Ehr incentives

More Electronic Health Records Funding

With basic health IT now near-ubiquitous across healthcare, Health and Human Services Secretary Sylvia Mathews Burwell has announced substantial new funding meant to help practices put that technology to work delivering value-based care.

The $840 million Transforming Clinical Practice Initiative will roll out over the next four years in support of some 150,000 clinicians nationwide. HHS sees the incentive as a way to help these physicians to team with their peers in a trend away from fee-for-service and toward value-based, patient-centered care.

Successful applicants – group practices, healthcare systems, and medical provider associations – will show progress toward measurable goals: improving clinical outcomes, reducing unnecessary testing, achieving cost savings and avoiding unnecessary hospitalizations.

Among the strategies meant to drive those changes, according to HHS: Using electronic health records on a daily basis to examine data on quality and efficiency; expanding the number of ways patients are able communicate with their care teams; improving the coordination of patient care by primary care providers, specialists and the broader medical community. “The administration is partnering with clinicians to find better ways to deliver care, pay providers and distribute information to improve the quality of care we receive and spend our nation’s dollars more wisely,” said Secretary Burwell, in a press statement. “We all have a stake in achieving these goals and delivering for patients, providers and taxpayers alike.”

Building upon federal initiatives such as the Quality Improvement Organization Program, Partnership for Patients with Hospital Engagement Networks and accountable care organizations, this project will provide opportunities for participating clinicians to collaborate and disseminate information, according to HHS. Through a “multi-pronged approach to technical assistance,” it hopes to identify existing care delivery models that work – and quickly spur other providers to adopt them.

“This model will support and build partnerships with doctors and other clinicians across the country to provide better care to their patients,” said Patrick Conway, MD, chief medical officer at the Centers for Medicare & Medicare Services, in a press statement.

These support and alignment networks would create an infrastructure to help identify evidence-based practices and policies and disseminate them nationwide, in a scalable, sustainable approach to improved care delivery.

By participating in the initiative, practices will be able to receive the technical assistance and peer-level support they need to deliver care in a patient-centric and efficient manner, officials say, which is increasingly being demanded by payers and purchasers as part of a transformed care delivery system.

If your practice is interested in finding out more on how you can qualify for government incentives to change your office to electronic health records give us a call today at 866-203-3260.


Electronic Health Records Twitter Feeds?

It won’t be long before every patient has a Twitter feed, and doctors subscribe to them for real-time updates.

This is a time when the demands of being a physician are changing, and we need to leverage technology to maintain awareness of a huge number of patients. There is also increasing need for handoffs and communication between providers.

Here’s the bottom line: how can we improve technology when doctors seem so resistant?

Current system is inefficient

The EMR has become essential for documentation, billing, medical reasoning, and communication, among other things. Currently, documentation is built on a system of daily progress notes. If  weconsult a cardiologist about a case, he needs to go through each note, containing narratives, laboratory values, vital signs, and physical exams.

Here’s how a Twitter-based EMR would work:

All clinical data, events, notes, and annotations are included in a single live feed. This stream will serve as the centerpiece of all functions, with a few carefully designed filters.

With this conceptual framework, there are several natural improvements on the existing EMR.

  • The Clinical Awareness view: By watching the raw live feed, you are immediately aware when your patient’s CT scan is complete or laboratory values are available.
  • The Patient Timeline view: By looking at a patient’s feed, you can learn about the entire course of illness. It’s much faster that flipping through pages of notes that may have been copied forward.
  • Progress Note Generation: Doctors and nurses need only focus on documenting in the Twitter feed. Progress notes are automatically produced from all the interval data.
  • Conversation view: different specialists can have a discourse about a difficult case, and it’s built into the EMR. This is the meaning of patient-centered care.

In medicine we spend a tremendous amount of time and money on antiquated software that acts like a digital version of a paper chart. We can learn a few lessons from the innovators in social media about how to manage large amounts of data.


More Clinicians Seek Mobile Access to EHRs

A new survey commissioned by EHR technology consultancy Software Advice in collaboration with digital data collection company, Research Now, suggests an ever growing demand for clinicians to be able to access patient data on mobile devices. The survey, which is on-going, has already logged 400 respondents from small (3 or fewer doctors) to large (11 or more doctors) ambulatory practices. While much of what the doctors are reporting will come as no surprise to those who follow EHR trends and usage, we did want to make note of, and comment on what I think is one of the more noteworthy findings–the kinds of devices doctors are using to access their electronic health records.

Survey respondents were asked to select all channels of electronic health record access. Many docs selected more than one channel which explains why the sum of the percentages reported totals more than 100 percent.

While the desktop computer is not surprisingly still the dominant means for accessing EHR systems, one third of respondents say they are using a tablet to access patient information and 20 percent are using their smartphone. A deeper dive into the data shows that about 17 percent of respondents say they exclusively use portable or mobile devices such as laptops, tablets, or smartphones to access their systems.

So why are these figures so intriguing? Because they really amplify information that has been coming from IT leaders and clinicians. The high demand for both mobile and desktop access also explains so many orders are being placed for tablet computers by hospitals and clinics. Tablets can easily replace laptops and desktops. They have the power, larger screen real estate and resolution to run any EHR–from the most contemporary cloud and touch friendly versions of modern EHR apps, to the full legacy software solutions found in most of today’s enterprise clinics and hospitals. These devices are helping Doctors be more productive without getting in the way of patient care.

As you can see the health world is rapidly changing. New devices are coming along every day to help with the daily tasks that nurses and clinicians have to deal with. Electronic Health Records are important for every practice to change over to. If you want to learn more about how you can qualify for government assistance to help with the changeover, give EHR Funding a call today at 866-203-3260.

use of ehrs by state

Electronic Health Record adoption in the US

Less than a decade ago, nine out of 10 U.S. doctors updated their patients’ records by hand and stored them in color-coded files. Today, nearly half of all office-based physicians type their clinical notes into computers and maintain electronic files that include patients’ demographic information, complaints, procedures, test results and prescribed drugs.

This greater use of electronic health records is supposed to help doctors and hospitals better coordinate their patients’ care and allow them to meet the cost-containment goals in the Affordable Care Act. Nationwide, 48 percent of office-based doctors used electronic records in 2013, up from 40 percent in 2012 and 11 percent in 2006.

While the doctors and hospitals in some states are forging ahead, in other states they are lagging behind. In North Dakota, 83 percent of physicians have made the switch to electronic records, according to a recent survey by the Centers for Disease Control and Prevention. Minnesota ranked second, at 76 percent, followed by Massachusetts at 70 percent.

But in Maryland, Oklahoma, Vermont, West Virginia and Wyoming, the adoption rate is only 37 percent. Nevada’s rate is 33 percent, and in Washington, D.C. it is 31 percent. Connecticut and New Jersey fare even worse, at 30 percent and 21 percent, respectively.

It’s not clear why there are such disparities among states, though researchers do know a few things about the kinds of doctors who are mostly likely to embrace electronic records.

According to a 2013 report by the Government Accountability Office (GAO), primary care doctors are nearly twice as likely to adopt electronic health records as specialists. Physicians who work alone are less likely to adopt electronic records than those in group practices, and younger doctors are more likely to embrace the change than older ones. Rural and urban doctors are equally apt to use electronic records. And of all health care professionals, dentists have the lowest adoption rate, at less than 1 percent.

Despite recent progress, the U.S. as a whole still lags behind other developing countries in adopting electronic records, according to a survey by The Commonwealth Fund, a health research group.

Ultimately, the Obama administration wants all U.S. doctors and hospitals to share electronic health records.

“Meaningful Use”

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the 2009 economic stimulus package, the federal government set aside up to $30 billion to help doctors and hospitals make the transition to electronic records. Under the law, office-based health care professionals can receive up to $44,000 in Medicare grants, in five yearly installments; and $63,750 in Medicaid grants, in six yearly installments. In addition, hospitals are eligible for millions of dollars under both health care programs if they develop and maintain electronic health records. The GAO estimates $15 billion in incentive payments went to individual health care professionals and hospitals in the first two years of the program.

In the first year of the Medicaid incentive program, doctors simply needed to agree to “adopt, implement or upgrade” a federally certified health records system. But in the second year, 2012, they had to demonstrate so-called “meaningful use” of their systems.

That meant doctors who wanted to continue receiving grants had to show that they were, in fact, using their electronic records and sharing them with other providers to improve the quality of patient care. They also had to share the information with patients to help them better manage their own care.

In addition to promoting greater use of electronic records, the administration credits the HITECH law with creating a robust market for health IT products: There are now 941 vendors offering more than 1,700 federally-certified electronic health records products. According to the Bureau of Labor Statistics, more than 50,000 health IT-related jobs have been created since the law was enacted.

If you or your office is interested in how you can qualify for the EHR incentive program Give EHR Funding a call today at 866-203-3260


Why Patients Prefer Electronic Health Records

Think about the last time you scheduled a doctor appointment. If you’re like most people with health insurance, the process probably involved picking up the phone.

Not necessarily the case with patients of Lakewood physician David Lieuwen, MD, a family medicine practitioner with Kaiser Permanente.

Dr. Lieuwen’s patients have the option of booking appointments with him through Kaiser Permanente’s Web site. They also can use Kaiser Permanente’s online tool, My Health Manager, to access personal health records, send him secure e-mails and order prescription refills.

Policymakers these days talk a lot about digitizing health information. The American Recovery and Reinvestment Act of 2009, signed in February by President Obama (at the Denver Museum of Nature and Science), includes $20 billion to help fund the effort.

While Capitol Hill debates the Ps and Qs of health reform, Dr. Lieuwen’s patients and other Jefferson County customers of Kaiser Permanente already experience some of what’s in store. “Patients really like it,” Dr. Lieuwen says about Kaiser Permanente’s electronic health record. “You can show them what’s going on with their labs. You can pull up notes from past visits. You can do a lot of things in real time.”

Hard to argue 
In an age of online banking and ordering dinner by way of iPhone, it’s hard to argue the logic of moving health information into the digital age. Clearly there’s a timesaving and convenience factor. This year in Colorado alone, Kaiser Permanente members will use My Health Manager to send more than 300,000 e-mails to their doctors and view roughly 1 million lab tests.

Dr. Lieuwen estimates he gets an average of five e-mails per day from patients. Sometimes they ask him about symptoms. Sometimes they want his thoughts on a particular treatment option they’ve read about. “If e-mail is not appropriate, I’ll either call them or ask a nurse to look into what’s going on,” Dr. Lieuwen says.

Beyond using Kaisers electronic health record to interact with patients, Dr. Lieuwen uses it to ask opinions of colleagues and track charts of patients he refers to specialists. “I’m not sure of anyone who wouldn’t like to work with a system like this,” he says.

Employer advantage
There’s an advantage here for employers, as well. Studies show health care premiums are less than 50 percent of the total cost of providing health care for employees. In fact, lost productivity due to health conditions and concerns is a much more significant expense.

So if an employee can access her latest lab tests online to confirm the diabetes is in check — rather than worry and wait for a follow up doctor visit — everyone wins.

“It’s not about technology in and of itself,” says Associate Medical Director Mike Chase, MD. “Ultimately it’s about applying the technology to improve patient care. What we’re learning is information now is care, particularly in chronic diseases.”

If you are a practice that is yearning to learn more about Electronic Health Records and how you can receive government funding to implement them. Give HER Funding a call at 866-203-3260 today.

EHR Funding

Use of Patient Portals Takes Hold in Family Practices

“By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems.”

That conclusion was reached by 11 medical researchers whose new report on the success of patient portals – a critical feature of the meaningful use program – was published in the “Annals of Family Medicine.”

The team, led by Alex Krist, M.D., a faculty member at the Fairfax Family Medicine Center in Virginia, found after a three-year study ending in 2013 that practices that pursued thoughtful, pro-active strategies to get patients to use the portal achieved a patient use rate of 25.6%, with the rate increasing 1% a month over 31 months.

Other findings included:

  • That 23.5% of portal users signed up within one day of their office visit
  • Older patients and patients with two or more chronic conditions were more likely to use portals
  • Blacks and Hispanics were less likely to use portals
  • Usage by practice varied from 22.1% to 27.9% depending on how effectively the practices promoted the portals

Eight primary care practices in Virginia participated in the study, with each using a series of learning collaboratives with practice “champions” and redesigning workflow patterns to integrate use of portals in patient care, according to the study abstract.

All used an Allscripts EHR system and two separate patient portal systems, a commercial portal that that only provided secure patient messaging, and one plugging into EHR data.

The noticeable point the researchers discovered was that small and medium-sized primary care practices can engage patients to use portals by incorporating promotion into routine care.

“This approach appears to be more effective than mailing invitations and to match the results of more elaborate promotion efforts by large integrated health systems,” the report says.

If you are a small to medium sized practice who is looking to receive assistance from the government and upgrade to Electronic Health Records then give EHR Funding a call today at 866-203-3260


A Prototype of EHR Effectiveness

Los Angeles County’s Department of Health Services is installing a new countywide electronic health record system that officials say could end up being a model for other health care organizations across the country.

L.A. DHS Faces Unique Challenges

Los Angeles DHS is the second largest public health system in the U.S. and serves nearly 10 million residents, according to the report. Robert Bart, CMIO of the department, said DHS includes four traditional hospital-based facilities — Harbor-UCLA Medical Center, Los Angeles County-University of Southern California Medical Center, Olive View-UCLA Medical Center and Ranchos Los Amigos National Rehabilitation Center — as well as several offsite clinics.

Data from DHS’ EHR system operating in six primary facilities cannot be shared with other providers.

“The simple task of transporting a patient from a DHS hospital to another hospital can be highly inefficient and cumbersome,” the report noted. “Paper medical records are photocopied while transport ambulances may sit idling” and, “in some instances, the receiving hospital may not have complete medical information about an incoming patient because all the paper records may not have been forwarded,” the report added.

This “silo effect” will be eliminated with the implementation of a countywide EHR system, according to the report.

Fixing a Fragmented System

DHS began work on its EHR system — called the Online Real-time Centralized Health Information Database, or ORCHID — in May 2013. The system is being created by Cerner.

By launching a “uniform, standardized and fully integrated” countywide EHR system, the agency aims to:

  • Comply with requirements to attest to the meaningful use program;
  • Improve patient safety and care quality;
  • Make DHS more competitive in the health care industry;
  • Replace the county’s “fragmented and obsolete” health record system; and
  • Support outpatient care restructuring as part of health care reform.

The new EHR system also will include a master patient index, with unique identifiers for each patient, according to the report.

“The movement to an EHR system is important to DHS for reasons that go beyond the usual factors as to why modern medical groups are adopting EHRs, having one system will bring us together as a single integrated system,” DHS Director Mitchell Katz said.

The new EHR system will be “a single source of truth so that we can have a single medical record for each person that receives health care at DHS,” Bart said. “It will be a huge improvement in patient safety and we hope also in … employee satisfaction and patient satisfaction.”

Making Progress

So far, the first two steps of the design and building of ORCHID — a system review and system validation — have been completed. Cerner now is adding hardware, software and infrastructure to support the system. Unit system integration and user acceptance testing are expected to begin soon and wide-scale training of staff was slated to begin last month. Bart said “a large number of … physicians, nurses, therapists, admission registration staff and other stakeholders have been involved in the building and designing of the solution.”

He said  the “go-live” dates for EHR implementation will be ongoing, with about one launch date every three months — beginning Nov. 1 with Harbor-UCLA Medical Center and a few of the comprehensive health clinics. The department already has begun initial training for staff at Harbor-UCLA and has gotten “encouraging” feedback, Bart added.

The county Sheriff’s Department, Probation Department and the Department of Mental Health also offer patient care and have separate EHR systems. “Currently, these departments have limited ability to share each other’s patient information electronically,” according to the report.

Bart said DHS is “working on a health information exchange to connect these medical records so that there can be appropriate movement of health information so that we can deliver care in a more effective and efficient way.”

A Model for Others

Bart said the department’s new health IT efforts are essential to keeping the county up to date in care delivery methods. “For DHS to be able to transform care delivery and transform the reimbursement for care delivery, we need to move on to this type of modern platform in order to stay current and in order to support the changes that the Affordable Care Act is asking of health care delivery in the U.S.,” he said.

Bart hopes the county’s EHR implementation project “will be a model not just for California, but also for other county, city or state government health care delivery organizations.”

“We want to be able to set an example that being able to have a modern technology infrastructure to support health care and leveraging that — both at the individual level and the level of the population we care for — will result in improved quality of care, improved efficiency of care … and improved efficiency for those who are delivering care,” Bart said.



How Electronic Health Records Give Seniors More Control

Managing senior care programs can provide unique challenges to health care professionals, as elder clients are more likely to have a greater number of concerns than their younger counterparts. As the likelihood of developing many illnesses and requiring a variety of medications increases with age, the task of coordinating care also becomes more difficult. Encouraging electronic health records is one technique that may prove useful to geriatric care managers and others working with senior clients.

Using traditional paper records, staying on top of older adults’ medical needs can present many problems. Records kept by one doctor may not find their way to another if seniors don’t keep track of their health providers, and there is plenty of information that may never make it into the record at all. Seniors using family caregiving could have incomplete records if they don’t supplement that care with doctor’s visits, while the daily minutiae of elders’ health complaints and solutions to minor issues are unlikely to make it into writing at all.

Securing records 
Electronic health records can help solve these problems by centralizing and automating many aspects of record-keeping. Storing information electronically can help keep records more secure and more thorough, according to Senior Housing News. Records stored on modern cloud-based platforms may be more up to the task of complying with HIPAA regulations than those kept in older networks, since new systems offer more security options. For instance, two computers or two wireless access points using the same infrastructure could have different restrictions on who can use them or what data they make available. That makes it harder for any unauthorized person to access the information without putting up barriers between the data and authorized users.

Power in users’ hands 
Another major benefit that electronic records can provide is the ability to capture data with limited input from users. With traditional records, it’s mostly up to health care providers to ensure that information is entered accurately. Few clients keep precise track of their own health when they’re responsible for writing down every medication they take and every change that they go through in nutrition or fitness. Electronic records can put a lot more power into the hands of people receiving care by allowing easy or automatic data capture.

The newest generation of health tracking software could go a step further, not only taking the burden of data collection from doctors, but removing it from people almost entirely. At a recent press conference, Apple announced its new product offerings, one of which came out of a partnership with the Mayo Clinic, the Star Tribune reported. The two organizations collaborated on an application called Health that may represent the easiest way yet for people to monitor their own health. Building on existing platforms that can track information such as exercise levels and calorie intake, often based on user input, Health allows for more robust data collection with less effort needed from users. The app could take measurements such as heart rate and body temperature and use changes in these metrics to determine – or even predict – when a user may be in danger of a health emergency or a less urgent change.

EHR Funding

Electronic Health Record Adoption Up Significantly

Substantial increases in the use of Electronic Health Records (EHRs) among the nation’s physicians and hospitals are detailed in two new studies published earlier by the HHS Office of the National Coordinator for Health Information Technology (ONC).

The studies, published in the journal Health Affairs, found that in 2013, almost eight in ten (78 percent) of office-based physicians reported they adopted an EHR system. About half of all physicians (48 percent) had an EHR system with advanced functionalities in 2013; a doubling of the adoption rate from 2009. About six in ten (59 percent) of hospitals had adopted an EHR system with certain advanced functionalities in 2013; quadruple the percentage for 2010.

“Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of Electronic Health Records,” said Karen DeSalvo, M.D., M.P.H., national coordinator for health information technology. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.”

The information in the studies was collected by the Centers for Disease Control and Prevention’s National Center for Health Statistics and the American Hospital Association in 2013.

The case for Electronic Health Records cannot be understated. Electronic Health Records (EHRs) are the first step to transformed health care. The benefits of electronic health records include:

  • Better health care by improving all aspects of patient care, including safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity.
  • Better health by encouraging healthier lifestyles in the entire population, including increased physical activity, better nutrition, avoidance of behavioral risks, and wider use of preventative care.
  • Improved efficiencies and lower health care costs by promoting preventative medicine and improved coordination of health care services, as well as by reducing waste and redundant tests.
  • Better clinical decision making by integrating patient information from multiple sources.

Don’t be left out in the cold with your paper records. Let EHR Funding help you qualify for funding from the government to start the process of converting your office to Electronic Health Records. Call today at 866-203-3260

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Paper Records VS EHR’S