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A recent article published on EHRIntelligence.com focused on the Health IT Policy Committee’s newest draft recommendations for Stage 3 of EHR Meaningful Use. The suggestions center around quality, patient safety, and timely interventions through population health management and clinical decision support. It’s hoped that these suggestions for the eight objectives will lead to a transition from using EHRs for data entry to using comprehensive health IT infrastructure to provide patient-centered care with an emphasis on engagement, care coordination, and safety. The suggestions for the objectives include the following:

• Clinical decision support (CDS)
Stage 3 would expand the scope of clinical decision support to include newly recommended areas targeted for intervention.

• Care planning
Care planning will be a core measure for eligible hospitals and a menu measure for eligible professionals. Providers meeting this measure will be required to ensure that patients older than 65 have an advance directive recorded in the EHR.

• Electronic medication administration record
Hospitals will need to be able to automatically track medications from order to administration as a core measure in Stage 3

• Imaging in the EHR
Another potential menu item for EPs and core measure for hospitals is the capability to access images directly within the EHR in order to streamline the radiology process and reduce accidental duplication of lost test results.

• Clarifications to progress notes
Certified EHRs will be required to clarify the origin of every entry.

• Order tracking
This new menu objective for EPs will require providers to assist with follow-up on orders to improve the management and coordination of results.

• Unique device identifier (UDI)
As a new menu item for both hospitals and providers, organizations will be asked to record the UDI for all implantable devices in order to better track patient safety, product recalls, adverse events, and complications.

• Medication adherence
EHR products may be required to allow providers to access detailed medication and drug monitoring information in order to receive certification.

The Meaningful Use incentive program has been a positive motivator for healthcare IT innovation and adoption, but some feel that the investment from healthcare providers has also been a distraction. The industry expects that, in four years, the MU program will have run its course, making way for private venture capital funding which will bring a new wave of opportunities. At this point, it is unclear whether the industry will be resistant to change or continue with the current momentum of being open to further advances.

The process of complete MU adoption is uncharted territory – no other industry has experienced large-scale government implementation such as this. Thus, it is difficult to predict how the industry will react when it comes to an end. So far, early indications show that the feedback will be spilt in thirds – 1/3 continuing to support it, 1/3 will be too burned out, and 1/3 will pick and choose which aspects they want to still implement.

For the organizations that do want to implement new technology there are areas on the horizon they should be monitoring.

  1. Mobile EHR applications that give clinicians access to patients’ charts, prescriptions, and the ability to communicate with their colleagues and patients anytime, anywhere.
  2. Mobile applications that allow consumers to purchase their healthcare from a web-based portal, make appointments, request refills of prescriptions, etc. all from their mobile devices.
  3. Technology that protects patients’ privacy and security. With all of the accessibility patients will have to their own medical records, and the accessibility their physicians will have, there needs to be a sound infrastructure for security.
  4. Analytical tools that help ACO and population health models work.
  5. Advanced and user-friendly EHRs. MU will be accessible via a cloud system, streamlining data capture and delivering more intelligent data mining and reporting.

The change will happen and the technology will be available – organizations and healthcare providers just need to decide how they will use it.

This week marks five years since the enactment of the HITECH Act, which allocated $25 billion to increasing the use of electronic health records, and some patient advocate groups are celebrating its success. Debra L. Ness, president of the National Partnership for Women & Families, stated that the widespread use of EHRs by providers made possible by the HITECH Act’s Medicare and Medicaid EHR Incentive programs are “helping to facilitate much-needed culture change by empowering patients.”

The Healthcare Information and Management Systems Society highlighted some of progress made since the law was enacted in 2009. For example:

• Enrollment in the Meaningful Use program exceeds 93% among eligible hospitals;
• EHR use among office-based physicians has increased from 48% in 2009 to 78% in 2013; and
• The percentage of acute care hospitals achieving Stages 5, 6 or 7 on the HIMSS Analytics Electronic Medical Records Adoption Model has increased from 11.2% to 37.4% (Leary, HIMSS blog, 2/14).

Looking ahead, there is still work to be done. The National Partnership for Women & Families also stated that the availability of EHRs needs to continue to grow “to ensure that all patients have access to their own health information and all providers have secure [EHR] systems capable of coordinating care across multiple settings.” The group added, “We need to build on the meaningful use program and significantly improve health IT to identify and reduce health disparities.”

The Centers for Medicare & Medicaid Services has announced that the deadline for healthcare professionals to demonstrate Meaningful Use has been pushed back by one month, allowing providers more time to qualify for the Medicare EHR Incentive Program.

Because of the strong interest from healthcare providers in EHR Incentive Programs, CMS officials decided to extend the deadline to make sure that all providers are able to apply and receive incentive payments. The deadline is also beneficial for hospitals that have missed the initial deadline, as they will have the opportunity to submit their attestation retroactively.

The deadline extension will allow more time for providers to submit their Meaningful Use data and receive an incentive payment for the 2013 program year as well as avoid the 2015 payment adjustment.
For more information on the ways Meditab helps its clients meet Meaningful Use requirements, visit http://www.meditab.com/company/ehr-meaningful-use/mu-readiness-program/.

As we kick off 2014 and prepare for new stages in the healthcare industry, I find myself reflecting on all of the positive changes that have come as a result of the Affordable Care Act (ACA). While it is easy to get caught up in many of the negative headlines throughout both industry and mainstream media, it’s important to recognize the good that has been brought about through these recent developments. The ACA puts consumers back in charge of their own healthcare.

There are a number of benefits including the development of coordinated care, especially through Accountable Care Organizations (ACOs), the implementation of Electronic Health Records (EHRs) and more affordable healthcare options, and one of the most important benefits to patients is the creation and implementation of patient portals. The Stage 2 objectives of Meaningful Use, the government incentive program, focus on the effective use of online patient portals and health information exchange, meaning that portals will now play an even more significant role for all practices looking to receive incentives.

In case you’re not familiar, first and foremost, portals provide patients with first-hand, convenient access to all of their own medical records. They are able to take the reigns of their own healthcare management and access what they want, when they want, from the comfort of their own home.

A patient portal is also extremely beneficial if a patient’s care has been placed in the hands of a spouse, child or other family member. Via the portal, the third-party caretaker can access all of the patient’s records and results and truly manage their relative’s progress remotely and on their own schedule. When used properly, a portal can allow a caregiver to schedule follow-up appointments, request refills, receive test results, track patient conditions and answer medication-related questions.

Additionally, if patients wish to send specific monitoring information from devices, such as blood sugar levels or blood pressures, they can do so via the portal and have that data become part of their electronic medical record. This type of access is particularly useful for those with chronic conditions, such as diabetes and arthritis that need to be monitored on an ongoing basis. Considering that approximately 25.8 million children and adults in the United States have diabetes (according to the American Diabetes Association) and an estimated 50 million adults have arthritis (according to the CDC), these tools are crucial for successful management of these conditions.

Portals also provide convenient access to information such as a physician’s post-treatment instructions, a pre-op checklist or directions for taking a prescribed medication. Alerts and reminders about upcoming appointments can also be transmitted through a secure and confidential communication channel. Portals can also incorporate electronic payment applications to streamline the billing process for both patients and practices.

Patient portals are crucial tools in enabling each individual to take a more active role in their own healthcare. It’s important to ask your physicians if they plan to incorporate a patient portal and how you can take advantage of all the tools to ensure you’re positively impacting your own experience.

Mike Patel, CEO of Meditab Software, earned his Degree in Pharmacy from Drake University at the age of 20. With the drive to improve the efficiency of his pharmacy, he built a revolutionary system that completely digitized the pharmacy. To further improve integration and functionality between the pharmacy and the prescribing physicians, he worked with physicians to help build a more efficient software for their offices. This led to the birth of Intelligent Medical Software (IMS), a multi-award-winning, multi-certified Practice Automation Platform. Patel’s vision is Meditab’s mission; to equip healthcare organizations with the most intelligent, intuitive, and efficient single platform software solution in the industry, while always providing the most comprehensive service to clients. Today, Meditab has built a wide variety of software platforms and hardware devices for the increasingly diverse healthcare market.

One of the hottest topics at the annual HIMSS14 conference in Orlando, Florida this month will be the transition from the ICD-9 coding system to ICD-10. The conference has ample resources and will feature training for ICD-10 topics to ensure that the attendees’ transitions go as smoothly as possible. Conference attendees can get a jump-start on the process by attending the ICD-10 Pre-Conference Symposium on Sunday, Feb. 23. Throughout the week, HIMSS14 will offer countless live and on-demand education systems to equip attendees with ideas and solutions to the biggest challenges they will face when converting to ICD-10. Topics include risk mitigation, organizational planning, and go-live monitoring.

With the firm compliance date of October 1st lurking, there is much preparation to be done throughout the year. While a change of this nature is not easy, the numerous benefits offered by the new ICD-10 coding system make it worthwhile. ICD-10 coding offers new opportunities to facilitate improved efficiencies and lower costs for providers, payers and patients, says HIMSS Executive Vice President Carla Smith, MA, CNM, FHIMSS.

Meditab is happily preparing for the transition to ICD-10. For more information on the Meditab’s ICD-10 resources, please visit http://www.meditab.com/company/ICD-10-readiness/.

Pediatric EHR Software customization has been a topic of question and concern for many parents during the transition from paper charts to digital records. The American Academy of Pediatrics openly supports healthcare IT and EHRs as an essential part of patient-centered medical practices. In a recent interview, Lisa Reichard, RN, gave some insight on the impact of EHR technology on the delivery of pediatric healthcare. According to Reichard, faster and more frequent charting will benefit pediatricians greatly. Pediatric patients generally require more frequent documentation, so a program that allows their symptoms to be charted quickly will make a tremendous difference in diagnosis speed. For example, the FACES Pain scale is a traditional charting method which assesses pain levels in children. Before EHRs, nurses typically presented this facial expression diagram to select the pain level in a young patient. After seeing several patients, the nurse would then document all patients’ selections at the nurse’s station at one time. This practice prolonged documentation, thus delaying diagnosis. Using an EHR gives nurses the ability to use an iPad containing a digital version of the chart, allowing documentation of patients’ responses immediately.

Reichard also believes that using iPads with their EHRs will create a more comfortable environment for their pediatric patients as iPads are familiar. Patients will feel more at ease during the procedure because iPads are often times used to play games and watch movies. However, Reichard does mention that there are still some kinks in customization. Currently, many EHRs function on a one-size-fits-all approach. That does not work for the prescribing process because dosing recommendations depend on the patient’s weight. Since this is currently the longest process in pediatric healthcare, customization in this area would be revolutionary.

Meditab offers many practice-specific EHR templates and medication dosing by weight. You can check out our customized product of offerings at: http://www.meditab.com/ehr-solutions/.

Top government endorsed certifying body Certification Commission for Health Information Technology (CCHIT) has announced that it will transition to an advisory role to healthcare vendors and providers, as it is no longer profitable in its current role. CCHIT will no longer certify or test EHR software for the first time since 2006. Instead, the CCHIT will focus on advising healthcare providers and health IT developers on the government’s requirements for certified EHR technology and how to comply with IT regulations. The CCHIT will also be developing new programs and policy guidance for providers and patients who use IT to transform healthcare.

The reason for the CCHIT ending relations with EHR testing and certification is economic. Running a certification organization requires investments in infrastructure and staff, but generates revenue only during periods when vendors are seeking certification. Most vendors didn’t start applying for certification until last September, but CCHIT has staff on payroll all year.

CCHIT has informed their current customers of the change and has suggested that they use ICSA Labs to maintain their certification or apply for new testing services. They will maintain their work with the Source, which offers ONC testing and certification preparation service.

For more information on this transition, published by Information Week, see the following link – http://www.informationweek.com/healthcare/policy-and-regulation/cchit-exits-ehr-certification-business/d/d-id/1113632.

The Centers for Medicare & Medicaid Services (CMS) recently conducted a patient participation survey on incentive payments under the Meaningful Use program and polled participants in the following categories: Meaningful Use participation, eligible professionals, and eligible hospitals. The results show strong participation and success, with 436,000 eligible professionals and hospitals having registered for the Meaningful Use programs since it launched in 2011.

The results of each category are listed below.

Meaningful Use Participation:
• 436,000 eligible professionals and hospitals have registered for the Meaningful Use program
• 82% of eligible professionals have registered
• 93% of hospitals are participating

Eligible Professionals:
• 97% provided electronic copies of health information
• 97% kept an active patient medication list
• 96% maintained a medication allergy list
• 92% provided transition of care summaries
• 93% provided active medication reconciliation lists
• 83% kept clinical studies

Some eligible professionals struggled with some menu objectives, for example:
• 33% submitted data to immunization registries
• 6% submitted syndromic surveillance data

Eligible Hospitals:
• 98% maintained a medication allergy list
• 98% kept an active medication list
• 96% recorded patient demographics
• 95% recorded advance directives
• 95% included clinical lab results in EHR data
• 92% recorded vital signs
• 83% maintained a computerized provider order entry system

The least-adopted objectives for hospitals were:
• 8% medical reconciliation
• 12% providing lab data to public health agencies

For more information on Meditab’s Meaningful Use program, visit http://www.meditab.com/company/ehr-meaningful-use/mu-readiness-program/.

New research out of Johns Hopkins University shows that EHR software and other digital tools are likely to curb the demand for physicians, therefore redefining the role of the doctor. Patients will simply not need to visit their physicians as often, with new EHR software and apps that will provide more immediate feedback and information.

The results of this survey provide a peek into the future of healthcare IT over the next decade or two. If history is any indication, IT will continue to take over – in just one decade, the percentage of physicians that used EHRs jumped 60% from 10% to 70%. Virtually every aspect of our lives is controlled and accessed through our smartphones and the Internet; it is only a matter of time before healthcare is put into that category.

However, because EHR software are redefining roles of physicians doesn’t mean that they are taking the place of physicians. In fact physicians say they are able to reach 4-9% more patients with EHRs because they increase efficiency, and that number will continue to climb as EHRs gain popularity and become smartphone-friendly.

In the same regard, e-referral systems will help reduce the national demand for specialists by 2-5% because specialist physicians will be able to delegate care to generalists. Health – IT could help address regional doctor shortages by enabling 12% of care to be delivered remotely by doctors living in other locations.

With more physicians and patients adopting e-health and IT solutions, it is clear that this is the new frontier and will help resolve physician shortages and delays.