The study looked at 117,606 individuals who were outpatients and one of the two hospitals between the dates 1/1/1999 and 12/31/2004. The conclusion was that 346 patients had tests done recently at the other hospital and 44 patients had already had the tests performed before this type of medical information system had been initiated. After the information exchange was initiated via EMR, the average number of test for each patient, that had prior tests, fell from approximately seven to about four. For those who did not have prior tests, the average fell from about six per patient to roughly five per patient.

For those patients who had not undergone prior tests, the amount slightly increased from about five tests to about six. If you compare the increase for patients who had not undergone tests, the total number of tests that had been ordered for patients with previous results, there was a decrease of 49% after the EMR exchange was initiated. When confounders were accounted for (sex, age, year and test numbers) – the tests that were ordered decreased by approximately 53%. However thee may be some discrepancy with research that had been done in the past.

The next step to be taken is a study of the actual potential savings hat result through the ordering of fewer medical tests. But in actuality, it’s been noted that the benefits will most likely go far beyond the money that would be saved. These benefits can include a sense of comfort for the patient. That sense of comfort can facilitate the healing process. With these types of exchanges resulting in fewer tests, there are fewer injections and blood draws. It has also been noted that it is certainly possible to decrease the number of medical test ordered nationwide once EMR has been initiated.

As it turns out, Maricopa County is, once again, in the process of gaining accreditation. The Correctional Health Services, last December, had received conditional approval for its re-accreditation. This means that Maricopa County could be accredited officially, once again, if it has proven that it has the ability and has taken appropriate steps to solve its outstanding issues that were identified by a national committee. These outstanding issues, of course, included poor medical record keeping. This comes on the heels of recommendations that have been made to the county regarding EMR that have been made for years regarding its inmates.

The county began its upgrade when the Board of Supervisors authorized a free records software system installation, last year, designed to address its medical records system. The software was provided by a pharmaceutical company that was contracting with the county’s Correctional Health Services. The software was provided for free under their yearlong agreement. Unfortunately, the software was incompatible with the county jail computer systems. This was verified by Correctional Health Services, the Sheriff’s Office and county spokeswoman, Cari Gerchick. Therefore, this move to address the problem was considered short-sighted and ineffectual. It’s hoped that this new move to install an EMR system will prove effective in its capacities.

It should be noted that the county Correctional Health Services is funded by taxpayers and treats approximately 130,000 patients each year at the five jails located in the county and Tent City. The new system software will be involved in the tracking of several types of information and perform several functions that include maintaining inmate information. This information can then be accessed from county jail facilities and can also process an inmate’s health information during the initial booking process. The terms of the new contract are now to be negotiated by NaphCare and county officials according to Gerchick.

This will translate into superior patient care without the encumbrance of having to physically transfer medical records and information. Lakeview Health CEO, Jeff Robertson, has stated that using the same electronic medical record for patients will entail a wide range of benefits. This can include improving the exchange of current information in regards to any treatments as well as keeping information up to date. In the past, having several records located in different areas ran the risk of some of the records not being complete. This can make a crucial difference in the quality of patient care. Especially in the areas that involve medications which would certainly need to stay current.

He also stated that the launch of the Epic system at Lakeview Hospital is an indication of the hospital’s commitment to the on-going positive changes in the health care system. These changes have been endorsed by the U.S. government in the form of incentives that have been offered for healthcare professionals that have adopted the use of electronic medical records in their own facilities. This has been one the priorities of the Obama administration and many heal care professionals have already taken advantage of these significant cash incentives.

In 2010, the Centers for Disease Control and Prevention have reported that only 48.3% of doctors have reported that they are currently using partial or complete electronic health records systems in their office practices. However, the HealthPartners clinics started using their EMR system (Epic) back in 1997. They were followed in 2005 by Regions Hospital and in 2010 by Hudson and Westfields hospitals. The use of the Epic system by HealthPartners has led them to being named by the American Hospital Association and “Hospital & Health Networks” magazine as one of the health care facilities “Most Wired” on two occasions.

Drchrono has accomplished streamlining of medical professionals through the use of iPad. Their iPad free application is designed to allow doctors to jot down notes, schedule appointments, issue prescriptions, schedule appointments, check lab results along with other medical record functions.

This has been made possible through president Obama’s administration which is currently offering very strong incentives for physicians to transfer their health records to an EMR format. Doctors can currently the start, finish and on-going management of the EMR process. Doctors who used Drchrono had received $44,000 in these incentives, last year.

Upgrades for additional storage may also be acquired by doctors along with medical billing functions. Previously, physicians had spent hundreds of dollars, each month for medical billing processing. Fortunately, for the convenience of the doctors, Drchrono can integrate with every insurance company – even those that are limited exclusively to paper billing.

With the application’s Billing Center, a doctor can register and receive their payments from iPad. Drchrono is also compliant with 5010, which is the government’s new requirement for billing procedures.

Drchrono made another iPad application available last August which is known as “OnPatient”. This app replaces the check-in process for a patient. This app is a replacement for the familiar clipboard with the check-in forms that patient had to fill out in the medical office waiting room. Originally, those forms required that the patient list their known medical problems, along with their medical forms, confidentiality agreement, etc.

The way that this works is by using the iPad to list items such as family history, medical insurance info and other information. After that is completed, a digital signature is used. The application is also designed to lock the patient into their section of the app so that they are unable to view information from other patients. This records security is, of course a critical factor.

The Drchrono free application had received high praise from physicians who are converting their patient records process to an EMR platform. Drchrono has recently announced that their application currently has over 15,000 registered medical providers with over 400,000 patients using the application.

Consider the way that a hospital treats and tracks patient bedsores (which are professionally known as pressure ulcers). Here, the patients that arrive at Truman Medical Center will receive a thorough exam in which it will be determined if a patient already has bedsores. These can appear in areas where the bone may rub the skin across a small section of the patient’s bed. The tailbone is a particularly vulnerable area for bedsores. If a bedsore is identified, then it is noted in an electronic chart which will then automatically trigger the necessary monitoring of that condition.

This electronic triggering of the bedsore monitoring will be in effect and will request treatment, even if the patient has come in for some other health issue that may require urgent treatment. In addition, the patient is also appropriately tagged for risks associated with bedsores according to their health profile. These factors will include; age, nutrition, wheelchair use, incontinence, time in bed and issues with mobility resulting from injury or chronic illness. The increased risk factors will determine the number of bedsore examinations. All of this is completely governed by EMR electronic charting entries that may even stipulate high tech beds in order to reduce pressure on the skin.

The EMR entries can also alert nurses of the risk of bedsores and will remind them to assist patients with movement difficulties or to have a patient roll over in their bed. This electronic fueled effort has paid big dividends when it comes to medical center budget. Between June 2010 and May 2011, Truman saw bedsores among its patients decline by 32%. In addition, that cut the costs of care by $1.39 million. That’s represents almost a rounding error for a hospital that provides $108 million a year in uncompensated patient care. But a million dollars is, as they say, still a million dollars. The one thing that can’t be measured in money is the alleviation of patient suffering and the possibility of actually saving a patient’s life.

In order to help with this project, Sebelius has eased the rules that are applied to EMR adoption for hospitals and doctors who are planning to use this technology replace their current format for storing and dispersing patient medical records. It was also announced that a Centers for Disease Control and Prevention survey indicated that 52% of doctors who work through private offices are now planning to adopt EMR as their medical records platform. This is in response to the incentives that are being offered in order to mitigate the expenses involved with EMR adoption.

It’s also been noted by the medical community that Cleveland stands out as being the area that has attracted national attention, over the past few years, by spearheading the nation’s move to adopt EMR. The region was visited by the U.S. president, Barack Obama, in 2009, as part of his endeavors to pass health care reform initiatives that total $27 billion for funds to be dispersed to hospitals and doctors who are making the move to EMR. These efforts, of course, also involve using a platform that can assure patients of complete confidentiality when it comes to their medical records.

Historically, the region of Northeast Ohio has spent millions of dollars in EMR adoption, which makes it the most progressive area of the country when it comes to making the switch over to EMR. All of this boils down to one thing when it comes to patient care. An example of this would be seen in a situation where a patient becomes unconscious outside their home city and is rushed to the hospital.The doctors there would be able to electronically pull up that patient’s health record in order to begin immediate and accurate treatment without having to wait for a medical record to arrive. This can, in some cases, save a patient’s life.

Training Center Conversion

In the Fargo area, a former Walmart has been converted into an EMR software training center. There, 30 classrooms have been created that can accommodate at least 300 staffers from Stanford each day for training. Bjornstad has pointed out that he plans to retire in April and take off for the summer (Bjornstad is a former school teacher). But he wanted to be working this winter and this assignment fits the bill nicely. His earlier role as a teacher (plus the job timing) made this the perfect job for his plans.

Another individual who has been hired as a Fargo EMR trainer is Barnesville, MN resident Lucinda Craft, who recently received her degree in Community Health. Her hopes lie in the possibility of this temporary position turning into a permanent job in the same field. Previously, she had taught healthcare classes that involved elderly students.

Last week, Sanford filled 48 of the 100 temporary jobs with an average hiring rate of 90%. This figure was reported by Fargo region’s chief clinical information officer, Caryn Hewitt. She expressed amazement over the high quality and education levels of the applicants. She stated that about 75% of the applicants had college degrees – including master’s degrees. She also stated that the current state of the economy has probably accounted for this phenomenon.

Interestingly enough, these temporary positions mostly pay $10 per hour and are entitled “application assistant”. However, there are a small number of positions that pay upwards of $15.78 or more per hour, depending on the applicant’s experience.

The software conversion is set up to take place in three different stages. In all, three Sanford locations have made their switch to EMR software access to patient medical records. The entire investment is slated to run $100 million over a period of several years.

References:

1. Sanford hires 100 for electronic record switch, Inforum, November 24, 2011, Patrick Springer, http://www.inforum.com/event/article/id/341781/group/News/

The continuous improvement of efficiency in medical care along with the quality of that care has always been the focus of Woman’s Care Florida, according to the President of Women’s Care Florida, Ignacio Armas, M.D. In addition, Dr. Armas has stated that recent attention has been directed towards the quality of reporting and coordination of reporting within the group. The advanced product development of eClinicalWorks® has been cited as the reason for its adoption. It was also stated that this move will promote the group to be far more efficient as an organization that functions as a leading healthcare provider.

Women’s Health Care Florida will be assisted with enhancing its group practice by eClinical Works through a comprehensive EHR package which will include specific specialty features such as OB flow sheets. Further efficiency will be achieved through the use of bi-directional interfaces between Women’s Health Care Florida’s labs and radiology departments. Additionally, the group will be connected with the hospitals labor and delivery departments that are responsible for annual deliveries of 15,000 infants. It has been noted that eClinicalWorks has a reputation of working closely with its customers when it comes to providing the specific tools needed for a medical specialty.

The CEO and co-founder of eClinicalWorks, Girish Kumar Navani, has ensured that his company will identify and provide the specific OB/GYN features that will be needed by Women’s Health Care Florida. This is designed to allow the group to excel through accurate, real-time medical information sharing with patients, providers and others that are involved in the health care process. As part of eClinicalWorks’ comprehensive EHR software solution, Women’s Care Florida will implement items that include the ability to enable clinicians to manage patient flow and information access. This will include referring physicians and the secure sending of clinical data and consult notes.

With incentives provided by the U.S. government and advances in technology, physicians are getting rid of their old paper records and integrating their offices with handheld EMR technology. As a result, there are a number of smaller Silicon Valley startup companies attempting to cash in on this innovation in order to compete with larger companies such as Allscripts (MDRX) and Cerner (CERN). The extra push comes in the form of the 2009 economic stimulus. This had set aside $27.4 billion in order to assist the transition to EMR.

Entrepreneurs and technology investors are proclaiming a “gold rush” similar to the boom in social medial. It is estimated that about 750 companies have joined in which is more than twice the number of existing EMR companies just two years ago. The main concern here is the number of companies that have products for sale along with money for capital – but very few customers, at present. This translates into companies that don’t have a future. Because of this, it is predicted that there will be inevitable consolidation.

The biggest problem that is being faced by these smaller companies is that there is still some uncertainty regarding the technology. This boils down to the ability of the different software programs to talk to one another in order to facilitate medical information sharing. Those who are tracking these things have noted that many of the current products may become obsolete as a result of this fact within 5-10 years. This consolidation is already in the works, it would appear. For example, In July, McKesson obtained insurance software supplier, Portico Systems, for $90 million and insurer Aetna (AET) purchased health information exchange company Medicity, back in December for $500 million. Even so, when all the smoke clears, the experts are predicting that the patients will be the beneficiaries of this changeover in medical record keeping.

Imagine a doctor who has been contacted at home regarding a potential problem with a patient’s EKG and who doesn’t even need to leave the house to make a real-time observation. This can now be done by creating a link between a physician’s tablet computer or other mobile electronic devices (such as smartphones) to the hospital’s electronic medical records system. The goal is to extend the reach of the doctor beyond the limitations of the hospital.

An example of this new trend can be seen in Green Bay’s Bellin Health facility which is in the process of a migration to an EMR system known as “Epic”.

The Epic system is currently developing various applications that are designed specifically for portable electronic devices such as iPads, Android smartphones and iPhones. According to Bellin’s director of information and services, Troy Schiesl; “We have a hardware assessment team that is looking at all the technology right now.” He further indicated that approximately half of the health system has been converted over to the new system with the expectation of completion by the summer of 2012.

Schiesl also noted that a hardware fair is to be held for physicians, at the end of August, in order to familiarize them with the pros and cons of the new information technology. The ultimate goal, according to Schiesl, is to get the correct information to caregivers as quickly as possible. This is the focus of information technological advancement.

“Whether that’s putting more devices in the right places or extending use of various mobile devices,” he said. “We view it as a positive development to be able to provide those solutions. It’s something we’re going to continue to see growing faster over the next two years.”

Accessing EMR though mobile applications is also considered a way to extend the value of the investments that hospitals have made in EMR technology. In 2010, hospitals in North America have invested $7.4 billion in EMR technology, according to the consultant Accenture. In addition, the 2009 stimulus act has promised $50 billion over the next five years to those providers in the government and private sectors who are moving over to EMR.