What Is The Average Time Before A Practice Is Comfortable With Their EMR?

Making the shift to an EMR-based practice is sure to impact your work-method in more ways than you can count. This impact recoils with a significant amount of change that practitioners are known to dislike as it brings them to a rather discomforting and unfamiliar territory. In fact, a research by evitontest.info suggests that the biggest obstacles to EMR implementation have been physician resistance and lack of useful information or not knowing where to start.

It does not take much to realize that the manner in which you approach these obstacles will determine the time it will take your practice to get comfortable with the EMR. Therefore, the real challenge resides in adopting realistic measures to help your staff internalize the new technology and utilize it to its maximum potential.


EMR Training and Change Management

As a practitioner, your goal is not just to accommodate the EMR in the daily work life of your practice but to have it used in a way that contributes to your productivity and Meaningful Use objectives. This process can stretch from a few months to even more than a year depending on the quality and effectiveness of EMR and IT training that is imparted to all levels of the practice. To begin with, all EMR users must be equipped with basic IT and computer skills to help them understand and efficiently execute the more advanced EMR processes. Only when they are comfortable with routine activities like using the mouse, printing, scanning, working with files and basic graphical user interface, should they be put onto working with the EMR. Sure, you want to take the system live as soon as possible, but you must allow for a learning curve, not expecting them to construct a whole sentence when they still haven’t been taught the alphabet!


EMR Implementation - One Step at A time

You must keep in mind that your staff is already resistant to this new technology. Overwhelming them with a load of new information to save on training time will only demoralize them and there is a strong possibility that going too fast may have them give up on it altogether. Taking one step at a time is a good idea to help your employees feel comfortable and confident about the software. Opt for a gradual and progressive training module that steadily moves from feature to feature instead of bombarding them with a whole new world of technical jargon and processes they are not likely to befriend.
Also, if an EMR feature is to be used only by a certain set of employees, training the whole staff on that feature will only eat into their grasping ability for the features they truly require. Hence, you must ensure that your training plan takes this redundancy into account and focuses on relevant function-based features.


Motivation Boosters

Without a doubt, for effective and expeditious EMR implementation, the motivation has to come right from the top. Physicians must convey the importance of incorporating the EMR into the practice and leading by example, should display the dedication and commitment they expect from their staff. In order to get employees to accept the new technology without feeling like they’re being punished, physicians must involve them in decision-making processes for training programs, schedules, time lines and so on.

To put a number on how long it takes for a practice to get comfortable with their EMR, one has to take the above factors into consideration. Instead of intimidating your staff by rushing in, focus on building a strong base and steadily look to capitalize on it. This might take you an additional few months to completely ‘go live’ and use it like second nature, but it is an investment that is bound to reap long term benefits of productivity and improved quality of care.


References:

1.    http://evitontest.info/tag/emr-implementation/
2.    http://www.healthcareguy.com/2011/03/12/waiting-until-2012-on-attestation-for-meaningful-use-doesnt-mean-you-shouldnt-buy-an-ehr-in-2011/
3.    http://hubpages.com/hub/Meaningful-Use-Made-Easy-Understanding-Core-Objectives
4.    http://www.revenuexl.com/blog/bid/23066/8-Cardinal-Sins-of-Electronic-Medical-Records-EMR-Training
5.    http://www.ctsguides.com/Training-makes-EMR-Software-Investment-Succeed.asp

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What Do Practices Look For When Hiring A Medical Assistant?

Digitization of the healthcare industry has lead to an increasing demand for qualified, experienced and IT educated medical assistants to help practices and physicians meet their Meaningful Use objectives. Although this has opened up many new opportunities for job seeking medical assistants, it has also resulted in practices raising the bar pertaining to candidate quality, experience and training standards.

Jobs and Duties of a Medical Assistant

As a medical assistant, you are in charge of performing administrative and basic clinical tasks of the practice. While your job description may differ depending on the size and location of the practice, your basic responsibility is to ensure the smooth and efficient running of day to day operations and clinical tasks that are assigned to you. The clinical duties that a medical assistant is eligible to discharge vary according to state law. Practices require medical assistants to be well-versed with patient and laboratory work, administrative activities like maintaining medical records, bookkeeping, filing tax returns and insurance forms, hospital admissions, appointment scheduling, patient-practice correspondence, billing and other practice management duties.

Some practices require medical assistants to help physicians with pre and post treatment procedures like recording vital stats (height, weight, blood pressure, temperature), medical histories, drug allergies and routine lab tests. They may also be expected to provide first aid, remove sutures, change bandages, give injections and take X-rays or other scans.

Formal Education, Training and Certification

Although practices impart training on the job, experienced candidates with formal education, certification or a degree are generally preferred. 1 year certificate or diploma programs, or 2 year associate degree programs are offered in vocational-technical high schools.
 
Candidates who have received formal training in medical assisting are well-versed with anatomy, physiology, medical terminology and administrative functions like maintaining records, transcripts, accounts and insurance processing. Clinical and diagnostic procedures, laboratory testing, pharmaceutical proficiency, first aid are also covered in these programs along with office management activities, skills and techniques. As formally trained candidates already have a good command over the duties and functions of medical assisting, they naturally hold the edge over novice medical assistants in job interviews and selection procedures.


Healthcare IT Skills

Practices require medical assistants to look after the front office administration including staff management, appointment scheduling, filing reports, maintaining patient charts, bookkeeping, billing, tax and insurance processes. With the federal government incentivizing Meaningful Use of EMR implementations, a majority of administrative and clinical tasks have been digitized. As the onus of meeting Meaningful Use objectives lies largely with medical assistants, practices have started to consider IT skills as indispensable to medical assistant skill sets and resumes.

Soft Skills

Medical assistants must be equipped with good communication skills. As they are essentially the connecting link between patients and physicians, it is important for medical assistants to develop soft skills that make the patients feel welcome and comfortable in a place they don’t really want to be in. Interacting with patients and their families, providing them all the information they would need in order to ease their apprehensions, displaying empathy and understanding the delicacies of communication in a dispiriting hospital environment, are skills that practices are imploring their medical assistants to imbibe and develop.

Lastly, medical assistants must be capable of handling intense emergency situations placed against chaotic emotions, flying egos and anxieties. It is absolutely essential for them to maintain a calm, patient and positive attitude to focus on keeping their nerves intact and getting the job done.

References:

1. http://medicalassistant-jobs.blogspot.com/2010/03/communication-therapeutic-skills-for.html
2. http://www.ehow.com/about_5341447_general-skills-needed-medical-assistant.html
3. http://technology4doctors.blogspot.com/2011/05/information-technology-orientation-for.html
4. http://www.medicalassistantx.com/expectations-of-behaviour-and-medical-assistant-code-of-ethics/
5. http://www.medicalassistantx.com/know-the-basic-medical-assistant-requirements/
6. http://www.medicalassistantx.com/the-skills-of-the-medical-assistant/
7. http://www.medicalassistantx.com/whatdoesamedicalassistantdo/

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What Do Hospitals Look For When Buying A Practice?

Hospitals today are aggressively engaging in practice acquisitions in their local markets.  Medical Group Management Association (MGMA) statistics reveal that over 50% of physician practices are now owned by hospitals.  Before buying a practice, hospitals assess the practice’s value in terms of its patient volumes, number of hospital referrals, estimates of patient turnover, and so on.

Sustainability

Hospitals usually avoid buying practices that are in the last stages of their life cycle. Practices that cannot offer sustainability do not make good prospects as they lack future planning and goals. It is true that hospitals get tempted to buy out retiring physicians only because of their reputation and respect in the medical community. However, a growing number of hospitals have started to realize the importance of the asset value of a practice in terms of its long-term sustainability, to make the acquisition profitable.

Financial Stability of the Practice

The practice under consideration must be financially stable. A thorough financial and performance evaluation of the practice is conducted by hospitals in order to ascertain the feasibility of the acquisition. The profitability of the practice is determined by reviewing its financial history. Trends, patterns and discrepancies in the practice’s records help hospitals estimate their return on investment and revenue growth from the acquisition.

Referrals

Hospitals look to expand their referral networks and increase profits by acquiring private practices. This not only widens the hospital’s patient base but also reduces outpatient competition with local physicians. Practices that will add to a hospital’s inpatient and outpatient referral base will naturally be considered better buys.

Communication Skills

Medicare has been pressing hospitals to address inpatient medical errors that seriously affect patient-safety.  As a result, hospitals are looking for practices and physicians that value patient-doctor communication as well as communication between the doctor and other employees. Many hospitals conduct a communication audit of the physicians in the practice to ensure high patient-safety standards and quality of medical care.

Unity of Service and Quality Goals

Hospitals are looking to overcome the historic physician – hospital clash that has lead to many failed acquisitions. They are looking for practices that share similar service and quality goals in order to improve the acquisition’s strategic alignment.
Practices where the physicians support hospital goals and are more agreeable to work in collaboration with the hospital’s service, quality and organizational objectives are considered better prospects.

Agreement Contract

The physician employment contract is of crucial significance in determining a practice’s rank in the acquisition process. Hospital boards want physicians to align themselves to hospital goals and work ethic. Physicians, on the other hand, are not known to compromise on their autonomy and independence. Compensation is another major issue. Practices that agree to balance the terms and conditions of both parties without demanding a contract that sways majorly in their favor are naturally preferred.


Practice acquisitions require hospitals to review and consider a number of financial, administrative and personal factors that determine the feasibility and profitability of the deal. It is important for both the players to respect each other’s objectives, concerns and work cultures. Open communication and a collaborative approach will allow practices and hospitals attain higher profitability without compromising on their individual professional and personal goals.


References:

1.    http://www.healthdirections.com/articles/acquiring-a-physician-group/
2.    http://www.deltahealthcare.com/pdf/Why-Hospitals-Buy.pdf
3.    http://www2.timesdispatch.com/news/2011/jan/09/tdcomm03-hospitals-are-buying-private-medical-prac-ar-760564/
4.    http://www.darkdaily.com/hospitals-on-buying-spree-snap-up-physician-practices-531
5.    http://blog.acpinternist.org/2010/04/hospitals-check-doctors-communication.html
6.    http://www.beckershospitalreview.com/news-analysis/10-best-practices-for-increasing-hospital-profitability.html
7.    http://www.beckershospitalreview.com/hospital-physician-relationships/3-considerations-for-hospitals-acquiring-practices.html

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Choosing the Right EMR for Your Practice

Converting your practice into an EMR-based one has the potential to change the entire working of your practice. It is a decision that requires you to carefully review a number of factors that will help you pick an EMR that best suits your goals and vision for the software.

Your EMR Must Understand Your Practice

 
In order to pick an EMR that best understands your practice, it is important that you understand it first. Before embarking on the selection process, you must make a note of the specific requirements of your specialization that must be supported by your EMR. Workflow and processes, customized templates, Meaningful Use objectives differ from one specialization to another. Your EMR must adapt to these parameters in order to maximize its usability and usefulness. You must also be aware of your reasons behind switching to an EMR. Whether it is improving the quality of care, your practice’s productivity, making more money, meeting Meaningful Use or simplification of workflow; to know what is driving you towards conversion will help you pick an EMR that suits your needs, goals and requirements.

User-friendly and Easy to Use EMR

A user-friendly and easy to use EMR helps lower the resistance most staff personnel display towards adopting new technology in their daily work lives. An EMR may be laden with stunning features and customizations, but a complicated interface will not allow your staff to be able to use the software to its full potential, rendering it useless. A handy, convenient to use EMR will help you achieve maximum productivity without wasting time on training and implementation.

EMR Features
 

Your EMR must provide features that serve the unique requirements of your specialization and enable you to achieve Meaningful Use. A lot of EMR systems are stuffed with redundant features that your practice will never need. It is important that you keep it simple by getting only the bare necessities incorporated, at least to begin with. Later, if you feel that a certain EMR feature can help you improve a certain aspect of your practice, you can always build on it by asking your vendor to provide you the required update.

Client-Server vs. Web Based EMR
 

Depending on the size, location and nature of your practice, you can choose between client-server EMR systems and web-based EMR systems. Client-server EMRs are locally installed in your system whereas web-based EMRs are remotely hosted and accessible over a secure web connection. While a number of very good and highly recommended web-based EMRs are available free of charge, client-server EMRs carry installation, training and maintenance costs. Regular, free updates, suggested by practitioners make web-based EMRs more flexible and dynamic as compared to client-server systems that require you to pay for such services.

EMR Training and Customer Support
 

While most EMRs sell on features, they lose out on their customer support. You must ensure that your EMR vendor has an efficient and responsive customer support platform. Technical and programming support must be provided with the least possible response time. They should also be willing to extend training and staff counseling services to help your team adopt the technology and get comfortable with the whole conversion process.  

Involve Yourself in the EMR Selection Process

 
As the key stakeholder in your practice, you must involve yourself in every step of the selection and conversion processes. Ask questions. Tell the vendors exactly what you want from your EMR. Help them understand your practice and your EMR requirements. Be aware of the preparedness and general attitude of your staff towards the conversion. Involve them in the selection process and be open to their suggestions as they are the eventual users of the system. Let them know how determined you are to execute the conversion and motivate them to identify with the approach.

Credibility of your EMR vendor

You must review the credibility and reliability of the vendors you have book-marked for consideration. Some points to keep in mind while making the final selection are the cost per license, experience in your specialization, customization and templates for your specialty, features, updates, out-of-pocket costs, customer support and training. Conduct a thorough research online and among other practitioners in your specialization who have purchased their EMRs from the same vendor. CCHIT Certification is a good benchmark to begin with. It does not guarantee performance and quality, but it is always safer to go in for a CCHIT certified EMR than to invest in one that is not.

Cost of the EMR

 
Cost is one of the prime factors that will influence your decision. Conduct a detailed cost-benefit and ROI analysis before signing up for an EMR. However, don’t go about searching for the cheapest EMR in the market that will not help you or your practice meet its goals and the desired level of productivity. This said, ‘costlier the EMR, the better it is’ also does not stand true. A good EMR will satisfy the various criteria discussed above and round it off with a reasonable price to match. Call for proposals and quotes from vendors that are good on your checklist, compare their terms and conditions, provisions and prices and only then make a decision. Finally, do not proceed until everything that has been discussed and agreed to, is taken down, written and duly signed.


References:

1. http://technology4doctors.blogspot.com/2009/11/top-10-mistakes-that-doctors-make-in.html
2. http://www.binaryspectrum.com/electronicmedicalrecord/how-to-choose-the-right-EMR-for-your-practice.html
3. http://www.morefreeinformation.com/Art/171972/24/How-to-Choose-the-Right-EMR-Software-for-Your-Medical-Practice.html
4. http://emrguy.com/ehr-software-how-to-choose-the-right-system/

5. http://technology4doctors.blogspot.com/2011/02/emrs-providing-indian-doctors-with-edge.html

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Are State Funds available to help off-set the cost of EHRs?

EHR funding as part of the information technology incentive program can be availed through Medicare or Medicaid. The primary difference between Medicare and Medicaid is that the Medicare Incentive Program is federally run by CMS and the Medicaid Incentive Program for EHR funding is provided by State governments. Choosing between Medicare and Medicaid EHR incentive programs requires you to consider some important points before taking a decision.

Eligibility Criteria for Medicaid EHR Incentive Program or State Funds

To avail of State Funds under Medicaid for your EHR, practitioners must have a practice that is 30% Medicaid. This number is lower for pediatricians at 20% and 10% for Acute Care Hospitals. Some providers like nurse practitioners, certified nurse-midwives, dentists, and physician assistants who practice in a Federally Qualified Health Center or rural health clinic that is led by a physician assistant, are eligible ONLY under Medicaid, i.e., they can only use State Funds to fund their EHR.

Differences between Medicaid EHR Incentives and Medicare EHR Incentives

There are no patient volume thresholds in the Medicare EHR Incentive Program. In terms of eligibility, if you can be paid under the Medicare physician fee schedule, then you can participate. Besides this, even though the requirements are similar, there are a number of important differences to look out for when making the selection. You can switch between the two programs only once. It is therefore essential to carefully evaluate the two plans to be able to settle upon the one that best suits your practice.

Given below is a comparison chart of the primary components of the Medicare and Medicaid EHR Incentive Programs.
 Source: http://www.hcms.org/

State Funds for EHRs in Your State

So far, the following states have launched their EHR Incentive Programs:
1. Arizona
2. Connecticut
3. Rhode Island
4. West Virginia
5. Alabama
6. Alaska
7. Indiana
8. Iowa
9. Kentucky
10. Louisiana
11. Michigan
12. Mississippi
13. Missouri
14. North Carolina
15. Ohio
16. Oklahoma
17. Pennsylvania
18. South Carolina
19. Tennessee
20. Texas
21. Washington

Other states will launch their Medicaid EHR Incentive Programs during the summer and fall of 2011. For more information on Medicaid or State funded EHR programs, visit, https://www.cms.gov/

Expected launch dates and contact details for each state are available at https://www.cms.gov/apps/files/statecontacts.pdf

References:

1. http://www.familydocs.org/files/MeaningfulUseOverview1.pdf
2. http://trusted.md/blog/mnpryan/2010/09/29/incentive_program_for_emr_funding#axzz1RPxhkARZ
3. http://www.revenuexl.com/should-you-choose-the-medicare-or-medicaid-incentive-plan-/
4. Medicare Medicaid EMR Incentive Comparison TMA From HCMS
5. http://srssoft.com/medicare-vs-medicaid-ehr-incentives
6. https://www.cms.gov/apps/files/statecontacts.pdf
7. https://www.cms.gov/EHRIncentivePrograms/35_Basics.asp#TopOfPage
8. https://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asp

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Can FREE EMRs get your practice through Meaningful Use?

With the federal government pushing EMR implementations by incentivizing their Meaningful Use, providers of Healthcare Information Systems are all rushing in to get a bite of that booming business pie. As a result, doctors and practitioners find themselves lost in a sea of information and complicated jargon about the various types of EMRs and EHRs available, each claiming to be the best for your Meaningful Use objectives.

Traditional EMR business-models have priced EMR systems for tens of thousands of dollars, making it prohibitive for practices to adopt them. However, with EMRs now being a statutory requirement, an increasing number of Healthcare IT providers are starting to work on revenue models that enable them to provide practitioners with outstandingly efficient EMR systems, absolutely free of cost.

Advantages of FREE EMRs over Locally-Hosted Priced EMRs

It is easy to assume that a free EMR may be inferior in terms of quality or has limited number of features and will hinder your practice from qualifying for the $44,000 incentive pay. The fact is that most free EMRs are web-based systems built with inherent technological features that not only allow them to be provided for free but also lend them a number of advantages over costly, locally hosted EMR systems.

FREE EMRs Cost Nothing

Being web-based, free EMRs can save you the cost of purchasing, installing and maintaining a private, local server which is a primary requirement for traditional, locally-hosted EMR systems. All you need to have, to get a free EMR up and running is a computer and a secure Internet connection. For smaller practices as well as for practices that lack the capital to invest in client-server systems and additional I.T staff to maintain local EMRs, free, web-based EMRs are an ideal choice. Because they are absolutely free, they carry no out-of-pocket, hidden charges that come to the fore after you have subscribed. With free EMRs, you can direct the $44,000 incentive pay to improve and develop your practice, instead of using it to pay for a local EMR.

Convenient and Easy to Use

Remotely hosted or web-based free EMRs are typically more user-friendly and easy to use as compared to other complicated EMR systems that take months of getting used to. Infact, free EMRs that are available in the market today, take only minutes to activate, saving you from all the lengthy, time-consuming installation processes that accompany local EMRs.

Data Security and Accessibility

Free EMRs, contrary to popular perception, are highly secure and protect your data by functioning under stringent confidentiality protocols. Remote hosting of free EMRs allows data to be accessed from any computer, anywhere, over a secure Internet connection. To add to that, your data is backed up on the remove server, completely discarding the possibility of data loss or system breakdowns. On the other hand, local systems are susceptible to hardware breakdowns, power cuts and system failures that bring your practice to a halt until someone arrives to restore it.

Features Required for Meaningful Use

Most local EMR systems contain a limited set of features that help you meet only a few of the required number of Meaningful Use objectives. You are thus forced to install supplementary systems to fulfil other objectives, amounting to additional cost, time and effort. One of the main reasons why free EMRs are so popular with practitioners today is because most of them are equipped to deal with feature requirements for all of the 20 objectives.


Feedback and Interaction with Users

Many Free EMRs make their money through the ads they place at the bottom of the system page. The success of an ad-based model such as this lies in how well and how much its users are able to employ it. Thus, free EMR providers take continual feedback and suggestions from the user community and incorporate them in the system. Free EMRs keep evolving with newer practices and suggestions, giving you immediate and regular updates of the software without having to install anything locally. On the other hand, local EMRs once sold are rarely updated, with each update requiring the EMR vendor to personally install it.


References:

1.   http://www.revenuexl.com/blog/bid/19051/Top-10-Electronic-Medical-Record-Software-Features-for-every-Physician
2.    http://digital-medicine.posterous.com/what-are-the-advantages-of-using-web-based-em
3.   http://www.binaryspectrum.com/electronicmedicalrecord/which-is-better-web-based-EMR-system-or-client-server-EMR-system.html
4.   http://emrguy.com/what-are-the-advantages-of-using-web-based-emr-software/
5.   http://www.practicefusion.com/pages/free_ehr.html

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America’s Top CCHIT Certified EMR Systems

With an estimated 300-400 companies peddling to sell their EMR systems in the country, medical practitioners find it overwhelmingly difficult to choose an EMR system that is best suited to their practice and specialization. In order to narrow down the multitude of options available in the market today, a good idea would be to start by reviewing America’s top CCHIT Certified EMR systems.

What is CCHIT Certification? Does it guarantee EMR quality and performance?

CCHIT is an independent, non-profit organization that develops criteria for its CCHIT Certified® program based on nationally recognized standards to certify EHRs. These certification criteria are developed by your peers – work groups of practicing clinicians and health information technology experts – taking into account the state of the art of EHRs and your complex needs.

CCHIT has been certifying EHRs since 2006.  For more information, visit http://www.cchit.org

CCHIT Certification is a good initial requirement that can help you limit the range of your search to a realistic number. However, it does not guarantee EMR quality and performance and should not have the final say in your decision. Because an EMR is CCHIT Certified, it does not imply that its features will help you meet Meaningful Use objectives.

Once, you have zeroed in on a list of CCHIT Certified EMR systems with the best reviews and recommendations in the market, it is your prerogative to determine which one of these systems has features that will help your practice function efficiently and meet Meaningful Use objectives.

Features of a good CCHIT Certified EMR System

Besides being CCHIT Certified, a good EMR system must provide you with the following features:

• It must be user-friendly and easy to understand.
• It should be low on maintenance and should be easy to update.
• System updates should be free and regular.
• It must include features that are required to manage workflow and functions specific to your specialization.
• Features must be customizable and easy to use.
• It should have a feedback and interaction channel connecting you to the vendors in case of feature requests, suggestions, complaints and grievances.
• The EMR provider must commit to customer support service, user-guidance and quick response time to complaints. 

CCHIT Certified EMRs – America’s Most Recommended EMR Systems  

SoftwareAdvice puts together a list of top CCHIT Certified EMRs in the country. The most recommended systems on their list are given below:

1. Allscripts EHR
2. ADP AdvancedMD EHR Software
3. eClinicalWorks
4. NueMD Complete
5. Aprima EHR (formerly iMedica)
6. Greenway PrimeSUITE 2011
7. MedLedger
8. CareTracker
9. SuiteMed IMS
10. Intivia’s InSync®

You may also take a look at a host of other EMR systems they recommend for consideration at http://www.softwareadvice.com/medical/cchit-certified-emr-software-comparison/

References:

1.    http://www.encounternotes.com/index.php?/before-getting-emr/cchit-certified-emr-software-worst-nightmare.html
2.    http://wirelysis.blogspot.com/2011/04/want-to-acquire-emr-vendor-look-out-for.html
3.    http://www.revenuexl.com/blog/bid/25572/Selecting-EMR-Software-life-beyond-CCHIT-Certification
4.    http://www.cchit.org/sites/all/files/cchit10Reasons.pdf
5.    http://www.himssanalytics.org/docs/Essentials/5thEditionEssentialsIntroduction.pdf
6.    http://www.articledashboard.net/Article/EMR-Software-Features-to-Look-Out-For/7531
7.    http://www.webpt.com/resources/practices/4-things-look-any-emr-system

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