Thursday, October 22, 2009

#ITOH EHR's what has worked.

#ITOH live panel discussion from IT Optimization in HealthCare captured in real time.

Mark Anderson, The AC Group

What is going on with EMRs in the real world.

Hybrid EMR (Paper + electronic) as a transition

Big Clinic Representative - Evolved a Patient Centered Record.

Separate data in an Enterprise + Patient View. Patient view is observations that are relevant to the Patient.
Other data e.g. about equipment used to draw blood, or take image etc. is the Enterprise data.

Meaningful Use: From the perspective of the patient

Mark Anderson, AC Group:
- 73% of Docs are still not using EMRs when seeing a patient 1 year after installation
- 83% of Docs are not associated with a hospital - they are independent.

In-Patient and Ambulatory EMRs are different and have different perspectives.

Hospital Incentive from Stimulus $2M + $225 per discharge up to 23,000 discharges.

We have to get out of in-patient to really treat health and wellness.

Everything in the Ambulatory setting is pertinent to the Electronic HEALTH Record. Only a fraction of In-Patient EMR is pertinent to Patient's EHR.

CCHIT only certifies on functionality and NOT usability. One of the biggest issues is USABILITY. CCHIT will be starting to look at usability. ie. How long it takes to perform a function.

Mark A: 73 systems were certified by CHIT in 2008 but they have vastly different usability AND functionality.

Meaningful Use: Intent is to encourage use of EMRs with a certified product but Meaningful use can be accomplished using alternative products to create reporting and metrics.

Mark A: Sales have dropped off 42% due to uncertainty of Meaningful use definition. Which is not finalized until April 2010. 83% of sales are going to certified vendors.

Organizational alignment and transformation is beyond the scope of the EMR Vendor but is the really driver in achieving meaningful use within an organization. People may be placing too much dependence upon use of certified products.

One of the challenges with going live is getting existing data loaded so that value can be gained from using an EMR. Systems slow Doctors down because with no data in the EMR it is the equivalent of seeing a new patient every time.

One way to improve use is to look at the patients at the top of the wellness pyramid (the sickest) and load their data because they will be the ones coming in most frequently.

Vendors are looking at transcription tools to populate the EMR. ie. natural language processing.

(tags: EHR, ITOH)

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