Researchers from Baystate Health and University of Massachusetts-Amherst College of Engineering recently analyzed how physicians distribute their visual attention when reviewing electronic notes to see where their eyes spend more time reading and comprehending.
According to the study conducted by Applied Clinical Informatics, Clinical Innovation & Technology, physicians mainly focus on the impression and plan section of EHRs and do not give much attention to the other sections.
Ten physicians were tested used eye-tracking devices to measure their attention patterns as they read three electronic notes. Examined were their reading rates and the sections of the EHRs they read.
The results of the study showed that physicians read through the laboratory results, medication profiles, and vital signs very quickly, almost at a skimming rate and paid more attention to impression and plan sections.
The researchers concluded that optimizing the design of electronic notes may include rethinking the amount and format of imported patient data as this data appears to largely be ignored.
Despite the congressional block, a majority of organizations have recently expressed their intent to proceed with the implementation of ICD-10. An American Health Information Management Association (AHIMA) poll conducted during a two-day summit last week uncovered the industry’s disappointment with the delay, and frustration at the expense of money and energy the delay will cause. More than half of providers are prepared for ICD-10 and will go ahead with the plan on a voluntary basis, if they are allowed.
One reason for the mass disgruntlement is that many organizations have already spent too much money on the transition to stop now. According to the poll, 42 percent said that their organization has already spent more than $1 million on transition activities. Due to the delay, money allocated to make it to October 2014 must now be stretched, and augmented, to make it another full year.
The AHIMA sample is small, with less than 100 professionals responding to questions, but the results mirror other surveys conducted by Deloitte and EHR Intelligence in recent weeks. All surveys show that the overwhelming concern among providers is a loss of momentum and detrimental reallocation of resources as the cost of labor and maintaining the technology builds up.
On April 1, President Barack Obama signed the Protecting Access to Medicare Act, delaying the implementation of ICD-10 until October 2015. This congressional move came as a surprise to members of the American Health Information Management Association (AHIMA) and members of the Centers for Medicare & Medicaid (CMS.)
Yesterday at the AHIMA ICD-10 Summit, CMS’ Denise Buenning addressed the delay and answered questions from the audience. She expressed that CMS was just as surprised by the move as everyone else, and that it has been hard on CMS. Rumors had been circling that the cause of the delay was that CMS was not ready, but Buenning denies this and maintains she did not expect the delay from Congress.
Buenning stated that CMS is looking into the law and has plans to develop an option to take to the management level and the U.S. Department of Health and Human Services secretary for approval.
In order to prevent any future delays, Buenning stated that CMS intends to communicate better with physicians on the benefits of ICD-10 and will work through various associations, as she believes that they will be much more effective with numbers on their side.
The rapid growth of EHRs in the health IT industry has created a dramatic increase of jobs in this field. Hospitals have even expanded their budgets 35% specifically for retaining health IT personnel and technology. The most popular EHR related jobs range from entry-level medical record technicians to executive positions at hospitals and physician offices. Health organizations need people to install, design and implement EHRs, train and support, provide mobile health, integrate EHR data, redesign workflow, and maximize efficiencies.
There are even job opportunities before EHRs are rolled out, such as clinical transformation specialists who perform all the preliminary work to understand how the requirements are translated into software. Nursing jobs have also felt a boost because hospitals are recognizing their value in assisting with integration into clinical processes.
Additionally, since ICD-10 is delayed for another year, there is still a demand for people who can efficiently convert ICD-9 to ICD-10.
The following are eight of the most popular jobs in health IT right now:
Implementing EHRs might seem like a daunting task for physicians who haven’t yet done so because they don’t know where to begin and the cost of the systems can be discouraging. Web-based EHRs however, offer a cost-saving and simple solution.
Cloud-based systems store all of the practice’s information on external servers that are accessed online, and only require a computer with Internet connection. Client-servers store data internally, requiring a server, hardware, and software to be installed in the office.
While client-servers have been popular for some time, the growth of healthcare IT has caused many physicians to transition to the cloud. The benefits of cloud-based systems are outlined below:
Easier implementation - Since the EHR system runs on the web, there is no need for any additional installation on computers. This prevents interruption of cash flow, allows for a quicker return on investment, and simplified implementation.
Savings – The biggest cost for practices is the initial cost to install the EHR system. While client-servers can cost upward of $40,000 for installation, cloud-based systems simply require a monthly utility fee and no set-up costs.
Requirements are reduced - When medical records are moved to a cloud, all requirements typically done by IT professionals are done internally and automatically, including updates, tests, configurations, and installations, so practices are always running on the most up-to-date version available.
Superior accessibility and collaboration - Patient records and internal documents can be accessed remotely from any computer, anywhere. This allows doctors to collaborate on patient care more effectively.
Simplified scalability - Small practices can expand without the complications of adding more servers, which is costly. New users, doctors, and locations can be added easily and quickly.
With healthcare technology becoming more and more popular, many physicians are looking for ways to utilize it in ways that will help them connect with patients and also make the patients’ experience more pleasant and seamless.
Smart devices, like the iPad, allow easier sharing of information between doctors and patients, optimization of care, and streamlined workflows.
Below are some easy ways to improve patient care and engagement:
Reception area- patients can become very stressed waiting to be seen by their doctor, especially if the check-in process is disorganized. Having patients use iPads equipped with apps for checking in, filling out paperwork, and even loaded with medical-related articles for entertainment as they wait will make their experience a pleasant one.
Treatment/consultation room- providing patients with images of their x-rays or scans and interactive demos will help them get a better understanding of their condition and treatment.
Practice administration- presenting practice updates and patient information to your team in an interactive way allows them to be more involved. Using a cloud system allows them to access documents, make notes, share their opinions, progress, etc.
Appointment management- providing patients with apps that allow them to make, confirm, cancel, and check on appointments makes their time commitment quicker and therefore more convenient.
Access on the go- mobile apps allow physicians to view appointment and patient information remotely from virtually any location, which optimizes patient care.
The SMART (Substitutable Medical Apps and Reusable Technology) platform has started an advisory committee to help support the growth of modular apps for EHRs. The committee includes representatives from The Advisory Board Company, AARP, BMJ, Canadian Institutes of Health Research, Centers for Medicare and Medicaid Services, England National Health Service, Hospital Corporation of America, Eli Lilly and Company, MyHealthBook, Polygot Systems, Surescripts, and professor Clayton Christensen from the Harvard Business School.
The responsibilities of the committee are to advise on how to scale adoption as well as use SMART themselves. They will help create an environment where SMART is the standard for mobile health, with a higher demand for the economy of scale provided by a SMART API.
SMART was created to allow app developers to have a large market for innovation and the ability to run apps, specifically mobile medical apps, anywhere. The current environment for innovation is limited and companies have a hard time getting their products off the ground. SMART counteracts this issue and allows quicker deployment into hospitals and integration from a one-off perspective.
SMART API allows health IT platforms and EHRs to connect to specifically designed HTML5 or iOS apps. The app has already demonstrated use and has a number of large vendors utilizing it.
The latest estimates from the Center for Medicare and Medicaid services show that 85% of Meaningful Use early adopters attested successfully for the third consecutive year.
Last year, 224,000 total eligible professionals attested. Below is a breakdown of that number:
63,000 first-year attesters
114,000 second-year attesters
47,000 third-year attesters
However the majority of eligible providers have attested to stage 1 only, with a limited number moving on to stage 2 adoption. Providers are not worried because while stage 2 is off to a slow start, they are optimistic that it will pick up.
Some other statistics show:
94% of eligible hospitals have registered for Medicare and Medicaid EHR incentive programs
90% of hospitals have been paid through the program
56% of professionals are registered for Medicare
28% of professionals are registered for Medicaid
15% of professionals have not registered for either
In February, 9,387 providers registered for the EHR incentive program, for a total of 458,137 eligible providers who are registered.
Marketing firm MedData Group recently surveyed over 500 physicians on their perceptions of health technology. The study found that contrary to popular belief, doctors are not resistant to new technology, but rather they embrace it. Many physicians use mobile apps to monitor medication interactions and find that it makes them more efficient in quality of care and communicating with patients.
As physicians become more comfortable and familiar with using mobile apps, their desire for more ways to utilize them grows. Some general suggestions from the physicians included easier access to EHRs, the ability to send secure texts, and get drug, device, and diagnosis information at the point of care.
Overall, physicians remained optimistic about the opportunities that a fully connected healthcare environment would present, especially in reference to patient care.
Other results included:
One in four physicians use mobile apps to help with diagnosis
>20% use them for access to EHRs, labs, images & tests, clinical notes, or e-prescribing
60% want mobile access to EHRs
< 40% would use secure texting
Meditab allows physicians to stay connected to patients outside the office with IMSGo, which provides access to patient records from any mobile device. The solution gives providers unparalleled access to critical patient data anywhere, at any time. For more information, visit http://www.meditab.com/ehr-solutions/mobile-ehr/.