Few Pediatricians Use Specialty Pediatric EMR Software Solutions

Only a tiny percentage of pediatricians use a specialized pediatric EMR, says the National Ambulatory Medical Care Survey.  EMR and EHR use, according to the results, depends largely on the practice’s size and the gender of the pediatrician.  The results were found to be troubling by experts in the pediatric field, as it means that important exams and procedures essential in pediatrics could be unsafely documented.

368 pediatricians out of 646 responded to the National Ambulatory Medical Care Survey .  The physicians were nonresident pediatricians belonging to the American Academy of Pediatrics in either offices or clinics.  In 2009, only 3 percent of survey respondents had implemented an EMR or EHR tailored to the pediatric specialty.  54 percent reported to use a general EMR and this number continues to rise because of the Meaningful Use reimbursement incentives.    

Pediatricians appear to be one to two years behind the national average in implementing fully functional EMRs, says the survey report’s author.  The biggest barrier to implementing a pediatric EMR is the cost, reported the responding pediatricians.  Along with cost, finding a software solution that meets their practice’s specific needs was the other reason.  Surprisingly, Meaningful Use isn’t a big motivator for upgrading to specialty software; growth charts are the only thing close enough to meeting actual incentive criteria.  However, using a general internal medicine EMR lacks commonly used pediatric templates such growth charts, immunization records and weight-based drug dose prescribing, leaving the pediatrician to complete them with paper charts or create a new template from scratch.

The survey also revealed that certain factors contribute to who implements and who doesn’t.  Single and two-physician practices were 5.1 times less likely to implement a basic EMR than a larger multispecialty group practice or hospital.  General pediatric clinics were more likely to have an EMR than specialty pediatric clinics. And curiously, the pediatrician’s gender shown to play a role in implementation as well - males were twice as likely to have an EMR software solution in their clinic than females.

Regular Exercise Keeps Both Body and Mind Strong

Exercise is good for you.  Regular physical activity in adults helps maintain a healthy body weight, reduces symptoms of depression and staves off heart disease and Type II diabetes.  Ok, this is not really news to anyone, but according to the researchers at the University of California Irvine’s Department of Neurology, physical exercise during the golden years could also reduce the odds of dementia.

Dementia is the loss of brain function that affects memory, judgment, behavior, perception and the ability to understand language.  Alzheimer’s disease is the most common form of dementia in the elderly, affecting one in eight in the United States.  Vascular dementia is another form caused by multiple small strokes.  Recording the amount and type of physical exercise in the neurology EMR charts of elderly patients could determine their risk for dementia or the progression of it. 

UC Irvine’s study examined the relationship between physical strength and performance and dementia in participants 90 years and older.  The tests consisted of a point system based on physical performance that included a 4 meter walk, 5 chair stands (standing up with arms crossed), balance while standing and grip strength; the average age of the 629 participants was 94.  The study found that those who scored lower in the performance tests (especially walking) were almost 30 times more likely to have dementia than those who scored well.  The Department of Neurology’s team suggested that further research be conducted to fully understand the why there is a correlation between poor physical performance and cognitive function, but concludes that there is indeed a relationship between the two and the neurodegenerative process may have a direct effect on one’s ability to perform basic physical activities.  

Psychiatry EMR Reporting Prevents Future Psychosis in Adolescents

Schizophrenia and bi-polar-caused psychosis can be debilitating for those living with it.  Symptoms like delusions and hallucinations make sustaining a job or attending school very difficult, if not near impossible.  New research has proven that if addressed early enough, intervention can prevent the deterioration of educational, occupational and social abilities from psychosis in teenagers and young adults.

By recording young patients’ primary psychotic episodes in a psychiatry EMR, mental health professionals and pediatricians can detect those who might be at risk for developing a debilitating psychosis and create in intervention plan to prevent the condition from progressing.  According to a study by Columbia University in New York, early intervention during the critical period for teens and young adults (within two to five years of the initial psychotic episode) can decrease the chances of longer-term psychosis into adulthood.  

Columbia’s study included 20 participants aged 12-20 years of age and included 16 males and 4 females, all diagnosed with their first psychotic episode within the past five years.  Participants were evaluated using a scale based on levels of substance abuse, depression, disability and depression.  The study’s representative, Dr. Michael Birnbaum, defined psychosis as a process that starts in utero and progresses into the patient’s 20’s and 30’s until a psychotic episode occurs.  The research team took an approach by addressing mental illness as a progressive pathologic process; they believe there are stages of mental illness and different methods of intervention for each stage.

Using their PEER program (Prevention, Education, Evaluation, Rehabilitation), symptoms were managed through medication, individual and group intervention, help patients plan goals, provide education about their illness and prevent exacerbation.  Initially, participants reported baseline high levels of anxiety and depression and 70 percent were considered a suicide risk.  After 3 months of the intervention program, the participants reported a significant decline in their anxiety and depression.  Reported disruptions in work and school also declined – from a 75 percent baseline to 55 percent three months later.  The Columbia researchers plan on following the participants throughout their lives and monitoring their progress, building a model for the field of adolescent psychiatry. 

Praise All That is Techie: EMR Jobs Are In Demand

It pleases me to report that growth is occurring in the health information technology sector of the job market.  More EMR technicians are needed to meet the demand of doctors and hospitals implementing EMR systems in order to meet eligibility requirements to receive CMS reimbursements.

EMR Implementation Technicians serve as liaison with clinical staff regarding training and product related needs.  The technician’s job is to take the EMR templates to fit them practice’s specific needs.  Say the client is a cardiologist, the tech will design the patient encounter and exam templates using to build a specialty cardiology EMR using cardiopulmonary-related vocabulary and diagrams.

Consultants take the working knowledge they learned as a technician and step it up a notch.  It is imperative that they know the EMR software product inside and out and with their experience, they can confidently identify the implementation needs of practices and hospitals.  Consultants provide the guidance needed to meet Meaningful Use criteria and suggest software solutions packages that would work best for them.   

Desired Qualifications:  Background in medicine and a desire to learn EMR software*

Compensation:  $50,000-$60,000 (entry level) and $70,000 and upward (with previous experience)*

*Source:  CNN Money

Taking the (Sinus) Pressure Off with Allergy EMR

Unfortunately, for many people, allergies aren’t just a springtime occurrence and pollen and mold continue to bother them throughout the year.  Most folks know the feeling of a fall sinus infection brought on by allergies all too well.  The good thing is that allergies are treatable, especially when assessed by an ENT specialist.  Allergy EMRs help otolaryngologists properly diagnose allergies and sensitivities as well treat the common conditions and complaints that accompany them.

Besides the most commonly known irritants, many people have allergies and intolerances to more unassuming things like pet dander, food, latex and medication.  To find out exactly what bothers the patient, the physician will perform sensitivity tests on either the skin, with a blood test or by changing the patient’s diet.  By using an allergy EMR, the ENT specialist can follow the testing procedure templates for scratch, patch and intradermal skin testing and enter the data and outcomes requested in each step of the procedure.  Most EMRs also interface with major labs, making it easy to request blood tests and receive results in a short period of time.  If food intolerance is in question, the doctor may ask the patient to keep a food diary, eliminate the foods in question (such as wheat, dairy, eggs or soy), log their results over a period of time and submit to them via patient portal.

Allergies also come with many other uncomfortable symptoms, so allergy EMRs come with exam templates to diagnose and manage them.  With a document management feature, image, video and audio files can be uploaded into the patient’s chart, enabling the physician to describe rashes, hives and eczema in full detail.  Chronic sinus infections commonly plague allergy sufferers, so EMRs come equipped with a customizable template to document which sinuses are being affected (frontal, ethmoidal, sphenoidal or maxillary) and allow the doctor to view X-Rays and previous surgeries and procedures to treat the condition.  Allergens also trigger asthma; the clinical decision support feature assists with the assessment of the severity of the asthma and come up with a management plan that works best for each specific patient.

CMS Releases Final Stage 2 Meaningful Use Rules

Well folks, it’s final.  HHS Centers for Medicare and Medicaid Services released the final rule for Stage 2 Meaningful Use last Thursday.  In fact there were two final rules released; along with Stage 2 Meaningful Use criteria for eligible physicians and hospitals, a companion final rule was released for medical software developers by the Office of the National Coordinator for Health Information Technology as a guide to the design and certification of electronic health record systems.

A press release confirmed that Stage 2 will begin in 2014, assuring eligible professionals that no one would be required to meet Stage 2 criteria until 2014, regardless of when they attested Stage 1.  The release of Stage 1 focused teaching eligible professionals how to capture data electronically.  Stage 2 emphasizes more on the exchange of captured data between other healthcare providers and allowing patients to access their medical records online.  Two new core objectives were added:  eligible providers must use secure electronic messaging to communicate with patients and eligible hospitals must track medications from order to administration automatically via assisting technologies with an eMAR. 

ONC’s final rule regarding EHR medical software focused on Certified EHR Technology definitions, interoperability and security.  According to the press release, eligible providers will be able to use their 2011 edition Certified EHR Technology until 2014.  Certified EHRs will need focus on encryption of data if it is stored in an end-user device and allow patients the ability to securely view their medical information and communicate with their physician.   Standards for transitions of care and referral summaries for the transmission to be viewed and downloaded by other healthcare providers must be met.  A common interface standard for the exchange of test results between the lab, providers and hospitals was also a new certification criterion adopted for 2014.  

The Cutting Edge of Pediatric EHR and Circumcision

According to an article published yesterday on NPR.org, a new report by The American Academy of Pediatrics claims that circumcision of newborn males proves to be beneficial to the infant as well as the grown man’s health later in life.  The beauty of electronic health records is the fact that they are mobile and follow the patient through all stages of their life.  This study could be the perfect opportunity for pediatric as well as urology EMR to shine by proving or dispelling the study’s accuracy over time.

Pediatric EHRs provide a detailed step-by-step circumcision guide for pediatric urologists to follow during the procedure with the specific templates for exams and procedures on infants and will properly document the procedure in the child’s medical record.   If the child moves and sees a different pediatrician, they will be able to quickly pull up the patient’s complete medical history where the circumcision will be noted.  The author of the report claims that the benefits of circumcision are immediate by the reduction of the risk of urinary tract infections in babies.  Customized urinary tract infection templates allow pediatricians to indicate whether the baby is circumcised or not and keep record of which patients appear to be having a higher occurrence infection.

The EHR will continue to record clinical data throughout the boy’s childhood and adolescence.  In another study, teens were shown to be more honest about their sex lives when given the opportunity to answer questions via tablet/kiosk instead of verbally in person.   The responses are then added to the rest of the exam data from that encounter and doctors will order tests for STDs if the teen is considered to be at-risk.  Through the EHR, higher-risk patients can also be flagged as needing a reminder to get tested more frequently as well.  Following the patient from infancy, through adolescence and well into adulthood, their medical data can be easily incorporated into the urologist’s EMR later in the event that the man develops more complicated sexually transmitted infections or penile cancer.  A lifetime of data from electronic health records will provide unbiased evidence-based information that can either prove or debunk the findings of the recent report.