Today there is a need for practices to ready to accept EHR failures than just blaming the software. This is where the core issue of EHR implementation comes in which also includes adoting the right EHR selection process.
An large scale EHR implementation is surely a big challenge and it depends on certain factors which need to be dealt with in an appropriate way.
I believe the following are the most crucial factors in a large scale quality EHR implementation:
1. Use of the right tools & Services :
Each specialty EHR has its own set of challenges or requirements which I believe is overlooked by in most EHR vendors in a effort to merely follows federal guidelines. This is resulting in low usability to the practitioners, thus less ROI, finally redundancy of the EHR solution in place.
2. Looking at the profitability of the EHR investment
I think ROI is very important factor that should be duly considered when look achieve 'meaning use' out of a EHR solution. Though one may get vendors providing 'meaning use' at a lower cost, their ROI / savings through the use of their EHR might be pretty low when compared to costlier initial investment.
3.Having the right ( in terms of appropriate knowledge and experience) support function
Also the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners.
4. Creating the right infrastructure for implementation:
Looking at the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models. It can be one of the possible answers to the
’safe vendor challenge’ as discussed by many critics.
I suppose this EHR vendor partiality would exist only in the initial phase.
Later on the growing demands of medical practices will force the REC’s to look out for more competitive yet certified EMR vendors. I think here suitable modifications in the hitect act, to strengthen the REC’s yet make them give quality service or EHR implementation to the practices is one way to tackle this ’safe EHR vendor’ challenge.
Also regarding the pricing of EHR’s, there many customizable and easy to use roi tools developed by many ehr vendors, which give a fair approximation of the overall costs but very few of them cover the cost of implementing the specific needs of various specialty EHR’s.
Do you all agree with me?
19 August, 2010
Is EHR technology acting as a enabler ?
With all the focus around implementing EHRs and deriving meaningful use out of the systems, it's easy to lose sight of the overall common goal, which is all efforts should be to create a healthcare system that delivers better clinical outcomes and eliminates waste.
If we keep to that mindset, EHR adoption should spread more rapidly, especially if providers also look at the massive transformation in patient-centric terms.
It's a good reminder for health IT vendors, as well. Federal funding aside, the whole federal and industry movement is to improve care. While the meaningful use criteria should serve as a sort of checklist for product functionality, EHRs and EMRs should be intuitive for the clinicians in order to drive adoption. Workflow and ease of use are part and parcel to product functionality.
I feel technology can play a role. The recent trend of using EHR’s by clinics is a great win-win situation not only to EHR vendors but also to a much greater extent to the physicians and the patients.
What do you all think?
Source : Blog at EHRwatch
If we keep to that mindset, EHR adoption should spread more rapidly, especially if providers also look at the massive transformation in patient-centric terms.
It's a good reminder for health IT vendors, as well. Federal funding aside, the whole federal and industry movement is to improve care. While the meaningful use criteria should serve as a sort of checklist for product functionality, EHRs and EMRs should be intuitive for the clinicians in order to drive adoption. Workflow and ease of use are part and parcel to product functionality.
I feel technology can play a role. The recent trend of using EHR’s by clinics is a great win-win situation not only to EHR vendors but also to a much greater extent to the physicians and the patients.
What do you all think?
Source : Blog at EHRwatch
Can use of EHR reduce medical errors ?
Technology is not perfect but got to say that it is the result of human work so it is bound to have some kind of errors.
I understand that these errors are highly unacceptable especially when it to comes to dealing with patients but in the vast majority of computer-human interactions, it is the human who makes the mistake, and it is the programmer of the software and hardware, another human, who may have made the program hard to use or poor in validating consistency of data. As a result, the real problem and a hard one is one of designing human-computer interfaces that minimize the chances for human error. Far too often, this aspect of design is minimized with the results being a higher probability for mistakes than what could be achieved with a better design.
Studies to date of computer errors in clinical care have by and large identified the computer/human interface as the most frequent cause of error: transcription errors, misreading of displays, mis-navigation among screens, ignoring alerts, overriding warnings or alerts, failing to update reference and resource information. It is comforting to know that very few of these have led to harm because most of these are recognized as errors by trained clinicians before harm occurs. There is little data currently to suggest that we are just seeing the “tip of a gigantic iceberg.” Even the harshest critic of UK’s attempt to implement a nationwide EHR has been focused on the business plans, difficulties of implementation, and cost.
Some more about this would be discussed in the upcoming blog on steps necessary for successful nationwide EHR implementation.
Also read more about this on Healthcare IT world.
I understand that these errors are highly unacceptable especially when it to comes to dealing with patients but in the vast majority of computer-human interactions, it is the human who makes the mistake, and it is the programmer of the software and hardware, another human, who may have made the program hard to use or poor in validating consistency of data. As a result, the real problem and a hard one is one of designing human-computer interfaces that minimize the chances for human error. Far too often, this aspect of design is minimized with the results being a higher probability for mistakes than what could be achieved with a better design.
Studies to date of computer errors in clinical care have by and large identified the computer/human interface as the most frequent cause of error: transcription errors, misreading of displays, mis-navigation among screens, ignoring alerts, overriding warnings or alerts, failing to update reference and resource information. It is comforting to know that very few of these have led to harm because most of these are recognized as errors by trained clinicians before harm occurs. There is little data currently to suggest that we are just seeing the “tip of a gigantic iceberg.” Even the harshest critic of UK’s attempt to implement a nationwide EHR has been focused on the business plans, difficulties of implementation, and cost.
Some more about this would be discussed in the upcoming blog on steps necessary for successful nationwide EHR implementation.
Also read more about this on Healthcare IT world.
EHR market share analysis !!
Calculating market share for the electronic health record (EHR) market is no easy task. There are over 300 software vendors, many market segments (consider: size of practice served, specialties services, inpatient/outpatient) and very “fuzzy” sources of data.
There is a great analysis done by the software advice team. There seems to be a lot of logic in it. I also feel that some of the numbers on this might be a bit less if you start to consider the smaller and mid-size ehr vendors.
Each specialty EHR has its own set of challenges or requirements which I believe is overlooked by in most EHR vendors in a effort to merely follows federal guidelines. This is resulting in low usability to the practitioners, thus less ROI, finally redundancy of the EHR solution in place.
I think ROI is very important factor that should be duly considered when look achieve a 'meaning use' out of a EHR solution. Though one may get vendors providing 'meaning use' at a lower cost, their ROI / savings through the use of their EHR might be pretty low when compared to costlier initial investment.
Also the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners.
Looking the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models. It can be one of the possible answers to the
’safe vendor challenge’ as discussed by many critics.
These new acts and growing urgency for EHR evolving out of this federal push is bound to put the numbers on the higher side.
Do you all agree with me ?
Read more at software advice........
There is a great analysis done by the software advice team. There seems to be a lot of logic in it. I also feel that some of the numbers on this might be a bit less if you start to consider the smaller and mid-size ehr vendors.
Each specialty EHR has its own set of challenges or requirements which I believe is overlooked by in most EHR vendors in a effort to merely follows federal guidelines. This is resulting in low usability to the practitioners, thus less ROI, finally redundancy of the EHR solution in place.
I think ROI is very important factor that should be duly considered when look achieve a 'meaning use' out of a EHR solution. Though one may get vendors providing 'meaning use' at a lower cost, their ROI / savings through the use of their EHR might be pretty low when compared to costlier initial investment.
Also the introduction of REC’s through the HITECH act. is a great way to avail of quality EHR solutions at competitive prices. The stiff competition among not only these REC’s but also among EHR vendors ( to become a preferred vendor of a given REC) will result in lot of positives to medical practioners.
Looking the funding provided to the REC’s, the staggered grant allocation system also promises to be an unbiased way of allocating funds. It will also help in the concept of REC’s helping out each with their own unique business models. It can be one of the possible answers to the
’safe vendor challenge’ as discussed by many critics.
These new acts and growing urgency for EHR evolving out of this federal push is bound to put the numbers on the higher side.
Do you all agree with me ?
Read more at software advice........
An economical journey from paper to electronic prescription
Recent Trend
The rate of electronic prescribing in upstate New York increased from 12% in 2009 to 17% in the first quarter of this year, a new report by Excellus BlueCross BlueShield found, Healthcare IT News reports (Merrill, Healthcare IT News, 7/15). The report also concluded that the percentage of physicians across the U.S. who use the technology doubled from 2008 to 2009, the Rochester Democrat and Chronicle reports. So why is there this growing trend of digitalizing patient prescriptions?
The answer lies not only in the benefits offered by e-prescription (eRx) services but also in the monetary federal incentives available to the practices. The section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized a new and separate incentive program for eligible professionals (EPs) who were successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, was separate from and in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI). Eligible professionals do not need to participate in PQRI to participate in the Electronic Prescribing (eRx) Incentive Program, which was a great flexibility offered to practioners and it has resulted in the recent growing trend to turn electronic.
E-prescription Incentives
Inspite of this trend there are many practices which are either unaware of all the clauses behind this eRx based incentives or are a bit skeptical about this modern way of prescribing. As the target for complete eRx based healthcare vision of the federal government come closer, it is important for practioners to take complete advantage of these services and implement them in an appropriate way or else it could result in some penalties for the practioners. The following table gives an idea of this scenario.
2009 2010 2011 2012 2013 Beyond
Incentive 2% 2% 1% 1% 0.5% None
Penalty None None None 1% 1.5% 2%
For 2009, to be a “successful e-prescriber,” eligible professionals must report the e-prescribing quality measure through their Medicare Part B claims on at least 50 percent of applicable cases during the reporting year.
Standalone eRx systems Vs Fully integrated EHR system ?
Electronic Prescribing is the new and innovative approach to prescription delivery and authorization. The technology, which is based on 100% online electronic transmission, places the power at the doctor's fingertips, instantly delivering information from the practice to the pharmacist and vice versa. No more phone calls, no more faxes, physicians can now develop and transmit a prescription or refill request at the click of a button. To give you a brief description of the unique and mostly unaware features of eRx, would like point out to this blog by Mr. Jason Harwell.
I truly believe that the crucial point in successfully implementing these services will be the decision to implement either a standalone eRx system or use the features provided by your EHR software. A dedicated eRx system is exclusively devoted to e-prescribing. They typically include some demographic information about the patient to facilitate patient identification and systems integration, but do not incorporate the broad variety of clinical patient information typical of an EMR. Lacking full EMR capabilities, dedicated eRx systems are less expensive than EMR systems and simpler to implement in a clinical practice. Dedicated eRx systems typically provide a more comprehensive set of eRx capabilities than eRx embedded in EMR systems. For example, most dedicated systems are SureScripts Gold Certified for offering a wide range of e-prescribing capabilities, while few EMRs have such certification.
Today most offer the fundamental capabilities of creating and transmitting new prescriptions and efficiently handling refills. Although some may currently lack capabilities such as formulary access, eligibility, and prescription history from external sources, EMR systems offer the additional benefits of complete clinical information at the point of care, even if the prescriber is working away from the office.
As mentioned before the quality of EHR solution provided along with a suitable network capabilities plays an important role in the successful eRx implementation. I would suggest a practice to look at e-prescribing services as a stepping stone to large EHR implementation, especially looking at the financial benefits one can earn.
The rate of electronic prescribing in upstate New York increased from 12% in 2009 to 17% in the first quarter of this year, a new report by Excellus BlueCross BlueShield found, Healthcare IT News reports (Merrill, Healthcare IT News, 7/15). The report also concluded that the percentage of physicians across the U.S. who use the technology doubled from 2008 to 2009, the Rochester Democrat and Chronicle reports. So why is there this growing trend of digitalizing patient prescriptions?
The answer lies not only in the benefits offered by e-prescription (eRx) services but also in the monetary federal incentives available to the practices. The section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorized a new and separate incentive program for eligible professionals (EPs) who were successful electronic prescribers as defined by MIPPA. This new incentive program, which began on January 1, 2009, was separate from and in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI). Eligible professionals do not need to participate in PQRI to participate in the Electronic Prescribing (eRx) Incentive Program, which was a great flexibility offered to practioners and it has resulted in the recent growing trend to turn electronic.
E-prescription Incentives
Inspite of this trend there are many practices which are either unaware of all the clauses behind this eRx based incentives or are a bit skeptical about this modern way of prescribing. As the target for complete eRx based healthcare vision of the federal government come closer, it is important for practioners to take complete advantage of these services and implement them in an appropriate way or else it could result in some penalties for the practioners. The following table gives an idea of this scenario.
2009 2010 2011 2012 2013 Beyond
Incentive 2% 2% 1% 1% 0.5% None
Penalty None None None 1% 1.5% 2%
For 2009, to be a “successful e-prescriber,” eligible professionals must report the e-prescribing quality measure through their Medicare Part B claims on at least 50 percent of applicable cases during the reporting year.
Standalone eRx systems Vs Fully integrated EHR system ?
Electronic Prescribing is the new and innovative approach to prescription delivery and authorization. The technology, which is based on 100% online electronic transmission, places the power at the doctor's fingertips, instantly delivering information from the practice to the pharmacist and vice versa. No more phone calls, no more faxes, physicians can now develop and transmit a prescription or refill request at the click of a button. To give you a brief description of the unique and mostly unaware features of eRx, would like point out to this blog by Mr. Jason Harwell.
I truly believe that the crucial point in successfully implementing these services will be the decision to implement either a standalone eRx system or use the features provided by your EHR software. A dedicated eRx system is exclusively devoted to e-prescribing. They typically include some demographic information about the patient to facilitate patient identification and systems integration, but do not incorporate the broad variety of clinical patient information typical of an EMR. Lacking full EMR capabilities, dedicated eRx systems are less expensive than EMR systems and simpler to implement in a clinical practice. Dedicated eRx systems typically provide a more comprehensive set of eRx capabilities than eRx embedded in EMR systems. For example, most dedicated systems are SureScripts Gold Certified for offering a wide range of e-prescribing capabilities, while few EMRs have such certification.
Today most offer the fundamental capabilities of creating and transmitting new prescriptions and efficiently handling refills. Although some may currently lack capabilities such as formulary access, eligibility, and prescription history from external sources, EMR systems offer the additional benefits of complete clinical information at the point of care, even if the prescriber is working away from the office.
As mentioned before the quality of EHR solution provided along with a suitable network capabilities plays an important role in the successful eRx implementation. I would suggest a practice to look at e-prescribing services as a stepping stone to large EHR implementation, especially looking at the financial benefits one can earn.
18 August, 2010
Waiting Room Solutions launches ARRA EHR Incentives Blog for discussion channels and news updates
Waiting Room Solutions has launched an ARRA Electronic Health Records (EHR) Incentives Blog to provide room for discussion and to offer information regarding the ARRA incentives that are impacting the EHR community. This blog’s main objective is to update medical professionals and all others affected by these incentives with the latest news and announcements relating to the incentive programs, such as the final meaningful use rules released by the U.S. Department of Health and Human Services on July 13 designating how health care providers can demonstrate "meaningful use" of Electronic Health Records (EHR) to qualify for Medicare and Medicaid incentive payments under the 2009 federal stimulus package.
New REC blog created by Waiting Room Solutions to provide information and facilitate discussion.
Waiting Room Solutions has launched a new blog focusing on the Health Information Technology Regional Extension Centers (RECs) that have become a relevant new addition to the healthcare industry. With the newly released final rule on meaningful use on July 13, Regional extension centers are offering guidance, technical assistance and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of Electronic Health Records (EHRs). The blog provides background information on the process of creating and funding these RECs, as well as an explanation of their purpose and how they will increase the spread of health information technology. In addition to educating visitors, The REC blog will also provide an opportunity for readers to express comments or questions they may have regarding the REC program. This portion of the blog allows providers to benefit from the exchange of knowledge, ideas, and shared concerns with their peers.
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