MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'emr implementation'. Sat, 03 Sep 2011 02:48:05 +0100 http://www.medworm.com/index.php?rid=5181958&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F2ScUo2cTw1c%2F Many of you might remember my recent post about EMR Performance Issues (ie. EMR Slowness). Turns out, the post had a pretty big impact on some readers of the site. In fact, it sounds like it was partially therapeutic for some to realize that they’re not alone. I asked permission to share one of the responses with you so you could get some more first hand perspective on the issue of EMR slowness. I share it in the hopes that others can be aware and avoid it. Plus, I hope the EHR vendors that read this will take it to heart and be fanatically focused on EMR speed and customer support. I’ve removed the name of the writer and the names of the vendors. Plus, realize that it was written originally in an email communication and not necessarily to be published. OMG…you hit the na... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5181958 Thu, 01 Sep 2011 22:28:48 +0100 5181958 http://www.medworm.com/index.php?rid=5169597&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FMv7wbsW1E7Y%2F Conclusion Don’t accept an EHR that’s slow. Make sure that the EHR performs at a satisfactory level. I know of nothing that frustrates a clinic more than a slow EHR. Related posts:Common EMR Implementation Issue – EHR Performance Issues We’re back again with our ongoing series on Common EMR... Common EMR Implementation Issues – Unexpected EHR Expenses This is the start of a new series of posts... Killer EMR Features According to EMR Vendors I previously posted a request to hear about the “killer”... (Source: EMR and HIPAA) EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5169597 Fri, 26 Aug 2011 19:49:29 +0100 5169597 http://www.medworm.com/index.php?rid=5159278&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F6jLMN8ZSAok%2F We’re back again with our ongoing series on Common EMR Implementation Issues. Seems like readers really liked my first entry in the series about Unexpected EHR Expenses. To be quite honest, I was really happy with how that post turned out myself. It’s one of the most comprehensive and useful posts I’ve written in the 5.5+ years I’ve been writing about EMR and EHR. Hopefully we can continue that trend. Today’s Common EMR Implementation Problem: EHR Performance Issues I have to admit that this is a really tough problem to crack. However, it’s also incredibly common. The symptoms for this problem usually are described as, “THIS EHR IS SOOOOOO SLOW!” (This is appropriate use of ALL CAPS since they are often yelling this.) Followed by a *huff* and... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159278 Wed, 24 Aug 2011 18:44:49 +0100 5159278 http://www.medworm.com/index.php?rid=5159279&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FHNwIjbnhAi8%2F I recently had the great opportunity to go to breakfast with Valerie Migliore and Karin Eichler during my visit to my in-laws in the upstate New York area (Rochester specifically). Despite being very pleasant ladies I was also happy to see they could speak EMR speak with me. I’ve met a whole lot of different people over the years and far too often I go and meet with someone who is just getting into the EMR world and so they’re still learning the ways of the EMR (excuse the Star Wars reference). I still enjoy those types of visits, but I really enjoy meeting with people like Valerie and Karin who can share with me some other EMR perspectives. In fact, they often show me new ways that I hadn’t looked at something before. Turns out Val and Karin recently did a presentation a... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159279 Tue, 23 Aug 2011 14:43:18 +0100 5159279 http://www.medworm.com/index.php?rid=5159283&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F42OlfYrK2Vg%2F This is the start of a new series of posts that I plan to do over the next week or two. I’ll probably try and space them out so that they don’t overwhelm anyone. However, it’s going to be a series of common EMR implementation issues that I hear over and over again. This series was prompted by a post on HIStalk by Inga where she talked about her visit to the doctor and his complaints about his EHR implementation. As I read through the list of complaints, I realized that they were all complaints that I’d heard before. If I’ve heard them all before, then they must be pretty common and worth talking about more. Ideally the discussions in this EMR implementation series will help practices and doctors that are implementing an EMR to avoid these issues. I also know t... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159283 Fri, 19 Aug 2011 19:45:47 +0100 5159283 http://www.medworm.com/index.php?rid=5118749&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FJZhjPfrltFs%2F Great counsel and advice for those still looking at various EHR software (especially specialists) @EMRAnswers Linda Lia Customizable content “offered”, doesn’t mean your specialty is available. Big difference. Ask for a “live” demo. #EMR #HITsm #healthIT EMR implementation in 6 weeks. Hospital EMR people will balk at this. However, it’s possible in the ambulatory setting. I wouldn’t recommend it, but one time I had to do it. @PediatricInc Brandon Betancourt New Post – Going from paper charts to EMR in 6 weeks; a summary http://bit.ly/npmSEH #EMR Everyone hates redundant work. So, this tweet caught my eye: @TheNerdyNurse The Nerdy Nurse In Case You Missed it: : Teetering Between EMR and Paper Charting: Frustration and Duplication – What ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5118749 Mon, 08 Aug 2011 05:21:27 +0100 5118749 http://www.medworm.com/index.php?rid=5107648&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Fneil%2F2011%2F08%2F04%2Frandom-thoughts-emr-projects-decentralized-problems-persist-despite-solutions%2F Once in a while, I run out of Big Ideas to share and resort to a rundown of short items. This is one of those times. Often, though, that approach turns out to be more interesting than a well-thought-out commentary. (Thus, the popularity of Twitter, right?) Speaking of Big Ideas, I’m thinking that the age of the massive EMR project may be coming to an end. You may have seen my piece in InformationWeek today about the reported end of the national EMR in England. London’s The Independent reported earlier this week that the Cameron government will announce next month that it will scrap the national strategy in favor of allowing local hospitals and trusts to make independent EMR purchasing and implementation decisions. This news comes on the heels of a decision by the government of ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5107648 Thu, 04 Aug 2011 22:22:35 +0100 5107648 http://www.medworm.com/index.php?rid=5062330&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F07%2F15%2Fehr-readiness-questions%2F In my interest of highlighting more EHR bloggers, I found this post by Ron Sterling on EHR Outlook quite interesting. In his post, Ron highlights a number of questions a clinic should ask itself to know if it’s ready for an EHR implementation. Here are the questions he lists: * Does your EHR effort have physician support? * Are you prepared to address ongoing problems? * Is your budget practical? * Does your EHR support your current workflow and operations? * Will your existing computer Infrastructure support an EHR? * Have you gotten your paper records ready? Check out the original post for Ron’s thoughts on each question and why that question is important. I think it’s a pretty good list to consider. I especially like the second question that addresses whether you&#8217... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5062330 Fri, 15 Jul 2011 15:14:37 +0100 5062330 http://www.medworm.com/index.php?rid=5028545&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fx2jHPP4ONKE%2F I can’t remember exactly where I saw someone talk about the “WIIFM” (What’s in it for Me) principle, but it really is an important principle that when understood can have an amazing impact for good. This post isn’t about whether you should live a life asking WIIFM. I’ll leave that question to people much smarter than me. Instead, I want to look at how applying the WIIFM principle to others can help those working on a successful EHR implementation. In most cases I’m talking about, the WIIFM should be changed to “What’s in it for Them?” Understanding the answer to this question can help you as an EMR consultant, an EMR vendor or even a practice manager or doctor that’s trying to work through an EMR implementation. One of the f... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5028545 Fri, 08 Jul 2011 19:48:02 +0100 5028545 http://www.medworm.com/index.php?rid=5008364&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FxQq6eLbUOGU%2F When I learned that HITECH included funds setting up the regional extension center system to support small medical practices in implementing EHRs, I thought, well, that sounds OK. I wasn’t thrilled, mind you, as I wasn’t optimistic that a government-sponsored organization would produce the quick EHR adoption process HITECH demands, but it wasn’t a bad thing. Since then, I’ve gone from mildly interested to downright irritated.  While I wasn’t expecting the RECs to blaze a path to glory, I thought it would be nice if they produced great educational materials and sessions, made themselves highly accessible to physicians and offered clear guidance on vendor selection. As far as I can tell, we’re largely zero for three. Yes, as a recent a recent study notes,... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5008364 Thu, 07 Jul 2011 02:59:47 +0100 5008364 http://www.medworm.com/index.php?rid=4975983&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FGtKVYCOyv1U%2F I know I’ve written about ERP and EMR before, but the more I think about the EMR selection and implementation process, the more I see the same issues that are experienced with an ERP implementation. The one issue that is a bit different about EMR versus ERP is that there are only a small handful of ERP vendors to choose from. However, we have 300-600 to choose from in the EMR world. That’s an important and challenging difference. However, the similarities to ERP are many. One of the most striking is how the EMR like the ERP is something that’s going to be used and have an effect on the entire organization. As such, the need to manage the participation of multiple stakeholders is so key. The key to a successful ERP implementation is to have a great project leader.  Some... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4975983 Tue, 28 Jun 2011 19:00:50 +0100 4975983 http://www.medworm.com/index.php?rid=4953046&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F3WSCeHECGNo%2F Two articles I’ve written in the last 24 hours have gotten me thinking that we’ve already entered the post-implementation era of EMRs, even as implementation remains in progress at so many healthcare organizations. While the vast majority of hospitals and physician practices in the U.S. still don’t have full-featured EMRs in place, many are already looking well into the future. As you may already know, HIMSS on Tuesday released its first-ever survey on “clinical transformation.” According to HIMSS and survey sponsor McKesson, “Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver in... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4953046 Thu, 16 Jun 2011 20:59:25 +0100 4953046 http://www.medworm.com/index.php?rid=4747722&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F22%2Fim-a-plumber-despite-just-wanting-to-be-an-emr-blogger%2F About a month ago, the market finally fell enough for my wife and I to buy our first house. It’s pretty exciting to finally be able to do it since we pretty much tried to buy a house every year since we moved to Las Vegas 6 years ago. Thankfully, we never did until now (although that’s another story). After purchasing the home, I found myself spending a fair amount of time having to repair a number of things around the house. One day I pretty much spent all day being a plumber as I (and a nice friend) replaced the garbage disposal, fixed a leaking sink, replaced the mechanism (whatever it’s called) in the toilet. Turns out that none of these things are really all that difficult. Although, it definitely had the initial learning curve for me to realize that it’s prett... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747722 Fri, 22 Apr 2011 18:57:58 +0100 4747722 http://www.medworm.com/index.php?rid=4600632&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F03%2F13%2Funbiased-targeted-and-useful-resources-for-doctors-evaluating-emr-systems%2F I got the following email from a reader of EMR and HIPAA which really hit me when it comes to providing the right resources for medical practices that are researching and implementing an EMR system in their practice. I remember achieving a feeling of solace after discovering your site. When initially researching and realizing how much misleading information is out there, it’s very overwhelming and leaves the researcher of a very important IT addition to a medical practice feeling very alone. Your transparent and no bones about it approach (whether positive or negative) is appreciated by many. Don’t ever change. While I definitely appreciate and am flattered by this reader’s nice comments, I was struck even more by their description of the challenge a medical practice has in findi... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4600632 Mon, 14 Mar 2011 06:24:33 +0100 4600632 http://www.medworm.com/index.php?rid=4455327&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F5kzcqXGTCIE%2F Some very interesting commentary from an EMRUpdate thread: Six-plus years ago, I started my own office and my husband insisted on an EMR – mainly because the real estate prices were so high that he did not want to pay for file storage. I have posted on this site over the years: early on, I was told I was crazy for picking an Application Service Provider (I think it’s now called “cloud computing”), and the site had a smartest-guy-in-the-room vibe. But my EMR worked so I didn’t need help or a tech consult. So I went on my merry way and grew my practice – and downloaded quite a few babies, too! EMR was a big deal for me back in 2004; but now I never really think about it. Maybe the reason is that I was never searching for “THE PERFECT EMR” &#82... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4455327 Wed, 09 Feb 2011 18:40:40 +0100 4455327 http://www.medworm.com/index.php?rid=4377636&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FSHVmBIBNzAU%2F The following is an interesting comment that’s kind of an extension to my previous post about a visit to an EMR using Doctor’s office. I think many of you will enjoy it. Can you imagine this in a manufacturing environment? If GM, Ford, etc were legislated (incented?) to implement automation and safety changes that caused them to cut production in half…and cause the workers to be a bit distracted from what they were doing on the other 50% (then maybe tax them higher if they don’t put the changes in place within 3 years)….how healthy would that be for GM? And for the cost and quality of the cars being built? Of course, not all EMR software causes you to cut production in half. EMR also doesn’t have to mean you’re distracted the other 50% of the time.... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4377636 Thu, 20 Jan 2011 21:05:33 +0100 4377636 http://www.medworm.com/index.php?rid=4349556&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F_JwApK3VUqQ%2F I must admit that I’m a little reticent to post the following story that I was sent to by a regular reader of EMR and HIPAA. I’m not afraid for the story to be told (I’m sure you’ve read and/or experienced it already), but I’m concerned that stories like this ignore what could be done to avoid the situations described. There are often solutions to the issues you’ll read in this story. Let me provide a few of them up front, and then I’ll include some other commentary in the story in [italicized brackets]. 1. Selecting an EMR that will maintain your efficiency is key. Certainly there’s some drop in efficiency during the beginnings of any EMR implementation, but 4 months after you shouldn’t still be at 50%. Selecting the right EMR can help... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4349556 Fri, 14 Jan 2011 18:14:47 +0100 4349556 http://www.medworm.com/index.php?rid=4343224&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FZZlCOmAUG3M%2F I have often found doctors talking about the 2014 mandate for adoption of EHR software. In fact, this post was inspired by a bunch of people searching online for the term “2014 EHR Mandate.” I think that they found my site because I previously did this post about Obama’s goal of Full EHR adoption by 2014. If I’m remembering right, this was actually just an extension of Bush’s goal of having 100% EHR adoption by 2014. Obama took Bush’s original EMR aspiration and kept it going. Although, I do have a real problem with people who like to call it an EHR mandate. It’s really not a mandate. A mandate for me implies that you are required to do it or there’s some grave consequence to it. It’s not like you’re going to be thrown in jail for... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4343224 Thu, 13 Jan 2011 19:00:37 +0100 4343224 http://www.medworm.com/index.php?rid=4338064&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FylTLrL6wBdI%2F Yesterday I was attending a conference that had almost nothing to do with EMR. However, in one of my conversations a young girl told me that her dad was a doctor. She went on to tell me how it is all that her dad can talk about her.  He was trying to convince himself why he should ignore the stimulus money and not do EMR. Of course, this part isn’t that interesting since I think we all know many doctors who are doing something similar. What was very interesting was that the daughter of this doctor explained how she was trying to convince her dad why he should do EMR. In fact, she suggested that she might have read my EMR site before because she’d done searches to learn more about EMR so that she could convince her doctor father to use an EMR. This discussion of why you shoul... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4338064 Tue, 11 Jan 2011 18:41:02 +0100 4338064 http://www.medworm.com/index.php?rid=4265914&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FfFyyf5rn0Fg%2F A reader of EMR and HIPAA asked the following interesting question: I was wondering if you had or heard of anyone coming up with a way to measure if the EHR implementation was successful. Other than “its in!”. Im trying to help some clients define this but cant seem to find anyone who has done this. Im thinking something like: Were all staff trained prior to go live? Were project goals achieved? etc Here’s my response that I hope you’ll find useful as well: It’s an interesting question. I’d suggest you download my free EMR Selection e-Book. In the book, I cover the various areas where a practice can get benefit from implementing an EMR. I suggest that each practice evaluate which of the benefits they are looking to achieve with their EMR implementation. ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4265914 Tue, 14 Dec 2010 16:45:58 +0100 4265914 http://www.medworm.com/index.php?rid=4251162&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F12%2F09%2Femr-and-older-doctors%2F Dr. Michael Koriwchak recently did a great post about implementing an EMR in a practice with an older physician. He does a great job analyzing the challenge that a group practice faces when one of the older physicians (I prefer mature physicians, but he said older) is the “lone hold-out.” Here’s his suggestion which is really valuable: So the older doc who claims to be ready to retire may not retire as soon as he thinks. So do you let him opt out of EMR or not? I would be happy to let him opt out of EMR…provided he commits in writing to a retirement date and allows the practice to begin making plans to recruit a replacement physician. The date would be fairly soon, no more than 18 months in the future. If he fails to retire by that date he would begin incurring costs re... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4251162 Thu, 09 Dec 2010 21:06:36 +0100 4251162 http://www.medworm.com/index.php?rid=4133906&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F10%2F26%2Fcookie-cutter-vs-customizable-emr%2F Honestly, this is one of my favorite discussions to have about an EMR system. The only hard part is that it’s an endless debate with no clear resolution. However, the choices that an EMR vendor makes in regards to their cookie cutter vs. customizable approach is really important. For those who aren’t as familiar with the issue, the challenge lies mainly in out of the box utility vs. ongoing improvement. The first part of that challenge is that most doctors think that when they spend their hard earned money on an EMR software, that it should be able to just work out of the box. I think many of the other software programs and other things we buy have created this culture of things just working. For example, it’s amazing how few things you have to do to setup a new computer ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4133906 Tue, 26 Oct 2010 16:18:54 +0100 4133906 http://www.medworm.com/index.php?rid=3999073&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FcRQU6XOSjhA%2F The Physicians’ Reciprocal Insurers (PRI) recently posted the results of a survey they did of 500 physicians regarding Electronic Medical Records (EMR) software and the EMR stimulus money and penalties. Here’s one of their most interesting findings about EMR implementation: One significant finding was awareness of financial incentives and penalties for implementing EMR systems. While 85 percent of physicians were aware of the financial incentives for implementing the systems, more than 35 percent did not know that they face government-assessed financial penalties for not complying. The penalties are equal to a one percent reduction of the physician’s annual Medicare payments per year up to five percent. However, those penalties do not seem to be having the intended effect, as mor... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3999073 Fri, 24 Sep 2010 17:10:01 +0100 3999073 http://www.medworm.com/index.php?rid=3876751&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F08%2F10%2Fmeaningful-use-experts%2F After my last post, a meaningful use checklist, I couldn’t help but start thinking about how many people are going to soon be looking for a meaningful use checklist. Certainly many practices are going to be interested in finding a meaningful use expert to help make sure that they get the EMR stimulus money. I’m guessing many EMR vendors are going to want to find a meaningful use expert that will help them navigate the hundreds of pages of regulations and wave of other meaningful use information which isn’t in the regulation cause let’s be honest. Despite a HUGE regulation, there are a still a ton of practical meaningful use details that you’re going to need to know to appropriately navigate the meaningful use world. The government doesn’t just hand out m... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3876751 Tue, 10 Aug 2010 18:33:51 +0100 3876751 http://www.medworm.com/index.php?rid=3876752&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F08%2F09%2Femr-stimulus-meaningful-use-checklist%2F A recent comment from Jim Hook from The Fox Group had a nice checklist of items that doctors and practice managers could start doing to make sure that their EMR implementation is ready to meet the meaningful use standards. This isn’t an exhaustive list, but I thought was a good list for those providers wanting to being their preparation for showing meaningful use and obtaining the EMR stimulus money. Everyone should keep in mind that there are no systems “Certified” at this point. Here are some things to check as you get ready to claim your incentives for EHR Meaningful Use under the HITECH Act. This information is based on (EPs) qualifying for the Medicare incentives. 1) Start talking to your vendor about their plans to submit their EHR software for certification as �... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3876752 Mon, 09 Aug 2010 16:14:36 +0100 3876752 http://www.medworm.com/index.php?rid=3876754&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F08%2F06%2Fan-emr-vendors-approach-to-bridging-from-icd-9-to-icd-10%2F This report will show the available ICD-10 codes. The doctor can study it, start to change, or ignore it. 3. The staff can opt to let the software map one ICD-10 to the ICD-9 or manually enter the code of their choice. 4. Our electronic claims software will have a flag per insurance carrier indicating whether or not it will accept ICD-10. For those that will, we will map the ICD-9 to the 10 and send that code. If no map identified, we will generate an error edit. 5. At some point down the road, we will use the information collected from billing to update the doctor’s preferred list of dx codes in the EMR. 6. We will have to augment customized programs at each client site that may be doing reports based on ICD-9. Related posts:A Look at Moving to ICD-10 The push to ICD-10 is rapidly... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3876754 Fri, 06 Aug 2010 16:37:30 +0100 3876754 http://www.medworm.com/index.php?rid=3827148&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F08%2F03%2Fmost-concerning-part-of-meaningful-use%2F Seems like we’re just about out of the daze that is the mammoth meaningful use final rule (yes, I know that other rules are even bigger, but it’s still mammoth). I thought it would be interesting to ask what’s the part of meaningful use that’s most concerning. Just so we’re not always pessimistic, I’ll follow up this post next week with one asking people to share the most exciting part of meaningful use. Both answers should be interesting. While I don’t want to bias your comments, I will say that the thing that concerns me most about meaningful use is physicians going deep into debt for an EMR system they barely want in the hopes of EMR stimulus money and then end up with no stimulus money. The first concern with this is those physicians that think... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3827148 Tue, 03 Aug 2010 13:06:06 +0100 3827148 http://www.medworm.com/index.php?rid=3813061&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FVoGkR7jQmcM%2F I’m really glad that the chorus of people singing the tune I’ve been singing is starting to swell. Here’s some comments from Barbara Hales of The Write Treatment talking about the right way to implement an EMR and the problems with the EMR stimulus carrot approach: I agree with you that EMRs should be implemented because it is the right thing to do,not because of the incentives. The government incentive is a dangling carrot. Money promised for implementation comes by way of increased Medicare and Medicaid reimbursements by 1-2% from each claim. Talks of slashing Medicare reimbursements by 21% came soon after. So after investing money and time in a system, you are going to get….what was that? This was considered by the government when they issued the proposal that r... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3813061 Mon, 02 Aug 2010 05:43:40 +0100 3813061 http://www.medworm.com/index.php?rid=3714284&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F06%2F29%2Femr-challenges-faced-by-recs%2F I’ve been meaning to write a post linking to BobbyG’s blog for a while and just never got around to it. If you follow the comments on here, you’ll have seen many of BobbyG’s comments as well. The thing that first struck me about Bobby was his sincere and thoughtful comments on the challenges that the RECs face. Here’s some of his thoughts on REC Challenges: Critics bemoan a lack of prior HIT deployment and QI experience among some REC awardees (as well as the heterogeneity of business models); While 60 REC contracts have thus far been awarded, with the newly chartered RECs frantically ramping up to meet the rather compressed Stage One Meaningful Use incentive payment timelines, both the requisite Meaningful Use reporting criteria and the EHR (Electronic Healt... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3714284 Tue, 29 Jun 2010 15:41:15 +0100 3714284 http://www.medworm.com/index.php?rid=3678587&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F06%2F15%2Femr-permissions%2F It’s always interesting to talk with someone about the permissions they should set in their EMR. Pretty much every EMR that has any footprint has a broad set of permissions available to restrict the access of your end users. It can often be a pretty significant task to set all of these permissions. Thankfully, it’s a project that you do once and then don’t have to go again (except for maybe some minor changes). Also, many EMR vendors have good templates for giving you a starting point for permissions. What usually happens is that users end up with ALL sorts of restrictions on user accounts. I can’t say this is such a bad thing. Users should only have access to the information and features they need for the job. However, in the application of this rule, people almost... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3678587 Tue, 15 Jun 2010 19:16:47 +0100 3678587 http://www.medworm.com/index.php?rid=3610397&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FZ8Nh-X85KBI%2F I’ve heard this mentioned a few times, but in all my posts I don’t think I’d ever mentioned it myself. But it’s very true that EMR is the Physician equivalent of an ERP (Enterprise Resource Planning). Wikipedia describes an ERP as such: Enterprise resource planning (ERP) is an integrated computer-based system used to manage internal and external resources including tangible assets, financial resources, materials, and human resources. It is a software architecture whose purpose is to facilitate the flow of information between all business functions inside the boundaries of the organization and manage the connections to outside stakeholders. Built on a centralized database and normally utilizing a common computing platform, ERP systems consolidate all business operati... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3610397 Fri, 28 May 2010 20:00:28 +0100 3610397 http://www.medworm.com/index.php?rid=3595681&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fj-sb8YS4Bgc%2F In a recent EMR webninar I attended, I heard some really good counsel that was worth sharing here on my blog: Limit EMR Investment Appropriately, but Don’t Skimp When people go into an EMR implementation I’ve seen all sorts of approaches. I’ve seen the phenomenally cheap to the no limits buying. Both of those are recipes for failure. The problem with the phenomenally cheap is that you’re going to end up not investing in the IT products and software that will make a huge difference in your EMR implementation. For example, you might buy a cheap scanner which 2 months later you realize was a horrible idea since you’ve literally burnt through the scanner and it no longer works. Instead, if you’d spent money on the right scanner (which do feel expensive), you... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3595681 Mon, 24 May 2010 16:22:40 +0100 3595681 http://www.medworm.com/index.php?rid=3556197&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FOCLOMf7dIcU%2F When I wrote my previous post about EMR consultant challenges, I thought it might be valuable to create a list of possible ways to do EMR consulting. This list is just off the top of my head, so please feel free to add other EMR consulting opportunities that exist out there in the comments: EMR Selection – Consult on selecting the right EMR. EMR Implementation – Consult on the best way to implement the EMR. Map EMR workflows to their existing paper workflows. Meaningful Use – Consult a practice on how they can achieve meaningful use and get the EMR stimulus money. EMR Vendors – Consult EMR vendors on their software, their marketing, etc. IT Consulting – Consult practices on the right IT infrastructure to support an EMR in their practice. EMR Review – Review an already implemen... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3556197 Tue, 11 May 2010 15:37:15 +0100 3556197 http://www.medworm.com/index.php?rid=3545515&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F0droqwckOvw%2F I always love to hear clinics talk about the challenges they face in implementing an EMR. For the most part, they are completely predictable. Especially when it comes to the small versus large clinic challenges. For example, small clinics will complain that they don’t have the resources that large clinics have to implement an EMR. Large clinics will complain that they have too much bureaucracy, red tape and stakeholders that they have to get on board an EMR implementation. They wish they were like smaller clinics who could quickly make decisions and had a much more focused need. Of course, the reality is that both of these point of views are accurate. It’s not news that small clinics can make decisions easier and that larger clinics have more resources at their disposal. Certai... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3545515 Wed, 05 May 2010 15:09:15 +0100 3545515 http://www.medworm.com/index.php?rid=3533944&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F05%2F04%2Femr-consultant-challenges%2F Everyone has been touting all the tremendous opportunities that are out there for EMR consultants and healthcare IT people. No doubt, there’s a lot of action right now around EMR. However, I’ve started to see many EMR consultants starting to wonder where the fountain of youthwork is that they heard was coming for EMR consultants. EMR consultants face a really interesting challenge. The small clinics usually can’t afford the services of a consultant (or feel that they can’t) and the large clinics have their own in house resources and so their reticent to pay an outside EMR consultant to come into their practice. Where does that leave the EMR consultants that heard there’s this amazing need for help with EMR selection and implementation? Not an easy problem to s... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3533944 Tue, 04 May 2010 15:06:04 +0100 3533944 http://www.medworm.com/index.php?rid=3529873&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Flxo6-gNHTFk%2F I’ve come across a number of websites and people who’ve made the assertion that with the short time frames for meaningful use, a SaaS EHR is the only option to be able to meet the meaningful use requirements in a timely manner. Let’s see if I can do my part to clarify this idea which isn’t completely accurate. First, there is still plenty of time for a clinic to implement an EMR of any type and get EMR stimulus money. At some point this might change, but at this point we are still far enough out that time is not an issue. Although, I’ll admit that it would be helpful if CMS and HHS would finally get some EHR software certified and provide some practical meaningful use details. Of course, these details shouldn’t be stopping doctors from evaluating and pla... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3529873 Mon, 03 May 2010 15:57:59 +0100 3529873 http://www.medworm.com/index.php?rid=3515479&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F04%2F26%2Fweight-loss-compared-to-emr-implementation%2F If you’ve read this blog for a while you know that I love to compare EMR implementation to other parts of life. It’s always amazing to me how similar other parts of life are to EMR selection and implementation. In case, you’re a newer reader, go and read my posts comparing EMR to Marriage (also talks about divorcing your EMR), EMR implementation to Pregnancy, and Marrying an EMR for Money (VERY important with all this EMR stimulus money). A presentation on comparing EMR to life would be a fun presentation to give, but I digress. The other day I came across a comparison that will be familiar to all types of people, but doctors will be acutely aware of this comparison (even more so than I). EMR implementation is very much like weight loss. Yes, that’s right. Weight Lo... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3515479 Mon, 26 Apr 2010 15:18:16 +0100 3515479 http://www.medworm.com/index.php?rid=3515481&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F04%2F22%2Fpossible-rec-business-model%2F As I said before, I’m finding the EHR RECs very intriguing right now. Thus a few extra posts about the RECs. First, thanks for those who have been helping update the EHR REC wiki page. There’s still a ways to go, but little by little we’ll get all of the RECs listed in one space. From what I can tell, and as evidenced by this CalHIPSO REC blog, these REC organizations have A LOT on their plate. First, they have to meet the mandates of the government (which I’ll talk about more another time). Second, they have to create an organization that didn’t really exist previously (for the most part). Third, they have to look at a long term business model for when the government funding for EHR RECs runs out. Not a simple task. I find the third item pretty interesting si... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3515481 Thu, 22 Apr 2010 16:03:00 +0100 3515481 http://www.medworm.com/index.php?rid=3490709&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F04%2F20%2Fehr-regional-extension-centers-recs%2F Every day I’m seeing little pieces of information come out about the EHR Regional Extension Centers (RECs). Sadly, there’s not one central location that is covering the activity of these RECs so that doctors and clinics could quickly see what’s going on and enjoy the benefits of the millions of dollars that was given to these RECs as part of the ARRA EHR stimulus money. Rather than just complain, I’ve started to create a wiki page that lists each of the EHR RECs, how much funding they’ve received and hopefully links to all of the REC websites. I have a long way to go, so I’d love to get your help in updating this list. So, leave a comment or feel free to update the wiki with the information you have about these RECs. Unfortunately, I’d guess that 9... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3490709 Tue, 20 Apr 2010 15:23:56 +0100 3490709 http://www.medworm.com/index.php?rid=3490710&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F04%2F19%2Femr-technology-exacerbates-problems%2F One thing that I’ve mentioned many times in the 4+ years of blogging about EMR is the impact of technology on a clinic. I’ve regularly mentioned that you shouldn’t implement an EMR to try and fix process problems in your clinic. Instead, you should first address the process problems in your clinic and then implement the EMR with the proper processes already in place. The reason for this is quite clear. Technology, in this case EMR, has a tendency to just exacerbate any problems that exist in a clinic. In fact, it will often bring to light problems that you didn’t know existed before EMR. A simple example is doctors who are behind on their charts. In the paper world, you might not know how far behind they are on their charting. In the electronic world many EMR softwa... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3490710 Mon, 19 Apr 2010 15:10:55 +0100 3490710 http://www.medworm.com/index.php?rid=3475907&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FfkjkT-hrRTg%2F I love the cycle that happens over and over and over again in the healthcare IT/EMR media coverage. Every 3-6 months a new study or article comes out that says that EHR Don’t Save Money. Here’s the one that I just got in my e-mail. At least this one talks about the short term issues, but leaves open the possibility of long term benefits. Don’t worry though, in the next 3-6 months another study and/or article will be out talking about the amazing benefits of EHR software. Let’s just cut through the crap for a second and really hit at the core of the issue. Some clinics have implemented an EMR and seen Amazing benefits (see great EMR ROI). Some clinics have implemented an EMR and seen little benefit. Some clinics have implemented (or should I say tried to implement) a... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3475907 Thu, 15 Apr 2010 14:54:51 +0100 3475907 http://www.medworm.com/index.php?rid=3467849&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FmFZPjwfDRQk%2F I was really intrigued by this well done article by Dr. Richard Hom about the Ethical Dilemma of the EMR. In it he describes the difference between the EMR technology world that will “sell anything at any cost” against the medical community values of things like the Hippocratic Oath. He ends the post with these stinging paragraphs: But medical angst persists. Because the EMR vendor is pursuing a “top down” sell, they bypass the medical leadership and pitch the C-level administrative staff. The medical input is usually an afterthought and the medical angst continues. Countering the medical angst and overcoming the perception of “business ethics” being ugly will not be easy. If there be a truth in medicine, it is the gaining and loss of trust. Trust is no... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3467849 Mon, 12 Apr 2010 15:52:10 +0100 3467849 http://www.medworm.com/index.php?rid=3403965&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F03%2F23%2Fregional-extension-centers-recs-and-hitrcs%2F One area of the HITECH act that I haven’t heard discussed nearly enough is the Regional Extension Centers. Sure, I’ve heard them mentioned in passing plenty of times. However, I haven’t heard any real good information on what’s being done to make sure that these RECs are going to be successful in their goal of 100,000 providers becoming meaningful users of EHR’s by 2011. Yes, that’s a pretty big hairy goal. Especially considering the EHR adoption rates up until today. Not to mention, these Regional Extension Centers (RECs) are going to have to find a way to effectively help doctors sort through the 300+ EHR vendors that are on the market with more coming out every day. This is not an easy task to accomplish and will require a lot of great tools to do it ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3403965 Tue, 23 Mar 2010 15:19:50 +0100 3403965 http://www.medworm.com/index.php?rid=3172015&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Femrfix.com%2FEMRFIX%2FDownload_Mr_John_Lynn_files%2FNina_Bryant_and_John_%2520Lynn_%2520Interview.mp3 I was recently contacted by Nina Bryant from EMR Fix. She was such a sweet lady, I consented to do an interview about EMR with her. There’s a reason that I blog and don’t do a podcast or video blog. I hate hearing my voice. That part aside, it was fun to do an interview with her and talk about what I’ve learned about EMR. You can sign up for Nina’s newsletter and it will automatically send you to a page where you can listen to and/or download the interview. It’s a 45 minute interview and is available for download in MP3 format. I’ll be interested to hear what people think of the interview. Related posts:EMR Selection and Implementation Books I’ve had in mind and been approached by a number... EMR Stimulus, Selection and Implementation Conference ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3172015 Wed, 13 Jan 2010 16:51:03 +0100 3172015 http://www.medworm.com/index.php?rid=3175978&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FPVmH6W4_jX0%2F I often get emails from people asking me to evaluate an idea. It’s always interesting to see what people come up with and how little research they’ve usually done on a specific topic. They just have an idea and start running with it. I actually love that attitude and I think that’s what makes entrepreneurs great. Well, one of the ideas someone sent me was the concept of implementing a kind of “Pre-EMR” before you go forward with the full EMR implementation. Here’s the description they sent me: The idea is to implement Smartlink long before a full EMR implementation. Once an EMR is selected then the data stored can be used to populate the EMR. The active interfaces to Smartlink can be aggregated and forwarded to the EMR with a single interface. Key benefi... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3175978 Mon, 11 Jan 2010 16:24:33 +0100 3175978 http://www.medworm.com/index.php?rid=3146059&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F01%2F04%2Fbalancing-workflow-customization-with-an-ehr%2F I’m a HUGE proponent of mapping your current workflows and evaluating how that applies to your EMR implementation. It’s absolutely essential to be able to do it right. It’s not an easy or necessarily fun task, but it pays big dividends when you go live with an EMR. However, far too many people get caught up with “my workflows” versus the “EMR workflows.” Some people like to argue that an EMR vendor should be able to customize their software to be able to support my current paper work flows. Other people argue that you should toss aside your current workflows and adopt the “best practices” standards of your EMR vendor. Of course, the real answer is as it should be: somewhere in the middle. The EMR should be built so that you can customiz... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3146059 Mon, 04 Jan 2010 17:04:01 +0100 3146059 http://www.medworm.com/index.php?rid=3092778&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FnaQJ3skPWfE%2F “Physician order entry and decision support I believe offer the most chance of improving healthcare delivery. There are a lot of information systems with bells and whistles that don’t focus on physicians’ real needs.” – Neil R. Powe, MD, MPH, MBA, Chief of Medical Services, San Francisco General Hospital source I previously posted about the benefits of EMR interoperability. The above quote touts Physician order entry and clinical decision support as the most likely to improve healthcare. Are these the three most promising features of an EMR or is there something they’re missing? What’s the killer feature of an EMR that will make every doctor implement an EMR whether they like it or not? Related posts:Killer EMR Features According to EMR Vendors I... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3092778 Mon, 14 Dec 2009 16:25:34 +0100 3092778 http://www.medworm.com/index.php?rid=3084853&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F12%2F12%2Femr-stimulus-selection-and-implementation-conference%2F I’ve started talking with some people about putting together an EMR conference. The main focus of the conference would be practical knowledge and skills to be able to understand the EMR stimulus and to deal with the EMR selection and implementation process. Here’s a short list of the types of sessions I’m considering: -EMR Selection – Getting Buy-In -EMR Selection – Vendors -EMR Contracts -EMR Implementation -IT Support Panel -EMR Reporting/Customization/Interfaces -Open Source/Free EMR -ARRA/HITECH Incentives -EMR Interoperability -PHR Looks like it’s likely going to happen in the Baltimore area. I’m really interested to find out if there would be interest in this type of conference. Here’s a poll to help me gauge interest: View Poll Also, ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3084853 Sat, 12 Dec 2009 16:52:14 +0100 3084853 http://www.medworm.com/index.php?rid=3084855&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F12%2F10%2Fbenefits-from-emr-come-from-interoperability%2F “Looking for savings in hospitals that use EMRs is short-sighted. The real payday for use of EMRs will come with interoperability. Measurable savings will be realized as middleware is installed that will allow for the electronic transmission and translation of patient records across different proprietary systems between delivery networks.” – Jim Lott, Executive Vice President, Hospital Council of Southern California, Los Angeles source “EMRs don’t save money in standalone situations. However, EMRs will absolutely save significant money (and improve care and safety) when connected and sharing clinical information.” Johnny Walker, MBA, CPA, Founder and past CEO of Patient Safety Institute, Plano, Texas source These two quote remind me a lot of my previous ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3084855 Thu, 10 Dec 2009 16:04:02 +0100 3084855 http://www.medworm.com/index.php?rid=3056736&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F12%2F01%2Finteresting-emr-data-conversion-story%2F Discussion between client and [EMR vendor] revolves around whether they are talking about [either of the 2 methods this EMR vendor uses]. It is finally decided that more fields are needed in the original spreadsheet. Which field should be used for “race”? Are patient names going to be converted in all upper case or upper/lower? They’ll check with another programmer – that might be a conversion parameter. More background discussion about the “autoflow” phone call scheduled for later that day. Call concludes that a new spreadsheet defining the fields will be sent out. Observations: This is just the tip of the iceberg in terms of time and space that will be required as sites migrate to EMR. It will take lots of TIME – you’ve made this point repe... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3056736 Tue, 01 Dec 2009 16:07:40 +0100 3056736 http://www.medworm.com/index.php?rid=3056737&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F30%2Fhit-projects-you-can-implement-today%2F Many people are sitting their on the proverbial fence waiting to see what’s going to happen with the HITECH act and meaningful use before they actually go and implement an EMR. Now, I’m not going to let those people off the hook from evaluating and selecting an EMR. That should be done anyway. However, lately I’ve been thinking that many of these clinics shouldn’t be waiting to implement technology in their offices. Sure, EMR is a game changer and a major change for any office and has tremendous upside (regardless of stimulus money). However, for those of you in the wait for HITECH act money camp, there are still a number of IT projects that you can implement today that will benefit you once you actually implement an EMR. Here’s just a few of them: Fax Server ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3056737 Mon, 30 Nov 2009 17:17:17 +0100 3056737 http://www.medworm.com/index.php?rid=3033654&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F25%2Fopenemr-success-story%2F A little while back I read an interesting EMR success story using the open source EMR appropriately named OpenEMR. The story is by Joe Holzer and I got his permission to republish it here for all to enjoy. You can find more about Joe on his website (not the normal website) or at his email im@holzerent.com I think you’ll enjoy his story and some of the unique ways he used OpenEMR to address some challenging problems along with his passion for open source EMR software: I have implemented OpenEMR in a number of sites, and I advise on its use in their forums at Sourceforge.net. My wife Lynne was my first “client”, and her use of FREE OpenEMR allowed her to eliminate all need for my services as her business office manager, as well as all clearinghouse costs, as it prepares bot... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3033654 Wed, 25 Nov 2009 16:00:28 +0100 3033654 http://www.medworm.com/index.php?rid=3023223&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F22%2Fbest-advice-for-those-implementing-an-emr%2F Since it’s the weekend, I like to open it up for the readers of this site to share their knowledge. Let’s hear the best advice you could give to someone who is implementing an EMR. I’ll admit that I had a hard time just choosing one piece of advice. My first thought was mapping your current workflows and map them to your EMR software. This is an amazing way to plan for an EMR implementation. Then, my next thought was to choose the right EMR. However, that just feels too easy. So, I’ll take… Make sure you get buy-in for your EMR implementation in all parts of your organization. Beg, borrow, steal, mandate, grovel, or whatever it takes to get buy in before you implement an EMR. Related posts:Advice for EMR Selection Consultants A recent comment asked me what I... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3023223 Sun, 22 Nov 2009 16:38:56 +0100 3023223 http://www.medworm.com/index.php?rid=3023225&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F20%2Fstudy-shows-little-benefit-from-emr-in-hospitals%2F People have been buzzing over a recent New York Times article (requires login, but you can get a login and password here) which discusses a Harvard study showing little benefit seen so far in Electronic Patient Records. The study is interesting and worthy of consideration. I think this part of the Times article summarizes the findings: The new study placed hospitals into three groups: those with full-featured electronic health records, those with more basic ones, and those without computerized records. It then looked at their performance on federally approved quality measures in the care of conditions like congestive heart failure and pneumonia, and in surgical infection prevention. In the heart failure category, for example, the hospitals with advanced electronic records met best-practice... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3023225 Fri, 20 Nov 2009 16:46:33 +0100 3023225 http://www.medworm.com/index.php?rid=3023226&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F19%2Femr-selection-and-implementation-books%2F I’ve had in mind and been approached by a number of people about writing a book about the EMR selection and implementation process. If you’ve read this blog for a while, you know I’ve had in mind to write some e-Books. I like the e-Book better than a hard copy book, but maybe if I combine all the e-Books it would make a nice hard copy book as well, but I digress. The good news is that I’ve started writing. I was actually amazed at how quickly and easily the content has come so far. I’m also quite happy with the value that it could bring to someone looking into the EMR world. Although, I still have a ways to go. One person that was interested in me writing this book send the following outline for the EMR Selection and Implementation book. I’d love to hear... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3023226 Thu, 19 Nov 2009 16:50:57 +0100 3023226 http://www.medworm.com/index.php?rid=2995806&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F13%2Fpaper-chart-to-emr-scanning-list%2F I’ve previously written about chart disposal after an EMR implementation and the concept of “thinning your paper chart for scanning into an EMR.” Because of those posts, one reader asked me about feedback on a list of what things should be included in the “thinned” paper chart. Of course, my first reaction was to tell them to ask the doctors. Each doctor/specialty/clinic is unique and so every one of those would have their own list of what they thought was important. However, I also said I’d post their list on here for people to take a look at and provide feedback on things that shouldn’t be on the list or things that might be missing from this list. So, check out this list and I’d love to hear feedback on it in the comments: Paper Chart to E... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2995806 Fri, 13 Nov 2009 16:46:49 +0100 2995806 http://www.medworm.com/index.php?rid=2927422&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F10%2F20%2Fchange-in-an-emr-implementation%2F I love when EMR sales people try to say that doing an EMR implementation will be just the same as what they’re doing now, but electronically. While this might be true in many respects there’s no way you can get around change. It’s an essential part of an EMR implementation. I apologize if you’re tired of hearing about this topic since I’ve talked about it over and over (some nice pictures on this one) and over again in the last 4 years. I just think it’s important that people have realistic expectations. One thing I recently heard at a conference was related to change in an EMR implementation. They said that you should “Change Enough to matter, but not so far that you have to change jobs.” I loved that description. It describes perfectly the ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2927422 Tue, 20 Oct 2009 16:16:13 +0100 2927422 http://www.medworm.com/index.php?rid=2927424&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F10%2F18%2Froadblocks-to-emr-implementations%2F I’ve decided that on Sunday’s I’ll just post a few interesting questions and give people the opportunity to share their experience and/or expertise. Hopefully we’ll get a lot of participation and we can all learn from each other in the process. No doubt many of my readers are more knowledgeable and experienced than me. Today, let’s talk about the roadblocks that people have faced or are facing in their EMR implementations. If you’ve already implemented an EMR, let’s hear the roadblocks and challenges that you faced when implementing and how you might have overcome those challenges. If you’re still deciding whether to implement an EMR, let’s hear what reasons are blocking you from implementing an EMR. EMR vendors and consultants can shar... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2927424 Sun, 18 Oct 2009 15:15:57 +0100 2927424 http://www.medworm.com/index.php?rid=2902837&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FlUtSFXEBkVE%2F In a recent EMR vendor demo I did, they talked about strongly encouraging purchasers of their EMR software to do what they called a “clinical process review” before implementing their EMR. They had a contract with a third party group that would do the analysis and give the organization an idea of their current processes and what the future processes would be with an EMR. It highlighted things that would need to change, additional processes that would be added and processes that would be removed. I’ve talked about this a lot in the past and I think it’s essential to a successful EMR implementation. I called it mapping your workflows, but clinical process review sounds prettier. Certainly if you’re a large organization it can sometimes pay off to get someone els... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2902837 Sat, 17 Oct 2009 14:07:47 +0100 2902837 http://www.medworm.com/index.php?rid=2901709&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F10%2F14%2Ftimeframes-to-implement-an-emr-and-the-emr-regional-extension-centers%2F I quoted this CIO in my previous post about EMR Motivations, but I also thought that Neal Ganguly provided some interesting analysis of the time frames involved with selecting, implementing and using an EMR. Plus, he takes it one step further and adds in the time frames to get the EMR regional extension centers in place as well. Check out the EMR timelines: Hospitals / Physicians: It can take 3-6 months to evaluate and select a system and then it takes 18-24 months to install a hospital clinical system. It takes 2-5 months to properly install a physician EMR. It can take 6-12 months or more to work out the kinks and become productive on such systems. The talent pool to accomplish this work is spread thin. Hence the extension center concept. However, it can take 3-6 months to establish cent... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2901709 Wed, 14 Oct 2009 15:12:38 +0100 2901709 http://www.medworm.com/index.php?rid=2846462&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F09%2F25%2Femr-data-archiving%2F In my previous post I talked about a few of the options related to shredding or archiving your paper charts after you’ve implemented an EMR and the paper charts aren’t being accessed. Now let’s take a look at what’s just begun to come up in our clinic: EMR Data Archiving Archiving Old EMR Records Once you’ve been on an EMR for a number of years, you start to think about all of the data that’s stored in your EMR. Do you really want to store ALL of the information you’ve entered into an EMR in perpetuity? The answer as usual is maybe. Quick Disclaimer: Before you do any EMR data archiving, you better talk to a good lawyer to make sure what you’re doing is legal in your state. I am not a lawyer and don’t even play one on TV. Just don&#8217... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2846462 Fri, 25 Sep 2009 17:00:58 +0100 2846462 http://www.medworm.com/index.php?rid=2846463&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F09%2F24%2Fpaper-chart-disposal-after-implementing-an-emr%2F I’d be planning on posting about this for a while and someone brought it up in the comments of one of my other posts. So I figure it must be time to talk about what to do with all those old paper charts. I’m not going to go into the specific regulations. First, I’m not a lawyer and don’t want to give any legal advice. Second, these regulations often vary from state to state and 50 is a lot of different regulations. With that disclaimer, let’s take a look first at what to do with all the old paper charts that are no longer being accessed. Archiving or Shredding Old Paper Charts One of the big questions people ask is what do we do with the old paper charts. In this post I’m not going to talk about the various ways that you can incorporate your old paper ch... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2846463 Thu, 24 Sep 2009 17:00:05 +0100 2846463 http://www.medworm.com/index.php?rid=2793260&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F09%2F04%2Femr-implementations-change-workflow%2F I saw an EMR demo today and they made a really interesting point about workflow. In fact, I was impressed that the EMR vendor admitted up front that you would need to change your clinic to work with their EMR software. I’ve said this a number of times on this site, but it was kind of refreshing to hear an EMR vendor admit it. I’ll have more on the rest of the demo/presentations in future posts. What was most interesting was that after admitting that you would need to change the way you work to use an EMR, he made a really interesting and powerful point. The basic concept was that if you don’t have an EMR, your current workflow is bound by the paper world in which you now live. Hopefully, adding an EMR to the mix provides some new ways to serve patients that were impossibl... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2793260 Fri, 04 Sep 2009 16:29:38 +0100 2793260 http://www.medworm.com/index.php?rid=2757879&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FX3EHmZz2J5U%2F I’ve been discussing the case for EMR implementation recently both on my blog and in emails with various people. In fact, someone even recently commented that the cost of an EMR was less than the EMR stimulus money and so it was a negative return on investment. I quickly responded that maybe he was looking at the wrong EMR companies and also that there were other benefits to implementing an EMR beyond just the EMR Stimulus money. One example of these benefits is those people who have multiple locations. I was recently talking with someone about how they managed paper charts between multiple offices. What a mess. I’m sure those who read this blog who have done this know about all the challenges. The most important of which is that sometimes you’re left without the chart fr... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2757879 Tue, 01 Sep 2009 16:29:00 +0100 2757879 http://www.medworm.com/index.php?rid=2724984&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fy3QhrRcZsUo%2F There was a lot of interesting response to my article on replacing an EMR. I actually got an email response that I believe is a really interesting read about one EMR vendors take on the challenges of converting the data from an old EMR to a new EMR. Here’s the email response (with old EMR vendor name removed since it could have been any EMR): Interesting article. This is where I live each and every day. Most recently, I’ve switched a client from [current EMR Vendor] to our product Red Planet. The price tag on upgrading [current EMR Vendor] was too prohibitive and they were already familiar with us since we were doing the PMS. So, we already had a foot in the door. There were two challenges: 1) Converting the data. 2) Converting the culture. The data was not easily accessible, ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2724984 Thu, 20 Aug 2009 17:38:27 +0100 2724984 http://www.medworm.com/index.php?rid=2678702&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FL9SVNfVtnpw%2F 1. Quickly locate a chart, never look for a chart 2. Access to chart from multiple locations by multiple users 3. Legible Charts 4. EMR Data: chart it, graph it, flag it and organize it Oh wait, none of those are financial are they? Try these potential EMR financial benefits. 1. Transcription cost savings 2. Space Savings 3. Eliminate Staff 4. Paper Chart Costs 5. Improved Charge Capture Oh wait, why not just hope you get $44k in stimulus money? That might work. See the full list of EMR Benefits. Related posts:27-41 of 50 Reasons to get an EHR or EMR – Greater Efficiency and Lower Costs I should really thank Medical Economics for creating the original...13 of 50 Reasons to get an EHR or EMR – Better Access to Data and Better Charting I found a nice article in Medical Economic... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2678702 Thu, 06 Aug 2009 16:36:25 +0100 2678702 http://www.medworm.com/index.php?rid=2674344&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F4Wk1XfeatxU%2F When someone comes to my clinic to see our EMR implementation, they always ask “what lessons did you learn during your EMR implementation?” It’s inevitable, and obviously a good question. One of the answers I give the most is that I was surprised at how much of the initial training was on basic computers skills and not actual EMR software training. On that note, I got an email from Michael Archuleta of ArcSys Inc. that described some of the challenges of training before an EMR implementation including training on some of the new technologies (see tablet, convertible, laptop and EMR discussion) that might be implemented with an EMR. First, no two medical professionals are alike. They have been taught differently and see things through different lens. Second, people have di... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2674344 Wed, 05 Aug 2009 16:14:15 +0100 2674344 http://www.medworm.com/index.php?rid=2660800&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FIsicydEuGpg%2F Sometimes I feel like it’s my mission to combat the myths associated with EMR certification, selection and implementation. Ok, so maybe it’s mostly the EHR certification, but selection and implementation are closely tied to EMR certification. On that note… An EMR certification that verifies “minimum EMR functionality” DOES NOT equal a usable EMR. Yes, it’s a subtle difference, but an important one that far too many people ignore. Call it good marketing by the certification body. Call it a misunderstanding. Regardless, it’s scary how many people think that by testing for a “minimum EMR functionality” they are more likely to have a successful EMR implementation. The problem is, it doesn’t. If it did, then we’d have a lot more ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2660800 Fri, 31 Jul 2009 15:58:28 +0100 2660800 http://www.medworm.com/index.php?rid=2639632&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FO3zkvsnC8ro%2F I’m always sad when I come across an EMR implementation that doesn’t have an interface between their EMR and their lab. I can appreciate someone having just implemented an EMR not having a lab interface. However, it should be one of the first things on your list to implement. It’s such a great compliment to your EMR software. First thing I must suggest is that you get a bi-directional lab interface if at all possible. One way lab interfaces can work, but do take more management to make it work right. Why Get a Lab Interface with Your EMR? Lab interfaces are so seamless. The order is made in the EMR and it’s automatically is sent to the lab. Talk about removing a lot of the possibilities for error. In our case, we have an in house lab and so this saves a ton of time ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2639632 Sat, 25 Jul 2009 17:00:19 +0100 2639632 http://www.medworm.com/index.php?rid=2553113&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F27%2Favailabilty-of-hit-help-for-emr-implementations%2F One of my regular readers, sent me the following email about the availability of IT help for those implementing an electronic medical record (EMR). If my conjecture about the mad rush for good quality IT help is correct, then I wonder if physicians will have to choose between experienced HIT contractors that have long waiting lists and may be overwhelmed with demand (particularly if they get greedy about taking on too many clients or have trouble scaling) or try to find a good but inexperienced firm that will be responsive. Could be an interesting dilemma? There’s no doubt that a physician’s IT support can sink an EMR implementation just as easily as a poor EMR vendor. I wonder how many failed EMR implementations should be credited to the IT people over the EMR vendors. I still... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2553113 Sat, 27 Jun 2009 16:39:50 +0100 2553113 http://www.medworm.com/index.php?rid=2553117&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F23%2Feasy-to-justify-ehr-implementation-at-hospitals%2F Many people have been arguing that it’s an easier process for hospitals to be able to justify the implementation of an EHR thanks to the new EHR stimulus money. Even more important might be the 5% penalty for not implementing an EHR. There’s no doubt that there’s a lot of money at stake in a large hospital system that has 100+ practices. You can do the math: number of providers x $44,000 = A lot of money. However you also have to add to that amount the penalties which is basically: Medcare reimbursement x 5% = Even more money. I’m certain that every hospital in the US is keeping a close eye on these developments. Even large group practices have some of the same financial equations with just a little bit smaller scale. What I think most people are forgetting is that ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2553117 Tue, 23 Jun 2009 15:07:19 +0100 2553117 http://www.medworm.com/index.php?rid=2469657&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F10%2Fthe-move-to-ehr-adoption%2F Considering most people put current EHR adoption somewhere in the 10-20% range, I found this part of the article on Healthcare IT news pretty interesting: Fifty-nine percent of providers surveyed said they have already implemented or plan to implement EHRs in the next 12 months but only 17 percent are participating or planning to participate in a health information exchange. These survey results are really interesting to me since it seems to show a huge shift in people’s plans for EHR adoption. It’s the shift from asking the question “Should I adopt an EHR?” to the question “How and when should I adopt an EHR?” Of course, it’s one thing for people to say that they are planning to implement an EHR and actually meaningfully using an EHR. I still thin... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2469657 Wed, 10 Jun 2009 15:24:51 +0100 2469657 http://www.medworm.com/index.php?rid=2464222&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F9HwApbjMlK4%2F I recently had a comment on my post about meaningful use that I thought was well worth sharing as a post of its very own. Unfortunately, this situation happens far too often. Notice that it seems the IT part of the equation is as important as the EMR part of the equation. I welcome other people to share their experiences with an EMR (good and bad) in the comments. I’m a meaningful EHR user, I’m family doctor caring for 1700 patients and working long hours in my small private practice office. Since I introduced HIT and EHR in my practice my costs hit the roof and after two years I see more problems then before. I had to earn to pay the nurse before, and now I have to pay the program solution, consultants, cartriges and toners, paper etc.. My nurse got nervous breakdown because of slow, ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2464222 Mon, 08 Jun 2009 15:37:15 +0100 2464222 http://www.medworm.com/index.php?rid=2447761&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F4kEh4vxTJj0%2F I decided to dig back in my archive of draft posts to post some items that I should have posted a long time ago (only so many hours in a day). In my list of half started posts, I found this interesting article which claims to talk about one of the first scholarly studies on EHR regulation. I’ve gone through most of the EHR scholarly literature, and I think they’re right. Very little scholarly work has been done on EHR. I think I’ll leave the discussion of EHR regulation for another post. What I found most interesting about the above article was this section on the costs of EHR software and EHR adoption: Financial support and incentives are also critical to the success of the transition to EHR systems. It is estimated that the cost of purchasing an EHR system is $33,000 f... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2447761 Mon, 01 Jun 2009 17:33:07 +0100 2447761 http://www.medworm.com/index.php?rid=2441905&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FmiGBboBIo-E%2F I was just reading through Jamie’s post on EMR and EHR talking about showing EMR “meaningful use” and EMR reporting. She provides some really interesting examples about the challenges of reporting out of an EMR that wasn’t designed to report those various data elements. This discussion caused me to think about the impact that having to report on meaningful use will have on an EMR implementation. An EMR implementation is hard enough as it is now. Now, not only will an EMR user have to focus on learning all the new EMR functionality and translating their various clinical workflows into an EMR workflow, but they’ll also have to take into consideration the reporting requirements that will be necessary to get access to the EMR stimulus money and show meaningful use... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2441905 Thu, 21 May 2009 20:28:08 +0100 2441905 http://www.medworm.com/index.php?rid=2408548&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FWk2JkDjgXuA%2F As I’ve been writing and reading about ARRA and the HITECH Act, I’ve had a few moments to consider the impact that things like the HIT Policy Committee will have on the future of EMR adoption in the US. Between that committee, ONCHIT and HHS the decisions they make will have far reaching impact on EHR adoption. I’ll leave the question of whether they’ll have a good or bad impact to another post. Instead, I couldn’t help but wonder what impact bloggers and various EMR related websites and forums can have on EMR adoption. More specifically, I’ve been asking myself what kind of impact does this blog have on overall EMR adoption including both selection and implementation. Maybe I should be asking myself the question of how much impact could EMR bloggers hav... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2408548 Thu, 14 May 2009 23:20:34 +0100 2408548 http://www.medworm.com/index.php?rid=2405562&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F05%2F13%2Fsink-or-swim-after-emr-purchase%2F I find it really disturbing the number of stories I read about doctors who have purchased an EMR basically being left to ’sink or swim’ once the EMR purchase and training process is complete. This is not always the case. Some EMR companies really take a vested interest in those who purchase their EMR software. That’s my biggest compliment of the EMR company I work with on a daily basis is that they really did care about us having a successful EMR implementation. I know a number of others who are just as vested in a clinic’s success. Unfortunately, far too many EMR vendors don’t take a vested interest in a practice and after the purchase and initial training, the practice is basically left to finish the EHR implementation on their own. Let’s take a look a... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2405562 Thu, 14 May 2009 02:32:03 +0100 2405562 http://www.medworm.com/index.php?rid=2405563&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F05%2F13%2Fkiller-emr-features-according-to-emr-vendors%2F I previously posted a request to hear about the “killer” EMR features that set an EMR vendor’s software apart from the other 400 EMR vendors out there. As expected, some of the people who sent me a message didn’t understand what I mean. However, a few of the responses we’re pretty interesting. I think we’ve barely scratched the surface on EMR features, so please keep submitting your best EMR feature on the contact us page. Here’s a quick look at three of the responses from EMR vendors. I’ve added strikethroughs when it’s not a killer feature and my commentary is in italics. First up is SRSSoft’s killer EMR feature: The SRS hybrid EMR is a killer EMR, with the prime killer feature being “speed.” Speed is built into the hybrid E... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2405563 Wed, 13 May 2009 07:41:14 +0100 2405563 http://www.medworm.com/index.php?rid=2405564&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F05%2F12%2Fbeware-of-errors-on-test-or-demo-emr-system%2F I’m sure that many of my readers have experienced the awkwardness of an error happening during the demo or training of an EMR system. I’ve been on both sides of the fence (watching or doing a demo) and let’s just say it’s really uncomfortable for both sides. Those that have experienced it know that the most common explanation for the error is “This is the demo system and so we haven’t finished setting everything up.” Or in the case of the training system, “This is the training system and so with all of the people training on this system it has some errors from those training on it.” In some cases, this is completely true. When I’m training my staff for an update to our EMR software, there has been a number of occasions where I was... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2405564 Tue, 12 May 2009 22:39:28 +0100 2405564 http://www.medworm.com/index.php?rid=2405565&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F05%2F12%2Fcost-of-leaving-emr-for-paper%2F I’ve just begun my series listing the benefits of an EMR in a clinical practice, but today I was kind of struck by a post over on the TempDev blog. The post is called “Would You Go Back to Paper?” The following section of an email they received is what struck me most: I cannot begin to tell you how the loss of EMRs has adversely impacted our work. Please keep up the good work with helping people implement EMRs. Sincerely, A Midwest RN They also have a poll on their post which should hopefully turn up some interesting results. However, this comment from A Midwest RN really made me think about what it would be like to leave an EMR and return to the paper world. I’ve quite often suggested that if the clinic I work for full time chose to move to another EMR, I’d j... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2405565 Tue, 12 May 2009 14:46:55 +0100 2405565 http://www.medworm.com/index.php?rid=2288985&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FZEQ3oTanUB4%2F I’m often amazed at how many people underestimate the impact that an EHR implementation will affect a practice. Actually, maybe far too many people understand this and that’s why EHR adoption is so low. What worries me is that so many of those people that do implement an EHR completely underestimate the impact that an EHR will have on their practice. Let me try and make the case about how important an EHR is to a clinical practice. I do this not to try and discourage people from implementing. Instead, I do this to encourage people to take the EHR selection and implementation process more seriously. The decisions you make in regards to which EHR you choose will have lasting impacts on your clinical practice. Let’s take a look at why this is the case. An EHR is part of EVER... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2288985 Thu, 19 Mar 2009 19:04:40 +0100 2288985 http://www.medworm.com/index.php?rid=2288986&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fce8R3BzhP3U%2F I’ve definitely said my fair share of things about CCHIT. Sometimes I wonder what CCHIT thinks about my comments. I’m really not trying to be mean, hurtful or ugly about it all. I just want to share my own feelings about the certification and educate people as much as possible about what the CCHIT certification can and can’t do. It’s not my fault if I just find a lot more wrong with it than I find right with it. At the end of the day, I try to follow the advice of a radio personality don’t try to please everyone. Just try to be right. The good thing for me on this blog is that when I’m wrong, people correct me in the comments. I always reserve the right to change my mind and make updates as are appropriate to make me right again. However, relatively rece... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2288986 Thu, 19 Mar 2009 13:10:48 +0100 2288986 http://www.medworm.com/index.php?rid=2272551&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FuPIdYOAatQk%2F I was recently reading a post on EMRUpdate (great EMR Forum) by a man I highly respect who goes by CEOMike. In his long post, he made the following short analysis that I thought was really interesting: I thought by now you would have figured out EMR vendors are LIARS, making some of the bankers look like choir boys. I have done other posts on the install base claims of vendors. Figure it out 4% (studies show) of approx 400,000 primary care docs is only about 16,000 EMRs in use. Divide that by the approximately 400 EMRs [see my list of over 400 EMR companies] that have been listed in the last three years = 40 users per EMR Or go at the other way - take all claims by EMR vendors and add them up (I did this exercise a few years back) and you get something like over a million doctors using EMR... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2272551 Tue, 17 Mar 2009 07:57:25 +0100 2272551 http://www.medworm.com/index.php?rid=2272556&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FJhakqtSwMpU%2F A reader recently sent me a couple personal stories about EHR implementations that I thought worth sharing. I’m not going to say that these are the typical implementations, but I will say that I’ve heard stories like this far too often to ignore. I’ve removed any identifying information about the people, practice or EHR company. This really isn’t about one company, because you could insert any number of names and get the same story. Also, excuse any bad grammar since they didn’t intend it to be posted here, but have given me permission to post it. Thanks to the reader who sent it to me. Son-in-law is a family medicine practitioner in a 5 doc group. Wife is a CFNP MSN in an EP Cardiology group. Both here in [CITY REMOVED]. Spouse’s group elected [EHR Vendor] ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2272556 Mon, 16 Mar 2009 16:44:08 +0100 2272556 http://www.medworm.com/index.php?rid=2258335&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FojVpaMKdLJk%2F When writing one of my previous posts about EMR implementation, I realized that it’s a lot like being pregnant. Maybe I just have pregnancy on the mind since my wife and I just went to the ultrasound for my 3rd child (It’s a boy), but hear me out. Anyone who’s seen someone in labor is familiar with the pain of pregnancy. It was no different for my wife giving birth to our first child. About the time she was dilated to a 4 she was in so much pain that all she could not even talk to me and writhing in pain in the fetal position. I’d never seen my wife in so much pain and hope to never see her that way again. Thanks to the modern marvel we call an epidural, the pain my wife was experiencing was almost wiped away for the rest of the pregnancy. The funny part is that abo... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2258335 Mon, 09 Mar 2009 17:30:39 +0100 2258335 http://www.medworm.com/index.php?rid=2249713&cid=t_99680_113_f&fid=36504&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalRecordShow%2F%7E3%2F5JcE2jSa4Sc%2F This is part 3 of a 3-part series: EMR 101. Along with Step 4, Step 5 starts to open the door into EMR 201: Getting Really Good. If EMR 101 is about surviving the day, EMR 201 is about getting efficient, which enables you to think widely and deeply about patient care, as well as proactively. Step 5a: Abstract Abstracting refers to distilling old chart or patient record info directly into your EMR. It differs from scanning those other records, in the same way that data is different from information – one is raw potential, the other is immediately useful. A scanned chart, or hospital discharge summary, is just a snapshot, an image in your medical record reference files. It can be accessed and read, and key info extracted, but until someone actively accesses, reads, and extracts that ... The EMR/EHR Show: Making Your Electronic Medical Records Really Work blogs http://www.medworm.com/rss/comments.php?id=2249713 Sun, 08 Mar 2009 17:26:46 +0100 2249713 http://www.medworm.com/index.php?rid=2249057&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FZm6KGM0_HWU%2F The more I read comments on this blog and on EMR forums, I realize that there’s a real need for some sort of simple but effective guide to understanding the EMR selection and implementation process. Basically, I’m talking about a mix of showing a realistic picture of selecting an implementing an EMR. A discussion of the realities faced by almost everyone implementing an EMR. This of course would be coupled with some strategies to avoid as many problems as possible. However, hopefully it would also help doctors have a better vision of what they can expect in the EMR selection and implementation process. DrQ from EMRUpdate was one of my motivations for wanting to do this, so I feel I should give him some credit. So, this weekend I’m going to start the process of creating a ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2249057 Thu, 05 Mar 2009 06:52:26 +0100 2249057 http://www.medworm.com/index.php?rid=2222369&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FuddX5LDJK-0%2F I saw a link go across my Twitter feed called “The Meaningful Use Timeline.” The title of course was interesting and so I had to check it out. The basic idea presented is a big image showing the potential time frame required for doctors wanting to become a Meaningful EHR user in order to cash in on the EHR stimulus from the HITECH act. The conclusion of the article is that you can show meaningful EHR use by 2011, but you need to start now. Until we really know what HHS is going to require of an EHR user to receive some EHR stimulus money, then it’s really hard to guess how long a user will need to have used an EHR to show meaningful use. However, it’s more than reasonable to make a goal of implementing an EHR by 2011. I personally implemented a local doctor starting... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2222369 Fri, 27 Feb 2009 19:30:35 +0100 2222369 http://www.medworm.com/index.php?rid=2195668&cid=t_99680_113_f&fid=36504&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalRecordShow%2F%7E3%2F5yygu52TgTE%2F Back in the day when I was a burgeoning kendo student, I read an account about a visiting fencing master. The writer, an established member of a kendo club, was looking forward like everyone else to the visit of this celebrity sensei. While having practiced kendo for nearly seven decades, the guest was appallingly fast, and had a reputation for winning known throughout Japan. He was, in a word, amazing, and every bit as impressive in person as his record suggested. When the guest asked the writer to practice with him, the club member was practically beside himself. What special techniques and feints would he be privileged to witness? What insights into timing, distance, and psyching-out your opponent would he be party to? “I’d like to work the overhead strike,” the guest ... The EMR/EHR Show: Making Your Electronic Medical Records Really Work blogs http://www.medworm.com/rss/comments.php?id=2195668 Wed, 18 Feb 2009 09:31:32 +0100 2195668 http://www.medworm.com/index.php?rid=2172718&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Flvcj8w9R72g%2F I recently read a really interesting and informative article called “Five Reasons Why EHR Implementations Fail.” My only problem with this post is that it focuses too much on the negative. Too many doctors (and all clinical staff) are looking for reasons to have their EHR fail and not enough of them are looking at the reasons why an EHR implementation will succeed. Therefore, here’s my 5 reasons why your EHR implementation will succeed. Amazing Trainers There are amazing trainers out there that have gone through hundreds of successful EHR implementations. Make the time for staff to utilize one of these trainers and you’ll see amazing results in implementing an EHR. Soon after implementing your EHR you’ll wonder how you practiced medicine without an EHR. Realis... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2172718 Tue, 10 Feb 2009 14:09:09 +0100 2172718 http://www.medworm.com/index.php?rid=2156325&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FyewxYfuKWLQ%2F Searches for Top EMR companies has been the biggest source of traffic to this site in the past month.  Users searching Google for this will be directed to my long list of EMR and EHR companies.  I feel a little bad that someone is searching for the top EMR companies and gets directed to a list of over 400 EMR companies (and that list is definitely old).  Hopefully as the EMR and EHR Matrix of Companies on the EMR and HIPAA wiki continues to fill out, it will be a better resource in finding the various EMR and EHR companies that exist. What’s interesting is that my guess is that many of those looking for an EMR company don’t know how to start the EMR/EHR selection process.  They’re overwhelmed by the over 400 EMR and EHR systems available on the market today.  I have... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2156325 Tue, 03 Feb 2009 17:00:55 +0100 2156325 http://www.medworm.com/index.php?rid=2144434&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F01%2F29%2Fobama-and-congressional-leaders-cant-overlook-emr-failure-rates%2F “If it’s [EMR investment and implementation] too hasty, you can create so many bad experiences that people say…’My data’s a mess and my patients are angry,’” Mr. Glaser said in a recent Wall Street Journal article on the possible wasted investment in EMR.  The scary thing is that John Glaser, chief information officer for Partners Healthcare, is probably right.  I know that President Barack Obama wants to “wield technology’s wonders to raise health care’s quality and lower its costs.”  I want to do that too.  In fact, I think we’d all like for that to happen.  Unfortunately, I think we have to seriously ask ourselves if the current electronic medical records offerings can raise health care’s quality and lowe... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2144434 Fri, 30 Jan 2009 07:22:11 +0100 2144434 http://www.medworm.com/index.php?rid=2144435&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F01%2F28%2Fallscripts-ceos-stunning-take-on-obamas-emr-plans%2F In a recent Wall Street Journal article on electronic medical records, they talk about Allscripts’ CEO’s take on the governments planned $20 billion investment in EMR.  Here’s a portion of the article: Glen Tullman, chief executive of the health IT outfit Allscripts-Misys Healthcare and an advisor to the Obama campaign on health information technology issues, argues that that any legislation should first help doctors buy and install electronic medical records, then give them financial incentives to actually use them in a way that could reduce waste and improve care. “That one-two punch would dramatically change the adoption rate for physicians,” he said in an interview with the Health Blog. I’ve talked about Obama EMR many times before on this blog and over the... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2144435 Thu, 29 Jan 2009 06:19:20 +0100 2144435 http://www.medworm.com/index.php?rid=2132232&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fit5eoXbvnVo%2F I’ve been really intrigued with how various EMR software has been touting how quickly they can get an EMR installed for a doctor’s office.  I’m sure that many people can tell of experiences where they spent literally years getting their EMR ready for use.  This is what makes these 5 minute EMR installs that I’ve seen recently seem so intriguing. Practice Fusion’s Live in Five Practice Fusion has a “Live in Five” marketing campaign and promise that they can get a practitioners charting in an EMR in five minutes.  Here’s their full description of Live in Five: Forget everything you know about software. Practice Fusion’s exclusive ‘Live in Five’ program allows you to be up and charting in less than five minutes. There are n... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2132232 Sun, 25 Jan 2009 19:58:42 +0100 2132232 http://www.medworm.com/index.php?rid=2131257&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F_m6Vrw2tkns%2F Details about Obama’s health care stimulus package are out. I prefer to call it Obama funds EMRs for medical practices. Here’s a summary of some proposed changes via HISTalk and John Glaser, VP and CIO at Partners HealthCare System (and thanks to Chris Paton for linking me there). Provision of $40,000 in incentives (beginning in 2011) for physicians to use an EHR Creation of HIT Extension Programs that would facilitate regional adoption efforts Provision of funds to states to coordinate and promote interoperable EHRs Development of education programs to train clinicians in EHR use and increase the number of healthcare IT professionals Creation of HIT grant and loan programs Acceleration of the construction of the National Health Information Network (NHIN) He also adds. &#8220... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2131257 Sat, 24 Jan 2009 17:58:46 +0100 2131257 http://www.medworm.com/index.php?rid=2107629&cid=t_99680_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FD4AAzPf_QMY%2F I’ve previously written about using a patient kiosk for inputting information into an EHR. I still think this is a fantastic idea. So much so that I’ve actually implemented it in the clinic I work in for my full time job. This includes “Walmart” like signature pads where patients can sign their HIPAA form, financial agreement and other check in forms. We also require them to fill out their health history form electronically where it’s automatically available to the doctor in the EMR. There are some other major advantages to this method which I’ll save for another post. Today I came across another interesting use for self service check in kiosks in a doctor’s office. Here’s a description of a different implementation of self service kiosks: Tw... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2107629 Thu, 15 Jan 2009 17:09:12 +0100 2107629 http://www.medworm.com/index.php?rid=2098744&cid=t_99680_113_f&fid=38130&url=http%3A%2F%2Fwww.tempdev.net%2Fblog%2F%3Fp%3D513 So being a consultant I’m very passionate about the topic of our series on the Good, Bad, and Ugly of the consultant community. I have to say that after cleaning up “the ugly” as a full time employee and as a consultant, it makes me even more fired up. I’m excited to contribute to John’s questions about Making the Most of an EHR Consultant. This is a huge topic, so I will break it down to the different types of consultants for the different phases of your implementation. Phase 1 - EHR/EMR Selection Consultants There are consulting groups that specialize in helping you make the selection of your EMR/EHR vendor. If your group needs help getting vendors together, viewing demos, knowing what to looking for, and helping you decide what would be the best for your g... Implementing EMRs blogs http://www.medworm.com/rss/comments.php?id=2098744 Mon, 12 Jan 2009 15:54:13 +0100 2098744