How community centers and EHRs are boosting primary care

With the implementation of the Affordable Care Act this year, the expansion of community health centers and other federally qualified health centers (FQHCs) has become commonplace across the U.S. These reform efforts have allowed many low-income citizens to attain the primary care they need to improve overall health, and electronic health record usage has already proven beneficial for many providers thus far.

EHRs and community health centers
EHR software use in community centers is still in the beginning stages in some respects. Yet it seems that over the past few years especially, these trends are starting to change. A 2010 study published in the International Journal of Medical Informatics showed that community health centers found system interface issues with EHRs were problematic, but other clinical tasks like lab ordering saw improvement. In the early days of EHR implementation with these providers, issues with compliance and other regulatory requirements presented key problems, according to the study.

"In 2014, the Commonwealth Fund released a survey indicated that health IT service usage overall in FQHCs had increased by a stunning 133 percent between 2009 and 2013."

The cost of implementing a medical software system can also be somewhat expensive for FQHCs, which are usually working on tight budgets as it is. However, according to a Health Resources and Services Administration press release from December 2012, the ACA granted $18 million in community health funds that were strictly allocated toward health IT improvements. An HRSA administrator further explained in the press release that the investments result in IT technology improvements across 600 health centers throughout the U.S.

In 2014, the Commonwealth Fund released a survey indicating that health IT service usage overall in FQHCs had increased by a stunning 133 percent between 2009 and 2013, showing that EHR implementation trends have changed dramatically in just a few years. Nearly all of the respondents who were surveyed (93 percent) indicated that they now have an EHR system in place.

How FQHCs can fund EHR software
It's clear that meaningful use incentives – which were first implemented in 2009 – have allowed many FQHCs to use this important technology in poor and underserved communities. According to HRSA, both Medicare and Medicaid incentive programs require the use of certified EHR technology in order to receive payments. Medical software must be tested and certified by an Office of the National Coordinator Authorized Testing and Certification Body to ensure that payments are processed.

It's important for intelligent medical software to reach people from all walks of life so that everyone can have the best tools in preventative and primary care.

Top challenges for FQHCs

It wasn't too long ago when community health centers and other federally qualified health centers were somewhat sparse. However, according to the Kaiser Family Foundation, there were 1,128 FQHCs located in the U.S. in 2011, and these facilities serve millions of individuals who live in America's poorest and underserved communities. Needless to say, they are an important part of our health care system, and such, require the IT tools needed to deliver optimal medical care.

What's more, the Affordable Care Act, one of the most expansive pieces of health care legislation in decades, has allowed FQHCs to play a central role in primary care. Many newly insured Americans will be heading to these centers, so long-term goals and tackling challenges for these providers is crucial for success. Here are some of the common roadblocks for FQHCs heading into 2015:

"Although FQHCs face significant challenges with sustainability, doctor shortages and specialty care, there are several tools that providers can use to improve quality of care and workflow, including intelligent medical software."

Funding sustainability
FQHCs are designed to be non-profit entities, but according to the University of Michigan Health Centers, the government cut appropriations for FQHCs by 27 percent in 2011. However, with meaningful use incentives and Medicaid's equivalent to the program, hospitals and practices can still optimize their medical software platforms despite these financial strains. According to the source, some FQHCs have also increased the number of Medicaid patients they see to encourage payments.

Doctor shortages
According to the National Association of Community Health Centers, health centers will double their current capacity to 40 million patients by 2015. These estimations are particularly worrisome seeing that the U.S. has been experiencing a widespread doctor shortage. This means that providers need robust electronic health record platforms that make help doctors work more efficiently. These tech tools can streamline workflow so that physicians can focus more on their patients and less time on administrative tasks.

Specialty care
According to UM Health Systems, one of the biggest barriers for FQHCs is a lack of specialty care for patients. This is especially challenging considering that many demographics are largely uninsured or Medicaid recipients, which creates issues for referring to non-health-center primary care practices. As a result, many FQHCs have created partnerships with hospitals to overcome these issues. Specialty templates used in EHRs can help doctors streamline these problems as well.

Although FQHCs face significant challenges with sustainability, doctor shortages and specialty care, there are several tools that providers can use to improve quality of care and workflow, including intelligent medical software.

EHR implementation proves worthwhile for FQHCs

Many Medicare recipients and individuals living in low-income communities rely on community health centers for comprehensive health services. Starting in 2010, the Office of the National Coordinator for Health Information Technology authorized 62 regional extension centers (RECs). This task was mainly focused on providing EHR software assistance to individual and small practices and providers located in medically underserved communities.

According to the ONC, 83 percent of federally qualified health centers associated with the Health Resources and Services Administration have already enrolled in RECs. These providers are diverse and cover a vast array of services, including speech language pathology, dentistry, social work, psychiatry and psychology, optometry, occupational and speech therapy, chiropractic services and dietetic services, among others.

EHRs prove beneficial for community health centers
Based on a study conducted by the Florida Association of Community Health Centers, there are many benefits related to medical software and EHRs. Unlike private practices, community health centers and other FQHCs cannot use EHR technology for coding or revenue increases, so much of their success with these advancements is demonstrated with quality improvement measures.

The research looked at six community health centers with EHRs across six states. Financial benefits were mostly attributed to efficiency gains, especially when it came to reduced medical record and transcription costs. However, the most noted benefits came from EHR software's use in quality improvement. All community health centers involved in the study used EHRs for basic issues like lab results, medications and coded lists for patient issues. Five of the six centers also utilized the registry to help in preventative care and chronic disease management. Data capture, reminders at the point of care, patient lists of those needed services and performance reports all contributed to success in quality improvements. Other benefits included data and analysis tools to obtain new grants and research funding. Overall, EHR technology gave clear benefits both to patients and payer stakeholders. 

Incentive programs for EHRs
Many FQHCs will need to demonstrate meaningful use attestation for Medicare recipients, and Medicaid also has its own incentive program with EHRs. With intelligent medical software, standards and implementation specifications can allow FQHCs to obtain the incentive payments that they need to comply with these programs' criteria. So far, millions of dollars in payments have been issued to providers that have attested to this type of technology, especially since the HITECH Act passed along with other major health care reforms in 2009.

Parents can better manage pediatric health with EHRs

Treating pediatric health issues doesn't always run on a 9-to-5 schedule, as parents already know. In this respect, electronic health records and patient portals have the potential to relieve some of the demand for pediatricians and put parents in the driver's seat when it comes to their children's health.

In fact, according to a 2013 study published in the Journal of Pediatrics, parental perceived patient portals to be especially beneficial for those who had children struggling with chronic illnesses. There are several noted diseases that often begin in childhood, including Type 1 diabetes, ADHD and asthma, that can be better monitored through electronic means.

"There are several noted diseases that often begin in childhood, including Type 1 diabetes, ADHD and asthma, that can be better monitored through electronic means."

"For busy parents, it may be difficult to prioritize or remember when to bring their young children in for well-child care visits or immunizations, particularly when they are healthy," Dr. Jeffrey Tom, the lead author and assistant investigator at the Kaiser Permanente Center for Health Research, explained, according to ScienceDaily. "Our study found that in two demographically and geographically distinct regions in the United States, PHRs appear to be a viable tool to help ensure children adhere to recommended preventive care."

The study indicated that many parents found Internet communication was an easier pathway between themselves and their pediatricians. What's more, they noted a sense of control, reduced anxiety and reassurance that they were taking the right steps to protect their child's health.

Why patient portals are great for pediatricians
Notably, there are a lot of milestones and changes associated with pediatric care, from the time a child is born until he or she reaches adolescence. Children also undergo many immunizations, and may need to see a physician regularly, especially if they are actively competing in sports and require regular physicals. With EHR software, parents don't need to make time in their busy schedules to contact a pediatrician, as the treatment guides and their child's electronic health record are available online.

Pediatricians can also benefit greatly from EMR systems, as there are specific templates that can be customized depending on a child's needs and health progression. Scheduling for routine, sick and well-child visits can also be better managed through a pediatric EHR.

Treating children requires a lot of time and effort, so pediatricians shouldn't be spending their days at the practice overwhelmed with administrative tasks. With EHR systems, doctors can spend less time going through paperwork and more time with their patients.

Pediatric EHRs experience major improvement in the past few years

Pediatric EHR design is no longer a thorn in pediatricians' sides, as this type of technology has become far more advanced over the past few years. During the first days EHR implementation, many pediatricians were hesitant to switch over to EHR systems. Early EHR templates may not have been ideal for pediatric medical issues, but these inconsistencies were largely resolved during 2013 and 2014, which was spurred by the 2012 design guide for pediatric EHRs released by the National Institute of Standards and Technology and efforts by the Agency for Healthcare Research and Quality. In practices large and small, doctors are discovering enhanced care coordination and data tracking with EHR technology, namely in the area of pediatric immunization rates. 

"In practices large and small, doctors are discovering enhanced care coordination and data tracking with EHR technology, namely in the area of pediatric immunization rates."

EHRs and pediatric immunizations
Dr. Susan Kressly, the founder and president of Kressly Pediatrics, is just one example of a physician who found exceptional success in making the switch from paper records to EHR systems. The Department of Health and Human Services highlighted her switch to this platform as a Health IT Success Story. After making health IT a priority in her practice, infant immunization rates have exceeded 95 percent. Kressly also noted that patient portals have allowed her patients' parents to view and print immunization histories online, which makes things much easier for individuals enrolling their children in schools. What's more, Kressly noted that some parents have even been able to pull up their child's medical history via mobile phone during a trip to the emergency room, creating flexibility and improved data access in a stressful situation.

EHRs and preventing pediatric diseases
Chad Jensen's experience with EHR-generated reminders is another example HHS highlighted. As the executive office manager for LaTouche Pediatrics, Jensen became the first practice in Alaska to demonstrate stage 1 meaningful use under the Medicaid EHR Incentive program. However, LaTouche Pediatrics' attestation wasn't the only notable milestone with EHRs. By using EHR software, the staff was able to create alerts for a list of patients who were due for certain vaccinations. LaTouche was also able to make great strides in identifying respiratory syncytial virus, a potentially deadly ailment in infants, with a color-coded EHR platform.

While EHR design might have been a little rudimentary in the beginning stages of implementation several years ago, it's clear that pediatricians are discovering success with practice management software.

What is HIE? And how is it benefiting cardiology?

This year was a big one for the health IT industry, and one of the most well-known catch phrases you've likely heard from many medical professionals relates to electronic health information exchange.

What is HIE?
In short, HIE is an comprehensive health IT system that allows doctors, nurses, pharmacists and many other professionals within the health care industry to share patient information by electronic means, according to the Department of Health and Human Services. The purpose of HIE is to streamline patient care and give doctors greater access to patient needs.

For decades, paper was the go-to means of storing patient information in practices and hospitals. However, as health tech has become increasingly more sophisticated, many doctors are moving toward electronic health records. According to HHS, sharing patient information between medical professionals leads to four important benefits:

  • Avoiding readmissions
  • Reducing the rate of medication errors
  • Enhancing diagnoses
  • Lowering duplicate testing

The HHS has stated that medical software is in no way trying to replace the value of the patient-physician communication experience, but rather improve it with a standardized process.

How does HIE benefit cardiology?
EHRs have already begun to make an impact on cardiology. According to the American College of Cardiology, 78 percent of cardiologists have reported that they used EHRs for at least two years or more. What's more, nine out of 10 cardiologists admitted to having a full-functioning EHR.

Several leading cardiologists expressed to the source that EHR systems have improved their practices in many ways. Some of these include improved medical billing and coding applications, e-prescriptions, better patient care and more accurate knowledge when it comes to workflow.

Interoperability was also cited as a major perk with HIE. For U.S.-based systems, this type of technology is practically a must for cardiologists, as they handle quite a few referrals and see many types of patients for their services. Having streamlined access to a patient's EHR can allow a primary care physician to communicate with a cardiologist in a much more timely and accurate manner. Imaging and other notes can be shared between doctors as well, which can save patients time and money.

Implementing HIE also has practical benefits for cardiologists as well, as there are meaningful use incentives and other financial benefits related to switching over to an HIE and EHR platform. However, in the long run, these innovations are ultimately there to help patients better manage their  medical finances, track their health needs and monitor important or missing health information.

EHRs prove beneficial for pediatricians

The development of electronic health records has taken over many specialties in medical care, and pediatrics is no exception. There are many reasons why pediatricians are making the move to EHR software, according to Modern Medicine. Some doctors are implementing EHRs to receive incentive revenue from the federal government, while others have them as part of accountable care organizations. No matter what is driving EHR adoption in pediatrics, one thing is clear: These innovations are proving beneficial for doctors, parents and patients alike.

The source noted that the way you have your EHR workstation set up in each exam room can play a big role in the success of your practice. For instance, having a printer in each room allows pediatricians to easily provide school notes and physical forms, while positioning the EHR with a large screen can help parents see and track their child's progress.

How EHRs are making a difference in child care
According to the Department of Health and Human Services, there are several ways that personal electronic health records for child patients can prove beneficial in your practice:

  • Parents can better manage their their child's health. Patient portals can be accessed from anywhere, which can be particularly useful when pediatricians are out of the office or not on call. This puts patients in the driver's seat and creates better communication between doctors and parents.
  • Data can be easily exchanged between patients and doctors: A child's personal and demographic information, emergency contacts, history of hospitalizations or surgeries, immunizations, lab and test results, and insurance data can all be stored in one convenient Web portal. This creates less hassle for pediatricians during visits, allowing you to spend more time discussing important matters with parents and patients.
  • EHRs were designed for data exchange and meant to be able to withstand frequent changes. Because child patients go through many notable changes and require several vaccinations and immunizations, EHRs can help keep better track of these milestones than traditional paper records. Tracking routine visits and growth charts can also be managed easily with this type of technology. 
  • Medical codes for pediatric care are simplified with intelligent medical software, as templates are used to configure billing for you. This is especially important considering the upcoming ICD-10 switch slated for 2015. 
  • These same templates can also be utilized to track specific pediatric ailments, such as ADHD diagnoses and assessments, child and adolescent psychiatry, nutritional counseling, ear and throat issues, and asthma. 

How podiatrists are using EHRs to better their practices

Podiatry has been one of the leading medical fields when it comes to health IT and electronic health record integration, and investments in these technologies are already starting to pay off. Because podiatry is such a specialized practice, there is a crucial need for the latest in EHR advancements.

One of the areas in which podiatrists have really shined with EHRs is the federal meaningful use program. Purchasing an EHR system and implementing it into your practice is a large expenditure, especially for busy doctors. However, according to Podiatry Today, the return on investment with this type of technology outweighs the cost in the long term, particularly with accuracy and efficiency. Integrating a practice management system allows podiatrists to only enter in patient information once, which reduces the risk of errors. 

"Integrating a practice management system allows podiatrists to only enter in patient information once, which reduces the risk of errors."

A lot of practices are watching their bottom lines these days, and podiatry EHRs allow doctors to reduce the need for additional staff and also save money sustainably by going paperless.

Podiatry and coding
Software also has many noted benefits in terms of code sets. Remaining ICD-10 compliant is a must for 2015, as ICD-10 plans to change the many existing medical codes and add in new procedures and treatments. Additionally, EHR software can let podiatrists conduct patient insurance verification before planned visits so deductibles and co-pays are determined in advance. Documentation such as driver's licenses and insurance cards can also be implemented into an EHR system for easy access. After a claim is made, the software processes the payment electronically immediately, saving staff time and allowing doctors to spend those additional minutes with their patients. Imaging is another area where EHRs can prove beneficial for podiatrists, as issues like stress fractures, sprains and broken bones are common with the foot and ankle. 

Like any other aspect of your practice, implementing an EHR into your workflow will take time and training, so it's important to prepare for these changes well in advance. Creating scheduling templates and referral management is crucial as well with an EHR system, as podiatrists are often recommended by primary care providers. EHRs are also quite mobile and scalable, so podiatry practices of all sizes can reap the benefits of software technology. Although installing an EHR platform will be a big change for your practice, the payback is well worth the investment down the road. 

Great tips for boosting pain management care with EHRs

Electronic health records are becoming one of the fastest growing innovations in the medical world, granting empowerment to doctors and patients alike. However, one of the most impactful fields EHRs could play a significant role in is pain management. 

According to a study published by the American Society of Clinical Oncology, health information technology and rapid-learning health care models through a pain management EMR could promote better clinical care and research when it comes to treating cancer patients. However, the source did note that data interoperability, national data policies on IT systems as well as workflow all need to be considered in order for these innovations to make an impact on pain management.

"According to a study published by the American Society of Clinical Oncology, health information technology and rapid-learning health care models through a pain management EMR could promote better clinical care and research when it comes to treating cancer patients."

Working with EHRs to increase patient engagement
Patients suffering from chronic pain need real-time solutions on a widespread scale, and EHRs could be an answer for these desired outcomes. Here are some of the ways that EHRs can help doctors improve pain management care: 

  • It's likely that many pain management patients will be prescribed medications, some of which may be addictive. EHRs can efficiently track e-prescriptions so that doctors know when and where patients were receiving high-risk prescription drugs. Built-in safeguards such as these allow for great patient protection and long-term health. In the same vein, e-prescriptions allow patients to order and review their medicine before they leave the doctor's office, saving time and money.
  • Patient portals allow individuals to take charge of their health and grant online interaction with their providers. 
  • Doctors can access the patient's record prior to entering the exam room easily with mobile devices and tablets. This allows doctors to have data on-hand prior to the appointment so that they can spend more face time with those who really need it. Likewise, patient portals can let people access their files or prescriptions remotely from home.
  • EHRs are very mobile, so doctors can have the opportunity to turn the monitor around while discussing treatment options or sharing radiological images. 
  • Return visits are likely in pain management centers. With an EHR already in place for your patients, there's no need for individuals to fill out various forms every time they enter your office. This reduces wait times and allows the doctor to see more patients on a daily basis. 
  • When coding efforts are accomplished electronically, it gives doctors more time with high-risk patients and less time with administrative tasks.

Meditab Partner Summit 2014

We had an inspiring event in St. Pete’s, reaffirming that the key to our success this year and next is to seek out collaboration. Our partners are expanding their definition of colleagues to include other partners and clients as well!  We are encouraged by the ideas they have begun to share! These ideas will be the key to our success, so we encourage everyone to work together and rely on each other to achieve greatness – we will do the same!

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We would like to extend our congratulations once again to the Meditab 2013 / 2014 Outstanding Achievement Award recipients!

Dave York
Fox Meadows
Partner with Highest Sales

Jason Keele
1st Providers Choice
Partner with Most New Providers

Vance Nelson
Healthtec Software
Rookie of the Year

Thanks again to our partners for their activity on our Facebook event page, Twitter, and LinkedIn! You can go back and take a look at what others shared here, or watch this video!