EHR Implementation in the Hosptials - Where are we?

Despite doubts about finances, hospitals moving forward with EHRs

Originally posted in HealthITNews

According to this article only 48% of healthcare business leaders said they're "somewhat comfortable" with the budgets allocated for the EHR deployment. 

Although there are incentive programs, and the obvious benefit of enhanced communication between departments as well as consolidation of the Electronic Medical Records for a given patient, a lot of learning has to take place between new and existing workforce to have the comfort level using the systems systematically. 

 We look at training as an integral part of the implementation that must be catered to different groups of workforce based on their involvement with the system. It is not just about the technology, it is about the staff that will use this technology.

NEW YORK – A new study from KPMG finds nearly half of business leaders at hospitals and health systems are more than halfway through full EHR deployments, even as many harbor doubts about how much funding their organizations have planned to support the initiatives.

Some 49 percent of hospital and health system business administrators who participated in the poll said they were more than 50 percent of the way to completing EHR deployment.

Meanwhile, almost the same number (48 percent) of health system business leaders said they're "only somewhat comfortable" with the level of budgeting their organization has planned for EHR deployment, according to KPMG. Nine percent said they weren't comfortable at all while 18 percent said they were unsure. Only 25 percent said they were "very comfortable."

"There is a level of uneasiness as to whether there is adequate funding to complete these projects," said Gary Anthony, principal with KPMG Healthcare. "In most organizations, EHR deployment will most likely be one of the most transformational projects that they've ever undertaken, as well as one of the largest investments outside of the construction of a new hospital they've ever made."

Nonetheless, he added, many hospitals still look at EHR deployments as "just an IT project, and that may be why we are seeing multiple extensions to scope, timeline and budget."

In terms of resource strategies used to complete EHR deployment, 46 percent of hospital and health system execs said they're using a multiple-resource strategy. This was followed by leveraging existing staff (16 percent), hiring new or additional staff (13 percent) and securing third party assistance (10 percent). Fifteen percent said they didn't know.

When asked whether their organization had a mobility access strategy that provides clinicians and patients with "anywhere" access to EHRs, roughly half of the administrators said they didn't know.

"EHR deployment isn't an end point," said Jerry Howell, principal with KPMG Healthcare. "It's an important step in an organization's journey to automate the clinical functions within the hospital or health system and improvement to quality and patient safety. There needs to be continued focus on resourcing and having the correct sponsorship and commitment to deploy an EHR and to continue to support and use it."

 

NYeC Digital Accelerator

As many of you know, I take an active participation in the events around implementation of EHR and health related technologies in general, training programs that surround these initiatives as well as user experience for providers, healthcare professionals and patients.

Recently NYeC (New York eHealth Collaborative) has partnered up with the New York City Investment Fund in a New York Digital Health Accelerator program that will enable New York State to expand and potentially build a unique ecosystem for the healthcare industry. Many technology companies, start-up and otherwise participated in the conferences and information session.

Below is a full text of a newsletter regarding the applications received for the program.

....

NY Digital Health Accelerator
Receives 250 Applications

After a flurry of applications just before deadline, the review process for theNew York Digital Health Accelerator (NYDHA) begins. A total of 250 early- to growth-stage software development companies submitted applications, anxious to participate in the 9-month long program. Up to twelve chosen companies will receive up to $300,000 of funding each for the development of new health IT products, along with invaluable mentorship from those healthcare provider organizations who their innovations will serve. The NYDHA, run by the New York eHealth Collaborative and the New York City Investment Fund, also provides developers with access to the technology platform that is connecting electronic health records across New York State, theStatewide Health Information Network of New York (SHIN-NY). The SHIN-NY will be the platform for innovators to develop products and software solutions to meet the needs of healthcare providers across the state. “The Partnership and our investment fund have been thrilled with the response we have received from innovators in healthcare technology,” said Maria Gotsch, CEO of the Partnership for New York City’s Investment Fund. “Our investor syndicate is looking forward to working with all of the healthcare providers involved to help grow the emerging health IT sector in New York City.” Dr. Nirav R. Shah, the New York State Commissioner of Health gave the opening remarks at a packed launch event in May at The TimesCenter in New York. The event brought together over 400 attendees curious to learn more about the Accelerator program, from startup software development companies, to healthcare providers and policy makers, and strategic investors. Along with a panel discussion with providers, Maria Gotsch and Dr. Herbert Pardes, Executive Vice Chairman of the Board, New York-Presbyterian Hospital and New York-Presbyterian Healthcare System also spoke. Dr. Pardes related the growth of health information across New York State as “the twenty first century’s Erie Canal.” The impressive number of applications came as no surprise in a time when health IT is growing at such a clip. Along with the fact that the program provides such a substantial amount of funding as compared to other accelerator or incubator programs, it also offers something extremely coveted among health tech developers: direct, one-on-one access to healthcare organizations, allowing for a more custom-made product to suit the very particular demands of a very particular market. “The economy and healthcare are the two most important issues facing the state, and the New York Digital Health Accelerator will allow us to tackle them both at once,” noted David Whitlinger, Executive Director of NYeC. “This initiative represents the best kind of marriage between the public and private sectors. We are leveraging New York’s investment in our statewide health information exchange network and empowering it with the free market.” Applications for the New York Digital Health Accelerator will be reviewed by a selection committee comprised of the participating provider mentors and the investors. The top 20 finalists will present their company to the selection committee in late July, and program participants will be selected in early August. The program will begin in September. Video highlights of the event are available http://digitalhealthaccelerator.com/events/.

Does EHR leads to decrease in malpractice claims?

Docs who used EHRs showed lower malpractice claims

June 26, 2012 | Mike Miliard, Managing Editor - Original Article posted in HealthcareITNews

The general idea here is that with the EHR implemented the number of the malpractice claims went down.

I believe that if a provider has access to more accurate and just more information about his/her patient it can and will lead to a higher quality of treatment. With the information at hand treatment plans are developed with more accuracy, given that a provider is aware of the pre-existing conditions and medications that patient is currently on. Although we have a long way to go for a full EHR implementation, even at this stage both providers and patients already notice the difference in the workflow and treatment.

I am enclosing one of the slides from the study as well as a full body of the article with appropriate links below.

BOSTON – A study by Harvard Medical School researchers, published Monday in the Archives of Internal Medicine, showed that Massachusetts physicians who used electronic health records saw a reduction in malpractice claims.

Correlation does not imply causation, of course. But the report's authors say their findings suggest that "implementation of EHRs may reduce malpractice claims and, at the least, appears not to increase claims as providers adapt to using EHRs."

The study, titled "The Relationship Between Electronic Health Records and Malpractice Claims," was written by Mariah A. Quinn, MD; Allyson M. Kats; Ken Kleinman; David W. Bates, MD; Steven R. Simon, MD.

"Given the potential of EHRs to reduce adverse events and health care costs, the question of whether EHRs reduce the risk of malpractice lawsuits is a logical one," they write.

"Risk factors for medical error and resultant malpractice claims, including poor communication between providers, difficulty in accessing patient information in a timely manner, unsafe prescribing practices, and lower adherence to clinical guidelines, may be ameliorable by health information technology," the report notes. "The high quality and availability of proper documentation in EHRs may increase the likelihood of successful defense against malpractice claims."
For this study, the researchers assessed groups of Massachusetts physicians who had previously been surveyed in 2005 and 2007 – tracking their malpractice claims over time.
"Because physicians in the sample were insured for different durations and used EHRs for variable amounts of time, the number of insured years was calculated for each physician before and after EHR adoption," they write. "We used Poisson regression to determine whether EHR use was associated with malpractice claims, modeling the rate of malpractice claims per year in periods with and without EHRs and adjusting for clustering by physician. We used the generalized linear mixed models version of Poisson regression to account for correlation between periods."

Of the 189 doctors surveyed in both 2005 and 2007, they note, 27 were named in at least one malpractice claim. Overall, 33 of the 275 physicians from multiple surgical and medical specialties who responded in 2005 and/or 2007 incurred a total of 51 unique claims. Forty-nine of those claims were related to events occurring before EHR adoption. Two were related to events occurring after EHR adoption.
"We found that the rate of malpractice claims when EHRs were used was about one-sixth the rate when EHRs were not used," the researchers write. "This study adds to the literature suggesting that EHRs have the potential to improve patient safety and supports the conclusions of our prior work,which showed a lower risk of paid claims among physicians using EHRs. By examining all closed claims, rather than only those for which a payment was made, our findings suggest that a reduction in errors is likely responsible for at least a component of this association, since the absolute rate of claims was lower post-EHR adoption."

The report does concede that other factors may be at work. "For example, physicians who were early adopters of EHRs may exhibit practice patterns that make them less likely to have malpractice claims, independent of EHR adoption; these early adopters contribute a disproportionate amount of time in our analyses, favoring an effect of EHRs on reducing malpractice claims."
Still, they argued, despite the small sample size, the reduction in malpractice claims shown in the EHR study "lends support to the push for widespread implementation of health information technology."
Access the report here.

EHR Adoption - Are we there yet?

"Docs adopt and adapt, yet still cling to old ways"

HealthcareITNews


In the article published in HealthcareITNews, shocking statistics on the implementation of the EHR. We are so far behind on the technology use among healthcare practitioners. Even those that recognize the need and benefit of the technology in their practice are still staying behind the curve, with Fax machines being the dominant technology. 


In providing training/educational services to providers and their staff the constant struggle is with the consistent, continuous usage of the technology that is being implemented. 


I am sure that we will come to the point when everyone is going to be using EHR technology and beyond but it is a rocky road so far. 


SEE THE FULL ARTICLE BELOW - 

"ATLANTA – The technology takeover has begun, and physicians nationwide are acclimating one step at a time, a new physician survey reveals. Laptop, smartphone and iPad usage is increasingly common among U.S. physicians, but the report finds old-fashioned methods of communication continuing to stand their ground.  

The second annual National Physicians Survey, conducted by the little blue book and Sharecare, polled 1,190 U.S. practitioners representing more than 75 medical specialties. It reveals physicians' perceptions about the ongoing changes in the healthcare system and how those changes are impacting their daily practices as well as their ability to provide optimal patient care.  

Two out of three physicians (66 percent) say the integration of electronic medical records (EMRs) is among their practice challenges. Despite that, most doctors (66 percent) acknowledge EMRs will at least improve or have a neutral effect on their future business. 


Almost one out of three doctors (30 percent) are using laptops regularly for e-prescribing, EMRs and more. Almost a quarter (20 percent) are using smartphones, and 12 percent use iPads, for clinical needs. 

Additional survey highlights:

• Peer-to-peer communication is occurring via email – despite not being a "secure channel."
• Thirty-four percent of physicians communicate with other clinicians via email – not defined as a "secure channel" by HIPAA.
• Telephone (95 percent) and fax (63 percent) are still the primary forms of communication.
• A dinosaur in most other office environments today, the fax is still king with physicians, supporting hand-written notes, insurance forms and lab test result transmissions.
• Fifty-eight percent of doctors communicate with peers in person.
• Five percent use social networking sites
• Doctor-to-patient communication remains fairly traditional, with some online inroads.
• The majority of physicians (91 percent) talk with patients via phone, 84 percent in person, 20 percent via email, 8 percent via personal health records (PHRs) and 6 percent via text.
• Few physicians are opting for solo practices these days -- a good portion are "employed" by hospitals, large practices or accountable care organizations (ACOs).
• Twenty-two percent of physicians are in ACO talks, up from 12 percent last year
• Of those who said they were aware of ACOs, 37 percent stated that they would participate as a member of a group practice, 27 percent as a member of a physician-hospital organization, 10 percent as a hospital-employed physician.
• Only 17 percent of the respondents were unfamiliar with the ACO term, down from 45 percent last year.

Doctors say new patients find them via:

• Word of mouth (71 percent)
• Practice networks referrals (33 percent)
• Print directories (29 percent)
• Internet searches (22 percent)
• Despite an onslaught of healthcare regulations and requirements and shrinking practice margins, physicians are finding some advocates.
• Forty-one percent say their state medical organization/society advocates for them. 
• Thirty-nine percent say their national medical organization/society does.
• But 40 percent report "no one."
• Still, overwhelmingly burdened by obtaining reimbursements from insurers (81 percent) and patient approvals (77 percent), most doctors (71 percent) believe the quality of healthcare will deteriorate over the next five years.
• Fifty-five percent fear they aren't spending adequate time with each patient.
• Thirty-eight percent are concerned they aren't seeing enough patients in a day.

"Physicians today are practicing in a healthcare environment that they never could have predicted much less prepared for," said Keith Steward, MD, senior vice president of medical affairs at Sharecare. "This year's National Physicians Survey provides valuable insight into the frustrations and opportunities of the day-to-day management of practices, administration tools doctors use, and how communication with both colleagues and patients is evolving.  

"Arming doctors with innovative solutions to ease administrative burdens is a top priority for the healthcare industry," he adds. "Doctors need to get back to what they were trained to do – provide their patients with the best care possible."

"Information Week - Top 9 Health IT Stories Of 2011"

Original Article  - Information Week

Marianne Kolbasuk McGee 01/05/2012

2011 was a challenging year for healthcare IT professionals. Providers rolled out electronic health record systems to qualify for the government's Meaningful Use financial incentives. Meanwhile, mobile health apps took off, e-prescribing increased, health info exchanges got a start, and some organizations suffered data breaches. On the plus side, more health IT jobs became available.

Demand Soars For Health IT Skills

The U.S. government estimates that the Meaningful Use initiative and related programs are fueling demand for about 50,000 new health IT professionals in the next few years.

According to the Bureau of Labor Statistics, the number of health IT jobs across the country is expected to grow by 20% from 2008 to 2018, much faster than the average for all occupations. To help prepare the future workforce, there were a number of program roll-outs in 2011 from the American College of Physician Executives, the training firm Alameda, and HITECH Act-funded efforts, including regional extension centers.

Despite these initiatives, job-seeking health IT professionals and prospective employers complain about skills mismatches and gaps. For instance, when InformationWeek Healthcare readers learned recently that the Healthcare Information and Management Systems Society (HIMSS) and the American Society for Healthcare Human Resources Administration (ASHHRA) were working together to match job seekers to thousands of expected vacancies in health IT, many reacted with excitement, but others expressed skepticism and cynicism.

"I have spoken to many highly qualified and experienced IT resources who have applied for positions in the Healthcare industry and the response is typically 'do you have experience as a nurse or as a healthcare practitioner?'," wrote one commenter. "Until the healthcare industry rejects the notion that you have to have medical experience to bring your IT skills to bear, they will continue to struggle with innovation and improved service to the public."

Among other organizations trying to bridge the skills gap is the American Medical Informatics Association (AMIA), which is helping train clinical professionals to fill high-level roles such as chief medical information officer and chief nursing information officer.

"EMR Daily News - Alameda Launches Healthcare Information Technology Professional Certification"

December 14, 2011 By Steve Campbell

Information Technology workers looking for an exciting challenge as healthcare IT professionals, can finally benefit from a new opportunity to train online, while earning an industry-recognized national certification. The Healthcare Information Technology Professional (HITP) course provides the fundamental knowledge and skills required by technical professionals to support a medical practice, clinic or facility in its adoption of Health IT and beyond.

Alameda Services, a New York based organization specializing in Healthcare courseware development introduced the new course to enable IT professionals to leverage their knowledge of information and computer science, while learning the core concepts of the US healthcare system, medical information systems and business intelligence and analytics.

“Our team of industry healthcare and information technology experts has designed this course specifically to offer new employment opportunities to IT workers and those who have a basic working knowledge of office technology,” says Lena Feygin, Dip LC, executive vice president and director of business development for Alameda Services. “We provide the crucial tools and training materials to facilitate the learning process, foster new skill development and ensure career success in the healthcare industry.”

The HITP course is based on core concepts including IT, healthcare practice, electronic health records / electronic medical records (EHR/EMR) and business intelligence and analytics. Students will learn about: healthcare technologies, patient data management, and the culture of the healthcare industry today.

The online learning system comprises in-depth activities to reflect the way that one area of Health IT knowledge blends into another, including:

• US Healthcare System
• Medical Law
• Terminology and effective communication in healthcare and the public health setting
• Electronic health record implementation and management
• Healthcare compliance
• Concepts of quality improvement including patient safety
• Healthcare data management and organization
• Principles of business intelligence (BI) and business analytics
• BI applications in Healthcare

The HITP course is approved by the National Healthcareer Association (NHA) to take its exam for national certification as a Certified Electronic Health Records Specialist (CEHRS), a certification often required by healthcare employers. Upon successful completion of the program, students will receive a certificate of completion from Alameda Services and they will be prepared to the NHA exam to earn the industry-recognized national certification.

The best candidates for HITP training are professionals who have experience in the following areas: Help Desk/Desktop support; Network Administration (A+, Network+, MCP); Quality Assurance; or Business Analysis.

“Unlike similar courses which can be very time-consuming and costly, we have designed this program to be completed at the student’s own pace, typically 5-6 weeks. The regular price is $395, nearly one-third of similar offerings. During the month of December we are running a 20% off promotion offering the program for only $316” says Feygin.

Photo By Walt Stoneburner

Read more: http://emrdailynews.com/2011/12/14/alameda-services-launches-healthcare-information-technology-professional-certification-online-learning-course/#ixzz1gcwuy4Wg

"Alameda Services Launches Healthcare Information Technology Professional (HITP) Certification Online Learning Course"

Brand New Online Training and Certification Opens the Door for Information Technology Professionals to Obtain a Career in the Healthcare Industry

New York, NY – December 13, 2011 –Information Technology (IT) workers looking for an exciting challenge as healthcare IT professionals, can finally benefit from a new opportunity to train online, while earning an industry-recognized national certification. The Healthcare Information Technology Professional (HITP) course provides the fundamental knowledge and skills required by technical professionals to support a medical practice, clinic or facility in its adoption of Health IT and beyond. Alameda Services, a New York based organization specializing in Healthcare courseware development covering Healthcare compliance, Healthcare IT, Data Management, Business Intelligence and Analytics, Electronic Health Records (EHR) training and workforce development, introduced the new course to enable IT professionals to leverage their knowledge of information and computer science, while learning the core concepts of the US healthcare system, medical information systems and business intelligence and analytics. The HITP course is approved by the National Healthcareer Association (NHA) to take its exam for national certification as a Certified Electronic Health Records Specialist (CEHRS), a certification often required by healthcare employers. More information about the Alameda Services HITP course is available at http://alamedaservices.com/HITPDetails

“Our team of industry healthcare and information technology experts has designed this course specifically to offer new employment opportunities to IT workers and those who have a basic working knowledge of office technology,” says Lena Feygin, Dip LC, executive vice president and director of business development for Alameda Services. “We provide the crucial tools and training materials to facilitate the learning process, foster new skill development and ensure career success in the healthcare industry.”

The HITP course is based on core concepts including IT, healthcare practice, electronic health records / electronic medical records (EHR/EMR) and business intelligence and analytics. Students will learn about: healthcare technologies, patient data management, and the culture of the healthcare industry today.

The online learning system comprises in-depth activities to reflect the way that one area of Health IT knowledge blends into another, including:

•  US Healthcare System
• Medical Law
• Terminology and effective communication in healthcare and the public health setting
• Electronic health record implementation and management
• Healthcare compliance
• Concepts of quality improvement including patient safety
• Healthcare data management and organization
• Principles of business intelligence (BI)  and business analytics
• BI applications in Healthcare

The hands-on component of the program includes usage of live certified EHR software from an industry-recognized vendor.

Upon successful completion of the program, students will receive a certificate of completion from Alameda Services and they will be prepared to take an exam to earn an industry-recognized national certification granted by NHA.

The best candidates for HITP training are professionals who have experience in the following areas: Help Desk/Desktop support; Network Administration (A+, Network+, MCP); Quality Assurance; or Business Analysis.

“Unlike similar courses which can be very time-consuming and costly, we have designed this program to be completed at the student’s own pace, typically 5-6 weeks. The regular price is $395, nearly one-third of similar offerings. During the month of December we are running a 20% off promotion offering the program for only $316” says Feygin.

About Alameda Services

ALAMEDA Services is an Allied Health training organization specializing in workforce development through in-class/on-line training. The company’s mission is to bridge the gap between the healthcare and information technology industries, and to satisfy their growing workforce demands by providing technology and educational expertise. More information is available at http://www.alamedaservices.com

Original article also appeared in: Technology Today, Education News Today, Healthcare Industry Today, World News Report, News Blaze,Healthcare News Articles, Industry News Article, eLearning News Articles, San Francisco Chronicle, Houston Chronicle, Chicago Daily Herald, The Miami Herald, Newsday