COLUMBIA, MO – Researchers from the University of Missouri are developing an electronic health record system aimed at meeting the needs of a population of older adults that’s expected to almost double in the next 20 years.

According to the U.S. Administration on Aging, there will be about 72 million older adults living in the U.S. who will require care from a workforce that is already projected to be lacking.

Researchers from MU are currently working on a solution they say may help alleviate some of the burden. They’re developing an EHR system that encompasses standard health assessments and those obtained through new technologies. The goal, they say, is to increase efficiency and accuracy, improve patient outcomes and reduce costs for long-term care.

“As the use of emerging technologies increases along with the older population, maintaining complete and accurate patient information can be overwhelming,” said Marilyn Rantz, professor in the MU Sinclair School of Nursing. “A comprehensive system that encompasses all measures, old and new, is the key to enhance and efficient clinical decision making.”

The EHR is being tested at TigerPlace, an independent senior-living facility in Columbia, Mo. According to the researchers’ initial findings, use of the EHR system can enhance nursing care coordination and advance technology use and clinical research.

“New technologies to passively monitor older adults’ health are being developed and are increasingly commercially available,” Rantz said. “The challenge remains to integrate clinical information systems with passive monitoring data, especially in long-term care and home health settings, in order to improve clinical decision making and ensure patient records are complete.”

Effective EHR systems display data in ways that are meaningful and quickly assessable for clinicians, Rantz said. With access to comprehensive data, clinicians can make more informed clinical decisions, better perform risk assessments and provide risk-reducing interventions.

Source: http://www.healthcareitnews.com/news/ehr-developed-long-term-care-holds-promise

Implementing an electronic health record system enables him to focus on more important activities and significantly contributes to hospitals’ savings. But choosing the right electronic health record (EHR) system for your healthcare facility may not that simple. There are several companies in the market that claim to sell a system you are searching for, but the fact is very few of them will actually deliver what you really want. It is easy to be overwhelmed by the sales pitch EMR reps may make once they identify you as a prospective client and the demonstrations may not address your practice needs.

It’s important that you select the best electronic health record (EHR) system because it will significantly impact the efficiency of your hospital or practice. A lot is riding on your decision and therefore, it is very important that you take your time to make an informed decision. These systems are usually very expensive and need thorough research before you actually purchase and install the EHR in your healthcare facility. It is good to know what you are looking for, otherwise you may be trapped by vendors attempting to sell something you don’t need. Having applications you don’t require is very frustrating.  Be sure that you make a list of problems you are currently facing within your practice as well as identify the areas of improvement.

Once you write down your hospital/practice needs and recognize the problem areas, you will have a better understanding about what you want from an electronic health record (EHR) system. Perhaps you want a system that minimizes the time spent in searching for patients medical records or simply want a more efficient billing system. Some physicians want to have a world class electronic prescribing feature. In a nut shell you must know what applications you want before exploring the vendor market. Once you identify your specific needs consider completing a request for proposal (RFP) to  inform the EMR vendors about your demands.

Try completing as many forms as possible so that you can receive enough responses to compare the various EHR products. Many forms are available for free on certain websites and with a little research on the internet you can find these well-prepared RFPs. If you are not able to find anything specific, you will  at least have the basic structure and questions for an EHR.

At this point you may wonder how to choose the recipients of these RFP forms. This may be easy if you do some basic research to see if the solutions offered by the EHR vendors have good ratings by previous clients. You can also find out if the electronic health record (EHR) system offered by the buyer is suitable for your practice size . Very few EHR vendors serve practices of all sizes and they typically target niche markets for small (1-15 healthcare providers), mid-sized (10- 99) or large practices (more than 100).

Selecting the best EHR vendors to send your forms to will save you from future disappointment as some solution providers may not respond to queries from buyers that don’t fall into their target market. Similarly, if you have a large practice and are sending these forms to EHR vendors who only serve small or mid–sized companies, you may receive quotes that are no significance.

Once you have received all of the responses you can begin reviewing the responses of each EHR vendor. The vendor with the highest ratings should be at the top of your list and usually their representative schedule a product demonstration.  A typical demonstration will take around three hours and it will be of benefit if other colleagues or end users can attend these events. Encourage these people to attend all the demonstrations so that you can select the best electronic health record (EHR) system for your healthcare facility.

These events will require additional work hours, so be ready to hear excuses from other participants. They may dislike spending their free time working and may not agree to sit through every demonstration. Sometimes EHR vendors may also fail to show up to a scheduled demonstration. When they do visit, they will be accompanied by a team comprising of sales professionals and sometimes a physician who will highlight the benefits of their solution in front of your group.

When this team arrives, ask them few questions related to the specific needs of your facility and try to ask the same questions to all the vendors. Don’t be impatient – wait to ask questions once the entire demonstration is over. Focus on the electronic health record (EHR) system’s ability to help end users and also the ease of use. Ask all of the members in your group to rate these vendors and solutions and make a comparison chart at the end of the EHR demonstrations.

You can also ask for previous clients that are currently using their EHRsolutions and talk to them before making a purchase decision. The most important factors to consider while searching for the best EHR are its functionality, cost of application and other related services offered by the vendor. Ideally, the product must have all of the features you need and should suit your budget. Ask if there are any hidden costs such as implementation and maintenance charges. You should also find out if the training is provided by the EHR vendor. This is important since your staff will need help using the new system and its various features.

Try not to focus completely on the cost angle as the EHR system has to be easy to use and easy to implement. It should also be scalable so that it can meet your future needs. It will also help to know the financial stability of your vendor since the company may not be available to provide support services with a weak financial background. Some vendors don’t discuss the costs involved in hiring new IT staff, regular network upgrades or even licenses required to set up the EHR system in hospitals or private practices. It is common for vendors to talk only about the EHR software charges and thus you must specifically ask these questions before you decide to buy.

The demonstrations will narrow your search to a few vendors ranked by your team and you may then consider visiting actual practices that are using the EHR systems. Choose a site similar to your practice and ask some colleagues to accompany you on these visits. Don’t hesitate to ask questions to the current EHR users and make notes for future reference. At the end of these short visits you will be in a position to decide the best EHR vendor for your practice. Try negotiating the price with your top EHR vendors and this may help you get the best deal. This entire process can take anywhere between six to twelve months and will help ensure you are choosing a system that delivers exactly what you need.

Above article publish on http://www.emrconsultant.com/education/buying-an-electronic-health-record-system

This initial pilot is planned to begin in mid-December 2009.

“Utilizing the NHIN’s standards and network will allow organizations like the VA and the Department of Defense (DoD) to partner with private sector healthcare providers to promote care for Veterans,” said VA Secretary Eric K. Shinseki.

Last week, the VA and Oakland, Calif.-based Kaiser Permanente sent a joint invitation letter to veterans in the San Diego area who receive care from both institutions to participate in this pilot program.

The pilot program connects Kaiser Permanente HealthConnect and the VA’s EHR system, VistA.

The program puts the highest priority on patient privacy and data security, and no exchange of information will occur without the explicit permission of the individual patient. Patient information will not be shared without first obtaining their consent.

The VA, DoD and HHS have been working closely to create a system that will modernize the way healthcare is delivered and benefits are administered. DoD will be included in the next phase of the pilot program in early 2010.

Above article published http://www.healthimaging.com/index.php?option=com_articles&view=article&id=19731:va-kaiser-permanente-invite-veterans-to-pilot-program

Unless you have done your homework on what makes a top-notch EHR system, you’re liable to have a hard time choosing which company to go with. Because of this, you’ll be more susceptible to a software company’s fancy sales pitches on why their software is the greatest ever, even though it’s actually quite dismal.

To aid you in your search for the top EHR companies, there are a few key factors you need to look for before making your investment. Some companies may satisfy one or two of these factors, but the best vendors will satisfy all of them. This is the second in a series of two articles that will cover five important factors to look for in EHR software.

In the first article of the series, we discussed two of the five factors to look for in high-quality electronic health records—1) buying true EHR software and 2) buying integrated EHR software—and this time we’ll address the last three factors. After reading both articles in the series, you’ll have a solid base of knowledge for making what can be one of the most important investments for your chiropractic practice.

5 Factors that Make for Top-Quality EHR Software

3. Fulfilling third-party payer requirements: It’s not enough that EHR software digitize all of your paper records and documents—the system should also meet or exceed all of the requirements demanded by Medicare and other third-party payers. While it’s important that the company you go with has the technological know-how to build a highly advanced software system, it’s equally vital that your EHR company have a complete and thorough knowledge of all of the rules and regulations regarding third-party payers

and has designed their software around this knowledge. Moroever, the software should also be regularly updated to ensure you’ll continue to meet third-party payer standards as they evolve and change in the future.

4. Customizable: Depending on the size of your practice and the way in which your work, a software system that’s excellent for one of your fellow DCs might not be the best fit for your office. For this reason, you should go with EHR companies that allow you to customize your software to get the features and components you really need and not have to buy those you have no use for. Such systems are often modular in design, so you can buy the features you need—or can afford—now and then add on others down the road. Furthermore, the software’s documentation features should also be customizable, so the system will fit efficiently with your practice’s workflow. You shouldn’t have to change the entire way in which you work when switching to EHR; instead, the system should be built in a way that both accommodates and maximizes your own documentation style.

5. Designed for chiropractors: Today, the entire healthcare industry is rapidly moving toward digital health records. Because of this, many EHR companies have sprung up to help everyone make the switch to a paperless practice. As a chiropractor, however, you should only go with a company that designs their software specifically for DCs. Some companies may claim their systems will work for all types of healthcare practices, but in reality, chiropractic clinics have many unique needs that can’t be met with a generic EHR system. Make sure the company you select has designed their software to work specifically with the procedures, workflow, and language used by chiropractors.

Above article published on http://www.chiroeco.com/chiropractic/news/8704/1100/5-factors-to-look-for-when-investing-in-EHR-software:-Part-II-of-II/

Dr. David Blumenthal, the national health IT coordinator, said yesterday his office will explain “in the coming weeks” how it will define a “certified” electronic health record,” which providers must purchase in order to qualify for new federal health IT incentive payments.

In an e-mail message, Blumenthal gave a preview of what further guidance providers should expect in coming months as his office works with the Centers for Medicare and Medicaid Services to finalize the set of requirements for “meaningful use.”

Under the health IT stimulus legislation, providers who are meaningful users of certified health IT will be eligible to receive increased Medicare and Medicaid payments.

“As efforts advance, we will turn our attention to other necessary supporting programs, some of which you will hear more about in the coming weeks, including defining what constitutes a ‘certified’ EHR, which is one of the requirements to qualify for Medicare and Medicaid incentives,” Blumenthal said.

Blumenthal said his office will also outline programs aimed at smoothing the transition process and identify steps that physicians and hospitals can take now to promote adoption of EHRs.

While awaiting the CMS rule, he urged providers to become “as familiar as possible” with the discussion of meaningful use criteria in the recommendations of the Health IT Policy and Standards committees, two panels advising Blumenthal.

The policy committee completed its second set of recommendations on meaningful use in July. “Be assured you will not be alone as you seek to adopt an EHR system,” Blumenthal wrote, citing grants for regional extension centers that would assist providers in establishing an EHR system.

The public will be able to comment on the definition, and CMS will consider those comments before the rule is finalized in early 2010. Any formal definition of meaningful use will include specific activities that health care providers need to perform to qualify for the incentives, he said.

Eligible physicians can receive up to $44,000 over five years under Medicare or $63,750 over six years under Medicaid for being meaningful users of certified EHRs.  Hospitals could receive up to four years of financial incentive payments under Medicare beginning in 2011, and up to six years of incentive payments under Medicaid beginning in October 2010.

Above article published on

http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72159

By Pamela Lewis Dolan,

Louisiana Gov. Bobby Jindal signed into law a bill that would create a loan program for physicians and hospitals hoping to buy an electronic health record system.

The Electronic Health Records Loan Program Act, signed July 9, gives the Louisiana Dept. of Health and Hospitals the authority to apply for $25 million in federal stimulus funds in order to administer loans for EHR purchases. The measure also included $5 million in matching funds from the state, a requirement under the American Recovery and Reinvestment Act. The state will learn later this year if it will get the federal grant.

“This is another step in updating and improving Louisiana’s health delivery system for all Louisianians,” Jindal said in a prepared statement.

The measure builds on legislation passed in 2007 that helped seven rural hospitals acquire EHRs. The law also established the Louisiana Rural Health Information Exchange. In 2008, additional funding allowed another seven rural hospitals to become connected.

To qualify for the loans, the purchased EHR system must be certified by the body eventually chosen by the U.S. Dept. of Health and Human Services for such approval. Loans could also apply to fully integrated telemedicine systems.

Acknowledging upfront costs are a barrier that the incentives wouldn’t help alleviate, many EHR vendors also launched financing options for physician practices as a result of the stimulus. General Electric Co., for example, is giving practices the options of deferring payments until incentives start being paid in 2011.

Jenny Smith, health information technology project manager for the Louisiana Health Care Quality Forum, which is the state-designated entity for distributing all grants coming out under the federal stimulus package, said details are still being worked out in terms of the loan agreements. Work groups consisting of several stakeholders in the state are currently working on structuring the loan program, she said.

“The goal is to maximize the amount of support we can give to providers in Louisiana who couldn’t otherwise purchase an electronic health record or upgrade their electronic health record to meet the meaningful-use criteria for the incentives,” Smith said.

Once the state has reached 100% compliance, Smith said, the fund would likely be used for support such as upgrading systems or training

Above article published on

http://www.ama-assn.org/amednews/2009/08/03/bise0806.htm

The Certification Commission for Health Information Technology is adopting a two-tier system of testing and certifying IT systems.

In a conference call with vendors and developers of health IT systems Thursday, CCHIT Chairman Mark Leavitt announced the not-for-profit organization’s new testing program, as the group readies itself for the new realities of the healthcare IT market since passage of the American Recovery and Reinvestment Act of 2009.

One testing and certification program, dubbed Preliminary ARRA 2011 Certification, will specifically test for compliance with what is expected to be—at least initially—a fairly limited set of criteria that HHS and the CMS will use to determine eligibility by hospitals and office-based physicians for an estimated $34 billion in federal subsidy payments for the purchase of EHRs under the stimulus law.

The other, the so-called CCHIT Certified 2011 testing program, will use an elaborate set of about 300 criteria, primarily developed by the organization since its founding, that will closely resemble previous CCHIT testing and certification programs. The core CCHIT criteria will be tweaked to ensure systems that pass muster for its more advanced testing program also will meet ARRA requirements.

When it began testing IT systems in 2006, and on through 2008, CCHIT had offered just one, gold-standard set of criteria for each type of EHR system it tested—ambulatory EHRs or inpatient EHRs, for example.

But by April, CCHIT announced it would halt further testing to adapt its systems to accommodate the stimulus law criteria, development of which remains a work in progress. At the time of the announcement, Leavitt said the organization would keep its full-featured certification program, but would add two new testing and certification regimes scaled down to meet the minimum requirements of the stimulus law.

One new program would have tested IT systems by “module” against the new criteria under the recovery act, which requires providers to put “certified” EHR systems to “meaningful use” in order to qualify for federal subsidy payments. The proposed new modular approach was expected to appeal to some physician office practices and, more commonly, to hospitals, that want to piece together a comprehensive IT system from component parts produced by multiple IT vendors.

The other new CCHIT regime would have offered “on-site” testing and certification of EHR systems—again, against the less stringent stimulus law criteria with an eye toward qualifying for federal subsidies. This form of testing would have been conducted on systems installed at physician offices or hospitals. It was an approach targeted to appeal to providers who have developed their own EHRs or planned to assemble an EHR from noncertified sources, and to the open source development community, according to CCHIT.

According to Leavitt Thursday, CCHIT’s testing scheme will be modified again, but only somewhat. While site certification has been dropped as a certification scheme in and of itself, “site certification is still there,” Leavitt said. “In Preliminary ARRA Certification 2011, you can get a product or a site certified.”

Leavitt said it’s unclear whether providers adopting EHRs that have passed the test under the more rigorous CCHIT Certified 2011 program would want on-site certification, but if there is demand for the service, CCHIT will provide it.

Starting in June and running through its latest report in August, the HIT Policy Committee, which was created under the recovery act, has issued three sets of recommended definitions of meaningful use. Some of those recommendations have been controversial. To have market relevance, however, any program of certification of EHR systems that CCHIT develops must take those meaningful use standards into consideration to ensure that certified systems will enable providers to meet meaningful use standards and qualify for federal subsidies. The meaningful use standards, ultimately, will be developed by the CMS, which is tasked with running the bulk of the EHR subsidy program through Medicare and Medicaid.

In addition, CCHIT has to keep an eye on the Office of the National Coordinator for Health Information Technology at HHS, which, on behalf of the HHS secretary, will issue its own certification criteria for EHR systems, since, to qualify for subsidies under the stimulus law, providers also have to use “certified” EHR systems. Leavitt said CCHIT is forecasting ONC will issue its final rule on certification standards by Dec. 31 this year and that they probably will be the same or perhaps even less stringent than the recommendations the HIT Standards Committee made to ONC in August.

“We believe the final requirements will be the same as or less stringent that the current recommendations,” Leavitt said.

Both CCHIT testing and certification programs will open for vendor applications Oct. 7. Duration of certification is expected to run though Dec. 31, 2012, when certification criteria under the ARRA are expected to be ratcheted up, becoming both more numerous and more stringent.

Fees for certifying systems will vary with the certification scheme and the product, according to CCHIT Executive Director Alisa Ray. Under the CCHIT Certified 2011 program, the fee to a vendor to certify an EHR is $37,000 for either an ambulatory-care or an emergency department system, $49,000 for an inpatient system and $18,000 for an electronic prescribing system. Annual renewal costs are $9,000 for each, except e-prescribing, which is $7,000.

For Preliminary ARRA 2011 Certification, costs are pegged to the number of modules being tested, with fees set at $6,000 for one or two modules, $10,000 for three to five, $15,000 for six to 10, $24,000 for 11 to 20 and $33,000 for more than 20. Annual updates range from $1,000 to $5,000.

According to EHR vendor representative Justin Barnes, who listened in on Thursday’s CCHIT call, CCHIT probably has hit on the right strategy by launching its new testing and certification program this fall, based on an educated guess at what the government’s criteria might be, but before the final rules are published. Barnes is the chairman of the Electronic Health Record Association, and a vice president overseeing corporate development, marketing and government affairs for Greenway Medical Technologies, a Carrolton, Ga.-based EHR system developer.

“The detail that we have right now around meaningful use, you really can’t write a product to it,” Barnes said. “The interim final rule will come down at the end of this year. I think that will be a fairly close definition that we could follow. I think it will be plenty to work off of. The certification process, I believe, will be tweaked a little bit as well.”

Barnes said he hopes Leavitt is right when he predicts the ONC and the CMS will not vary too far from the current recommendations in writing the preliminary rules. He also said he hopes they don’t dally in unveiling their preliminary rules so everyone involved, both EHR vendors and users, have time enough to act.

“If there are any discrepancies, that could pose an interest to some people if you have to do heavy product development,” Barnes said. “It takes 12-plus months for the product cycle to add functionality on the ambulatory side and 18-plus months on the inpatient side. There is a word of caution here. That’s why we’ve urged ONC to move on this as fast as they can.”

Above article published on

http://www.modernhealthcare.com/article/20090904/REG/309049989/0