GBS White Paper EHR: The Prescription for the Health Records Problem The Crisis State For nearly two decades the word crisis has been applied to the state of healthcare in the United States. While the quality of care advances by leaps and bounds, the problems include escalating costs, privacy issues, and an inefficient flow of information for proper care. Unfortunately, there is no one product or service capable of completely handling these three issues, let alone the other complexities of the healthcare issue. There is, however, an existing concept that addresses them in degrees - and is a positive move toward a more efficient American healthcare system. This is Electronic Health Records (EHR) - a computer-based system of entering, automating, and sharing medical information. It has been deemed so important to our healthcare system that President Obama and all 2012 Presidential candidates name it as key in helping to reduce medical costs and errors in care. The Roots of the Problem Why would simple recordkeeping be such an issue to healthcare? Consider the impact that healthcare has on the American economy. It accounts for twice as much than in European nations, and expenditures are growing twice as fast as the rate of inflation. But like a pebble thrown into a pond, if the shuffling of this paperwork - the flow of information - is disrupted, it can have far reaching consequences. Consider four areas where an impeded data flow cause problems for patient and practice alike: GBS www.gbscorp.com Page 1
Corporate Identity Standards Preventive care. No matter which side of healthcare you look at, the largest single cost is disease that is not properly diagnosed, maintained or treated proactively. Other complications include neglected patients, overworked medical staffs, allergic reactions to medications, and drug interactions. Patient charts. Because charts are used to record every interaction with the patient, the paper trail created by a patient chart is intense and difficult. To give an idea of the demand placed on charts, consider how they come into play under the following circumstances: A phone call from a patient. The practice must find the chart before taking any kind of action. The patient visits a physician. The physician must examine the chart and read dozens to hundreds of pages of history to glean needed data - including lab tests, hospital visits, previous visits, referrals, social and family histories, and more. Completing the visit. To complete the visit, the physician must document or transcribe the results of the visit including the diagnosis, any outcomes, and the need for scheduled follow-up. Insurance requirements. To guarantee payment, the practice must use the chart to store insurance or self-pay information. The specialist state. The days of the General Practitioner are gone. In the 21 st century, there is a GBS www.gbscorp.com Page 2
Corporate Identity Standards medical specialist for every part of the body, and there are those who specialize in methods of diagnosis or specific treatments. This means that each medical practice will have its own set of patient records, disconnected from the others and reliant on the patient's own ability to remember information and fill out forms accurately. Push from outside agencies. Governmental and commercial payers are pushing for more preventative care to reduce overall claims. To enforce this they are offering compliance bonuses, reducing reimbursements, re-negotiating contract fees, and are requiring detailed documentation for reimbursements. The result is a system that takes a piece of vital information and passes it through a number of hands - nurses, physicians, transcriptionists, bookkeepers, and others. In a field where cutting-edge technology is the order of the day, the reliance on a "dead trees" solution seems out of place and old-fashioned. Further, it is a system that invites disaster in the event that a record is lost, misplaced, or stolen. Script for a Prescription The solution to the problems created by paper records is simple - a computerized system of recording medical data. The system would work on a patient-by-patient basis, be easy to use and easily accessed by any number of hospitals, practices, clinics, and specialists. It would contain information needed by the system from blood pressure and weight to address, phone number, and the name of an insurance provider. Finally, to allay the fears that patient records might be publicly accessed through Google, security and privacy considerations are critical. GBS www.gbscorp.com Page 3
Electronic Health Records are not restricted by the limitations of paper. The result of EHR implementation would be a sea change as the medical industry closes in on full participation, addressing the many problems of paper with the power of the computer: Authorized users could access the data simultaneously. Changing conditions in the patient's health, treatment, or insurance coverage would be highlighted or flagged. Patient education would be tracked, and a course of proactive treatment could be created and monitored by the system. It would allow better tracking of financial responsibility for payments by providing immediate flow of medical coverage information. It would mean more rapid payment by collecting relevant information before it is needed and flagging criteria in advance of billing - reducing penalties. It would improve accuracy, giving access to needed information 24/7/365. It could alert a practice when to schedule a patient visit, warn of drug allergies or interactions, and improve quality of care by suggesting patient health initiatives. It would reduce administrative costs of the practice through reduced costs for records keeping, improved and increased workflow, and the re-allocation of staff members into areas where they can be more productive. Time lost looking through pages of a chart for specific information would be eliminated through powerful categorization and search tools. Customizable reports would ensure payers get the exact information they need for billing purposes. Health Maintenance would be automated with the system sending reminders to the practice on a patient-by-patient basis. Because charts are stored on a secure server, they would be instantly accessible with the danger of lost or misplaced charts eliminated. GBS www.gbscorp.com Page 4
Residence on a secure server also addresses issues of patient privacy and control of the records themselves. It would coordinate and track Pay for Performance (P4P) initiatives. A documentation system using buttons and check boxes would eliminate poor documentation by simplifying the process of reporting encounters, customizable by specialty practice. While not a panacea for the problems in the American healthcare system, the power of EHR eliminates some problems and takes great strides in addressing others. EHR and Your Practice Because EHR implementation is such a tremendous task, many companies have jumped onto the bandwagon as providers - but not all are created equal. There are, however, a number of questions you should ask when choosing your EHR partner. 1. Do you have a strong partner for long-term viability, support and service? Having a strong partner will allow your investment to be maximized by using them as a consultant as your practice is met with new demands. 2. Does the solution have a solid foundation and technology that is stable, compatible, and flexible? In the ever-changing environment of healthcare, a flexible and standard technological base - such as Microsoft SQL - allows for adaptation and change. As new measures or standards are added to the different aspects of the patient record, a solidly founded EHR can quickly adapt to these needs. GBS www.gbscorp.com Page 5
3. Is the solution CCHIT compliant today and in the future? CCHIT is quickly becoming the standard for system interoperability. As the healthcare industry broadens to patient records from practice or provider records, the ability to communicate with other systems while maintaining patient confidentiality will be critical. 4. Does the system allow you to manage your practice's records using your methodology? Each practice, provider and specialist differs on how they practice medicine and chart patient information. Since many EHR solutions focus on primary care, they are not equipped to meet the needs of specialties like cardiology, orthopedics, or urology - to name a few. A solution with specific content for individual specialties means higher levels of documentation, faster encounters, and better coding. 5. Does the solution provide a solid business case that meets your goals and offers a solid ROI for the coming years? There is a difference between a system that improves a practice's documentation and one that will show a significant return on investment and offer a plan to meet its objectives. When considering an EHR system, a practice should base their choice on the total cost of ownership - not simply the price tag. The Case for GBS When your company comes to GBS for an EHR solution, you are partnering with a powerful ally. GBS has the experience and technological expertise to provide you with a smooth transition. GBS chose NextGen as their software platform of choice because it is recognized as one of the most effective solutions on the market. It is offered by one of the most financially successful companies in the business - one that is a recognized industry GBS www.gbscorp.com Page 6
Together, NextGen and GBS take a customized approach to the training and installation plan to insure high user understanding. This includes options for on-site training, e-learning, a solid implementation process and exhaustive documentation. The partnership also encourages a high level of involvement by practice physicians to integrate it into their daily activities. As a software solution, NextGen is a single database that is CCHIT certified for current standards and is committed to meeting future standards. It is 100% HIPAA compliant. NextGen has specific content for over 30 different specialties, and is the most flexible, adaptable system on the market. From both an EHR and practice management standpoint, NextGen will show a viable ROI in eighteen months or less after replacing a traditional paper system. NextGen features no less than 16 key features* that make it a state-of-the-art EHR solution, including a database designed by doctors, not programmers; point-of-care documentation; prescription management; document and image management; and their partnership with GBS. GBS takes a consultative approach to understanding your practice. They will help establish your goals and return on value invested based on your practice's current situation and desired results. As the leading distributor of NextGen, GBS provides a single-source solution for EHR that includes consultative discovery; software and hardware installation, training, and implementation; network support; an EDI support help desk; and programming and conversion services. Further, GBS has served the physician marketplace since 1980, and has been supporting and implementing NextGen since 2001. With clients in 33 states, the average GBS client satisfaction rating is 97.6%. *See appendix for the complete list GBS www.gbscorp.com Page 7
About GBS For more than 40 years, North Canton, Ohio-based GBS has been an information solution provider, offering a line of products and services designed to help businesses better CREATE, MANAGE, RETRIEVE, and DELIVER information on both sides of the technology fence. Technology is at the forefront of all the solutions GBS offers, allowing it to act as a Total Information Solutions Provider for clients. To learn more about how GBS can add to the efficiency and bottom line of your business through an Electronic Health Records solution, contact them today at 800.860.4428 or healthcare@gbscorp.com. GBS www.gbscorp.com Page 8
APPENDIX: SIXTEEN KEY FEATURES OF NEXTGEN 1) Over thirty specific knowledge bases designed by doctors who use the system. 2) NextGen s Practice Management and Medical Record share the same database. 3) Point-of-care documentation. 4) Strong automation for clinical messaging and workflow. 5) Prescription management and e-prescribing. 6) Document and image management. 7) Patient education materials (4,000+). 8) E & M coding support. 9) EDI engine for labs, PMS, and hospitals. 10) Automated Document generation. 11) Automated Referral and recall letters. 12) Outcomes analysis and reports. 13) The most powerful and flexible product in the industry. 14) A powerful service and implementation partnership with GBS. 15) Stable leadership at both NextGen and GBS. 16) One of the few EHR vendors making a profit through sales and support of their product. GBS www.gbscorp.com Page 9