Winners of White House’s Health Design Challenge Create Mobile EMR

With the firm belief that the look and feel of electronic medical records needed a major overhaul, the White House launched the Health Design Challenge to make EMR more mobile and user-friendly, whether that user is a physician or patient. Collaborating with the White House Administration, a community of web design mentors and investors collectively known as Designer Fund organized the contest. The winners have been announced and their designs will be open sourced and used as the EMR format for Veterans Affairs. The contest was targeted at startup designers with a prize $25,000 for the winner and have their creation used in the largest EMR network in the country.

Health Design Challenge Objectives:
1. Improve the visual layout and style of medical data
2. Create a people-friendly design, making it easier for patients to manage their own health
3. Make information easier to understand and use by healthcare providers
4. Find a way to include family members and friends in the care of the patient

Best Overall Design - Nightingale
Best Medication Design - M.ed by Josh Hemsley
Best Problem/Medical History - Grouping by Time by Matthew Sanders
Best Lab Summaries - Health Summary by Health Ed

A combination of the winning designs will be put together for the VA to help their patients understand their medical records. The EMR designs will also be open-sourced on Github, allowing them to be integrated with other EMRs as well as accept continuous contributions to the project from physicians and other designers. Click here to see the winners’ showcase.

Alarming Number of Doctors Copy EMR Progress Notes

Starting from the first day of kindergarten, schools teach children that copying is a definite no-no.  However, according to a new study, doctors seem to have forgotten this rule somewhere along the way as over half of intensive care unit physicians were shown to copy and paste information in patient progress notes in the hospital’s EMR system.

The Society of Critical Care Medicine conducted a study that analyzed 2,068 progress notes for 135 patients in an ICU, written by 62 residents and 11 attending physicians.  The study showed a disturbingly high occurrence of copied material in the notes, ranging from 20 to 61 percent.  82 percent of resident physicians copied information from previous progress notes and pasted it into a new one, all in the name of cutting corners to save time.  The attending physicians studied didn’t fare much better, as 74 percent of them were guilty of copying information.  Following at least one day off work, the percentage of attending physicians who copied information from their own prior notes increased to 94 percent. 

 Not only is the copying of EMR progress notes (information cloning) seen as immoral from a societal standpoint, but more importantly, this practice can also be very detrimental to the patient’s health and treatment.  Cutting and pasting medical data that’s a day old, or even a few hours old, can skip over and disregard pertinent information about the patient’s condition that occurred between the time when the physician saw them last, such as an event or changes in medication.   Information cloning can also lead hospitals and physicians to be investigated for insurance fraud if found to have consistent repeated diagnosis billing codes.  Medicare has vowed to crack down on record copying saying, “Identification of this type of documentation will lead to denial of services for lack of medical necessity and the recoupment of all overpayments made.”  

Physician Billing Software and EMR Team With Eyemaginations

The San Francisco Chronicle posted a press release from NexTech Systems, Inc., announcing their partnership with patient education software Eyemaginations.  NexTech, experts in Ophthalmology EMR, patient management and physician billing software will be integrating their NexTech Practice 2011 with Eyemaginations' LUMA software.


The integration of LUMA with NexTech fulfills the meaningful use criterion requiring doctors to educate patients on their specific conditions.  The objective for the joining of forces is to present Ophthalmic subject matter information in such a way that patients will easily comprehend and to provide patients with more thorough care.


"This integration is an exciting initiative that truly demonstrates NexTech's commitment to provide better software for better patient care in the Ophthalmology field. Eyemaginations is a leader in cutting edge patient education, and NexTech is a leader in innovative Electronic Medical Records, creating an unparalled collaboration for our Ophthalmology, Refractive Surgery, and Optometry clients." affirmed Christina M. Majeed, NexTech's Vice President Business Development, New Products, and Technologies.

Mostashari Assures Rapid Safety Plan for Electronic Medical Record Systems

This week, the IOM (Institute of Medicine) released a report regarding the potential safety hazards of electronic medical record systems.  The report made the recommendation that HHS spend the next 12 months on developing an independent federal entity to record and monitor patient safety events as reported by EMR end users.  Another issue addressed was the relationship vendors had with end users and how IOM felt that sharing information by users regarding errors they encountered was not encouraged by the vendors.  IOM stated that if this plan was not ready in 12 months, that HHS should allow the FDA to regulate health care IT.

In response to this report, the national health IT coordinator, Dr. Farzad Mostashari spoke at a meeting of the advisory Health IT Policy Committee earlier today.  "My understanding of the report is that one of the key issues was the recognition that a broader set of issues needs to be addressed, not just the devices, but the entire system of how care is delivered, how training is done, and how workflows are done," Mostashari said.  He assured that the Office of the National Coordinator for Health IT will coordinate with the FDA, the Agency for Healthcare Research and Quality and the National Institute for Standards and Technology to address the safety issues.  “We appreciate the IOM’s recommendations in making sure that we really do have a coherent structure for reporting, analyzing and acting on the information about EHR-related safety incidents."

Read the full Government Health IT article.

The Results Are In: The Doctors Have Spoken

Last month, Software Advice posted the results for their survey aimed at doctors and health care providers regarding their feelings about the benefits of EMR software.  The questions asked providers (who have already implemented EMR) whether or not their EMR helps them record and retrieve more accurate and legible patient information, if it benefited operations financially and the effect on office workflow.

Rating was based on a scale of 1-5: 1 meaning "I Highly Disagree" or "I Have Not Experienced This Benefit" and 5 being "I Highly Agree" or "I Have Experienced This Benefit".  The survey results demonstrated that the most commonly used EMR programs in use are Allscripts, eClinicalWorks, GE Centricity, Greenway PrimeSUITE and NextGen.

The questions revealed that most providers agreed that their EMR allowed them greater accessibility of charts and improved the coordination of treatment between multiple providers.  On questions regarding reduction of transcription costs, improving office communication and reduction of paperwork, only slightly more than half were in strong agreement of seeing a benefit after implementation.  However, a slight majority of providers disagreed when asked if their EMR improved their clinical decision making process or reduced medical errors and improved medical safety.

While it's very encouraging to see that EMR implementation is improving the quality of patient information, it's equally frightening that many still feel that it does not prevent medical errors from occurring - one of the main reasons for going electronic.  Thankfully, EMR technology is still in its infancy and proves to be performing relatively well at such an early stage of development.  Perhaps Software Advice should run the same survey again next year - I'm curious to see how different the results might be.

Click here to see the rest of the survey results and doctors' comments.

Google Health EMR: Rest In Peace

Google Health, mentioned in a previous post, will be closing the virtual doors on their electronic medical  record (EMR) application starting next year.  Health was a free user-friendly service to the public, much like Google's Maps, Docs and Picasa.  Although much to Google's dismay, Health didn't turn out to be nearly as successful as Maps.

In 2008, Google Health was created to as a means to put patients in the driver's seat of their own health and bodies.  Their objective was to "have a real impact on the day-to-day health experiences" of their users.  Health features many easy to use health statistic monitors, ranging from the typical, like blood pressure and blood glucose to the more unusual, like breaths per minute, body temperature and vegetable servings eaten.  Health also allows patients to enter the usual PHR information such as medications, allergies surgeries and insurance info as well as a file upload function to add electronic medical records.

It certainly wasn't a fancy EMR application but it genuinely worked well and it's a shame to see it go.  The reason for its demise is because it didn't reach the broad audience that Google hoped it would and remained contained to a small computer-savvy audience.  In a recent Google blog post, they said it was a difficult decision to discontinue service to Health.  Service will be terminated on January 1st, 2012 but patients' medical records will still be available to download until January 1st of 2013.

The Green Future of Electronic Medical Records

Doctors who have converted their patient health records into electronic medical record (EMR) format could be unknowingly saving the life of both their patients as well as Mother Nature.  A study showed that the use of EMRs will be more beneficial to the environment than paper records.  It goes beyond paper though, using EMRs could actually reduce the amount of greenhouse gas and toxic chemical waste.

Oakland, CA based health plan and medical group, Kaiser Permanente, conducted a study revealing that using EMRs could have a positive impact on the health of the planet.  The obvious way the old method of keeping patient health records is damaging the environment is with paper consumption.  Did you know that creating paper medical charts uses up 1,044 tons of paper per year?  With an EMR system, the need for consumption is greatly reduced - as well as records, practices can have patients can fill out forms online and send them bills electronically.

The study also showed that EMR use reduces the amount of greenhouse gas emissions and that the healthcare industry contributes 8 percent of all greenhouse gases in the U.S. through refrigeration and deforestation.  Viewing patient health records electronically can also cut back on negative environmental impact.  X-Rays actually create lots of toxic waste.  Digitally printing them would cut back on the disposal of silver nitrate and hydroquinone used to make the X-Ray film.  Along with reducing paper use, the biggest beneficial environmental impact using EMRs would have is cutting down carbon emissions - 99,000 tons total, according to Kaiser Permanente.  With EMRs and patient portals, patients can make less car trips in to the doctor's office.  An electronic network accessible from home would eliminate the need to drive to the office to fill out paperwork and get prescriptions filled.  Patients can communicate with their doctors over patient portals through chat, email or video, which can even eliminate the need to see the doctor in person for a consultation.  This would be like taking 300,000 cars off the road.  Now, if saving the environment is not a good incentive to implement EMR systems, then I don't know what is.

Your practice can save the planet too by contacting the expert EMR consultants at EMRApproved.com today.

5 Hints for an Easier EMR Implementation

This year, many doctors this will will start the EMR implementation process for their practices. Understandably, it could be seen as a very daunting process because converting your entire medical records system is a major undertaking and change is never easy. Questions arise such as which EMR software to buy, whether or not the staff will be able to learn it quickly and if the practice has enough money for the system they need.  Here are some helpful hints for an easier EMR implementation transition:

1. Explore All Options

Exploring all available options by speaking with an EMR consultant is the best method for EMR comparison.  Your consultant will ask what size your practice is, like how many providers are in one office, and what type of practice it is.  Ambulatory?  Inpatient?  Also, whether you're a specialty practice or not.  You will then be able to choose from an array of software and equipment that will best suit your needs.  Product demos are generally available for all software platforms to give the doctor and staff the ability to take it for a test drive before buying.  When looking for an EMR system, be sure that it is certified, meaning that it's been certified by the CCHIT and meets Medicare's meaningful use incentive requirements.

2. Carefully Calculate Costs

All businesses worry about budgeting - or at least the smart ones do. It's wise to speak to the practice's accountant before contacting an EMR consultant.  Remember, you will be receiving incentive money for 5 years, so your first year's payment can go toward the new system.  How much do you have in the budget to spend after that?  Along with the initial cost of the system, factor in the operating cost for the next 5 years.

3. Purchase the Right Equipment

With a budget in mind and after a consult with an EMR systems expert, the next step would be to pick out equipment to that works with the software. Generally, an equipment setup would include a desktop computer and at least one laptop or tablet to carry around to enter patient data.  A printer is necessary as well as a scanner for images.  An additional hand held scanner may be helpful for barcodes, such as for prescriptions. 
A cart work station may also be needed if using a laptop or tablet.  Medical devices are also available that can be attached to a computer via USB cable that are compatible with EMR systems that directly input patient data.

4. Have Tech Support Handy

Having a tech support team on speed dial cannot be stressed enough.  Their job is to help you with any software and equipment questions you might have about your new EMR system.  Many times, instruction guides for software is online and really hard to find when in a hurry and device manuals are about as thick as a phone book.  The quickest answers can usually be found through tech support's hot-line.  Be sure each one of your staff that uses the new system has the number on hand as well.  

5. Educate Your Staff

After all the correct equipment has been purchased and the software set up, your office staff will need to be educated on how to use it.  Be sure you know it as fully as possible in case they might have questions.  Hold training sessions or assign a project manager to teach the rest of the team.  Once again, have the number of your tech support easily accessible for questions.  The more training your staff has with the new system, the more comfortable they will be using it with the patients.

Getting Intuit: Staking Claim in EMR Territory

Thanks to the Medicare meaningful use incentive, the electronic medical records (EMR) technology industry is huge.  Ok, if it's not already huge, it's certainly growing at an exponential rate.  As doctors' demand for EMR hardware software programs increases, the supply scrambles to keep up.  Any smart business would know when to jump onto a bandwagon (stuffed with money) when they see it.  That's precisely what QuickBooks creator Intuit plans on doing.  For most, Inuit is a familiar face in town - the jack of all business trades.  It's the butcher, the baker but...not the candlestick maker.  Well, not yet at least.  

The Software Advice Blog by Austin-based consulting firm Software Advice wrote a post about Intuit's desire to make a name for themselves in the electronic medical records (EMR) industry.  The company made it's way into the doctor's office by acquiring patient portal MedFusion in May of last year, but has yet to develop an EMR system.  The blog post then focuses on who Intuit might want to acquire.

The post provided a list of requirements they're looking for in a company such as it must be a smaller vendor who specializes in EMR and patient management for small practices.  The company must also have a low price point, an easy to use interface (such as Turbo Tax), must be reputable and already have a name for itself, have an ability to work with cash-based practices (specialists like chiropractic and psychiatric therapy) and be web based.   Software Advice's blog also gave a list of the six companies in which they saw potential.  They even added a handy chart for readers to compare and share their opinion.  The list of vendor is as follows:  Medisoft/Lytec, Office Ally, Health Fusion/MediTouch, Practice Fusion, Kareo and Advanced MD. 

According to the chart, the obvious winner is Practice Fusion, who fulfilled all of Intuit's requirements.  Practice Fusion is a free (subsidized by in-program advertising), completely web-based EMR system and is partnered with Kareo, a patient management and medical billing platform.  The thing is, Intuit would have to buy both companies.  At the end of the blog post, there's a survey for readers to take where they can vote which company they think Intuit should go with.  My vote would actually go to AdvancedMD.  AdvancedMD was actually just acquired by ADP in March of this year and like Intuit, has a recognized name in other industries - ADP's being a provider of human resources and payroll solutions.  Admittedly, AdvancedMD does not meet all the listed criteria, but then again, can you think of any new partnership that has met all your requirements from the get-go?  They get my vote because they actually do rank well in three important categories: a simple user interface, a large market share and are a completely web-based system.  Another thing that sells me on AdvancedMD is that not only does ADP a name in human resources and payroll, but they also have a reputable dealer management system for auto dealers.  In other words: they already have experience in EMR systems, but for cars.  Software Advice's blog mentioned that the system might be a bit expensive for Intuit, but as with all good products you love and names you can trust, spending the extra money is usually worth it.

Wait, So What Is a PHR Again?

So you might be wondering what a PHR is exactly.  All the acronyms can be a little confusing!  There are three terms you will see being used here on a regular basis: EMR, EHR and PHR.  The three are different entities but are all tied together to create a flow of information. 

An Electronic Medical Record, or EMR, is an electronic health record of an individual created and maintained by licensed physicians and authorized staff from one health care organization.  For instance, the record created by your primary care physician.  If have seen your doctor or their medical assistant walking around with a laptop or an iPad in the past few years, they're keeping your records electronically now instead of in the old bulky manila folder. 

An Electronic Health Record, or EHR, is the collective electronic health record of an individual created, shared and maintained by licensed physicians and authorized staff from multiple health care organizations.  An example of an EHR is if you have start going to a specialist, your specialist can access your EMR from your primary care physician and add to it and your primary physician can see the notes from your specialist.

A Personal Health Record, or PHR, is a collective electronic personal health record of an individual created, shared and maintained by licensed physicians and authorized staff from multiple health care organizations that the patient keeps for their personal use.  The patient is the legal owner of their PHR and has the right to share it with others such as family members.  PHRs can be accessed and managed from web applications called patient portals, where patients may able to communicate with their doctor as well as privately view their medical records.  Patients have the ability to to add their own information to their PHRs, such family history, vaccinations and previous surgeries and illnesses.  PHRs can also be used to track test results such as blood pressure, blood sugar, weight, BMI, cholesterol and triglycerides, which can be beneficial to both you and your physician.