Jr. and the health and human services secretary, Kathleen Sebelius, cited “troubling indications” that some providers are billing for services never provided and vowed to prosecute. They sent a letter to five major hospital trade associations on Monday, two days after an article in The Times described in detail how greater use of electronic records might be making it easier for hospitals and doctors to submit erroneous payment claims. Read more
New York Times, September 21, 2012
BEI Commentary: Please make sure you are not using your EHR to overbill. It looks like some hospitals, in search of additional revenue, are doing just that. I’m sure that CmS and payers will be looking for this in the data analytical tools that are coming online, and some people will have fines and fraud charges to deal with.
When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.
But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care. Read More
Fierce HealthIT, September 20, 2012
BEI Commentary: This is perhaps one of the most important items I have read about EHRs in the past few years. When searching for an EHR, we advise our clients that above all other things, select an EHR that is easy to use and easy to learn. The logic is rather simple: physicians, especially those seeing large volumes of patients, must be able to document encounters efficiently and effectively, regardless of whether they are using paper or an EHR. If the EHR is cumbersome to use – forget it. If EHRs were easy to rate in the usability category, then at least from our point of view, EHR selection would be pretty straightforward. However, there is no easy way to quantify usability, and there is no industry resource that provides this information. The Institute of Medicine is recommending that this all come to an end, and serious effort be devoted to rating usabililty. This is perhaps the most telling sentence in the report: “After a decade of development and experience, EHRs and other health IT products have not advanced sufficiently; nor have they been adopted widely and enthusiastically, in step with other consumer products such as smartphones and iPads.” Let’s hope that these ratings come out sooner, rather than later. Vendors will be forced to make their products more usable, which will be better for the physicians and patients alike.
The world of electronic health records needs to open itself up to critical comparisons and earnest user evaluation if it wants to avoid formal regulation by the Food and Drug Administration, according to a discussion paper released this month by the Institute of Medicine.
Not only is there nowhere for health IT users to share publicly their experiences with different products, but vendors often prohibit users from sharing screenshots or otherwise publicly discussing EHR problems, notes the paper, “Comparative User Experiences of Health IT Products: How User Experiences Would Be Reported and Used.” Read More