It has become more and more apparent that the way an EMR vendor implements the meaningful use requirements is going to be critically important to a doctor’s successful adoption of the meaningful use criteria which is of course essential to get the $44,000 in EMR stimulus money.
I think it’s easy for doctors and practice managers that aren’t as familiar with the various EMR software and with the details of the EMR stimulus to get confused. On face, it seems that the effort to get the EMR stimulus money shouldn’t be affected by which EMR software you choose as long as it is an ONC-ATCB certified EMR. However, this is just categorically WRONG!
The EHR certification is meant to tell you that it CAN meet the meaningful use guidelines. It doesn’t tell you how easily it is to meet the meaningful use guidelines. It doesn’t tell you how well they integrated the meaningful use guidelines into your regular workflow. It doesn’t tell you how well it lets you delegate the meaningful use tasks to other staff members so you can optimize the doctors time. So, yes, EHR certification should mean it’s possible to show meaningful use. EHR certification does not make any claims to how effective that EHR software will actually accomplish the task.
Here’s a simple analogy:
If I wanted to dig a hole for a footing on a house, I could probably use a spoon to dig the hole. It would take forever to actually dig the hole, but a spoon could work. It would not be easy to use a spoon to dig the hole and quite honestly I’d probably give up before I finished, but with enough blood sweat and tears I could get the hole dug.
Of course, if I had a shovel, digging the hole would be much easier. I could get it done with just a bit of hard work. It would obviously go a lot faster than a spoon. Now, if I had a backhoe, digging the hole would basically be academic. Achieving the goal would be simple to accomplish, because the tool was designed perfectly to achieve it.
It’s worth asking yourself whether the EMR you use or the EMR you choose is a golden spoon or a powerful backhoe when it comes to achieving meaningful use. Maybe both can achieve the goal of meaningful use, but is it just made to look nice and shiny or was it really designed to make achieving meaningful use as painless as possible?
EMR And HIPAA
Dec 18, 2010
Saturday, December 18, 2010
New England Journal Of Medicine Cites A Lack Of Patient Safety
In 1999, the Institute of Medicine released a study noting that medical mistakes were responsible for over 98,000 deaths and more than one million injuries each year. Since that time, hospitals have been focusing on different ways to improve patient safety. Despite efforts by hospitals to decrease the chances and rates of injuries to patients, a recent study published in the New England Journal of Medicine questions whether any progress has been made.
As part of the study, 14 hospitals in North Carolina were asked to participate, with 10 of the 14 being selected for inclusion. From 2002 to 2007, 10 admissions records from each hospital were randomly selected for review every quarter. After reviewing nearly 2,400 adult admissions records, the researchers concluded that 18 percent of patients were injured during their stay. Overall, there were 588 injuries to 423 patients, meaning some patients were injured more than once in a single visit.
Approximately 42 percent of the harms experienced by the patient were temporary, but nearly 43 percent of all harms required some intervention by doctors or nurses and resulted in an extended stay in the hospital. Three percent of the identified harms resulted in a permanent injury and 8.5 percent were life-threatening. In almost 3 percent of the cases in the study, the injury resulted in or contributed to the death of the patient.
North Carolina was selected for the study because it has been noted as one of the leaders in patient safety reform. Despite the state's focus on preventing hospital errors, the study found no statistically significant drop in the rates of mistakes over the six year period of the study.
In a Bloomberg interview, Christopher Landrigan, the lead author of the report, noted that the use of electronic medical records and better methods of tracking patient safety are key to reducing medical mistakes over time. The study notes that only 1.5 percent of U.S. hospitals have a comprehensive system of electronic records and only 9.1 percent have any form of electronic record keeping in use.
The study shows that despite efforts of hospitals and doctors to make patient safety a priority, injuries frequently occur while under their care. If you have been injured by the negligence of your provider or by any act of medical malpractice, it is important to discuss your options with an experienced attorney as soon as possible.
24/7 Press Release
Dec 18, 2010
As part of the study, 14 hospitals in North Carolina were asked to participate, with 10 of the 14 being selected for inclusion. From 2002 to 2007, 10 admissions records from each hospital were randomly selected for review every quarter. After reviewing nearly 2,400 adult admissions records, the researchers concluded that 18 percent of patients were injured during their stay. Overall, there were 588 injuries to 423 patients, meaning some patients were injured more than once in a single visit.
Approximately 42 percent of the harms experienced by the patient were temporary, but nearly 43 percent of all harms required some intervention by doctors or nurses and resulted in an extended stay in the hospital. Three percent of the identified harms resulted in a permanent injury and 8.5 percent were life-threatening. In almost 3 percent of the cases in the study, the injury resulted in or contributed to the death of the patient.
North Carolina was selected for the study because it has been noted as one of the leaders in patient safety reform. Despite the state's focus on preventing hospital errors, the study found no statistically significant drop in the rates of mistakes over the six year period of the study.
In a Bloomberg interview, Christopher Landrigan, the lead author of the report, noted that the use of electronic medical records and better methods of tracking patient safety are key to reducing medical mistakes over time. The study notes that only 1.5 percent of U.S. hospitals have a comprehensive system of electronic records and only 9.1 percent have any form of electronic record keeping in use.
The study shows that despite efforts of hospitals and doctors to make patient safety a priority, injuries frequently occur while under their care. If you have been injured by the negligence of your provider or by any act of medical malpractice, it is important to discuss your options with an experienced attorney as soon as possible.
24/7 Press Release
Dec 18, 2010
Health Professionals Need Not “Reinvent The Wheel” For EMR/EHR Compliance
Electronic Medical Records (aka Electronic Health Records) are becoming a requirement for health care professionals in the coming years. December 13 marked a notable turning point in the healthcare debate - the Virginia Federal Courts rejected the Minimum Essential Coverage Provision of the Patient Protection and Affordable Care Act (PPACA), declaring it as unconstitutional. While Virginia’s decision is only the most recent ruling, it sets the stage for the potential dismantling of Obamacare. Because the United States House of Representatives will transfer control to the Republicans, health care professionals have begun to question the safety of EMR/EHR funding. “The Health Information Technology for Economic and Clinical Health (HITECH) Act, from which the EMR/EHR funding and incentives originates, is a different statute than the PPACA,” says Justin Barnes of the Healthcare Blog, a respected independent voice in the healthcare industry. Barnes points out that the funding for HITECH is grounded in law, and is drawn from the Medicare Trust Funds held by the US Treasury. As a result, physicians must prepare for when the EMR/EHR legislation takes effect over the next several years.
In other words, the Obama Health Insurance plan, and the EMR/EHR Mandate are two very different pieces of legislation.
PRLog
Dec 18, 2010
In other words, the Obama Health Insurance plan, and the EMR/EHR Mandate are two very different pieces of legislation.
PRLog
Dec 18, 2010
Thursday, December 16, 2010
Blumenthal Says Docs Eventually 'Will All Support EHRs'
Returning to the 2004 roots of the national health IT coordinator's role as cheerleader-in-chief for EHRs, Dr. David Blumenthal took advantage of a public speech last week to say that EHRs will indeed be in widespread use nationwide in the not-too-distant future.
"History has shown that things that improve healthcare become part of what is used. I propose to you that in a few years doctors will all support EHRs," Blumenthal said at the 18th National HIPAA Summit in Washington, according to Healthcare IT News. "Using EHRs will become a core competency for physicians. And once we've established that, it will be considered an absolute requisite."
The national coordinator then said EHR adoption will take an escalator-like trajectory once federal financial incentives kick in next year. "I think we're going to see the upward slope of the adoption curve within a year or two, but it will be difficult to predict the slope," Blumenthal said.
Another top HHS IT booster, Agency for Healthcare Research and Quality Director Dr. Carolyn Clancy, said that the pace of adoption will depend on how useful electronic health data is to physicians. "Information is the lifeblood of medicine," Clancy told the gathering. "Clinicians are trained to look at patients one at a time. But, what's missing is aggregated information." AHRQ, of course, is in charge of comparative-effectiveness research, and thus will be providing such aggregated information to help establish standards of care.
FierceEMR
Dec 16, 2010
"History has shown that things that improve healthcare become part of what is used. I propose to you that in a few years doctors will all support EHRs," Blumenthal said at the 18th National HIPAA Summit in Washington, according to Healthcare IT News. "Using EHRs will become a core competency for physicians. And once we've established that, it will be considered an absolute requisite."
The national coordinator then said EHR adoption will take an escalator-like trajectory once federal financial incentives kick in next year. "I think we're going to see the upward slope of the adoption curve within a year or two, but it will be difficult to predict the slope," Blumenthal said.
Another top HHS IT booster, Agency for Healthcare Research and Quality Director Dr. Carolyn Clancy, said that the pace of adoption will depend on how useful electronic health data is to physicians. "Information is the lifeblood of medicine," Clancy told the gathering. "Clinicians are trained to look at patients one at a time. But, what's missing is aggregated information." AHRQ, of course, is in charge of comparative-effectiveness research, and thus will be providing such aggregated information to help establish standards of care.
FierceEMR
Dec 16, 2010
Wednesday, December 15, 2010
Berwick: Repealing Healthcare Reform Would Be A Big Mistake
In his first appearance before Congress after his highly criticized recess appointment, CMS head Donald Berwick told a Senate panel that repealing the healthcare reform would be a big mistake, The Hill reports.
"I can't think of a worse plan," Berwick told the Senate Finance Committee. If the bill were repealed, seniors would not get the 50 percent discount for prescription drugs, senior access to preventive services like colonoscopy and mammography would vanish and plans to improve the care of chronic illnesses and be more transparent would disappear. "It would be a terrible plan," he said.
Berwick contends that "every person in America, and certainly every beneficiary of Medicare and Medicaid, should be able to get all the care they want and need, when and how they want and need it."
For Republicans, their first chance to grill Berwick was anti-climactic, despite irritation over how President Obama appointed him (bypassing a Senate confirmation). The hearing, which lasted 90 minutes didn't leave much time for questions at the end, something Sen. Orrin Hatch (R-Utah) took issue with, according to The Hill. "It's like asking us to drain the Pacific Ocean with a thimble," he said. "We ought to have time to ask the most important man in healthcare sufficient questions."
FierceHealthCare
Dec 15, 2010
"I can't think of a worse plan," Berwick told the Senate Finance Committee. If the bill were repealed, seniors would not get the 50 percent discount for prescription drugs, senior access to preventive services like colonoscopy and mammography would vanish and plans to improve the care of chronic illnesses and be more transparent would disappear. "It would be a terrible plan," he said.
Berwick contends that "every person in America, and certainly every beneficiary of Medicare and Medicaid, should be able to get all the care they want and need, when and how they want and need it."
For Republicans, their first chance to grill Berwick was anti-climactic, despite irritation over how President Obama appointed him (bypassing a Senate confirmation). The hearing, which lasted 90 minutes didn't leave much time for questions at the end, something Sen. Orrin Hatch (R-Utah) took issue with, according to The Hill. "It's like asking us to drain the Pacific Ocean with a thimble," he said. "We ought to have time to ask the most important man in healthcare sufficient questions."
FierceHealthCare
Dec 15, 2010
Governor-Appointed Panel In Virginia Calls For Reform 'Regardless' Of Law
Calling Virginia's health system performance "mediocre," a panel appointed by Republican Gov. Bob McDonnell recommended that the state work toward implementing the federal health law's provisions--and toward improving performance as a whole--despite a ruling by a Richmond-based federal judge on Monday deeming part of that same law unconstitutional.
Despite a fundamental opposition to the law, McDonnell--as well as all other governors both for and against reform--still must be prepared for whatever outcome is decided, reports Kaiser Health News, hence, the panel. The panel recommended creating an exchange run by the state where both individuals and citizens could obtain health coverage; increasing the number of doctors in the state thus, addressing the physician shortage; and a more team-based approach to healthcare that includes turning more decision-making authority over to nurses.
Still, the panel pointed out that most of its suggestions could be implemented regardless of the law's outcome.
"Health reform is a process, and successful health reform is a participation sport," the panel wrote. "The vast majority of these suggested actions are independent of the new federal law. This accentuates the fundamental point that health system reform can be in the Commonwealth's interest regardless of federal actions or inactions."
Bill Hazel, the state's Health and Human Services secretary, reiterated that point when announcing the panel's findings on Tuesday. "[I]t's easy to assume we are not interested in health reform, but we very much are," he said, according to KHN.
The panel cited the lack of individuals and small business with insurance access, despite the state's ranking No. 6 in the nation in terms of median family income, as just one reason for change.
"Since so many recommendations hold promise to improve quality, lower cost, or make insurance and care more affordable and accessible, opportunities for 'early adoption' should be prudently explored and acted upon," they wrote."
In related news, in response to the aforementioned judge's ruling Monday, the Justice Department said it will appeal the decision, reports the Wall Street Journal.
FierceHealthCare
Dec 15, 2010
Despite a fundamental opposition to the law, McDonnell--as well as all other governors both for and against reform--still must be prepared for whatever outcome is decided, reports Kaiser Health News, hence, the panel. The panel recommended creating an exchange run by the state where both individuals and citizens could obtain health coverage; increasing the number of doctors in the state thus, addressing the physician shortage; and a more team-based approach to healthcare that includes turning more decision-making authority over to nurses.
Still, the panel pointed out that most of its suggestions could be implemented regardless of the law's outcome.
"Health reform is a process, and successful health reform is a participation sport," the panel wrote. "The vast majority of these suggested actions are independent of the new federal law. This accentuates the fundamental point that health system reform can be in the Commonwealth's interest regardless of federal actions or inactions."
Bill Hazel, the state's Health and Human Services secretary, reiterated that point when announcing the panel's findings on Tuesday. "[I]t's easy to assume we are not interested in health reform, but we very much are," he said, according to KHN.
The panel cited the lack of individuals and small business with insurance access, despite the state's ranking No. 6 in the nation in terms of median family income, as just one reason for change.
"Since so many recommendations hold promise to improve quality, lower cost, or make insurance and care more affordable and accessible, opportunities for 'early adoption' should be prudently explored and acted upon," they wrote."
In related news, in response to the aforementioned judge's ruling Monday, the Justice Department said it will appeal the decision, reports the Wall Street Journal.
FierceHealthCare
Dec 15, 2010
Thursday, December 9, 2010
Radiation Overdose, Alarm Fatigue Top List Of Health Technology Hazards
Considering that just last week, 700 healthcare providers at the Radiological Society of North America's annual conference signed a pledge to use less radiation, it should come as no surprise that the No. 1 health technology hazard heading into 2011, according to the ECRI Institute's list of top 10 hazards, is radiation therapy overdose.
"There's been a rapid growth in the number of treatment systems and an increase in their complexity," Jim Keller, ECRI's vice president for health technology evaluation and safety, told the Wall Street Journal.
Alarm hazards caused by desensitization, or "alarm fatigue" ranked No. 2 on ECRI's list while cross-contamination from flexible endoscopes, last year's top hazard, ranked third.
Flexible endoscope contamination issues "can inconvenience patients and create anxiety," the ECRI report says, according to WSJ. "[A]t worst, they can lead to life-threatening infections."
High radiation doses of CT scans and data loss leading to repeated testing, injury or death rounded out the top five hazards.
The rest of the top 10 hazards included:
Luer misconnections: Essentially, tubes, needles and catheters incorrectly connected with one another.
Oversedation during use of patient-controlled analgesia (PCA) infusion pumps: Too much of a painkiller being administered to a patient on a medicine drip.
Needle sticks: Patients, providers or other staff members accidentally being stuck by needles.
Surgical fires: Which, according to WSJ, are nearly as common as wrong-site surgeries.
Defibrillator failures in emergency resuscitation attempts.
FierceHealthCare 12-9-2010
"There's been a rapid growth in the number of treatment systems and an increase in their complexity," Jim Keller, ECRI's vice president for health technology evaluation and safety, told the Wall Street Journal.
Alarm hazards caused by desensitization, or "alarm fatigue" ranked No. 2 on ECRI's list while cross-contamination from flexible endoscopes, last year's top hazard, ranked third.
Flexible endoscope contamination issues "can inconvenience patients and create anxiety," the ECRI report says, according to WSJ. "[A]t worst, they can lead to life-threatening infections."
High radiation doses of CT scans and data loss leading to repeated testing, injury or death rounded out the top five hazards.
The rest of the top 10 hazards included:
Luer misconnections: Essentially, tubes, needles and catheters incorrectly connected with one another.
Oversedation during use of patient-controlled analgesia (PCA) infusion pumps: Too much of a painkiller being administered to a patient on a medicine drip.
Needle sticks: Patients, providers or other staff members accidentally being stuck by needles.
Surgical fires: Which, according to WSJ, are nearly as common as wrong-site surgeries.
Defibrillator failures in emergency resuscitation attempts.
FierceHealthCare 12-9-2010
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