5 GUIDLINES TO ENSURE THE RIGHT EHR FOR YOUR HEALTHCARE PRACTICE

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1 5 GUIDLINES TO ENSURE THE RIGHT EHR FOR YOUR HEALTHCARE PRACTICE ELECTRONIC HEALTH RECORDS The discussion of the right EHR/EMR for your practice and achieving the proper certification is primarily geek speak...but, because making a EHR/EMR choice is probably your practices top financial expense in the near future; knowing what geek speak is critical and what is vendor fluff is imperative. With that said, in the past, development of many EHR/EMR systems has been an industry led initiative; based on achieving theoretical efficiencies and data that is structured, allowing for better global analysis and perhaps better medicine. A change in that industry led process came about due to the American Recovery and Reinvestment Act (ARRA) of As we are all now aware, the AARA calls for implementation of an electronic medical record for all patients by The ARRA also deployed the carrot or stick methodology for adoption. Financial incentives provide the reason to get it done while financial penalties await those daring to delay beyond published deadlines. This made it necessary that the development or modification and adoption of EHR/EMR systems be designed to allow for at least some level of consistency, i.e., equal.. for financial incentives and help end users to meet meaningful use goals and measures. The federallyrequired reportable data is the same for all EMRs: the core objectives, the menu objectives and the Clinical Quality Measures (CQM). All required data must be reported to Medicaid, or Medicare or a local State agency, or the stick starts hitting. THAT IS WHERE THE EQUALITY OF EHR S/ EMR S STARTS AND ENDS. This equality is evidenced by a stamp of approval from one of two main types of EHR certification organizations, The Certification Commission for Health Information Technology (CCHIT) and Office of National Coordinator Authorized Testing and Certification Bodies (ONC ATCB). EHR s/emr s that will help you meet requirements necessary to earn incentives have to be certified by an ONC ATCB, which is required to test and certify EHR s/emr s to the criteria adopted by the Secretary of Health & Human Services (HHS). This test is targeted at the meaningful use measures and does not test everything an EHR system would need to function well in a practice. CCHIT is, quite honestly, a better test as it is more comprehensive in nature. So, yes, EMR s are equal in the fact that they must be able to extract the exact same data to be reported or sent to federal and state agencies

2 Certification by an ONC ATCB will signify to eligible professionals, and hospitals, that an EHR/ EMR technology has the capabilities necessary to support efforts to meet the goals and objectives of meaningful use. That Certification and two dollars will buy you a cheap cup of coffee from the gas station. Beyond an indicator of federal compliance, the certifications carry little meaning to user organizations. CCHIT uses test scripts to evaluate an EHR/ EMR system s programming code. These scripts have been developed by experts to test whether an EHR/EMR system can accomplish tasks that most users expect. It is important to pay attention to the year the product was certified. CCHIT certification may mean the product can perform to a certain level overall, but it does not mean it will qualify a practice to receive meaningful use incentive payments. One way to make sure the EHR/EMR you are using or about to purchase is certified for meeting MU measures is to verify that it is on the list of The Certified Health IT Product List (CHPL). You can still catch MU Incentive money! You are sitting on the sofa watching a basketball game and suddenly get motivated to chase the meaningful use money for your medical practice. Is it too late for you? Not necessarily. The first step is to actually utilize an EMR in your practice. This seems obvious There are many variables that come into play when choosing an EMR for your practice. Let s spend a few minutes to look at the top 5 things to consider in evaluating an EMR and how they could impact your practice. It s not too late to start using an EMR, meet MU, and still gain some incentive dollars. You may not qualify for the full amount at this point (2013); however, you can still catch a significant amount and avoid penalties in the very near future. PAGE 2

3 MUST MEET STANDARDS AND BE CERTIFIED Does the EMR you re considering meet the ONCATCB standard and is it CCHIT certified to help you achieve meaningful use reporting in order to access incentive dollars? If it s a no, this EMR should not even be a consideration, even if it does the dishes for you at the end of the day, or brings you chips during the basketball game. It doesn t matter if it s a free EMR and has every bell and whistle; if it s not going to help you meet the standards to achieve meaningful use, you will feel the pinch of penalization standards that begin later. One of the most important questions to ask your vendor is: Will they have the ability to meet future federal requirements and what is your guarantee of that statement. If they do not have a solid answer, preferably in writing and in your contract,, do not walk! SECURITY OF PATIENT DATA This is probably your top concern; you would like to think that if an EMR meets the requirements set by the government that it would also meet the security needs of your practice. One question a practice should be sure to ask all vendors: Where is my Data? Is it stored in the cloud? Do they have a secondary backup system in another state? (Very important to know if you re in the south east region or recently the north east region of the US and a hurricane is coming in to shore and threatens the primary backup facility, is there a back up facility to the primary). What are the security protocols to insure no breach of your patient data will happen? What about indemnification of a data breech? Is it solely your responsibility and solely your fines if the vendors have a security breech or will they share in the fines as set by the government. If you don t believe me, just read your software vendor contract, you are in for a rude awakening. PAGE 3

4 PAGE 4 OVERALL COST/INSTALLATION/IMPLEMENTATION NEW EHR You remember when you were told you get what you pay for. Well this is one of those times that it might be worth an extra couple of dollars for improved functionality in your EMR system so you don t see the employee hours go to a manual process that could have been handled by your EMR at half the cost. What is a reasonable budget for your practice? There are price differences in EMRs and that is due exactly to the overall functionality of what the EMR and or combined Practice Management (PM) software can and cannot accomplish. Check out the competitive offerings in the market. Don t forget server and individual computers, printers, and training for you and your staff and IT resources if they will be in house or outsourced. Be sure to add all tangible and intangible cost in your budget. CHOOSE SMART NEW EHR Is the EMR you re considering an appropriate choice for the size of your practice? Not all EMRs are designed to accommodate all specialties, you need to look at an EMR that was designed for the size of your practice and also take into consideration scalability. Are there modules or licensing you can purchase as your grow your practice and need additional specialized functionality? Be very weary of pre packaged solutions. Every practice is unique. There are many consulting firms that will use a cookie cutter approach to a project and train their staff. It s a great idea to have support and expertise with the software and practices and problems similar to yours. One of the best sources of information for a given EMR is to find current users NOT used as a referral source by the software vendor. A great place to find these organizations is vendor specific forums. WORK FLOW, WORK FLOW,N WORK FLOW... This is not just about the workflow of the EMR, how does it integrate into the current workflow of your office and what workflow changes will be necessary? Be sure to consider from check in to check out. We could spend another two hours on implementation considerations. My point here is to make you think about how a particular product will change your way of doing business. Site visits are absolutely critical. Don t just send one of two people, send eight ten people, from different operational areas, including operations, finance, billing, compliance, IT and management at a minimum. Our solutions piece together the puzzle of practice operations including practice management, revenue cyle management, government compliance, and providing optimum patient care. Medical Management Services provides the peace of mind you need to focus on patient care and outcome. Healthcare Consultants Interim and Permanent Management Services Governance/Corporate Structure Physician & Executive Recruiting Physician Compensation Provider Enrollment Training Programs Speciality Specific Assessments Business Valuation/Assessments Finance Revenue Cyle Management Business Development Business Development Joint Venture Opportunities Acquisitions and Leases Medical Billing Solutions Optimum Reimbusements Carrier Compiance Software & Systems* Revenue Cycle Consulting & Training * full implementatiom, management of, or training

5 If done the right way you will have an EMR that not only meets federal guidelines but is also functional within your practice environment. Ideally, an EMR should help improve the work flow of your staff to the point that you are able to increase your patient population, get rid of some old habits, have an office that is very efficient and an electronic medical record that is more streamlined. It s a unique world with many unique practices and just as many unique consultants. The right consultant can make your EMR/EHR implementation or post implementation as smooth and painless and worry free as possible. Be sure to hire a consultant that will complete a needs assessment (if warranted) and has the infrastructure in place to support your needs. At the end you should realize gains in operational efficiencies and overall increase in practice profits. Visit us at com and check out our consulting team as well as services we can provide regarding your EMR challenges. Meet The Author Robert Kimball Business Development Specialist, Executive Consultant Robert Kimball, Executive Consultant with Medical Management Services, has 25 years of clinical experience in various capacities in the healthcare industry along with 10 years of Electronic Medical Record (EMR) experience as an end user, super user, and trainer. This experience signifies him as exceptionally qualified to bring the clinician s perspective and expertise to the adoption of the EMR. Robert s 20 years of Navy service included several capacities ranging from managing day to day operations of an Operational Clinic responsible for the care of 3,000 patients to teaching medical and EMR classes to providers and technologist at the Naval Aerospace Medical Institute. As a previous independent EMR consultant specializing in the design, training, implementation and support of various McKesson, HMS clinical and nonclinical applications, Robert is a subject matter expert bringing special talent to the Medical Management Services team. In addition, he has extensive experience in working with one of first generation EMRs introduced to many government hospitals and ships. PAGE 5