January 11th, 2012

An electronic medical record (EMR) implementation isn't just about replacing paper charts with digital technology. EMRs also provide a perfect opportunity to review and improve your workflows. The result can be increased efficiencies—which means decreased costs.

Your medical practice has probably been doing things the same way for a long time. Maybe you think you do things well, and most likely you actually do. Most practices, however, have not recently reviewed and optimized processes to the extent possible. Few have standardized procedures in writing, for example.

Implementing an EMR won't automatically make these improvements. In fact, most people think EMRs solve problems, but they actually amplify problems that already exist in a practice.

Because of this, adopting an EMR presents a good opportunity for you to make your practice more efficient by reviewing processes and optimizing your own workflows. In fact, you may find that with little effort you are able to identify new efficiencies that could save time and money.

Be patient, however. The adoption of technology is an iterative process. In other words, while EMRs are full of functions that will bring efficiency to your practice if implemented correctly, this won't happen overnight. Give it some time. Typically, health care groups are in the learning and adoption phase of their transition for several months. You should see results after that.

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January 10th, 2012

Electronic medical record (EMR) implementations aren't always simpleespecially for small physician groups, which may lack dedicated information technology resources. However, following a few best practices regarding your constituents can help ensure that the process proceeds smoothly. Here are three.

Personalize for physicians. No two physicians are exactly like, so no two physicians should have to do things the same way. And that applies to functions both large and small. People approach even the simplest of technologies, such as email and word processing, differently. A good EMR will provide several ways to accomplish the same task, so be sure you offer physicians the option to choose which will best fit their practice styles.

Include nurses. With that said, an EMR isn't all about the physician. While physicians may be leaders and key decision-makers, they are not the exclusive users of an EMR. According to some reports, nurses account for almost 75 percent of chart use, and physicians just 25 percent. As a result, one of the greatest mistakes of EMR implementation is forgetting about nurses. When you create an EMR committee, be sure to have nursing representatives on it.

Round on users. Just as physicians and nurses "round" on patients at a hospital, you should round on everyone in the practice to gauge their comfort with the EMR. Thirty days and then again six months after you go live, visit each user to observe how he or she uses the EMR, take suggestions, and offer tips about how to best use the EMR within your workflows.

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December 1st, 2011

Electronic medical records (EMRs) are safer than their paper counterparts, according to a new survey of physiciansbut a similar survey of patients didn't get the same response. They think paper is still safer, which means some education is in order.

The survey, which was conducted by GfK Roper on behalf of Practice Fusion, asked patients and medical professionals how they view EMR safety versus paper chart safety.

Fifty-four percent of physicians answered that EMRs are safer, with just 18 percent selecting paper as the safer option. Patient views, however, differed: Forty-seven percent of them said paper is safer, with 39 percent selecting EMRs as the safer option.

Also interesting is why physicians and patient responded the way they did when choosing paper records. Of physicians who believe paper is the safer option, 36 percent said paper is more secure because it is less likely to be hacked or lost. Of patients who believe paper is the safer option, 59 percent said paper records are more private than EMRs, allowing for more control over who sees them.

Interestingly, of the patients who said EMRs are safer, 77 percent said the greatest benefit of EMRs over paper records is being able to access records when needed.

What does it mean? The medical community is rejecting paper charts and embracing technology, says Practice Fusionand that's easy to understand if you're a practicing physician who has any experience with an EMR. But it's also easy to understand patient concerns, which means more education about why EMRs are safer than paper charts is necessary.

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November 23rd, 2011

The American Medical Association (AMA) is taking an active role in persuading physicians to use information technology (IT), including electronic medical records (EMRs), in their practiceswhich shouldn't come as a surprise, given that the AMA has been working with a number of leading health care IT organizations, such as the EHR Collaborative, e-Health Initiative, and the National Alliance for Health Information Technology, for some time.

Physicians have clearly expressed concern about the cost of converting to an EMR, and some think it's unfair for the AMA to think that physicians can foot the bill themselves. But the AMA has pledged to work with Congress and insurers to align incentives for physician adoption of health care IT.

To make health care IT adoption easier for physicians, the AMA also made November 2011 "Heal that Claim," month, launching its annual campaign with new resources to help physicians automate administrative tasks for checking insurance eligibility, submitting and tracking claims, and obtaining payments.

This year, the AMA campaign features free tools, such as webinars, that offer step-by-step instructions for conducting electronic health care transactions. It is also supported by a new online forum for asking questions, getting answers, and accessing resources about automating a medical practice.

The tool kit is available here.

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November 9th, 2011

Electronic medical record (EMR) implementation has the potential to be an arduous process, in part because medical practices tend to make four major mistakes when transitioning from paper-based records: mismatching IT, misplacing resources, ignoring accountability, and mismanaging logistics. Below we outline those mistakes and explain how you can avoid them.

Mistake #1: Mismatching IT. According to a recent report, one of the main reasons for EMR implementation failure is unreliable IT infrastructure. When implementing an EMR, you'll certainly need to choose the software that meets your needsbut you'll also want to run it on the appropriate hardware.

Mistake #2: Misplacing resources. While it may be tempting to assign office staff to oversee your EMR implementation, a medical practice is not an IT organization, and managing major changes that involve IT may be beyond your staff's abilities. It's likely to be much more cost effective in the long run to outsource your implementation to experts.

Mistake #3: Ignoring accountability. An EMR implementation involves sweeping changes, and everyone in your medical practice likely plays a role in your normal operations, but not knowing who is responsible for what during the implementation specifically can derail the process. According to the EMR Starter Assessment Tool developed by the Community Clinics Initiative, a medical practice is ready to implement an EMR only when roles and responsibilities are assigned and clear.

Mistake #4: Mismanaging logistics. Implementing an EMR isn't like installing software on your home computer; it requires tweaking and adjusting during many phases. Given the complexity of the undertaking, you'll need to spend a significant amount of time planning on the front end. Document tasks, develop an implementation timeline, assign responsibilities, identify risks… and the list goes on.

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November 7th, 2011

When your medical practice makes the transition to an electronic medical record (EMR), which is inevitable, careful planning can help the change go smoothly—and careful planning, in the context of EMR implementation, can be referred to as “change management”.

Change management consists of up-front assessment and planningbut there's much more involved than simply creating a project plan for your new IT implementation. You'll need to select the appropriate technology, choose your implementation team carefully, and assign responsibilities. Change management also involves looking at your existing processes and determining what's working and what's not.

The reason: You don't want to carry forward ineffective processes. If a prescription-related workflow is ineffective when handled manually, for example, it isn't going to become effective when handled electronicallyand the transition to an EMR, which is supposed to make your practice more efficient, is the perfect time to address such problems.

If not managed properly, the transition to an EMR can exact a high price on a medical practice. Careful consideration of implementation issues as well as process issues in advance will facilitate effective change management. And that, in turn, will help you minimize the overall impact of change on your practicedecreasing disruptions and reducing costs.

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October 12th, 2011

Government's incentives for electronic medical record (EMR) adoption could pay off in improved quality of care, according to a new study. It found that patients in physician practices that used EMRs got better care and had better outcomes than those in physician practices that used paper records.

The study, published in the New England Journal of Medicine, looked at 500 primary care physicians treating 27,000 adults with diabetes.

According to the study, those patients in physician practices that used EMRs were significantly more likely to have care that met certain standards as well as positive outcomes than those in physician practices that used paper records.

Standards included timely measurements of blood sugar, management of kidney problems, eye examinations, and vaccinations for pneumonia. Positive outcomes included meeting national benchmarks for blood sugar, blood pressure, and cholesterol control, as well as achieving a non-obese body mass index and avoidance of tobacco use.

Almost 51 percent of patients at EMR-based practices received care that met all of the endorsed standardscompared to only 7 percent of patients at paper-based practices. And almost 44 percent of patients in EMR-based practices met at least four of five outcome standardscompared to just 16 percent of patients at paper-based practices.

According to the study, these findings were consistent regardless of insurance type (Medicare, Medicaid and commercial payers) as well as for the uninsured.

David Blumenthal, MD, former National Coordinator for Health Information Technology, says these results support the expectation that federal support of EMRs will generate quality-related returns on investment (ROI).

Related articles: EHR Incentives Can Generate "Quality-Related" ROI, Study Says

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October 5th, 2011

Lack of usability is often at the root of slow electronic medical record (EMR) adoptionbut usability refers to more than user satisfaction. It's not about the screens and the number of clicks used to navigate them; it's about the functionality of the system. Below are five ways to ensure your EMR won't cause headaches.

Ease. Your EMR cannot be burdensome. To ensure it isn't, you may want to look at how physicians interact with nurses (both in the office and on the phone) when using the demo EMR.

Supportiveness. Your EMR should support your office workflows. To ensure it does, you may want to present EMR vendors you're considering with three clinical scenarios: one that's common, one that's challenging, and one that involves many staff interactions.

Efficiency. A good EMR will ultimately save you time and this can be accomplished in many ways, big and small. For example, keeping an electronic chart open on the desktop can help workflows, because if a provider is often in one patient’s chart when a phone call interrupts his work, he may want to open another chart but keep the first one open. To ensure efficiency, you'll want to watch providers using an EMR in real-life scenarios.

Flexibility. A good EMR will adapt to your changing needs. Ensure that it can evolve as providers become comfortable with improvements in workflow and operational efficiencies as new technologies are developed.

Effectiveness. Finally, your EMR has to work. In other words, does it help you achieve current results, which are based on volume of patients and procedures? Will it help you achieve future results, which many health care analysts believe will be value-driven, and for which clinical data is used to measure quality?

Related articles: Five Keys to EMR Usability

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September 14th, 2011

Many health care practitioners are still reluctant to implement electronic medical records (EMRs) despite increasing evidence of their benefits to practices and patients as well as significant financial incentives from the federal governmentbut the following five myths should not be among your reasons for reluctance.

EMRs are primarily for hospitals. EMRs are used more in large medical facilities, but they're quickly gaining traction among small health care practices as well.

It's hard to learn to operate an EMR. While there is a learning curve during EMR adoption as with any new technology, EMRs are increasingly easy to use, and many adopters are back to normal operations within as little as three weeks. Moreover, once implemented, EMRs can actually make work easier and significantly improve workflows with tools such as dictation software and an integrated dashboard to keep important information at your fingertips.

EMRs destroy the interaction between doctors and patients. According to a 2010 Government Accountability Office report, EMRs actually help doctors gain more information about a patient and thus improve communication.

EMRs present a security risk. Federal regulations give EMRs significant protection: Health care practitioners need login credentials to access charts, and the EMR's system tracks access. Plus, data is backed up so it's protected from disasters such as floods and fires, which would destroy paper charts,

EMRs are expensive. New EMR technology is emerging that is both effective and affordable, making it easier for small practices to join the EMR revolution.

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September 7th, 2011

Now there's one more reason to implement an electronic medical record (EMR): Patients are demanding it. The overwhelming majority of Americans believe health care practitioners who use an EMR to store records offer better care than those who use paper, according to a new survey.

The survey of 1,004 adults, conducted by GfK Roper, found that 78 percent of patients whose doctors use an EMR believe the EMR helps deliver better care—and 38 percent of patients whose doctors don't use an EMR would like them to do so.

On patients' wish lists when it comes to EMRs are emailed appointment reminders and online medical records. In fact, patients worry more about access to their medical records than they do about security, according to another survey by GfK Roper, this one of 1,000 adults. And another survey by Beth Israel Deaconess Medical Center found that patients are willing to give up some privacy for full access to online medical records.

The surveys highlight the importance of "participatory medicine," which promotes transparency between health care practitioners and patients, and which is being driven by increased technology, which eliminates the administrative burden of copying and faxing medical records.

Unfortunately, only 49 percent of patients reported that their health care practitioner used an EMR during their last office visit, a number that is unchanged from a similar survey conducted February 2010.

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