Electronic Medical Record Use On The Rise With Doctors

Posted by AMS at 25 JAN 7:05 am

Three recent surveys showed that the adoption of electronic health record systems amongst U.S. physicians and hospitals is increasing.

A survey by the Centers for Disease Control and Prevention’s National Center for Health Statistics found that the number of primary care physicians who have started using EHRs has increased from 19.8 in 2008 to 29.6 in 2010, a 49 percent jump.

The survey also showed that 41 percent of office-based physicians are planning to achieve the so-called “meaningful use” of EHRs, which would qualify them for government incentive payments. An American Hospital Association survey found that 81 percent of acute care non-federal hospitals hope to meet all meaningful use requirements to apply for the incentives, and 65 percent of hospitals plan to do so in the next two years.

The incentives were part of Health Information Technology for Economic and Clinical Health Act, which was part of 2009′s Stimulus bill. It stipulated that healthcare providers can receive up to $44,000 through Medicare or as much as $63,750 through Medicaid if they implement and prove meaningful use of an EHR system. Under both Medicare and Medicaid, hospitals are eligible for millions of dollars if they complete the EHR programs’ requirements.

In a letter to the American public, National Coordinator for Health Information Dr. David Blumenthal touted the results of both surveys.

“At [the Office of the National Coordinator for Health Information Technology] we are gratified that such sizable percentages of physicians and hospitals intend to take the plunge’ and to take the plunge sooner rather than later,” he wrote.

A survey of about 3,000 physicians by Thomson Reuters and HCPlexus, which makes management products for physicians, indicated that most physicians do not feel negative about the impact of EHRs on patient care. While only 39 percent of the survey’s respondents saw a positive impact of the Health IT systems, a smaller 24 percent saw a negative impact.

The survey, which was conducted via fax machine, also found that doctors are pessimistic about the healthcare reform law, with 65 percent saying it will cause healthcare to “deteriorate” and 74 percent saying it will result in reimbursement becoming “less fair” over the next five years.

Source: http://www.medcitynews.com

Point of Care EMR Reduce Errors in Health Care Facilities

Posted by AMS at 18 JAN 6:51 am

The treatment of patients has over the years suffered from mistakes in paperwork like nurse scheduling, medication delivery, and difficulties accessing patient records. Human error form the paper records of old was routinely at a high level, to the detriment of those who depended on them. Hospitals realized that cost-efficiency could be improved the more they integrate electronic systems and they computerized patient care. These are available through mobile laptop carts at the point of care.

We live in a time when information technology is advancing exponentially, making product prices lower and more available. Since the 1990s computers have gotten progressively smaller while their memory capabilities grew to be astronomical. The IT revolution took a while to reach North American hospitals but then flourished as they realized that costs could be cut dramatically with the help of computers to keep track of patient care records that were previously compiled on paper and kept in huge filing cabinets. Medical staff would often make mistakes when deciphering the handwriting of doctors, notoriously famous for poor penmanship.

Those records are now known as EMR which stands for Electronic Medical Records. The concept is to have updated information available at the point of care. In 2004 there was growing pressure from the public for all health care facilities to recognize electronic systems such as computerized physician order entry (CPOE). This was largely because not all patients receive their treatment in large hospitals; the smaller budgets of clinics and long-term facilities meant that the old method was still widespread, and still subject to greater human error that could result in the deaths of elderly family members. Reducing errors was often secondary to investing money in new equipment and systems, at least in some countries.

Most extensive surveys are carried out in the U.S. due to its enormous population, about ten times larger than Canada. The two countries can’t be compared on the same ratio in matters of medical care due to opposing attitudes concerning health versus profit. Canadian health care facilities find less resistance when procuring something of benefit to humans whereas the American government prefers the business model of supply and demand. A survey conducted in 2003 by MercuryMD Inc. indicated that bedside data entry done electronically reduced the workload of health care residents by three hours per week, this leaving more time for direct patient interaction. Using mobile computing integrated with bar code scanning, delivery of medication, and charting vital signs automatically would maximize available work time. The EMR systems are accessed from mobile laptop carts, wall mounted kiosks, or wall-mounted panel pc units.

In typical daily usage, a nurse would go to the bedside pushing a computer cart and begins to collect vital signs with a monitoring device. The data is seamlessly entered into the EMR. The mobile cart also has a bar code scanner to capture the patient’s ID and medication label, also bearing a bar code. The records appear on the screen; if the green light flashes the nurse has the go-ahead to deliver the medication. If there are any mistakes like incorrect dosage, wrong prescription, etc. the computer will alert the nurse, who can then identify and correct the problem with no written notes, no transcription, and no guesswork.

The ultimate cost of these systems in the U.S. is reflected in the bills sent to the patient of course since health care costs are borne by the public or the insurance companies they must pay to have medical coverage. The economy is stimulated this way since the private insurance companies now have a free hand to scoop it out of the pockets of the citizens who are now required by law under the Obama administration to obtain health insurance or else pay a fine. This was the ultimate result of the year-long debate over Health Care that should have resulted in a universal health care public option. Even if it had however, the resulting system would be two-tier, one health care system for the higher income patients and one for the people without insurance or money. Canada and many countries found out that socialized universal health care did not lead to disaster; just the opposite – doctors have a wider variety of patients with conditions that can add to knowledge and experimentation with cures. Health care facilities no longer have to turn a profit or spend excessive amounts of effort to collect money for their services.

Jan 13, 2011 | Author: Pat Boardman

Source: http://www.articlism.com/computers/software

Cell Phone EMR Can Save Lives in Emergency

Posted by AMS at 11 JAN 8:29 am

A software application called “Med Records To Go”, that stores electronic medical records, can help reduce errors in emergency conditions, as well as in hospital or medical clinic admissions. *A new feature of this application includes placement of medical records on Android, iPhone, and Java-enabled cell phones. The cell phone applications are readily available from the iPhone App Store and Android Market. For Java-enabled cell phones, the cell phone application is available from Vital Record Corporation.

A software application called “Med Records To Go”, that stores electronic medical records, can help reduce errors in emergency conditions, as well as in hospital or medical clinic admissions. *A new feature of this application includes placement of medical records on Android, iPhone, and Java-enabled cell phones. The cell phone applications are readily available from the iPhone App Store and Android Market. For Java-enabled cell phones, the cell phone application is available from Vital Record Corporation.

Med Records to Go uses flash drive technology to record and store personal health information for emergency viewing by medical personnel and for electronic transmission to medical facilities using Health Level 7 (HL7) standards. A new function of the application includes the transmission of the personal medical records from the storage unit to cell phones.

All software, controls, transmission features, and personal medical records of Med Records to Go are contained in the portable storage unit. To place personal medical records on a cell phone, the encrypted medical data recorded in the storage unit is first sent to the Vital Record Corporation server. User identification and password controls are used with the cell phone application to retrieve the medical records from the server for storage on the phone. The process to place an optional digital picture on the cell phone is performed in similar manner as the medical records.

The supported cell phone models include Android, iPhone, and all Java-enabled phones. The categories of medical information are easily viewed and updated on Android and iPhone using touch screen buttons. For Java-enabled phones, medical information is viewed using simple key pad selection.

The types of personal medical information that can be viewed on the cell phone include identification and general medical data, vital signs information, physicians, prescription and non-prescription drugs, medical history, treatments, emergency contacts, and DNR orders. This information is categorized for easy selection and viewing.

The cell phone applications are available free from the iPhone App Store and Android Market and Vital Record Corporation.

Source: San Diego, CA (PRWEB) January 10, 2011

A New Year’s Resolution for Adopting Electronic Health Records

Posted by AMS at 4 JAN 6:00 am

I’m looking forward to 2011, which among other steps in a healthy direction will deliver incentives for doctors and other medical care providers to adopt electronic health records (EHR). The push for better health IT (HIT) is long overdue.

A few months ago I had the opportunity to hear Dr. David Blumenthal, National Coordinator for HIT in the U.S. Department of Health & Human Services, give a talk on this topic. In a semi-Socratic style, he addressed an audience of medical students, faculty and administrators:

“What do patients think if you ask them what’s the value of an EHR?” he asked. “No more clipboards,” he informed us.

Indeed, as a patient I think it would be fantastic to skip all that endless, redundant paperwork. Whenever I visit a new doctor, or go to the physical therapist after an interval of more than a few months, I am asked to fill out new forms about my medical history, medications, allergies, gynecological and surgical history, cancer pathology and more. It’s hard to imagine it wouldn’t be easier — and more accurate — if the details were maintained in a private health record, much like encrypted bank account information.

Should I need another procedure, future-doc might scan a summary of my history, double-click, and focus on a clot I had in 1974 after spinal surgery. Right away, she might review extensive blood tests done in 2003 to assess a possible genetic tendency for thrombosis. Or she might just pull up the pathology reports, and maybe even see digital images (imagine that!) of the breast adenocarcinoma. Or look over a CT scan from 2008 … You get the idea.

The problem is that many doctors are reluctant to take on electronic systems. Prior to the Health Information Technology for Economic and Clinical Health Act (or HITECH Act) of 2009, only a small fraction of physicians used fully-functional EHRs. Few hospitals have HIT encompassing all categories of data, like radiology and path reports along with doctors’ and nurses’ notes, vital sign and cardiogram recordings, lab results and records from prior admissions.

“What’s the barrier?” Blumenthal asked. “Money is numbers one through eight. Then logistics, technical problems and fear,” he said. “And it’s a psychological issue,” he added. “That comes in whenever you’re asking people to change.”

He’s right; just tweaking the culture of medicine isn’t easy. Many doctors don’t like being told what to do, even if they know it’s good for them and for their patients.

Legitimate reasons for physicians’ hesitation include that many EHR systems are non-intuitive; the learning curve can be steep, especially for some older, practicing physicians. Another down-side is the blandness of electronic reports, all similar in appearance and length: sometimes a short, scribbled note indicating “jaundice ++, spleen is palpable and tender,” can convey more information about a patient’s changed condition than a long, complete template with plenty of i-dotting but irrelevant components of the physical exam.

Still, the potential benefits of EHR far outweigh the costs. In the long term, HIT will save doctors time and effort. For example, if a cardiologist evaluating a man with atypical chest pain can see notes and prior cardiograms from the patient’s primary care provider — and can access those whether it’s the middle of the night on New Year’s or 3 p.m. on a Wednesday — that would allow the cardiologist to focus her questions, thoughts and decisions about what’s happening to the patient then and there. She could quickly review the patient’s background and step right into the real-time dilemma, and help the patient sooner.

But the greatest value of HIT, perhaps, is that it might continually provide new information to physicians. This component, Clinical Decision Support, would promote evidence-based practice by having current findings — published data and recommendations – linked to a patient’s electronic chart and diagnostic codes. Doctors would see and, hopefully, might even read new materials about their patients’ medical conditions as they go about their work. With almost no effort, they would see relevant, published reports as they write notes, prescribe drugs, order tests and interpret lab results within a patient’s electronic chart.

Here’s a simple example of an EHR’s potential for educating doctors. Say a physician starts to order a new antibiotic for a patient with liver failure. She’s using a computerized order entry system. A pop-up message says: “Are you sure you want to order that antibiotic? It is metabolized by the liver … Here’s a table that lists other antibiotics you might consider for your patient.” And so the physician would learn, or be reminded, that the new drug she ordered is metabolized by the liver. What’s more, she might quickly reinforce and update her knowledge of antibiotics.

“This caught my interest because it doesn’t diminish physicians’ autonomy,” Blumenthal said. An HIT system enables doctors to make decisions for patients in the context of additional, current information. “The end goal is not to adopt technology, but to improve care,” he emphasized.

As of January, 2011, the administration will provide economic incentives to providers who switch to EHR and demonstrate its meaningful use — such as a switch to electronic prescriptions, easier exchange of records to promote quality care, or using the new system to achieve measurable goals, like weight reduction or smoking cessation.

Still, EHR systems are a tough sell for some smaller practices and institutions. In the future, mandates may be necessary to assure physicians’ competency in health IT. This might be accomplished through state medical licensing boards and other credentialing agencies. The point is that managing and navigating electronic information are essential skills for doctors to provide safe and high-quality, efficient care in the 21st Century.

As we enter 2011, it’s hard to see what’s controversial about electronic medical records. Moving forward from a cumbersome old system loaded with stacks of hand-written notes, illegible prescriptions, disconnected services and a strange fax dependency doesn’t seem particularly modern or innovative. Adopting HIT is just something we need to do, now, to take better care of ourselves.

Source: http://www.huffingtonpost.com
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