South Florida Hospital News
Monday December 17, 2018
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February 2006 - Volume 2 - Issue 8

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The Era of EMRs

Look around you and you’ll find that our society is moving into the computer age. Computers influence our lives in many ways. Therefore, it is no surprise that there is pressure by the government, payers, and even in some ways by patients to move towards practicing medicine that is guided and supported by computers. This move is focused on the introduction of electronic health records (EHRs). Two years ago, President Bush called for the widespread adoption of interoperable electronic health records (EHRs) in the next 10 years as part of an effort to transform our healthcare system. It is based on a growing consensus that the creation of electronic health record systems (EHRS) will help reduce medical errors, increase the quality of care, and bring greater efficiency to the clinical, administrative, and financial side of healthcare. EHRS are at the heart of health information systems. The term EHR describes all of the health information that exists about one person in many facilities, including potentially several family practitioners, clinics and hospitals, and a wide range of medical specialists as well as medication histories at pharmacies, a health history at a wellness institution, and the personal health record a patient may keep in the future. In contrast to this widely distributed information is the electronic medical record (EMR), which is the interoperable health information collection kept at one of these providers, e.g. at a hospital enterprise or a physician’s office. In short, the EMR is the patient information kept electronically at a clinic, nursing home, hospital, or other provider. The sum of these EMRs is the EHR.

For decades, people have been promoting the implementation of (EMRs). The idea is convincing: If we can have detailed records on buildings, cars, machines, household devices, etc., surely we can have comprehensive and detailed health records of our bodies. Yet it continues to be acceptable that anyone at any age who needs healthcare has no comprehensive record of previous diagnoses, including allergies and genetic dispositions, of healthcare services provided, or of medications used. It is common to have only skimpy provider-specific, often specialty-specific medical notes (sometimes scribbled on paper and partly illegible), and even these are not coordinated or complete when you look at hospitals, specialists, or other care providers. Naturally, this leads to negative results. In many cases, health professionals have to act blindly without any background data on the patient, tests have to be repeated, and other practitioners often do not know an individual’s previously identified conditions and allergies.

Small, Medium, and Large Practices Show The Way

It is interesting that physicians are increasingly moving to EMRs for their offices. In the past, it was difficult to identify the return on investment. This has changed. The Medical Records Institute is conducting a number of EMR Road Show™ seminars in Florida to help physicians and others familiarize themselves with the pros and cons of EHRs so that they understand their benefits as well as hurdles and pitfalls. In connection with the Voice of the Physician™ program it offers an assessment kit that helps defining a strategy for deciding whether the time is right for implementing an EMR. Its components are (1) determining why a practice should move to an EMR and what it wants to achieve, (2) deciding how to select a vendor, (3) making the implementation as painless as possible, (4) establishing the results and benefits, and (5) considering next steps for improving your system.

Is the Time Right For You?

Too often we are accustomed to the organizational pain within our practices. The Medical Records Institute has found that EMRs are being purchased for very different reasons. The top four reasons are a decrease in or elimination of transcription costs, the creation of continuity of care, an increase in charge capture, and the decrease or elimination of chart filing costs. However, other reasons such as increased revenues, decreased administrative costs (for instance from eliminating many phone calls and faxes), the improved quality of care, and improved quality of life rank high on the list. It is unrealistic to achieve all 18 or more measurable benefits equally and immediately. Priorities must be made and systems need to be selected accordingly.

Which System?

The Medical Records Institute has over 300 EMR vendors on its database. Each offers different features and approaches. Further, the price for software ranges from a few hundred dollars per physician to more than $30,000 per physician. And there is no "generally accepted" vendor. Many companies are small and focus on special features. Starting with the "wrong" system can cause major problems later. The fact that many vendors do not have their system adapted to the needs of each specialty makes the selection process even more difficult. Therefore, it is essential to attend relevant conferences where one can compare. The key features for EMRs fall into the following categories:

  • Rx writing
  • Rx reporting
  • Referrals
  • Practice messaging
  • Charge capture
  • Order management
  • Results reporting and tracking
  • Document management and scanning
  • Clinical documentation and information capture
  • Health maintenance reminders
  • E&M coding and compliance
  • Charge capture and coding review
  • Remote chart access
  • Population/disease management
  • Reference information (patient education, formularies, etc.)
Continuity of Care

After savings in transcription costs, the creation of continuity of care is the top desire of many practices. Numerous vendors have integrated the Continuity of Care Record (CCR), a widely accepted national standard on an interoperable dataset that provides all essential patient status information from allergies, insurance information, medication lists to other providers’ contact information. Many providers find that this alone is worth moving to an EMR.

Medical Records Institute offers the EMR Road ShowTM on February 22, 2006 in Tampa, February 24, 2006 in Orlando, March 2, 2006 in Miami, and March 3, 2006 in West Palm Beach. Each event starts by noon, offers lunch and educational sessions as well as up to a dozen exhibits.

Also, it is worth considering attending TEPR 2006, May 20-24 in Baltimore, MD, the only conference with over 150 EMR vendors exhibiting and public comparisons of systems. For more information on either event, visit www.medrecinst.com or call (617) 964 3923.

C. Peter Waegemann is CEO, Medical Records Institute.
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