19 August, 2010

Challenges against large scale EHR implementation ?

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?

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

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.

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........

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.

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.

Waiting Room Solutions offers information and discussion through recently launched PQRI blog

Waiting Room Solutions has launched a blog that focuses on the Physician Quality Reporting Initiative (PQRI) program, which was established in 2006 as a result of the Tax Relief and Health Care Act (TRHCA). This multi-sections WRS blog features an overview of PQRI, including details regarding the changes made to the program over the past few years. The blog also lists many of the different measures used to satisfy the program requirements, and gives a step by step process for using an EHR system to facilitate PQRI qualification. Lastly, the blog contains pages with PQRI national provider caller information as well as the answers to frequently asked questions. On each of these informative pages there is also a section for visitors to submit questions and comments to Waiting Room Solutions or to their peers.

Walnut Grove Family Health Center to Streamline Practice’s Workflow with Waiting Room Solutions Family Care EHR and Practice Management System

Walnut Grove Family Health Center has an office located in Midlothian, TX, and is also associated with the Methodist Charlton Hospital in Dallas, TX. There are two practice physicians, Charlie Ruby, DOPA DBA, and Gayle Ponder, MD, and the practice also employees a family nurse practitioner and two physician assistants. Walnut Grove Family Health Center aims to provide quality medical care to its patients from their birth through childhood, adolescence, adulthood and the older years of their lives. Some of the many services offered by the practice include physical examinations and school physicals, women’s wellness from gynecology to menopause, diabetes management, newborn care and immunizations, pediatric, adolescent and geriatric medicine, and osteopathic manipulative therapy. Walnut Grove Family Health Center has chosen the Waiting Room Solutions Family Care Electronic Health Record (EHR) and Practice Management System (PM) for its family healthcare practice. The Waiting Room Solutions Family Care EHR and PM is specifically designed to maximize the efficiency of a family care practice. The system provides specialty templates for history of present illness, review of systems, drug prescription, and more.

Suncoast Advanced Surgery PLLC to Streamline Practice’s Activities and Records with Waiting Room Solutions General Surgery EHR and PM

Suncoast Advanced Surgery PLLC is a General Surgery practice located in Spring Hill, FL. The office has one office location as well as associations with Brooksville Regional Hospital and Spring Hill Regional Hospital. The sole physician of the practice is Dr. Nitin Babel, MD, who specializes in general surgery with a subspecialty in gastrointestinal surgical oncology. It has chosen the Waiting Room Solutions General Surgery Electronic Health Record (EHR) and Practice Management System (PM) for its General Surgery practice.

Dr. J Paul Mahfood selects Waiting Room Solutions to streamline its healthcare process

J Paul Mahfood, M.D., M.S., is a Rheumatology specialist board certified by the American Board of Internal Medicine. Dr. Mahfood specialized in diagnosing and treating arthritis, back pain, muscle strains, common athletic injuries, etc and in treating diseases of the joints, muscles, bones, and tendons. With an unparalleled passion and commitment to insure the very best healthcare for his patients and his unrelenting attention to clinical excellence and patient safety, Dr. Mahfood recently started his solo practice. It became very important to Dr. Mahfood, as a solo physician, to find the best EMR system that could help him efficiently manage and protect critical medical information for his patients. Dr. Mahfood has chosen Waiting Room Solutions web-based Rheumatology Electronic Medical Record and Practice Management System to streamline office workflow and improve patient clinical experience upon his friend's recommendation.

Worthalter, M.D., P.A. selects Waiting Room Solutions Psychiatry Electronic Medical Record

Peysaf W. Worthalter, M.D., P.A is a Psychiatry practice that has operated in Miami, FL for over twenty years. Dr. Worthalter is the founder and sole physician of the practice, In addition to his office location, Dr. Worthalter is also associated with Aventura Hospital, Atlantic Shores Hospital, Ft. Lauderdale Hospital and Grand Court Lakes Retirement Community. Peysaf W. Worthalter, M.D., P.A. hopes to use the Waiting Room Solutions Psychiatry & Behavioral Health EMR system to better streamline billing, credentialing, scheduling, and charting functions. The practice’s network and IT objectives include improving inhouse data entry, which is currently limited by paper charting methods, and increasing website use.

Advanced Allergy Associates select Waiting Room Solutions Allergy and Immunology EMR and PM

Advanced Allergy Associates and Advanced Surgical Associates has been in operation for fifteen years. Dr. Cheryl Williams, M.D., F.A.A.P. is the co-founder of the practice. The practice has two office locations, one in New Orleans, LA and one in Opelousas, LA, and it is also associated with Opelousas General Hospital. Dr. Williams specializes in pediatric and adult allergy and immunology diagnosing and treating allergies relating to food, trees, animals and other irritants. It has chosen the Waiting Room Solutions Allergy and Immunology Electronic Medical Record (EMR) and Practice Management System (PM) for implementation in order to take advantage of the software’s specialized features and ability to integrate the EMR and billing functions.

Physician’s Choice Wellness, LLC selects Waiting Room Solutions Web-based Bariatric Medicine EMR

Physician’s Choice Wellness, LLC is a family medicine practice that specializes in weight loss management and obesity treatment. It has a dedicated and trained healthcare team that uses a comprehensive, medically-managed weight control approach to improve patients' quality of life. Previously, Physician’s Choice Wellness, LLC used paper charting to record its patient health records. The difficulty and inefficiency to access, track, and manage patients' medical information between its main office and satellite clinics in 3 cities had motivated Physician’s Choice Wellness to go paperless. It has chosen Waiting Room Solutions affordable web-based, Bariatric Medicine EMR and PM to build a comprehensive electronic repository with integrated patient information that can be shared between its headquarters and satellite clinics.

Coppin State University Community Health Center selects Waiting Room Solutions Web-based University Health Centers EMR

The Coppin State University Community Health Center, founded in 1994 by the former Dean of the School of Nursing, Dr. Doris Starks, is a non-profit, nurse-managed, community-based primary care clinic that provides care to students at Coppin State University and the underserved and uninsured residents of the Coppin Heights community. The facility is operated by the Helene Fuld School of Nursing (HFSON). The Center provides readily accessible, low cost, high quality care; such as health screenings, health clearances, general internal medicine, health education, laboratory, radiology, and EKGs. It has chosen Waiting Room Solutions as its University Health Centers EMR system . The Waiting Room Solutions application will allow the University Health Center to provide care with a cost-effective and customized system for maintaining and accessing patient medical information.

East Alabama Ear, Nose and Throat, P.C. selects Waiting Room Solutions Web-Based Otolaryngology EMR

East Alabama Ear, Nose and Throat, P.C. has been in business since 1994. The practice offers a wide array of patient care services within its offices. Previously, the practice used paper charts and other Otolaryngology EMR / ENT EMR specialty solutions to manage its office workflow. Dr. William Blythe, President of East Alabama Ear, Nose and Throat, P.C., had been considering switching to an integrated and powerful Otolaryngology EMR / ENT EMR solution. After comparing across multiple EMR systems, he chose WRS Otolaryngology EMR/ ENT EMR Software (http://www.waitingroomsolutions.com/wrs/ENT.html) to enhance the patient encounter experience and maximize the return on investment for East Alabama Ear, Nose and Throat, P.C.

Dr. Huh selects Waiting Room Solutions Web-Based Gastroenterology EHR and Practice Management System

Dr. Huh is a Board Certified, Internal Medicine, Gastroenterology and Hepatology specialist at Gastroenterology Consultants of Northern Virginia. The practice has been in business for 6 years, and has been using paper charts to record patient's individual medical history, insurance information, and office visit documentation. In addition, Dr. Huh also sees patients in Fair Oaks Hospital/Chantilly Outpatient Department. Dr. Huh had been seeking an opportunity to join the digital revolution with a paperless Gastroenterology specialty EHR. After evaluating several EMR systems, Dr. Huh has decided that Waiting Room Solutions user-friendly, feature rich and affordable Gastroenterology EHR (http://www.waitingroomsolutions.com/wrs/Specialty_gastroenterology.html) is the perfect investment for his practice. When he was asked about the main clinical objectives for using this application , Dr. Huh answered “The main clinical objectives is to reduce time spent on charting and to be able to improve the process of faxing notes to referring physicians.”

26 May, 2010

Catherine Arvantely, MD chooses Waiting Room Solutions Electronic Health Record and Practice Management System to Automate Her Women’s Health Practice.

CATHERINE ARVANTELY, MD, located in Newport Beach, California, has chosen the web-based WAITING ROOM SOLUTIONS Practice Management System Version 3.0, a CCHIT Certified® 2006 Ambulatory Electronic Health Record (EHR), for her Women’s Health practice.

Dr. Arvantely’s practice focuses on women’s health and she provides consultation on preventive healthcare, natural medicine, nutrition, and wellness. She provides specialized services for women including hormone replacement therapy.   The specialized Women’s Health EHR (http://www.waitingroomsolutions.com/specialty/Specialty_womens-health.html)  features in Waiting Room Solutions include gynecologic visit templates, incontinence templates, nutritional consultations, infertility templates, Colposcopy procedure templates and other women’s health workflow efficiencies.

25 May, 2010

Women's Health EHR and Practice Management Solutions



Waiting Room Solutions offers award-winning eletronic medical record (EHR) and practice management solutions designed to help Women's Health practices enhance efficiently, profitability, and patient care:
  • ACOG Antepartum Forms with Digital Pen
  • Digital Pen Solutions for Obstetrics and Gynecology
  • ERx (electronic prescriptions) and Medication Management
  • Lab and Pathology Interface with Quest, Labcorp, and many others.
  • Initial Obstetrics and Gynecology Templates and Comprehensive Clinical Content for Quick Charting
  • Obstetrics and Gynecology CPT Codes and ICD-9 Crosswalks
  • Order Tracking System
  • Patient Portal
  • PQRI Medicare Incentive
  • Ultrasound Report and Image Interface
  • Standardized Obstetrics and Gynecology Procedure Notes


12 May, 2010

*Press Release

Waiting Room Solutions Announces Surescripts Solution Provider Certification for its Web-Based EHR and Practice Management System v 4.0

WRS web-based EHR and Practice Management System v4.0 system provides speed, accuracy, security and reliability for the transmission of electronic prescription information through Surescripts, the Nation’s E-Prescription Network. As a Surescripts Solution Provider, WRS commits to protect data confidentiality through its connection to Surescripts.


Application Modules

27 April, 2010

Michael Trueworthy, CNP of South Portland, Maine, is streamlining his practice with a leading edge, web-based technology


Michael Trueworthy, CNP of South Portland, Maine, is streamlining his practice with a leading edge, web-based technology. Waiting Room Solutions (WRS), the leading Internet-based EMR and PMS provider, announced that Michael Trueworthy CNP has chosen Waiting Room Solutions as his practice management and electronic medical record solution. Michael Trueworthy, CNP will be using WRS to automate his thriving psychopharmacology practice located at 837 Broadway South Portland, Maine.


19 April, 2010

Martin Children’s Clinic is a new clinic that provides pediatric health care services to children, including well, sick, young female visits and mental health management.

Martin Children’s Clinic selects the Waiting Room Solutions Web-based Pediatrics Electronic Health Record (EHR) and Practice Management System (PMS) to Improve Quality of Patient Care and to Enhance Information Exchange

Martin Children’s Clinic has selected Waiting Room Solutions Web-based Pediatric Electronic Health Record (EHR) and Practice Management System (PMS) to bring its patient care services into digital age, enhancing the operational efficiencies, and improving financial outcomes for their organization.

Pediatrics: Web Based EMR and Practice Management System Completely Customized for a Pediatrics Practice. 


06 April, 2010

Waiting Room Solutions' web-based Urgent Care EHR to provide a kiosk for self- service registration

Pace Clinic Selects Waiting Room Solutions Urgent Care Electronic Health Record (EHR) and Practice Management System to speed Treatment

Pace Clinic, an Urgent Care Center in Springville, Utah, selected the Waiting Room Solutions' Electronic Health Record and Practice Management System to help optimize its workflow. Waiting Room Solutions Practice Management System, Version 3, is a CCHIT Certified® 2006 Ambulatory EHR and a leading web-based Urgent Care Electronic Health Record system