EHRs vs. Paper-based Systems: 5 Key Criteria for Ascertaining Value

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1 Research White Paper EHRs vs. Paper-based Systems: 5 Key Criteria for Ascertaining Value Provided by: EHR, Practice Management & Billing In One

2 Before evaluating the benefits of EHRs, one must first understand what EHRs are and their historic journey so far. EHRs (Electronic Health Records) are a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. This information contains patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, radiology reports, and more. EHRs automate and streamline clinicians workflow, they have the ability to generate a complete record of clinical patient encounters, as well as support other care-related activities directly or indirectly via interface including evidence-based decision support, quality management, and outcomes reporting. Historically, the deployment of EHRs can be divided into two major time periods. First, the early efforts began in the 1960s and 70s, when academic medical centers developed their own systems. Second, beginning in the 1980s, leaders saw benefits to industry-wide standards and began forming organizations to tackle the broader issues that would facilitate the widespread use of electronic medical information. The first EHR systems were known as clinical information systems in the mid-1960s. After then, EHRs have appeared in the national political forum, indicating widespread concerns about record keeping s effect on public health. President Bush mentioned the topic in his 2004 State of the Union address, and President Obama incorporated EHRs into his American Recovery and Reinvestment Act (ARRA) of 2009 as part of the Health Information Technology for Economic and Clinical Health Act (HITECH). This act provides for higher payments to health care providers that meet meaningful use criteria, which involve using EHRs for relevant purposes and meeting certain technological requirements. The goal for 2015 is every medical clinic, medical office, and hospital to all be securely sharing patient information, most likely through the HL7 (Health Level 7) exchange. A simple example benefit of EHRs is they can store all records pertaining to patients, and multiple providers can access the data depending upon the requirements, request, and reference. So, paper storage becomes virtually obsolete, fewer medical errors occur, and each provider can see the patient history of medication and hence prescribe accordingly. 5 key criteria for ascertaining EHR value are: 1. Can EHRs improve quality and convenience of patient care? 2. Can EHRs increase patient participation in their care? 3. Can EHRs improve accuracy of diagnoses and health treatments? 4. Can EHRs improve care coordination? 5. Can EHRs increase efficiency of practice and cost savings? 2

3 EHRs allows physicians and staff members to View medical histories and insurance information Document interactions with patients Perform and manage referrals Order laboratory tests and view test results Send electronic prescription requests to pharmacies (reducing the risk that hard-to-read handwriting will lead to medical errors) Flag potentially harmful drug interactions Tragic events like those that occurred in the U.S. on Sept, 11, Hurricane Katrina, and the California fires have showcased the benefits of electronic record keeping. Those injured or affected by any of those events were more easily treated and may have found better outcomes than those for whom no medical records were available. Large scale EMR systems replicate their stored records in several places across the country so that one tragic event won t destroy them. However, with all the benefits described above, one should note that implementing an EHR is not like buying a new copy machine; it takes time, effort and resources both financially and physically to implement one successfully. Providers considering implementation typically also have questions such as, What is in it for my patients? What is in it for me? Will it be worth it? Insights to these questions can be found below For Providers: Quick access to patient records from inpatient and remote locations for more coordinated, efficient care Enhanced decision support, clinical alerts, reminders, and medical information Performance-improving tools, real-time quality reporting Legible, complete documentation that facilitates accurate coding and billing Interfaces with labs, registries, other EHRs, and HIEs Safer, more reliable prescribing Meaningful Use incentives For Patients: Less requirement to fill out the same forms at each office visit Reliable point-of-care information and reminders notifying providers of important health interventions Convenience of e-prescriptions electronically sent to the pharmacy Patient portals for online interaction with providers Electronic referrals allowing for easier access to follow-up care with specialists 3

4 Assessing Return on Investment Two main results from implementing EHRs are that users gain a secure and reliable environment with more data access options among staff; and second, workflow is improved gaining greater efficiency among staff thus slowing down the need to add more staff even as the practice grows while increasing the amount of quality time spent with patients. The majority of physicians report data access as the top safety benefit. The key to any of these benefits is effective management of the transition from a paperbased system to electronic health records: administratively, financially, culturally, and technologically. Security ROI Internal Control: With EHRs, providers can track who accesses all files. Anyone working in a paperbased practice could potentially access, view, and copy the protected health information undetected. Encryption: Encrypted files require a specific code key to read data. If EHRs are appropriately encrypted, then if data are accessed not according to procedure, the information is unreadable. Disaster Recovery: Back-up is one of the biggest advantage of digital records, while papers are likely to be destroyed due to natural disasters, fires, etc., web-based EHRs utilize remote backups to allow doctors secure access to critical data from anywhere they have internet access. Practices can save hours previously spent on manual back-ups and improve reliability due to the high rate that tape back-ups are inaccessible due to unreadable tape. Other Areas for ROI Reduced Storage: Paper records require a substantial amount of space compared to digital records; providers have to keep information on file for the treatment of their patients and also have to keep those files on hand due to health care regulations for at least 6 years. Access Anytime, Anywhere: EHR users enjoy the relatively new luxury of access to their data from wherever they want, whenever they want, whiles still remaining HIPAA compliant. Multiple departments can add clinical information to the health record, too, and view the same file even when another user has it open with some EHRs. Improved Accuracy: Malpractice is possible in paper-based medical records due to incomplete documentation and unreadable handwriting, while electronic systems come with features that make sure all information related patient care is included on the form are proper. Reduced Costs: Overall costs of implementing an electronic health records are less than the paper record, as paper based records have higher costs due to the necessity of more manpower to manage, access, file, and maintain. Improved Risk Management: With all patient information in digital form, providers are able to track clinical issues more effectively allowing them to more easily identify areas of risk. These areas include easier access to patient histories, drug information, decision support, proper coding, and more. 4

5 5 key areas for return on investment summary Regardless of how familiar one s paper-based systems are, it is clear that EHRs can improve quality and convenience of patient care, increase patient participation in their care, improve accuracy of diagnoses and health treatments, improve care coordination, and increase efficiency of practice and cost savings. Implementations require careful care and planning, but as outlined, can offer providers myriad benefits. Hours saved generating reports Medical record staff working hours decrease Paper medical record forms printing and binder costs savings Nursing and front office staff hours saved Training the staff for manual documentation hours saved Chart audit and assembly hours saved Less time on documentation and more time to treat more patients Costs for long-term and on-site storage of medical records eliminated Immediate retrieval of medical records Greater employee satisfaction gaining efficiency in the workplace No lost (and easy to audit) medical records Decision support and coding tools including prescriptions 5 Paper-based Systems Paper charts can be easily misplaced Time consuming to pull charts and re-file Appointment reminders have to be sent manually Scheduling is done manually Manual filing of insurance cards Manual communication about billing Drug recalls are difficult to communicate and cross-reference with affected patients Difficult and time consuming tasks include identification of patient characteristics Difficult to manage chronic diseases Human error can occur in clinical information Electronic Health Records Electronic files can be easily searched and backed-up, available on server Charts are updated and e-filed easily Automatic appointment reminders are sent from the EHR Scheduling is much more automated Insurance cards are scanned and instantly put into the system The EHR system sends billing reminders Patient files can be flagged for drug recalls and updates Patient characteristics are fully searchable and linked to patient histories Patient groups can be set up and managed Reduced risks due to human errors

6 Regardless of which EHR you choose for your practice, the best decision is an informed decision. OmniMD experts are available to answer questions you may have about EHRs, practice management systems, or revenue cycle management services regardless of which systems you are evaluating. With OmniMD, Consensus is On Your Side 1,000,000 claims per month are processed with OmniMD 3,500 insurance plan details feed into OmniMD 10,000+ providers use OmniMD Talk to Us Today for a Guided Overview Dial (914) or The integrated registration, scheduling, EMR, fax server, document imaging, and billing modules have improved the efficiency of Kimball Medical Center s outpatient occ-health and rehab services immensely. OmniMD s onsite training and electronic customer support keep our 40+ users very pleased. Thank you for exceeding our expectations. Caryl Russo, Senior Vice President Development St. Barnabas Health Care System, Kimball Medical Center Foundation, NJ Specialties Served: Allergy and Immunology Anesthesiology Cardiology Dermatology Emergency Medicine Endocrinology ENT Family Practice Gastroenterology Geriatric Medicine HBOT/Wound Care Hematology Internal Medicine Nephrology Neurosurgery Neurology Oncology Ophthalmology Orthopedics OB/GYN (Gynecology) Occupational Health Pain Management Pediatrics Podiatry Psychiatry Pulmonology Rheumatology Surgery Sports Medicine Urology Vascular Surgery

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