EMR Vendors

AccuMed™ v12.10 Electronic Medical Records (EMR) from Accumedic Computer Systems eently received the “meaningful use” approval designation by the federal government. It has been certified by the Drummond group as a Modular HER (electronic Health Record). This certification indicates that the software is deemed capable of enabling health care providers to qualify under ARRA (American Recovery and Reinvestment Act).

AccuMed™ was specifically designed to address front and back office workflow streamlining and improve the reliability and consistency of healthcare documentation. It will provide healthcare providers the ability to easily manage the health record process beginning with the initial patient appointment to electronic record documentation.

The information that is provided will be accessed virtually instantaneously. This is meant to improve patient care and to reduce operating costs while increasing profitability. The CEO of Accumedic Computer Systems, Inc., Mark Kollenscher has stated that health care providers are now able to utilize the software in order to achieve meaningful use and make improvement in the healthcare system. Healthcare users will also no qualify for ARRA incentive funds. He has indicated that his company is committed to improving and delivering innovations that are practical and reliable in the field of easily accessible management of medical data that will improve medical office operations on a daily basis.

The AccuMed™ software has been certified under the Drummond Group’s ONC-ATCB program as 2011/2012 compliant in accordance with standards and criteria set down adopted by the Secretary of Health and Human Services. Those healthcare providers that use certified vendor EHR systems will qualify for federal stimulus funds upon the demonstration of technology “meaningful use”. This is a key part of the push by federal agencies to make improvements in the delivery of clinical care.

Accumedic Computer Systems, Inc. is an industry leader in medical care technology and has been providing services and solutions to healthcare professionals since 1977. The company is dedicated to providing a comprehensive set of healthcare technical solutions that address the current requirements initiated by the federal government. In addition the company is committed to creating solutions that address future additions and changes within the healthcare industry.

Drummond Group, Inc. is a leading software testing lab that provides efficient and effective EHR testing for medical information and healthcare technology hospitals and vendors. It is part of the ONC-ATCB (Office of the National Coordinator Authorized Testing and Certification Body) and works closely with hospitals and software vendors to certify EHR systems.

Currently, there is a bill making its way through the state Legislature that, for security reasons, would make it more difficult for health care professionals to make changes to electronic medical records (EMR) without leaving a record of the change.

Sen. Mark Leno, D-San Francisco, has stated in a May hearing that EMR changes can be more difficult to trace and can often go unnoticed as opposed to changed made to paper records. Sen. Leno is the author of SB850. The Senate passed the bill on May 31 and it is scheduled to be heard, in the next few weeks, in the Assembly’s Health and Judiciary committees.

Evidence of the need for such a bill was indicated by the case of Diane Stewart. Stewart died suddenly after having knee surgery a few years ago at the Stanford University Medical Center. A subsequent investigation revealed that sections of her computer health files had been deleted shortly after her death. It was also revealed that a nurse had been instructed to make entries regarding Stewart’s care after her death. This led Stewart’s family to level charges of a cover up perpetrated by the medical center in order to hide any errors in treatment. According to Hearst Newspapers, the medical center has denied any wrongdoing.

An attorney for the Stewart family, Christopher Dolan, has pointed out that health care professionals are not required to track changes in medical records under the current federal guidelines. In addition, records that are kept in electronic form are very easy to manipulate. This can make an investigation, in the case of medical malpractice, cost-prohibitive for victims. In cases such as those, the victims or their families would need to hire special investigators to address concerns of potential cover-ups.

The new bill, under consideration, would require any changes to an EMR to be automatically recorded. It would also require an indication as to who made the changes. Patients would also be able to see any changes that have been made to their medical records upon request.

However, concerns have been expressed by the California Hospital Association and the California Medical Association. These concerns revolve around the cost that would be involved to make the changes necessary to support this level of technology. It has been stated that the frequency of problems with EMR changes is too low to justify the expenditure that would be required to comply with the bill.

In Springfield, OH, a local physician is currently leading the field when it comes to switching over from paper medical records to electronic medical records (EMR). The switch will be required by all providers of health care by the year 2015.

The physician, Dr. Peter Muir, practices at the Springfield Center Family Medicine. He has not only instituted EMR practices in his own medical office but has actively promoting EMR practices to other providers of health care.

He has pointed out that his own office was utilizing paper charts a few years back and many doctor’s offices are still using them. This means that a new paper data sheet is required for every new patient that enters their care. Updating paper records entails information consolidation and thus detail can be lost.

With the utilization of EMR, all detail is kept intact and readily available. This allows a physician to note trends in patient health, which can be vital to treatment. There is also the ability to perform cross checks for allergies, medications and other diagnoses. This will, in effect, decrease the risk of error and promote greater patient safety. Patients have also expressed enthusiasm for the switchover to EMR. This allows patients to view past results and observe their progress over time.

As of this time, the federal government has been encouraging physicians to start switching over their paper records and e-prescription processes by offering incentive payments. These payments will be available until 2012 – healthcare professionals must adopt EMR systems by then. This means that it must be demonstrated that an existing EMR network must be in place and can share medical record with other members of the healthcare community. This must also include sending prescriptions to pharmacists electronically. In May 20, the Office of the National Coordinator for Health Information Technology recognized Dr. Muir and one other physician for attaining the steps necessary for EMR use. This means that up to $44,000 could be earned if the EMR system is maintained for five years.

Currently, in Ohio, only seven health care providers have achieved the “meaningful use” status that has been achieved by Dr. Muir’s office. Out of the seven, four are from the Springfield Center Family medicine. Dr. Muir has stated that “It takes a group working together” to achieve this.

It should be noted that while the incentive payment from Medicare helps, it will only cover a portion of the cost involved to make the switch to EMR. An example of this is that the $18,000 incentive earned by the Springfield center only covered about half of the expenses needed to make the transition. But the benefit to patients is considered well worth the expense and effort involved by Dr. Muir and his patients.

As reported in New York’s Marketwire, last week, it would initially appear to most that items such as font size and the number of needed keystrokes needed to make an entry would not be such a hot topic. Especially when considering a market that deals with billions of dollars on an annual basis and is pushing for wider acceptance throughout the medical community. But, as it turns out, the exploding electronic medical record (EMR) industry is focusing on those very items. Kalorama Information, a noted market researcher for the healthcare industry has noted than even small annoyances within a software package will add up to a big difference when doctors and healthcare facilities make their decisions when it comes to adopting EMR technology.

In fact, the latest report from Kalorama Information: “EMR 2011: The Market for Electronic Medical Record Systems,” has indicated an expectation of EMR market growth to be around 15.% each year for the period of the next five years. However, it has also stated that these numbers would depend significantly on the availability of user-friendly software packages and systems. The usability factors of the future EMR offerings are now considered to be a major trend that bears close watching.

This has made EMR usability factors the subject of a hearing that was held on April, 2011 by the HHS Health Information Technology Policy Committee. Some of the usability issues that were pointed out included the need for multiple entries of the same information. Other issues involved critical information that was obscured by more routine notations and ordered tests status confusion. There has also been a call from EMR software developers that EMR software should utilize familiar and routine Windows-like interfaces. One example that was offered as an indication of some of the difficulties still present was a physician who complained that it took 10 minutes for her to place an order for a routine mammogram.

So it all is beginning to boil down to items such as the number of screen shots, the number mouse clicks and the number of keystrokes that need to be used in order to accomplish a task. While these may seem like small issues, it has been determined that these small factors are bound to play a huge role in the overall adoption of EMR technology.

One solution to this issue can be found in the suggestion that “usability” be added to the EMR vendor certification process. Other proposals have called for various levels of mandatory standardization when it comes to EMR software design.

In a long term effort to save on medical care costs by increasing patient care efficiency, The Arizona State University Dept. of Bio-Medical Informatics (BMI) is currently in collaboration with Arizona Health-e Connection (AzHeC) is a project that is designed to facilitate the adoption of an electronic medical records system. To this end, ASU has received a grant amounting to $1.5 million with an additional sub-award going to AzHeC in the amount of $10.8 million. This was provided by the Office of the National Coordinator through funds awarded by the 2009 American Recovery and Reinvestment Act. This project award is currently set to run through summer of 2012 with a likely extension to be given up till 2014.

It’s been noted that the portion of the project provided by ASU will include the creation of educational materials along with intern training for the proposed workforce. Additionally, ASU will provide educational events along with advanced practices demonstrations that illustrate the vast potential of this aspect of technology dealing with health information storage and dissemination. These project aspects were stated by the director of BMI, Robert Greenes. This collaboration is expected to greatly facilitate the ability of various healthcare providers to share patient information and even provide patients with a way to access their own medical histories and test results.

Greenes also added that the fundamental means of improving the health care in the United States, overall, is the standardization of electronic health records. The way to begin this is to start with current expansion projects that would bring EMR to hospitals and clinic facilities, especially those in outlying areas that have experienced communication delays in the past. Besides speeding up the communication process, EMR technology can also assist in the reduction of medical errors while improving the overall efficiency of the health care process for the entire U.S.

However, it’s an unfortunate fact that almost 75% of physicians in Arizona don’t have access to EMR technology. In light of this deficiency, AzHeC and BMI are working hard to utilize their grants in order to effectively spread the technology that will improve medical care access in the state of Arizona. The ultimate goal is to have the entire nation connected to EMR technology by the year 2014. In light of this, the HITECH Act has been instituted as a consumer protection, once medical records have been converted over to an electronic medium. Security will be maintained through extensive monitoring.

The Watertown Massachusetts medical billing service company known as Athenahealth was selected as one of four companies for a federally funded EMR system. This system will be used to replace the current record keeping systems that are in use by health care providers through Athenahealth’s satellite office located in Belfast Massachusetts which current employs 300 workers.

John Hallock, a spokesperson for Athenahealth, stated that this constitutes big news for a company that started its Belfast office just several years ago and has since been endeavoring to make significant strides in the EMR management industry. He has stated that Maine is a perfect location for this initiative sine it contains major population states that make use of major health systems. However, he said that this isn’t the unique thing about Maine. The unique attribute of Maine is that there are literally thousands of individuals who live outside the primary circle of healthcare resources.

Web-based services, up until now, have been marketed by Athenahealth to various independent doctor’s practices around the U.S. This has been offered in lieu of the more expensive software based services that are in use by hospitals. This is a primary demographic that the Maine Regional Extension Center (MREC) will be attempting to reach.

It’s been noted, in the past that it’s unreasonable to expect a small physician’s office to be able to purchase and utilize a system costing up to $70,000 or more in order facilitate the use of EMR. In cases such as those, it would be necessary to integrate that office into an EMR network. It appears that Maine has suddenly taken a turn in this direction and is now considered to be a pioneer in this area.

There will be a relatively complex interaction between MEREC, a non-profit EMR administrator, the federal government, vendors and the actual doctor’s practices. Even so, the main goal is to simplify medical information exchange between physicians. MEREC is a newer program initiative whose main goal is the institution of EMR in order to increase ease of communication between doctors.

As part of this EMR process, an independent director’s board, along with HealthInfoNet, have made the selection of three different vendors as their providers of EMR. These are e-MDs, Ingenix and athenahealth. A fourth company, Concordant, was chosen as the implementation services provider which was deemed necessary to assist those practices that are already using EMR, but may not be using them to their full capability.

The devastation that has been recently experienced in Japan has profoundly illustrated how important EMR (electronic medical record) technology can be when it comes to preserving patient medical information. Those who keep tabs on the medical industry are using this example in order to further promote the use of digital patient records.

Janet Chiew, a research manager for IDC Health Insights, has stated that the tsunami and earthquake in Northern Japan has effectively illustrated how valuable EMR technology can be when dealing with large-scale rescue and medical operations. It has been pointed out that there is immeasurable enhanced effectiveness when it comes to quickly accessing patient records during these unusually overwhelming crisis situations. This means that the necessary equipment and medication can be put on stand-by for those who are being rescued and possess chronic medical conditions. This information may be obtained through national EHR (electronic health record) systems.

With many clinics and hospitals demolished, it would be conceivable that many necessary health records would be destroyed. This can lead to even more problems than those initially caused by the original disaster. Complications arising from the destroyed medical records would be extraordinary. In the case of Japan, even though they do have EMR systems in place, the overall structure is still immature – as it is in the United States.

It’s been noted that the EMR coverage is patchy although becoming more widespread. However, software research in this area has garnered a high level of interest. For example, there has been a format for clinical data exchange developed, known as the Medical Markup Language. This type of communication is similar, in some respects, to HTML (Hypertext Markup Language) used in Internet formats. But this software sharing format is still in its infant stages. It’s also suggested that a robust backup system be put into place, in the event of catastrophic damage to the infrastructure.

But, even though EMR has been given priority in many areas of the world, putting together a national EMR system is a huge task that cannot be done quickly. Besides the financial aspects and government support, there must also be support from private providers of healthcare. Technology must be balanced with policies that ensure privacy and offer seamless communication between hospitals, clinics and other agencies. This can only be accomplished when there is standardization in place.

One example of EMR coverage that is near completion can be found in Singapore. Singapore began its EMR implementation in the late 90s and is only a couple of years away from full implementation. Once completed, this will serve as a world-wide example of EMR advantages.

With EMR (electronic medical records) standards looming on the horizon, physicians are beginning to see the benefits of using EMR records. This scenario is also being facilitated by various government stimulus packages, as well. In fact, the government has increased their stimulus benefits, this year, in order to encourage more doctors to begin utilizing this technology. This is in response to the fact that currently, only 20% of hospitals and only 30% of primary care doctors have instituted some form of EMR technology in their practices.

But it is widely acknowledged that the benefits to doctors are considerable. With EMR, a physician has instant access to a patient’s most relevant and recent medical history. This will assist the physician when it comes to making an informed decision regarding a patient’s healthcare. This will include knowing which pertinent tests to order and information that can be used for proper medication treatments. Alerts and reminders are also included that may tell a doctor when a certain medication is dangerous to the patient or if certain allergies exist. All of this equates to better healthcare and potential huge savings in money and time. Patient advocates are quick to point out the increased level of patient care and safety.

An additional benefit of EMR technology is ease of access. With an EMR system in place, communication is far more expedient for the doctor. A quick patient inquiry can be answered through the patient’s email. Prescriptions can also be ordered and medications may be refilled from a distance. This can be exceptionally handy in remote areas where a trip to the doctor’s office can be highly inconvenient for smaller matters. Patients will also have the ability to monitor their own healthcare which is especially advantageous with chronic conditions, such as diabetes. In fact, studies have indicated that the level of patient care increases if the patients are involved with their own care.

Of course, there are concerns when it comes to EMR technology. For example, there must be proper security measures in place in order to ensure patient confidentiality. In addition, identity theft is also a concern with any type of personal information that can be accessed online. At this juncture, there are no government agencies that ensure encryption of patient information. These are issues that are currently being worked out with EMR standards that are being developed and will need to be addressed prior to EMR becoming the overall standard of patient record management.

Nightingale Informatix Corporation, which is an application service provider of EMR software (Electronic Medical Records) along with related services has just disclosed that during its 3^rd quarter it will provide 190 seats of its on-demand EMR services to various healthcare facilities. In terms of definition, a “seat” is defined as an one healthcare provider that is paying for Nightingale’s EMR service. These seats will be provide to provided to facilities throughout the U.S. and Canada. For example, one facility that is being included within the 190 is a large Ontario Cardiology practice. Another is an upstate New York specialized care center.

President and CEO of Nightingale, Sam Chebib, stated that he was pleased with the current success regarding the addition of Nightingale’s new EMR customers and that the company wished to expand its presence in North America. He also stated that he believed that there was growth potential for the future for Nightingale’s EMR services. He pointed out that the company had achieved certifications throughout Canada, which have included: Ontario, Nova Scotia, Saskatchewan and others. It was also stated that Nightingale’s EMR services is expected to obtain a meaningful use certification from the U.S. Office of the National Coordinator (ONC).

Some of Nightingale’s successes with signing on new clients have come from the Ontario clinics which are supported through implementation funding from Ontario’s OntarioMD EMR program. Nightingale has experienced a growth in sales, due to a greater awareness of the available funding that is currently available to specialists in the Ontario area. These specialties are wide-ranging and include internal medicine, cardiology, orthopedic surgery, neurology, nephrology and others. The key to Nightingale’s success with obtaining their contracts is the flexibility of the “Nightingale On Demand” services when it comes to meeting the various individual needs of these differing specialties and medical care services.

The Nightingale corporation is currently one the swiftest growing services in the North American healthcare software industry. It is also recognized as a Web-based (ASP) clinician leader as well as a leader in community based EMR services that tend to the needs of smaller healthcare practices, outpatient clinics that employ multiple physicians and large scale networked and regional healthcare organizations. Nightingale offers a comprehensive set of services that also entail integrated practice management, revenue cycle managing and transcription management. These services allow their customers to enhance patient care while increasing their revenue potential and fully optimizing their operations.

Over a number of years, there have been failed attempts to bring electronic medical records (EMR) to the forefront of the medical profession. However, this may be changing in the near future. A new initiative known as “Direct Project” was just announced by David Blumenthal, who is an IT Coordinator for National Health. Blumenthal, along with Aneesh Chopra, Chief U.S. Technology Officer, and other agents for government health care are involved in the project, along with various IT health vendors.

This initiative will involve the use of a standardized protocol that will allow hospitals, physicians and other medical providers to communicate patient medical information without having to resort to proprietary communication protocols. The information that can be shared will include: laboratory results, summary documentation, medical referrals and various other related medical information. This will also allow medical professionals to upload data directly to patient health records. This data network is designed to be compatible with the data transference protocol of the National Health Information Network. However the design for the Direct Project was undertaken by a private/public collaborative effort. This design had been placed under the Office of the National Health IT Coordinator’s leadership.

The HITECH Act was also partly responsible, since it is designed to offer various initiatives to those health care providers that are able to demonstrate a “meaningful use” of their EHRs. The term “meaningful use” refers to the ability to effectively communicate between health care professionals by using their EHR systems. This definition also includes the ability to provide a patient with a health care summary, as well. The technology behind the Direct Project will make this possible by using a secure messaging system which will send a patient an attachment in much the same way as one would send an email. This will keep patients informed and up to date regarding their medical care procedures.

However, the ultimate goal that the Direct Project is focused on is the ability to exchange medical data between providers. This is especially critical in cases where providers and hospitals may be located in outlying areas or in cases of independent physician providers.

It is understood, though that the road to effective EHRs is still a long one. There need to be more technological advances in order to make the communication process a seamless one. However, the advent of the Direct Project is a major step in the right direction towards this universal health care communication.