BEI HIT Blog
NY Times, January 12, 2014
BEI Commentary: Scribes have entered the scene in clinics and operating rooms, liberating physicians from the constant note-taking that modern electronic health records systems demand.
Amid the controlled chaos that defines an average afternoon in an urban emergency department, Dr. Marian Bednar, an emergency room physician in Dallas, entered the exam room of an older woman who had fallen while walking her dog. Like any doctor, she asked questions, conducted an exam and gave a diagnosis — in this case, a fractured hand — while also doing something many physicians in today’s computerized world are no longer free to do: She gave the patient her full attention.
Standing a few feet away, tapping quickly and quietly at a laptop computer cradled in the crook of her left arm, was Amanda Nieto, 27, Dr. Bednar’s scribe and constant shadow. While Ms. Nieto updated the patient’s electronic chart, Dr. Bednar spoke to the woman, losing eye contact only to focus on the injured hand. Read More
EMR & EHR, January 6, 2014
BEI Commentary: One of the purposes of an EHR is to provide better data at the point of care so that providers can make more informed clinical decisions. Clearly that is the case here where a hospital has materially reduced its mortality rate due to sepsis.
Two years ago, New York City’s Mount Sinai Hospital was struggling to catch cases of sepsis early enough to save lives. Since then, the hospital has almost halved the number of sepsis deaths taking place there thanks to use of its EMR, according to a piece in the Canadian Medical Association Journal.
Attacking sepsis deaths is critical for hospitals worldwide, which have been fighting what has been described as a losing battle against the condition. According to the CMAJ, hospitalizations for sepsis have more than doubled over the last 10 years, and an estimated 1/3 to 1/2 of those patients die as a result of the condition. Read More
Modern Healthcare, December 10, 2013
BEI Commentary: Cutting and pasting in patient records can be dangerous. This article summarizes the issues and discusses how the federal government is cracking down on the practice and associated fraud.
Federal officials say the cut-and-paste features common to electronic health records invite fraudulent use of duplicated clinical notes and that there is a need to clamp down on the emerging threat. That concern is enhanced by the fact that it’s too easy to turn off features of EHR systems that allow tracking of sloppy or fraudulent records.
In an audit report released Tuesday morning (PDF), HHS agencies confirmed that they are developing comprehensive plans to deter fraud and abuse involving EHRs, including guidelines for cut-and-paste features. The issue arises at a time when critics say federally subsidized digital patient record systems are sometimes being used inappropriately by providers to drive up reimbursement.
“Certain EHR documentation features, if poorly designed or used inappropriately, can result in poor data quality or fraud,” according a report from HHS’ Office of the Inspector General. Read More
Physicians Practice, 10/23/13
BEI Commentary: An interesting point in this article: although quality is often discussed, value is the real metric of the future. You will need to be able to show proof of “value provide” through analytics from your EHR.
A new wave of change is occurring in healthcare: a seismic shift from volume-based payment to value-based payment. To succeed in adapting, your challenge is to catch the “right wave.” The wave you want to catch is not quality. That wave has crested. Value is the wave that successful medical practices will ride in the next decade. My challenge is to share tips from the experts to help you find the right wave. I’ll also offer advice on timing, for, as with body surfing, mistiming your approach means you miss the wave. Read More
Fierce Mobile Healthcare, October 7, 2013
BEI Commentary: We are just starting to scratch the surface of electronic provider – patient communications. Here is a good example of how text messaging can be put to use.
The Centers for Medicare & Medicaid Services has awarded a three-year contract to support the implementation of text4baby, the nation’s largest and only free mobile health service for expecting and new moms, in four still-to-be-determined states.
According to the announcement, CMS is currently working with text4baby founding partners Voxiva and the National Healthy Mothers, Healthy Babies Coalition to determine the target states for this pilot project. Read more
iHealthBeat, August 23, 2013
BEI Commentry: There are many things to consider when negotiating EHR contracts, even things that might not be related to technology. Here is a story about who gets access to patient data when a physician leaves a practice. It also has a link to best practices when negotiating an EHR contract, published by ONC.
A Canadian physician who left a medical group to start her own practice was not able to maintain access to 1,500 patient electronic health records, one example of the challenges of negotiating EHR vendor contracts, EHR Intelligence reports.
Dianne Smith left her position at the Didsbury Medical Clinic to begin her own practice, hoping to take patients with her. However, she was denied access to their records by Didsbury’s owner and its EHR vendor. Read More
Healthcare Informatics, July 23, 2013
BEI Commentary: Payment Patient Portals are becoming ever more important ways of communicating, and they are required for stage 2. Reach the second half of this article to see how Parrish Medical Center is rated #1 in this area.
It seems that while everyone in healthcare is talking about patient engagement, many are struggling to come up with strategies to achieve it.
Stage 2 of the Meaningful Use electronic health records (EHR) incentive program requires 5 percent of patients to log into and upload data via a portal or personal health record for providers to earn incentive payments from the program. And last year, the National eHealth Collaborative and the Office of the National Coordinator for Health Information Technology (ONC) created the Patient Engagement Framework, which was vetted by over 150 healthcare stakeholders, and is meant to help providers understand how to start and continuously improve a patient engagement initiative. According to the lead authors of the framework, a properly implemented patient engagement strategy should transform the way a health system delivers care. Read More
AAFP, July 3, 2013
BEI Commentary: The good news here is that physician adoption of EHR and Meaningful Use continues to grow. The bad news is that some physicians did not attest in 2012 after having successfully done so in 2011. This is rather perplexing as the workflows are the same and should not require any additional effort on the part of the practice. We know of a practice that fell into this trap simply because the practice manager forgot to attest. It cost the practice over $60,000. Please remember that Meaningful Use is a process, not a one-time event. Make sure to run your Meaningful Use measures on a regular basis and make sure you are meeting and exceeding the thresholds. And remember to attest!
As U.S. physicians continue to embrace electronic health records (EHRs), data on CMS’ EHR incentive program holds both positive and troubling news regarding family physicians’ participation and success in achieving meaningful use of their EHRs.
According to CMS’ recently published EHR meaningful use attestation data(healthdata.gov), 23,636 family physicians became first-time meaningful users in 2012. The number represents a 180 percent increase compared to 2011 EHR statistics. Read More
iHealthBeat, June 24, 2013
BEI Commentary: This goes in the category of “what will they think of next!”. Really fascinating article about how pill use can be tracked electronically and data fed into an EHR or a smartphone.
Next year, some family physicians likely will be using ingestible digital pills to keep track of patient’s health, the New York Times’ “Bits” reports (Bilton, “Bits”, New York Times, 6/23).
Such pills feature an embedded microchip to transmit patient data to health care providers. Last month, FDA said that it is easing federal oversight of the pills. Read More
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