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Challenges and Forces Driving the Adoption of EHR/EMR
| Author: Michael D. Paquin, FHIMSS |
| Article Date: 2/1/2008 |
In this first of many segments on Electronic Healthcare records, being sponsored by Physicians Office Resource, we will look at the challenges and forces that are impacting Physicians today. As you begin to enter the technology market place of an Electronic Healthcare Record (EHR) there will be many things that you will want to consider. Some of your choices will have very positive impacts and benefits and some of your choices can and will impact your future negatively if not thought out carefully. In this issue, as well as issues to come, we will give you the tools to make your EHR choice a positive improvement to your practice.
First, let's start with the terminology that you will encounter as you move forward that will help you with your journey. These terms will help you to better understand the various products, what they can do and how you make the most of them in your practice.
Terminology:
EMR vs. PHR vs. EHR
EMR- Electronic Medical Record The EMR is provider centric, it is the patientŐs record of care; they are owned, managed and controlled by the provider. It is the legal document of care.
PHR - Personal Healthcare Record The PHR is patient-centric, the record is owned, managed and controlled by the individual, the patient.
EHR - Electronic Healthcare Record The EHR is the aggregate record, it is the electronic record which spans time and distance. The EHR spans multiple providers, institutions and delivered care.
PMS- Practice Management System This is the business management
Software system that manages billing, scheduling, insurance, accounts receivable, and payable.
Worth noting:
CMR - Computerized Medical Record
PM - Practice Management
EPR - Electronic Patient Record
CCR - Continuum of Care Record
Integrated - Two disparate systems using one data base- Example: Most often written by the same organization, an EMR and a PM system both using one data base. These systems are easier to maintain.
Interfaced - Two systems using separate data bases. Example: A PM system by one vendor and an EMR by another vendor. Both integrated and interfaced work depending on the level of commitment and support by both vendors. It is usually best that the two organizations be non-competing.
LHIO - Local Health Information Network
RHIO - Regional Health Information Network
NHIO - National Health Information Network
HIMSS - Health Information Management Systems Society
The organization that is most supportive of IT in health care, a great resource of information. www.HIMSS.org
CCHIT - Certification Commission for Healthcare Information Technology IT Is a recognized certification body (RCB) for electronic health records and their networks, and an independent, voluntary, private-sector initiative. Their mission is to accelerate the adoption of health information technology by creating an efficient, credible and sustainable certification program. The commission certifies EHR systems. www.cchit.org
So now that we have the terminology down lets see what is driving the adoption of the EHR. There are many drivers pushing the EHR. In the last 5 years every politician has taken up the charge of mandating the use of digital records. President George Bush has even discussed Electronic medical records in his State Of The Union Address, suggesting that every American have a PHR by 2014. To date, there have been no laws passed mandating the use of an EHR.
P4P or Pay for Performance measures have been promoted as a solution to help physicians pay for an EHR, however reviewing documentation has been contradictory at best. The biggest issue has been how much can be paid to a physician to support best practices, so that it is enough to really help. Can a 2% bonus be enough? So far the jury is out.
It is this writerŐs opinion that each of us know that an EHR, EMR is a business tool that all practices must have. The tools and information that an EHR will provide us with are numerous. One of the advantages is increased reimbursement. Physicians tend to under bill, an EMR will on the average increase reimbursement 10-15%. Other advantages include elimination of paper, elimination of record storage space both at the office and off site, elimination of chart pulls and the constant problem of finding the chart, dictation costs and the ability to stay up to-date with medications, and contra-indications. In short, better Patient care and better quality of life for the physician.
We could have probably led with these two positive qualities of an EMR; however, most of us tend to put little value on the intangible until it is too late. It is at this point that I reflect on a presentation given by Bill Crounse, M.D. of Microsoft, where he shows a video interview with a Pharmacist telling a story. The video has us watching a pharmacist telling how he inadvertently filled a prescription for a very young girl that was incorrectly read by him from a poorly written prescription. The pharmacist is devastated and in tears. We can all point fingers at each other but it is not importantÉ there is a better way!
An EHR will allow you to log on to your PC at home enabling you to review a patient record before calling in a prescription re-fill. And yes, the EHR can automatically send the prescription with a mouse click to the patientŐs pharmacy of choice without you ever leaving your home. All of which is just one of the benefits of your EMR.
The EMR just makes sense! We can go on line for our banking, use our ATM card to see our balance, buy groceries, and fuel for our cars, 65% of us purchase over the internet. The medical profession is behind almost every other business and or service provider doing business today.
IN THE NEXT ISSUE:
Discussion on the various EMR's in the marketplace and how they rank in an industry survey. We will look at important topics such as price, implementation and other features and benefits of EMR's and how they affect your office.
First, let's start with the terminology that you will encounter as you move forward that will help you with your journey. These terms will help you to better understand the various products, what they can do and how you make the most of them in your practice.
Terminology:
EMR vs. PHR vs. EHR
EMR- Electronic Medical Record The EMR is provider centric, it is the patientŐs record of care; they are owned, managed and controlled by the provider. It is the legal document of care.
PHR - Personal Healthcare Record The PHR is patient-centric, the record is owned, managed and controlled by the individual, the patient.
EHR - Electronic Healthcare Record The EHR is the aggregate record, it is the electronic record which spans time and distance. The EHR spans multiple providers, institutions and delivered care.
PMS- Practice Management System This is the business management
Software system that manages billing, scheduling, insurance, accounts receivable, and payable.
Worth noting:
CMR - Computerized Medical Record
PM - Practice Management
EPR - Electronic Patient Record
CCR - Continuum of Care Record
Integrated - Two disparate systems using one data base- Example: Most often written by the same organization, an EMR and a PM system both using one data base. These systems are easier to maintain.
Interfaced - Two systems using separate data bases. Example: A PM system by one vendor and an EMR by another vendor. Both integrated and interfaced work depending on the level of commitment and support by both vendors. It is usually best that the two organizations be non-competing.
LHIO - Local Health Information Network
RHIO - Regional Health Information Network
NHIO - National Health Information Network
HIMSS - Health Information Management Systems Society
The organization that is most supportive of IT in health care, a great resource of information. www.HIMSS.org
CCHIT - Certification Commission for Healthcare Information Technology IT Is a recognized certification body (RCB) for electronic health records and their networks, and an independent, voluntary, private-sector initiative. Their mission is to accelerate the adoption of health information technology by creating an efficient, credible and sustainable certification program. The commission certifies EHR systems. www.cchit.org
So now that we have the terminology down lets see what is driving the adoption of the EHR. There are many drivers pushing the EHR. In the last 5 years every politician has taken up the charge of mandating the use of digital records. President George Bush has even discussed Electronic medical records in his State Of The Union Address, suggesting that every American have a PHR by 2014. To date, there have been no laws passed mandating the use of an EHR.
P4P or Pay for Performance measures have been promoted as a solution to help physicians pay for an EHR, however reviewing documentation has been contradictory at best. The biggest issue has been how much can be paid to a physician to support best practices, so that it is enough to really help. Can a 2% bonus be enough? So far the jury is out.
It is this writerŐs opinion that each of us know that an EHR, EMR is a business tool that all practices must have. The tools and information that an EHR will provide us with are numerous. One of the advantages is increased reimbursement. Physicians tend to under bill, an EMR will on the average increase reimbursement 10-15%. Other advantages include elimination of paper, elimination of record storage space both at the office and off site, elimination of chart pulls and the constant problem of finding the chart, dictation costs and the ability to stay up to-date with medications, and contra-indications. In short, better Patient care and better quality of life for the physician.
We could have probably led with these two positive qualities of an EMR; however, most of us tend to put little value on the intangible until it is too late. It is at this point that I reflect on a presentation given by Bill Crounse, M.D. of Microsoft, where he shows a video interview with a Pharmacist telling a story. The video has us watching a pharmacist telling how he inadvertently filled a prescription for a very young girl that was incorrectly read by him from a poorly written prescription. The pharmacist is devastated and in tears. We can all point fingers at each other but it is not importantÉ there is a better way!
An EHR will allow you to log on to your PC at home enabling you to review a patient record before calling in a prescription re-fill. And yes, the EHR can automatically send the prescription with a mouse click to the patientŐs pharmacy of choice without you ever leaving your home. All of which is just one of the benefits of your EMR.
The EMR just makes sense! We can go on line for our banking, use our ATM card to see our balance, buy groceries, and fuel for our cars, 65% of us purchase over the internet. The medical profession is behind almost every other business and or service provider doing business today.
IN THE NEXT ISSUE:
Discussion on the various EMR's in the marketplace and how they rank in an industry survey. We will look at important topics such as price, implementation and other features and benefits of EMR's and how they affect your office.