HIMemo

Audio Feature: Live from HIMSS: The Evolution of Information

At the annual HIMSS conference in Atlanta, Brian A. Yeaman, MD, chief medical informatics officer at Norman (OK) Regional Health System, discusses combining evidence-based medicine and decision support in EMRs.

Survey: Physician use of EMRs rising

About 38% of office-based physicians used electronic medical records in 2008, according to preliminary estimates by the National Center for Health Statistics. About one in five physicians used a “minimally functional” EMR system, which let them order prescriptions and tests, view laboratory/imaging results and enter clinical notes.

Results from the survey will be combined with results from the 2008 National Ambulatory Medical Care Survey to produce a final 2008 estimate of EMR use by office-based physicians, excluding radiologists, anesthesiologists and pathologists. The preliminary results are up from 2006, when about 29% of NAMCS respondents reported using EMRs.

[ via AHA News Now ]

Impact of electronic medical record rule changes examined

Many hospitals are proceeding cautiously in helping physicians with electronic medical records, despite regulatory changes allowing them to do so, according to a new study of 12 communities by the Center for Studying Health System Change. Factors impeding hospital action include ongoing hospital information technology projects, budget limitations and lack of physician interest.

Under August 2006 exceptions to the federal physician self-referral and anti-kickback laws, hospitals can subsidize up to 85% of the costs of EMR software and related information technology support services for physicians. The exceptions will expire on Dec. 31, 2013, when physicians must assume any ongoing EMR costs.

“While hospitals have strategic incentives to provide support, particularly to tie referring physicians to their institution, the effects of the regulatory changes on physician EMR adoption will ultimately depend both on hospitals’ willingness to provide support and physicians’ acceptance of hospital assistance,” said study co-author Joy Grossman. The findings are based on visits to the 12 communities in 2007.

[ via AHA News Now ]

CCHIT makes EMR certification simpler

Given pressure on vendors to re-certify early and often, it's definitely a good sign that the Certification Commission for Healthcare Information Technology (CCHIT) is rolling out plans to make EMR certifications simpler. CCHIT is now working with the MITRE Corp. on an open source software-testing framework, dubbed LAIKA, which will let vendors test and verify on their own whether their products meet CCHIT standards. The software, which will be distributed by Apache 2.0, should be be available at no charge as of March 21.

With HHS's demanding that re-certifications take place every 12 months to meet its safe harbor rules, vendors have been in a quandary, as they typically only do upgrades every 18 to 24 months. The new tool won't change the vendors' development cycle, but it will help them determine where they stand and possibly take steps to meet standards on the revolving 12 month schedule HHS has set. All in all, while this won't be a cure all, it can't be a bad thing either.

To find out more about the new software, read this Healthcare IT News article.

[ via FierceHealthIT ]

Medical Records Institute announces survey results

[ via EHR Connection ]

Lack of adequate funding or resources is one of the major barriers to implementing EMR, according to the results of an annual poll by the Medical Records Institute (MRI), which announced the findings in an October 15 press release.

Other barriers to EMR implementation included anticipated difficulties in adopting an electronic system, difficulty in creating a plan to implement the change, and inability to find affordable solutions and components.

Nearly two-thirds of 819 participants whose responses were tallied identified themselves as having final or strong influence in EMR decisions. The total group of 1,011 survey participants had included vendors and consultants whose responses were deleted.

To read the MRI press release, click here.

New physician site offers digital record creation, documentation

A new Web site, DocPatient.com, offers physicians something they've never had before - digital record creation, reports Doctations, the company behind the site. Physicians can document in their usual way by writing or dictating and buy transcriptions at a discounted rate through Doctations' DocPatientNetwork.

The new site offers integrated dictation and transcription, a shared patient database, and facilitated physician-to-physician and physician-to-patient collaboration. Doctations, founded three years ago by and for physicians, provides other paid and free services, such as messaging that patients can use to report their symptoms to their physicians, and EMRs accessible by both patients and their physicians. Patients can enter digitally-readable test results (e.g., diabetes, other blood-level testing, blood pressure, and vital signs) into the system and receive alerts when results are at a high risk. Patients can also receive and pay their physicians' bills through the network.

[ via EHR Connection ]

Consumers see EMRs as factor in choosing MDs

Does it matter whether you roll out an EMR system now or later? Apparently, it does to some consumers. According to a new study by Accenture, the majority of consumers give at least some weight to whether a physician uses an EMR when choosing a practice--and what's more, most are willing to pay more to such practices.

To draw these conclusions, Accenture surveyed 600 U.S. consumers and interviewed more than 100 physicians. Two-thirds of consumers surveyed said that the presence of an EMR was at least slightly important in choosing a doctor, and just over half said they would be willing to pay more for EMR use if it wasn't too expensive.

Consumers who favored EMRs said that, among other factors, they liked the idea of having greater control over their own records and felt the records would help them ask better questions.

To learn more about the study, read this press release from Accenture.

[ via Fierce Healthcare ]

Electronic medical records use may rise

Health care advocates have long encouraged physicians to switch to computerized medical records, saying they could improve patient care and increase efficiency. Doctors, however, have been more concerned about the high price tag — often more than $20,000 per physician for software, hardware and Internet connections — as well as having to maintain a computer network. Surveys estimate less than 20 percent of doctors have fully automated their offices. But federal officials last month paved the way for hospitals to come to the rescue, allowing them to donate medical record systems to physician practices to blunt some of the financial bite.

Read the full article from AP/Yahoo!

Electronic recordkeeping may have pros and cons

The Sunday New York Times examined electronic medical records, including the new efficiencies and patient safety ramifications. It also speculated on some of the drawbacks that a fully integrated health information system could bring.

Overall, most experts cited in the article believe an efficient, easy-to-use system will provide better care for patients and can save hospitals money by reducing errors and cutting down on duplication in care.

Critics, however, are concerned that the new systems could disrupt the economic foundation of healthcare, such as hospitals more readily using generic medications and spending less. There are also privacy concerns, which were highlighted when the VA hospital system recently lost some patient data.

To read the complete article, click here.

[ via Patient Safety Monitor ]

The Price of Paper

Former Health & Human Services Secretary Tommy Thompson once said, “The most incredible feature of this 21st century medicine is that we hold it together with 19th century paperwork. This is just inexcusable. And it has to change.”

We may have had our disagreements, but this is one instance when I completely agreed with Secretary Thompson. Nearly a decade into the 21st century, many health care providers still rely on handwritten notes for communication and record-keeping, and some still use typewriters to prepare patients’ bills. American families are suffering the consequences.

Last year, I met Renae Wallace, a small business owner in Kingsley, Mich. Wallace’s son Randall was just turning 8 years old. But unlike a typical 8-year-old, Randall has seen the inside of an operating room more often than most people do in a lifetime because he was born with complex heart and lung defects.

The Wallaces visit health care specialists miles apart in Traverse City, Grand Rapids and Ann Arbor, Mich. But because there is no easy way for Randall’s doctors to talk to each other, his mother carries around a file of Randall’s medical records--X-rays, MRI scans and surgical notes--in the trunk of her car. Otherwise, the specialists would not know the results of Randall’s previous treatments.

It would make a lot more sense if the doctors, nurses and hospitals treating Randall had that information readily available without his mother having to haul her son’s medical records to each provider.

For the full story, click here.