Importance of Post-Implementation Analysis in EHR Implementation. Public Comment of
|
|
- Lee Moody
- 8 years ago
- Views:
Transcription
1 Importance of Post-Implementation Analysis in EHR Implementation Public Comment of Gary C. David, PhD Associate Professor of Sociology Department of Sociology ehealthrecords.wordpress.com Bentley University Waltham, MA June 26,
2 David Blumenthal, M.D., M.P.P. National Coordinator Office of the National coordinator for Health Information Technology U.S. Department of Health and Human Services 200 Independence Avenue Washington, D.C Dr. Blumenthal and Members of the HIT Policy Committee, I am Gary C. David, PhD, an Associate Professor of Sociology at Bentley University (Waltham, MA). For the past two years, I have been conducting an intensive study of how medical records are created. This research began with examining the work of medical transcriptionists 1,2 (MTs) and the medical transcription industry. The project has expanded to include technologies that are employed in this process, such as speech recognition technology 3 (SRT) and now electronic health records (EHRs) and electronic medical records (EMRs). Along with speaking with MTs and others in this industry, I have had the opportunity to speak with HIM directors, hospital senior administrators, physicians, and other healthcare providers regarding the creation of medical records, as well as the impact of technologies on this process. I also have had the opportunity to review the materials 4 associated with the committees work around meaningful use, and wanted to take the opportunity to share my thoughts based on my research findings to date. Impact of EHRs on Medical Record Content Upon reviewing the materials that are publically available from the HIT Policy Committee, along with other government and industry sources, there are some concerns that I have regarding the impact that the broad introduction of new medical record production technologies will have on the content of medical records. It can be expected that once the mode of creation is changed (e.g., from dictation-transcription to template-based EHR direct entry), the content of the medical record also will change. At this point, it is too early to make determinations of whether this change will constitute better or worse. It can be safely assumed, and is borne out by my own (as well as other research), that change will occur. Given the 1 Gary C. David (2007) 2007 Survey of Medical Transcriptionists Preliminary Findings. 2 Juliann Schaeffer (2008) Getting in Tune New Survey Spotlights the MT s Role in Healthcare. For the Record, 20(15), p Gary C. David, Angela Cora Garcia, Donald Chand and Anne Warfield Rawls (2009) Listening to What is Said Transcribing What is Heard: The Impact of SRT on the Practice of Medical Transcription. Sociology of Health and Illness. In press. 4 Since the minutes and transcript from the June 16, 2009 meeting have just been made available, and I have not had the chance to review them in depth. 2
3 importance of the medical record, this change must be understood and needs to be part of the conversation around the implementation of EHR systems. The medical record is not only important to patient care; medical records are vital to all aspects of health care. This point will be evident to members of the committee, but bears restatement because of its importance. Those whose work relies on the medical record is large and increasing. Beyond the doctor, this includes: other doctors and healthcare providers, billing personnel (such as coders), legal personnel, researchers, insurance and reimbursement agents, auditors, and patients. Each party has their own reason for using the medical record, and as a result different (and at times divergent) needs exist in terms of content. The more that medical records become accessible, the greater the potential harm that could result from errors in those records. On June 14, 2009, the House Energy and Commerce Subcommittee on Oversight and Investigation held a hearing on the act of post-claims underwriting and rescission practiced by insurance companies. Part of the testimony touched on how errors in medical records can have drastic repercussions on patient coverage and care. The testimony of Robin Beaton, a 59 year-old nurse, illustrated this point: In May 2008, I went to the dermatologist for acne. A word was written on my chart and interpreted incorrectly as meaning pre-cancerous. Shortly thereafter, I was diagnosed with Invasive HER-2 Genetic Breast Cancer, a very aggressive form of breast cancer.the Friday before the Monday I was scheduled to have my double mastectomy, Blue Cross red flagged my chart due to the dermatologist report. The dermatologist called Blue Cross directly to report that I only had acne and please not hold up my coming surgery. Blue cross (sic) called me to inform me that they were launching a 5 year medical investigation into my medical History (sic) and that this would take approximately 3 months 5. The point of this story is not raise the issue of rescission, but rather to illustrate how errors in medical records can have dramatic impacts on patient care in often indirect ways. The impact of medical records is far reaching. Anything that impacts their creation has to be carefully studied and understood. While the concept of quality was a constant theme in the documents related to meaningful use, the word accuracy is not prominent. Notable exceptions include p.7 of the May 11, 2009 meeting minutes, which refers to a statement by Dr. Neil Calman, Dr. Calman raised the issue of patient access to information. He pointed to examples of inaccurate information being transferred, noting that this is a significant concern. Another example is from p.22 of the May 11, 2009 meeting transcript, where Scott White is quoted as saying The (sic) early on, we learned about computers, it was garbage in, garbage out, unless we have the workforce trained properly, understanding their role on the bigger picture, we will fail from the beginning. 5 House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations, Testimony of Robin Beaton, Hearing on Terminations of Individual Health Policies by Insurance Companies, 111 th Cong. (June 16, 2009). 3
4 Quality and accuracy can be different things. Quality is a more subjective assessment based on the needs of the person using the record. So quality really is about quality for what purpose. Accuracy is a more objective assessment in that does the record provide a reliable and accurate account of what occurred in the medical encounter. In my own research, I have found numerous instances where a document might be quality in terms usability, but not accurate (as well as other examples of records being low quality but accurate). The impact of EHRs on both quality and accuracy needs to be considered carefully. Impact of Sharing Records with Patients A stated objective in the meaningful use criteria is that documentation will be readily shared with patients. This is a noteworthy goal. The Association for Healthcare Documentation Integrity (AHDI), the professional association for medical transcriptionists, has a campaign called Have you read your medical record? This campaign has attempted to create awareness among patients regarding what is in their medical records, which would have the impact of finding errors and correcting them before harm could occur. It is not surprising to find that even though people have the legal right to their medical record, the vast majority never see them. One thing that has not been considered is what the impact of this sharing will be on the doctor-patient relationship. In research interviews with medical transcriptionists, I have been told repeatedly of instances where doctors make negative assessments (both medical and personal) about their patients. Some of these might appear relatively benign, such as referring to a patient as fat or obese. Others are more derogatory. One story spoke of a doctor characterizing his patient as having frequent unprotected sex, while leaving out the additional information that this was with her husband. MTs have told me of going to doctors and asking them if they wanted to reconsider what they said in their dictation. They often have reconsidered their statements. Dr. Neil Calman s personal blog (February 16, 2008) related a story of a patient who panicked after receiving a letter from his office which stated that her mammogram results were negative. Since the word negative is often associated with bad news, she interpreted the letter to be indicative of illness. Dr. Calman s blog entry then provides an introspective examination of how doctors word their clinical documentation, and how confusing this could be to patients. One could envision a situation where doctor s offices are inundated with calls from concerned or upset patients regarding what is in (and what patients think is in) their medical records. I have spoken with physicians who do not believe that their notes should be shared with patients. The reason why is easy to understand. Doctors and other healthcare personnel have to make frank assessments of their patient s physical and mental well-being. The documentation becomes the thing that is repeatedly referred to in order to provide some continuity of care. I frequently ask physicians, If you knew that your patients would in every instance see your notes, would it change what you write? The answer is typically, Yes. Referring back to the issue of quality versus accuracy, a record may accurately depict what occurred in the exam, but is not quality in terms of the impact it has on patient 4
5 satisfaction and the doctor-patient relationship (as in Dr. Calman s example). As I tell my students, when you write your papers or give a talk, you have to consider your audience. For doctors, this point is greatly complicated by the fact that there are multiple audiences that make use of their clinical documentation. When patients are included into this mix, they must be considered. I have come across medical practices that have begun to run parallel documentation systems: one for patients and one for themselves. If a patient wishes to have a medical record, one is provided for them. However, there is another record that exists for more institutional purposes, such as billing and medical care. I asked one doctor if patients routinely see their records, how will he communicate sensitive information to other physicians? He responded that he will likely use the phone. It is then ironic that a system that is meant to make communication between physicians more expedient may increase the reliance on phone calls. There has been some growing concern regarding the impact of computers on the doctor-patient exam. Some research exists on this point 6. Everyone seems to have a story about a computer freezing or a healthcare provider having difficulty accessing screens. Another potential issue is how the technology begins to structure the nature of the interactions. When asking physicians what determines what questions they ask and when, they will list a variety of factors that go into making this judgment. When using systems that are not flexible in terms of question order, healthcare providers may follow the prompts rather than their judgment. It is not clear what, if any, impact this will have. But, it is a change in the ways which exams are done, information collected, and records created. Need for Post-Implementation Analysis and Assessment Whenever a new technology is introduced into a workplace, its impacts and use can be highly varied. This is especially the case when an implementation is done at the enterprise level. It then becomes important to understand that use. As has been noted in the work of the HIT Policy committee, and other related materials, the presence of a technology does not equate with use. A letter from NCVHS 7 (May 18, 2009) to Dr. Blumenthal makes the point, The impact (positive or negative) of the EHR on the user s workflow can be as important as the EHR functionality (p.3). This impact can be seen in how the technology is used on a daily basis. Re-engineering attempts in other industries have shown how such projects can be highly disruptive to work. The difference is that the margin of error is healthcare is extremely low. Any disruption to medical work can have drastic repercussions. 6 David Greatbatch, C. Heath, P. Campion and P. Luff (1995) How do desk-top computers affect the doctor-patient interaction? Family Practice, 12(1): Letter from Harry L. Reynolds, Jr., Chairman, National Committee on Vital and Health Statistics, to Dr. David Blumenthal, National Coordinator, ONC for HIT (May 18, 2009). 5
6 This creates the need for what I refer to as a post-implementation analysis and assessment. The idea of this is to carefully examine how technology is used after it has been implemented. Current recommendations of the committee revolve around what functionalities are used. These metrics can be generated from the system itself, and are in essence a proxy of use (rather than a direct indicator of how the technology is used). While information is in the system, it does not speak to how it got into the system. So, if a system is being used 85% of the time by physicians, it is not an indication of what they are doing with it. Actual use remains a black box for healthcare administrators. In one instance, I was speaking to hospital administrator who was overseeing the implementation of a new EHR system in which physicians would no longer be able to dictate but directly enter information into the system. I inquired what would be a metric of success, and was told that as long as the system worked and was being used, it would be a success. I asked further whether there would be any examination of documentation before and after the implementation to gauge whether there would any impacts, and was told this would not be done. Given how important medical records are to all aspects of healthcare, this is troubling. We have no way of knowing whether use was meaningful without examining all aspects of outcomes, and in the end ultimately examining actual use. On p.14 of the May 11, 2009 HIT Policy Committee meeting transcript, Dr. Calman references the need for a post-implementation analysis and assessment: So I think that there needs to be an extension there which would mean that certification might need to include something like some post-implementation assessment of the sites where products were implemented to make sure that they re meaningfully used. This echoes an article that I co-wrote and which appeared in the HIT publication For the Record 8. In this article, we state: We advocate a reorientation of perceptions about what is involved in an enterprise system implementation, one that deviates from an exclusive focus on design and implementation and instead concentrates on iterative cycles of design/implementation/analysis/assessment/recommendation/and (re)design. Based on users lived experiences, there are often opportunities in the post-implementation period to modify (or even customize) the configuration to realize more benefits. By examining technology-in-use, there are opportunities to increasing the success of the implementation, which in this instance must be measured by the quality and accuracy of the clinical documentation. These include the following: Workforce Training: As has been pointed out in the committee s materials, workforce training is a critical success factor in implementing EHRs. Training before implementation is at best an abstraction of intended use, and not a reflection of 8 Susan Newell and Gary C. David (2009) Rethinking EHR Project Timelines. For the Record. 21(2), p
7 actual use. Being able to capture best (and worst) practices that are located within the workplace will augment workforce training through real-life examples. Documentation Audit: The quality of medical records can be best understood in their various contexts of use. It is not possible to know all the instances that they will be used. However, it is possible to compare what the documentation looks like before and after implementation. Healthcare organizations should undergo a process of post-implementation clinical documentation audit to begin to determine the potential impact of the implementation. Analyzing Multiple Modes of Entry: In and of itself, the implementation of an EHR system does not determine how information gets into the system. However, EHR solutions often are sold as a way to cut costs through the elimination of medical transcription. This is illustrated by the Congressional Budget Office paper 9 Evidence on the Costs and Benefits of Health Information Technology, which states that EHRs can Eliminate the use of medical transcription and allow a physician to enter notes about a patient s condition and care directly into a computerized record (p.1). While this might decrease the turn-around time of creating documentation, it does not necessarily increase the quality or accuracy of the records. It also does not necessarily make physicians more efficient in terms of seeing patients. Research needs to be devoted to comparing the various modes of entry, including MT-based EHR entry, the use of front-end SRT systems, and template-based entry, in order to weigh efficiency gains across the creation of documentation and actual delivery of treatment. System (Re)Design: Companies that are responsible for developing EHR systems have a difficult task in trying to envision use across a variety of specializations and healthcare settings. Physician complaints often center on the extent to which the system does not integrate into their particular needs. While there is a need to standardize, and to some extent re-engineer, how documentation is created, there also is a need for a system to be flexible enough to handle all the contingencies that physicians face. While it was previously thought that physician narratives would no longer be a needed element of the record, recent thinking demonstrates the need for the flexibility that narrative afford 10. Understanding how systems are being used can provide an opportunity to (re)design systems to fit how work is done. 9 Congressional Budget Office (2008) Evidence on the Costs and Benefits of Health Information Technology. May. 10 Stephen B. Johnson, Suzanne Bakken, Daniel Dine, Sookyung Hyun, Eneida Mendonça, Frances Morrison, Tiffani Bright, Tielman van Vleck, Jesse Wrenn, and Peter Stetson (2008) An Electronic Health Record Based on Structured Narrative. Journal of the American Medical Informatics Association, 15(1):
8 Create user buy-in: One principal challenge in implementing a new system is getting user buy-in. When users feel that their input and concerns are being listened to, it can aide in getting their buy-in. Observing technology-in-use provides that opportunity for users. Innovation and Organizational Change: Learning and innovation, as well as organizational change, ultimately comes down to communication among users. There are numerous examples of innovations existing within an organization, but not being leveraged due to the lack of dissemination of lessons learned. By conducting a post-implementation analysis, organizations can create a more fertile ground for distributed innovation which will ultimately assist in generating organizational change. I am currently working with a small team at Bentley University, along with Erik Vinkhuyzen, Ph.D. of the Palo Alto Research Center (PARC), to study the use of EHRs in the medical setting. The goal of our research is to carry out post-implementation analyses and assessments of EHR implementations in order to begin answering the questions being raised in this document. Another goal of the project is to create a scalable post-implementation toolkit that can be implemented by healthcare organizations in order to empower them to answer these questions for themselves. Currently, there appears to be hesitancy among healthcare organizations to address these questions. Part of this is likely due to a lack of awareness of these issues, along with a lack of resources to do so. However, despite these barriers, the need to conduct such an examination remains. I applaud the work of the HIT Policy Committee for their diligence in tacking on the concept of meaningful use. Doing so in a way that is simple yet complete is an onerous task. I thank the committee for the opportunity to provide these comments, and do so in the hope that the content will be useful in your work. I hope that the information in this document is useful to the committee. If there is any clarification or follow up needed, I would welcome the opportunity. Thank you, and I look forward to following the committee s work on the topic. Sincerely, Gary C. David, PhD Associate Professor of Sociology Department of Sociology Bentley University 8
The Value of MTs in Healthcare Documentation Production?
The Value of MTs in Healthcare Documentation Production? Gary C. David, PhD Associate Professor of Sociology Bentley University, Waltham, MA 2009 Spring Fling Michigan AHDI Chapter Frankenmuth, MI The
More information2011 EHR Future Roles Survey Report
2011 EHR Future Roles Survey Report Bentley Research Team Donald R. Chand IPM Department Gary C. David Department of Sociology and IDCC Balaji Sankaranarayanan IPM Department Jan 21, 2012 Executive Summary
More informationAssessment of Quality Management in Medical Transcription
Assessment of Quality Management in Medical Transcription Nora Palugod, Ph. D. (Corresponding Author) Assistant Professor of Business The Richard Stockton College of New Jersey Pomona, NJ 08240, U.S.A.
More informationASSIGNMENT 2: THE HEALTHCARE RECORD AND HEALTHCARE DOCUMENTATION TECHNOLOGY
ASSIGNMENT 2: THE HEALTHCARE RECORD AND HEALTHCARE DOCUMENTATION TECHNOLOGY Read Chapters 2 and 3 in your textbook, Healthcare Documentation: Fundamentals and Practice. Then read Assignment 2 in this study
More informationHarnessing the Untapped Potential of EHR Systems
CASE STUDY Harnessing the Untapped Potential of EHR Systems TalkChart Transforms the Documentation Efficiency of the Child & Adolescent Psychiatry Department of a Large Academic Institution Electronic
More informationTop 5 Medical Transcription Myths: Don t Turn Down the Career Till You Know the Facts!
Top 5 Medical Transcription Myths: Don t Turn Down the Career Till You Know the Facts! Top 5 Medical Transcription Myths: Don t Turn Down the Career Till You Know the Facts! What s medical transcription?
More informationConsolidated Clinical Document Architecture and its Meaningful Use Nick Mahurin, chief executive officer, InfraWare, Terre Haute, Ind.
Consolidated Clinical Document Architecture and its Meaningful Use Nick Mahurin, chief executive officer, InfraWare, Terre Haute, Ind. Helping Doctors Regain Their Voice SM A Whitepaper for the Healthcare
More informationCLINICAL DOCUMENTATION TRENDS IN THE UNITED STATES, 2013-2016. October 2013
CLINICAL DOCUMENTATION TRENDS IN THE UNITED STATES, 2013-2016 October 2013 Table of Contents Executive Summary... 2 Clinical Documentation Today... 4 Clinical Documentation in 2016... 8 Recommendations
More informationWEST TENNESSEE HEALTHCARE & M*MODAL FLUENCY DIRECT
WEST TENNESSEE HEALTHCARE & M*MODAL FLUENCY DIRECT case study Background West Tennessee Healthcare is a public, not-for-profit healthcare system headquartered in Jackson, Tennessee. The anchor hospital
More informationPractical Steps for Meaningful Physician Documentation in Healthcare
Practical Steps for Meaningful Physician Documentation in Healthcare A White Paper from Webmedx Table of Contents: 1. Executive Summary 2. Physician Productivity versus Structured Data 3. Transcription
More informationThe Physician Productivity Hit
WHITE PAPER The Physician Productivity Hit Addressing the Efficiency Failures and Design Flaws of EHR Systems in Medical Practices Abstract Immediate and dramatic loss of productivity is one of the most
More informationThe Complexity of America s Health Care. Industry. White Paper #2. The Unique Role of the Physician in the Health. Care Industry
The Complexity of America s Health Care Industry White Paper #2 The Unique Role of the Physician in the Health Care Industry www.nextwavehealthadvisors.com 2015 Next Wave Health Advisors and Lynn Harold
More informationM*Modal Transcription Services
On-Time, On-Target Clinical Documentation Meets Today s Demands on Your Terms High-Quality, Cost-Effective, Timely Clinical Documentation: Meeting Today s Demands on Your Terms The Challenge The ever-expanding
More informationNuaNce TraNscripTioN ServiceS h e a l t h c a r e
Nuance Transcription Services h e a l t h c a r e Full-service, Outsourced for the Capture Anywhere Understand Everything 2 Transcription Healthcare Enterprise CHALLENGE: How does a healthcare organization
More informationOn-Time, On-Target Clinical Documentation Meets Today s Demands on Your Terms
On-Time, On-Target Clinical Documentation Meets Today s Demands on Your Terms High-Quality, Cost-Effective, Timely Clinical Documentation: Meeting Today s Demands on Your Terms The Challenge The ever-expanding
More informationEHR IMPLEMENTION CASE STUDY #1
EHR IMPLEMENTION CASE STUDY #1 THE EVERETT CLINIC Everett, Washington Sharon Cordisco, Transcription Manager Background The Everett Clinic is a physician owned primary and specialty care group with eight
More informationMEDICAL TRANSCRIPTION: PROVEN ACCELERATOR OF EHR ADOPTION
MEDICAL TRANSCRIPTION: PROVEN ACCELERATOR OF EHR ADOPTION The recently enacted Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009 represents an important first step
More informationHow to Conduct a Thorough CAC Readiness Assessment
WHITE PAPER How to Conduct a Thorough CAC Readiness Assessment A White Paper from Nuance Healthcare HEALTHCARE COMPUTER-ASSISTED CODING Contents Introduction... 3 The Benefits of CAC... 4 The New Role
More informationAvoiding Revenue Cycle Disasters While Implementing Enterprise Integrated Systems
Avoiding Revenue Cycle Disasters While Implementing Enterprise Integrated Systems 2 The past year has been rife with articles in the healthcare provider sector about large enterprise-wide system implementations
More informationWhite Paper. The Combined Solution: EHR and Outsourced Transcription Working Together for Improved Patient Care
+ White Paper The Combined Solution: EHR and Outsourced Transcription Working Together for Improved Patient Care Introduction How will the role of traditional transcription fit into the new Electronic
More informationDesigning Flexible EMR Systems for Recording and Summarizing Doctor- Patient Interactions
Designing Flexible EMR Systems for Recording and Summarizing Doctor- Patient Interactions Kyle Larkin Arts Media and Engineering Arizona State University 699 South Mill Avenue #396 Tempe, AZ 85281 USA
More informationWebmedx Technology and Services Provide a Bridge to the EHR for Rockwood Clinic
Webmedx Technology and Services Provide a Bridge to the EHR for Rockwood Clinic Combination of Narrative Transcription and EHR Templates Ease Transition, Improve Physician Adoption and Support Physician
More informationWHITE PAPER. QualityAnalytics. Bridging Clinical Documentation and Quality of Care
WHITE PAPER QualityAnalytics Bridging Clinical Documentation and Quality of Care 2 EXECUTIVE SUMMARY The US Healthcare system is undergoing a gradual, but steady transformation. At the center of this transformation
More informationMarch 10, 2015 CONFERENCE CALL DOCUMENTATION FOR C.N.A.s Presented by Dwana Jackson, CNA, AIPP Quality Specialist
March 10, 2015 CONFERENCE CALL DOCUMENTATION FOR C.N.A.s Presented by Dwana Jackson, CNA, AIPP Quality Specialist Good morning everyone and welcome to today s conference call, our topic today is documentation
More informationJanuary 29, 2016. RE: Feedback on Draft Bill BAI16031. Dear Senator Alexander:
The Honorable Lamar Alexander Chairman of the Health, Education, Labor and Pensions 455 Dirksen Senate Office Building Washington, DC 20510 Submitted via email to: HealthIT@help.senate.gov RE: Feedback
More informationAcademyHealth State Health Research and Policy Interest Group February 8, 2011 Meeting Summary
AcademyHealth State Health Research and Policy Interest Group February 8, 2011 Meeting Summary The State Health Research and Policy Interest Group (SIG) met on February 8, 2011 in conjunction with AcademyHealth
More informationExploring Meaningful Use: Results of an EHR Survey by AMGA and JHD Group
Exploring Meaningful Use: Results of an EHR Survey by AMGA and JHD Group Expectations for EHR Value and Care Improvements Increase with Use as medical practices nationwide focus on meaningful use of electronic
More informationCLINICAL DOCUMENTATION DRIVING PERFORMANCE IN THE NEW WORLD OF HEALTHCARE
CLINICAL DOCUMENTATION DRIVING PERFORMANCE IN THE NEW WORLD OF HEALTHCARE Patient CARE Financial Integrity HEALTHCARE S New REALITIES A host of critical imperatives from Meaningful Use and ACOs, to ICD-10,
More informationThe Economic Effect of Implementing an EMR in an Outpatient Clinical Setting
Reprinted from Volume 18, Number 1 Winter 2004 Original Contributions The Economic Effect of Implementing an EMR in an Outpatient Clinical Setting Scott Barlow, MBA, Jeffrey Johnson, MD, Jamie Steck, MBA
More informationEstablishment of a Temporary and Permanent Testing Program
April 9, 2010 David Blumenthal, MD, MPP Office of the National Coordinator for Health Information Technology (ONCHIT) Attn: Certification Programs Proposed Rule Hubert H. Humphrey Building, Suite 729D
More informationHow To Write A Grant For A Health Information Technology Program
HealthInfoNet s Maine State Innovation Model Testing Model Grant Request for Proposals (RFP) for Behavioral Health Information Technology (HIT) Reimbursement Date of call: February 7, 2014 Questions are
More informationAccountable Care: Implications for Managing Health Information. Quality Healthcare Through Quality Information
Accountable Care: Implications for Managing Health Information Quality Healthcare Through Quality Information Introduction Healthcare is currently experiencing a critical shift: away from the current the
More informationEHRs and Contexts of Use
2 EHRs and Contexts of Use A Providers Perspective on EHR User Experience Presented by March 2013 1 EHRs and Contexts of Use It s not a new concept. Most modern EHRs, descending from products designed
More informationA Long Way to Go for EMR Usability By: Jessica Green
Topic Overview & Introduction: A Long Way to Go for EMR Usability By: Jessica Green With the ever increasing implementation of Electronic Medical and Health Records (EMR and EHR) systems into hospitals,
More informationEHR: Secrets of Successful Usability
Prepared for: Macadamian Technologies No. of pages: 8 Audio recording Identification: 20130620_UnSalted 00:11:06 Transcript prepared by : Capital Transcription Services, Ottawa Canada Host: Lorraine Chapman,
More informationTitle in Franklin Gothic Demi 18pt. Cerner Ambulatory. ICD 10 Conversion, Coding Confusion, and Cerner s Solution
ICD 10 Conversion, Coding Confusion, and Cerner s Solution solution cuts down coding and conversion confusion A physician s visit with a patient often centers on telling the patient s story. Yet a physician
More informationWhite Paper. Maximizing the Benefits of Computer Aided Medical Transcription by Outsourcing to Multiple MTSOs
White Paper Maximizing the Benefits of Computer Aided Medical Transcription by Outsourcing to Multiple MTSOs Introduction The potential for background speech recognition to decrease costs, reduce turnaround
More informationHow to Protect Revenue & Physician Productivity
How to Protect Revenue & Physician Productivity Before, During & After EHR Adoption Presented By Kirk L. Miller, FACHE, VP of Physician Services, Mark Suzuki, MD & Howard Brumberg, MD G. William Brown,
More informationThe webinar will be starting shortly. Thank you!
The webinar will be starting shortly. Thank you! Welcome to the Disparities Solutions Center s Web Seminar Series Hearing All Voices: Race, Ethnicity, Language, and the Patient Experience Thursday, October
More informationSix Sigma: Expert team vastly improves transcription productivity
Children s Hospital Boston redefines workflow with consultancy from Philips Speech Recognition Systems Six Sigma: Expert team vastly improves transcription productivity Customer Story Following the implementation
More informationEVIDENCE OF COVERAGE. A complete explanation of your plan. Health Net Green (HMO) January 1, 2010 December 31, 2010
EVIDENCE OF COVERAGE A complete explanation of your plan Health Net Green (HMO) January 1, 2010 December 31, 2010 Important benefit information please read H0755_2010_0389 10/2009 January 1 December 31,
More informationShellie Sulzberger, LPN, CPC, ICDCT-CM. Coding & Compliance Initiatives, Inc.
Shellie Sulzberger, LPN, CPC, ICDCT-CM Coding & Compliance Initiatives, Inc. My connection to coding and documentation My connection to clinical processes My connection to ICD-10 My connection to YOU Coding
More informationprepared in making referrals through Choose and Book, which doesn t create any additional work for me.
Health Management Limited has been appointed as the supplier to deliver Fit for Work (previously Health and Work Service) in England and Wales. The following is a personal account of a service user s journey.
More informationEHR Implementation Best Practices. EHR White Paper
EHR White Paper EHR Implementation Best Practices An EHR implementation that increases efficiencies versus an EHR that is underutilized, abandoned or replaced. pulseinc.com EHR Implementation Best Practices
More informationADDENDUM REQUEST FOR PROPOSAL (RFP)
ADDENDUM REQUEST FOR PROPOSAL (RFP) Proposal Closing: September 9, 2005 at 3:00 p.m. (Local Time) Page 1 of 1 Proposal Number: 216542/LP Date: September 1, 2005 PROPOSALS MUST BE SUBMITTED ON OR ATTACHED
More informationMenu Item: Dashboards and Analytics/Business Informatics
Cover Page Menu Item: Dashboards and Analytics/Business Informatics Name of Applicant Organization: Fremont Family Care Organization s Address: 2540 N Healthy Way, Fremont, NE 68025 Submitter s Name: Elizabeth
More informationConsidering an EHR? Tips for a successful approach to selecting and implementing the right solution
Considering an EHR? Tips for a successful approach to selecting and implementing the right solution Presented by: Chuck Meisel Vice President of Sales, Surgical Notes Agenda Let s define the products Electronic
More informationWorkflow Redesign for EHRs. College of St. Scholastica
Workflow Redesign for EHRs Phil Deering Regional Coordinator REACH Pam Oachs, MA, RHIA Assistant Professor College of St. Scholastica 1 Objectives Learn the value of understanding current clinical workflows
More informationClintegrity 360 QualityAnalytics
WHITE PAPER Clintegrity 360 QualityAnalytics Bridging Clinical Documentation and Quality of Care HEALTHCARE EXECUTIVE SUMMARY The US Healthcare system is undergoing a gradual, but steady transformation.
More informationReadiness Assessment: is your practice ready for electronic medical records?
Readiness Assessment: is your practice ready for electronic medical records? This is the first article in a series designed to help the practicing physician understand the complexities, benefits, problems,
More informationLesson 1 The Exciting World of Medical Transcription
Lesson 1 The Exciting World of Medical Transcription Step 1 Learning Objectives for Lesson 1 When you have completed the instruction in this lesson, you will be trained to do the following: Explain how
More informationMeaningful Use as a Driver for EHR Adoption
white paper Meaningful Use as a Driver for EHR Adoption How Nuance Healthcare Can Help Bridge the Gap to Structured Data Entry healthcare Contents Executive Summary...3 Introduction...3 Emerging Hybrid
More informationELECTRONIC HEALTH RECORDS. Nonfederal Efforts to Help Achieve Health Information Interoperability
United States Government Accountability Office Report to Congressional Requesters September 2015 ELECTRONIC HEALTH RECORDS Nonfederal Efforts to Help Achieve Health Information Interoperability GAO-15-817
More informationCost Savings with Computer Aided Medical Transcription
WHITE PAPER Cost Savings with Computer Aided Medical Transcription Three Case Studies HEALTHCARE INTRODUCTION: THE MILLION DOLLAR QUESTION On the television game show Who Wants To Be A Millionaire, Meredith
More informationWorking with an Interpreter Online Education. Children s Hospital of Wisconsin
Working with an Interpreter Online Education Children s Hospital of Wisconsin This presentation will help you Understand the role of an interpreter Work effectively with an interpreter Access interpreter
More informationSlide 1 Welcome to Installation and Maintenance of Health IT Systems, Elements of a Typical EHR system.
Installation and Maintenance of Health IT Systems: Elements of a Typical EHR system Lecture 3 Audio Transcript Slide 1 Welcome to Installation and Maintenance of Health IT Systems, Elements of a Typical
More informationEMR: Putting Flexibility Up Front
EMR: Putting Flexibility Up Front By Jeanne-Marie Phillips Orthopedists implement innovative electronic medical records system that adapts to their business needs. I wanted an EMR program that would reflect
More informationDragon Medical Group Health Cooperative Promotes Physician Adoption of EpicCare EMR and Achieves Higher Quality of Patient Care with Dragon Medical
C U S T O M E R C A S E S T U D Y Dragon Medical Group Health Cooperative Promotes Physician Adoption of EpicCare EMR and Achieves Higher Quality of Patient Care with Dragon Medical Group Health Cooperative
More informationAgenda. Government s Role in Promoting EMR Technology. EMR Trends in Health Care. What We Hear as Reasons to Not Implement and EMR
Agenda A 360-Degree Approach to EMR Implementation Environmental Overview Information on the HITECH Stimulus Opportunities Hospitals, Physicians and Interoperability Preparing for an EMR Implementation
More informationFour Years On: From HITECH to Optimization
Four Years On: From HITECH to Optimization 2 Overview Healthcare Provider IT Marketplace and Impact of Last Four Years Calculating the ROI Associated with Healthcare IT Investments Establishing a Monitored
More informationAmerican Academy of Pediatrics
American Academy of Pediatrics TESTIMONY OF SUSAN KRESSLY, MD, FAAP PRACTICING PEDIATRICIAN AMERICAN ACADEMY OF PEDIATRICS before the COMMITTEE ON SMALL BUSINESS SUBCOMMITTEE ON REGULATIONS AND HEALTHCARE
More information0805EHEALTHTRANSCRIPT02 Kate Berry.txt 2 MS. BERRY: Good morning. I'm Kate Berry. 7 First of all, I applaud the direction that
2 MS. BERRY: Good morning. I'm Kate Berry. 3 I was asked to make a few brief remarks about the 4 landscape that relates to e-prescribing and some of 5 the success stories out there and some of the 6 challenges
More informationStandardizing Electronic Medical Record Documentation By Curtis M. Rimmerman, MD, MBA, CPE, and Arnette Colbert, MA
Electronic Medical Records Standardizing Electronic Medical Record Documentation By Curtis M. Rimmerman, MD, MBA, CPE, and Arnette Colbert, MA In this article Cleveland Clinic takes on a 10-step project
More informationFIVE COMMON PROBLEMS FACING PHYSICIAN LIAISON PROGRAMS
FIVE COMMON PROBLEMS FACING PHYSICIAN LIAISON PROGRAMS By Richardson Bricken McKenzie, IV, MBA, FACHE, FACMPE As primary healthcare providers continue to be overburdened with patient care and paperwork,
More informationHow To Use Praxis
Praxis EMR Case Studies For more client case studies in a variety of medical specialties, go to http://www.praxisemr.com/testimonials.htm Our most recent and extensive case study covers Jeremy Bradley,
More informationovercoming barriers to physician adoption of EHRs
TECHNOLOGY REPRINT February 2014 Stuart M. Hochron Paul Goldberg healthcare financial management association hfma.org overcoming barriers to physician adoption of EHRs AT A GLANCE > A hospital s success
More informationShellie Sulzberger, LPN, CPC, ICDCT-CM Coding & Compliance Initiatives, Inc.
Shellie Sulzberger, LPN, CPC, ICDCT-CM Coding & Compliance Initiatives, Inc. Reasonable efforts have been made to provide the most accurate and current information on CPT 2015 code changes. However codes,
More informationTransforming Healthcare in Emerging Markets with EMR adoption
Transforming Healthcare in Emerging Markets with EMR adoption Author Ann Geo Thekkel User Experience. Accenture, India Ann.geothekkel@accenture.com Abstract Compromising 24 countries, 35 percent of the
More information6/8/2012. Cloning and Other Compliance Risks in Electronic Medical Records
Cloning and Other Compliance Risks in Electronic Medical Records Lori Laubach, Partner, Moss Adams LLP Catherine Wakefield, Vice President, Corporate Compliance and Internal Audit, MultiCare 1 AGENDA Basic
More informationhospitals within a hospital system for other payment purposes and could easily do so for this program as well.
Statement by Phyllis Teater on Health Information Technology and the Electronic Health Records Incentive Program submitted to the Committee on Ways and Means United States House of Representatives July
More informationNorth Shore Physicians Group Primary Care Redesign
North Shore Physicians Group Primary Care Redesign Christine Sinsky, MD 12.23.11 The physician cannot do this work alone, notes Lindsay Gainer, Director of Clinical Services and Innovations at North Shore
More informationPROTIVITI FLASH REPORT
PROTIVITI FLASH REPORT HHS Announces Plans to Reconsider Implementation Timeline for U.S. Healthcare Industry s Transition to ICD-10 February 17, 2012 On Wednesday, February 15, the Department of Health
More informationNew Beginnings: Managing the Emotional Impact of Diabetes Module 1
New Beginnings: Managing the Emotional Impact of Diabetes Module 1 ALEXIS (AW): Welcome to New Beginnings: Managing the Emotional Impact of Diabetes. MICHELLE (MOG): And I m Dr. Michelle Owens-Gary. AW:
More informationEvaluation of the Information Technology Professionals in Health Care ( Workforce ) Program - Summative Report
FINAL REPORT: EXECUTIVE SUMMARY Evaluation of the Information Technology Professionals in Health Care ( Workforce ) Program - Summative Report MARCH 2014 PRESENTED TO: Office of the National Coordinator
More informationFinance Leaders Rethink Transcription: Six Critical Criteria in a Changing Landscape
Finance Leaders Rethink Transcription: Six Critical Criteria in a Changing Landscape A White Paper from Webmedx Table of Contents: The Realities of Medical Transcription Today Demand for Medical Transcription
More informationThe Michigan State University Institute for Health Policy (IHP) is recruiting a sample of office based primary care providers to be interviewed
The Michigan State University Institute for Health Policy (IHP) is recruiting a sample of office based primary care providers to be interviewed concerning their perceptions of the Meaningful Use of electronic
More informationHealth Care Delivery and Information Technology (HIT) Subcommittee : DRAFT Recommendations
President s Information Technology Advisory Committee (PITAC) Health Care Delivery and Information Technology (HIT) Subcommittee : DRAFT Recommendations April 13, 2004 President s Information Technology
More information10/21/2014. Improving EHR Navigation with the Use of Scribes. Charles H. Mann, MD FACS. Improving EHR Navigation with the Use of Scribes
Improving EHR Navigation with the Use of Scribes October 22, 2014 12:30 1:30 p.m., EDT Charles H. Mann, MD, FACS 2014 The Carolinas Center for Medical Excellence Charles H. Mann, MD FACS Practicing otolaryngology
More informationUsing Health IT to Engage Patients in their Care: The Role of Providers in Implementing Online Access
Using Health IT to Engage Patients in their Care: The Role of Providers in Implementing Online Access The National Partnership for Women & Families conducted a series of eight interviews in the winter
More informationEffectively Managing EHR Projects: Guidelines for Successful Implementation
Phoenix Health Systems Effectively Managing EHR Projects: Guidelines for Successful Implementation Introduction Effectively managing any EHR (Electronic Health Record) implementation can be challenging.
More informationSolutions for Clinical Documentation Improvement and Information Integrity
Solutions for Clinical Documentation Improvement and Information Integrity Improve patient care. Optimize reimbursement. Ensure regulatory compliance. Each of these mission-critical imperatives depends
More informationExecutive Summary. At the end of the twentieth century and. Enterprise Systems for Higher Education Vol. 4, 2002
01 Executive Summary At the end of the twentieth century and into the twenty-first, higher education has invested, by a conservative estimate, $5 billion in administrative and enterprise resource planning
More informationProven Practice Management and EHR Solutions
Proven Practice Management and EHR Solutions The Smart Choice to Enhance Office Productivity, Profitability and Care Quality Your small practice faces big challenges. Finding time and resources to prepare
More informationEthics Case Study for ABC Incorporated and Questions
Ethics Case Study for ABC Incorporated and Questions By Renee Rampulla, CPA, Technical Manager, AICPA Professional Ethics Division and updated by Ellen Goria, CPA, Senior Manager Independence and Special
More informationMedical Transcription Solutions For Your Unique Organization WITH EMR COMPATIBITLTY NEW
UZMASCRIBE a division of JB Software and Consulting Inc WEB BASED ONLINE MEDICAL TRANSCRIPTION COMPANY Company Brochure Medical Transcription Solutions For Your Unique Organization WITH EMR COMPATIBITLTY
More informationQuantitative study reveals data about VNA, ECM and clinical content
Quantitative study reveals data about VNA, ECM and clinical content Survey reveals preference for a patient-centric, unified health record that presents all relevant data at the point of care Fueled by
More informationEHR Implementation Best Practices: An EHR implementation that increases efficiencies versus an EHR that is under utilized, abandoned or replaced.
EHR Implementation Best Practices: An EHR implementation that increases efficiencies versus an EHR that is under utilized, abandoned or replaced. By Tana Goering, M.D. EHR Implementation Best Practices:
More informationHillside Medical Office
EHR Case Study Hillside Medical Office Hillside Medical Partners with Pulse to Quickly Achieve Meaningful Use pulseinc.com Pulse Complete EHR 8 board-certified physicians. 40 employees. Over 65 years of
More informationWorkforce Strategies A SUPPLEMENT TO HUMAN RESOURCES REPORT
BNA, INC. Workforce Strategies A SUPPLEMENT TO HUMAN RESOURCES REPORT VOL. 29, NO. 7 ISSN 1523-2832 JULY 2011 Reproduced with permission from Workforce Strategies, 29 WFS No. 7, pp 10-14, 07/01/2011. Copyright
More informationHow To Improve Health Information Technology
The American Society For Clinical Pathology Policy Statement Health Information Technology/Informatics (Policy Number) Policy Statement: ASCP supports the implementation of standardized health information
More informationThe Electronic Patient Narrative
WHITE PAPER The Electronic Patient Narrative A Clinical Imperative in the EHR Era HEALTHCARE CONTENTS Executive Summary... 3 Structured Data for Medical Decision Support... 3 The Patient Narrative... 4
More informationQuality Program Overview. M*Modal Quality Department
M*Modal Quality Department 2012 Table of Contents The Quality Department Team........................... 3 What is Quality?........................................ 3 How is it Measured?.....................................
More informationELECTRONIC MEDICAL RECORDS. Selecting and Utilizing an Electronic Medical Records Solution. A WHITE PAPER by CureMD.
ELECTRONIC MEDICAL RECORDS Selecting and Utilizing an Electronic Medical Records Solution A WHITE PAPER by CureMD CureMD Healthcare 55 Broad Street New York, NY 10004 Overview United States of America
More informationBig Time, Big Deal. Strategies for Creating a Successful Organization-wide EMR. Charles B Wang Community Health Center Laminasti (Ina) Elbaar
Big Time, Big Deal Strategies for Creating a Successful Organization-wide EMR Charles B Wang Community Health Center Laminasti (Ina) Elbaar 5 th Annual Asian & Pacific Islander Community Health Center
More informationCHANGE MANAGEMENT PRINCIPLES AND PRACTICES IN ORGANISATION
CHANGE MANAGEMENT PRINCIPLES AND PRACTICES IN ORGANISATION Dr. Mane Vijay Annaso Associate Professor in Commerce Mahatma Phule Mahavidyalaya Pimpri, Pune-17, India. vijay_mane5777@yahoo.co.in ABSTRACT:
More information206-478-8227 www.healthdataconsulting.com. ICD-10 Now What? Joseph C Nichols MD Principal. A Health Data Consulting White Paper
206-478-8227 www.healthdataconsulting.com ICD-10 Now What? Joseph C Nichols MD Principal A Health Data Consulting White Paper Oct 1, 2015 TABLE OF CONTENTS IT S NOW THE STANDARD... 3 CHARTING A COURSE
More informationEVIDENCE OF COVERAGE
Samaritan Advantage Health Plan (HMO) EVIDENCE OF COVERAGE Conventional Plan 2016 H3811_MM170_2016B Form CMS 10260-ANOC/EOC OMB Approval 0938-1051 (Approved 03/2014) January 1 December 31, 2016 Evidence
More informationHow To Make A Change Management Program Successful
By Scott Hopkins and Sheila Sirois Successful software implementations go hand-in-hand with well-planned change management programs. A change management program can make a difference on several levels
More informationPARTICIPATORY ANALYSIS
PARTICIPATORY ANALYSIS Expanding Stakeholder Involvement in Evaluation Veena Pankaj Myia Welsh Laura Ostenso April 2011 2011 Innovation Network, Inc. You may remix, tweak, and build upon this work for
More informationRunning Head: WORKFLOW ANALYSIS 1. Workflow Analysis of a Primary Care Clinic Before and After Implementation of an Electronic Health Record
Running Head: WORKFLOW ANALYSIS 1 Sample Answer to Workflow Analysis Assignment Workflow Analysis of a Primary Care Clinic Before and After Implementation of an Electronic Health Record There are numerous
More information