The Use of Tablets in the World of EMRs

With a growing number of physicians adopting tablet PCs for their EMR implementations, EMR vendors and IT manufacturers are looking to build compatible native systems to facilitate user-friendly and efficient EMR execution. From table desktops to thin clients and now the tablet, EMRs have been tried and tested on a variety of hardware, each bringing its own benefits and drawbacks. However, the striking surge in EMR adoption on tablet PCs has made providers sit up and take notice of this remarkably promising technology. 

 Evolution of Tablets in the EMR Space

The tablet technology has found a significant number of users in the healthcare industry. A survey conducted by Manhattan Research reveals that practitioners are leaning largely towards mobile platforms in order to improve the productivity and quality of care, as well as for efficient EMR implementations. According to the research, it is estimated that around 30% of doctors own an iPad, which is the leader in the tablet PC market today. Supported by increased bandwidths and wireless internet speeds, the tablet is expected to become a popular choice among physicians, who are already displaying considerable interest in EMR adoption on tablets. Tracing this dramatic rise in the adoption of tablet PCs in the healthcare industry, IT companies are working on designing specialized platforms that connect smart devices like tablets and smartphones to EMRs. 

Tablets and EMRs  

Even though EMRs on wireless tablets are neatly poised to be the next big thing in the healthcare industry, they do have their detractors. Positively, tablets lend EMRs a host of benefits ranging from portability and enhanced patient communication to increased data accessibility and productivity. Physicians who have worked with EMRs on tablet PCs appreciate their connectivity, usability and design benefits. Tablets are small and light, easy to use and can be conveniently carried for patient visits (as opposed to old-world hospital carts carrying the EMRs on king-sized, unhandy desktops). Physicians can access data from hospital systems and complete their charting in real time while working with patients. Notes can be handwritten using tablets and documents can be wirelessly sent for printing directly from the device. Tablet interface also opens up communication channels between the patients and doctors, contributing to better relationships and improved quality of care. 

While tablet PCs are serving EMR implementations well by helping physicians devise a seamless and efficient flow of healthcare processes, users have nonetheless identified a number of pain points that need to be addressed for the tablet to deliver a dependable and sure-fire system to support EMRs. Firstly, most tablets are not designed specifically for medical use (though this appears to be changing as tablet marketers have identified compelling potential in the healthcare industry). Physicians may not be comfortable using the touchscreen on tablets that do not have a stylus. This makes the data entry process sluggish and eats into the valuable time doctors can spend interacting with patients. Tablets are also tough to clean and sterilize, and touchscreens don’t work with surgical gloves. Since it is a relatively newer technology, hospital IT infrastructure and wireless networking platforms are often not equipped to support and integrate EMR implementations on the tablet. It is easy to lose your wireless signal in old hospital buildings with limited IT support, and a tablet with dropped wireless is as good as of no use considering that most Medical Solutions for the Tablets today are pretty much web based solutions.  

Selecting a Tablet for your EMR

There are a number of factors physicians must consider before investing in a tablet to run their EMR. It is important to ensure that your tablet serves all the primary EMR functions and process requirements. To begin with, your tablet must have a good battery life. It must be easy to operate, user-friendly and durable. Tablets are available in two styles, the slate-style and the convertible-style. The convertible-style has a built-in keyboard and therefore, is heavier as compared to slate-style tablets that do not have a keyboard.  

It is always better to go for specialized tablets that have been specifically designed for medical and EMR use. iPad and Android are introducing a number of features and applications that support a host of certified EMR systems. Samsung is also making custom Android operating system tablets for EMR and medical use. CNET editors list the highest-rated tablets in the market with Apple iPad 2, Samsung Galaxy Tab, Asus Eee Pad Transformer, BlackBerry PlayBook and T-Mobile G-Slate emerging as top contenders. Other models that have become popular with physicians are Motion LE1600 Tablet PC by Motion Computing and Fujitsu ST5000 Tablet PC by Fujitsu. They are both slate-style tablets and range between $2000-$2500. The Toshiba Portege, Acer C200 and IMB Thinkpad are also good convertible-style options. 

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TIPS FOR PHYSICIANS FOR A GOOD DICTATION

1. Know your Dictation Equipment: Make sure you have read the manual once when using a new microphone.
2. Make sure there is little or no background noise when recording on the microphone.
3. Keep silent gaps of a couple of seconds at the start and end of each recording to avoid the voice being clipped during processing.
4. Always state the full name and contact information of the patient, date and time of the interaction being captured for better offline reference.
5. Spell out Medical Terms to make sure they are captured properly, this is a must in case of manual transcription.
6. Do not use slang or short forms unless they are the medical norm.
7. During dictation ensure that the microphone is at an optimum distance from the mouth.
8. Do not mumble, fade out mid/end sentence or talk very slowly, this may lead to errors during transcription
9. 
   Always mention documentation information for e.g. carbon copy, copied to, page no of referenced document, etc.
10.  Use proper indicators at the start and end of paragraphs and sentences, in case of manual transcription mention “Full Stop” at the end of each sentence, auto transcription may have similar such rules. Follow them.
11. Switch of your telephone, mobile phones or pagers when dictating into the microphone.
12. Be organized and keep required stuff handy otherwise noise from paper shuffling, drawers opening and other noise from movement will generate interference.
13.  For similar items create a standard set of phrases you refer to often, this will let the software / manual transcriptionist learn for better and quicker transcription.
14. In case of errors rewind and delete the phrase and re-record over it, do not talk out the delete instructions.
15. Service your dictation equipment regularly.

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How an expert helps you with EHR Selection?

Implementing an EHR can be a time consuming and an expensive affair.  It requires you in most cases to devote a full time staff for the implementation process.  Also the selection of the right EHR is critical to maintain practice efficiency, productivity, and its financial stability and also be eligible for Meaningful Use.

Given the above factors, it is a good option to the have a selection / implementation expert by your side to help you decide on the right EHR for your practice and then help you implement, train your staff and provide on-going support.

Below we outline how we at Technical Doctor Inc. provide EHR Consulting to help our clients select the right EHR, implement it with the right hardware and provide post implementation support / training.

EHR Selection:

1.       Technical Doctor has created and revamped the ordinary "workflow" with a more EHR / IT focused workflow.  This workflow measures the tech savviness of the users and their ability to perform documentation within a computer system to ensure patient care, proactive Billing and Meaningful Use measures.   This workflow takes approximately 2 days and a conversation with all staff members.   

2.       Technical Doctor "shops" the practice's work flow against EHR software that would be most suitable for the practice's budget and level of need.   The shopping list is narrowed to 2-3 EHR's that meet the need of the practice's workflow.

3.       Present the prospective EHR solution to the client with Technical Doctor's discovery of the EHR Company and support staff.  The practice will choose the DEMO's they want to see.

4.       We arrange the Demo and the EHR Company has to win the sale by presenting their product. They use the Technical Doctor - Workflow documentation to give the demo based on the exact requirement of the practice.

5.       Selecting the EHR:  We help the practice decide based on several key parameters.

a.       The main parameter is the clinical understanding that's focused to the specialty 

b.      The secondary parameter is the support and technical programmers on staff

c.       Most physicians do focus on price more than the other parameters

d.    The government and hospital incentives also play a huge role on what EHR is available at discount.

6.        We assist in arranging with clearing house, help selecting the interfaces, and faxing solutions that is a best fit for the practice and the EHR selected.

7.       We ensure the practice Sign contracts with all vendors and help them in understanding the contracts.

EHR Implementation:

1.       We help the practice decide what hardware to Purchase and offer them options and discount pricing due to our leverage with providers.

2.       We help setup, install, and configure the EHR and integrate other solutions with it to help build a secure, HIPAA compliant and robust infrastructure.

3.       We manage Installing and configuring computer equipment including workstations, servers, network hubs, PDA and wireless devices, printers and scanning solutions.

4.      
We ensure that proper and secure data backup solution is in place for your EHR data to be safe. 

Post Implementation:

1.       Stay with the client during training and assist after the training is completed.

2.       Provide on-going technical support for your computer equipment and communications infrastructure.

3.       We will provide all the up-to-date information on chosen EHR for version upgrades, updates and new releases. Hence no need for you to keep track or waste time with follow ups.

Benefits:

1.       Save time of staff and decision makers:

a.       No need to research and decide on the initial short list of EHR vendors

b.      Ensure hands-on support for training and hand holding

2.       Save money for the Medical Practice:

a.       Help select the right EHR to maintain profitability.

b.      Help select the right EHR to maximize Meaningful Use incentives.

c.       On hardware by leveraging on our long term tie-ups with Vendors.

d.      By providing you a solid and affordable support plans.

3.       Technical Doctor is an agnostic company for the sake of physician's / practices best interest, hence the EHR selection is finally decided by the Medical Practice based on the demos and expert inputs provided by us.

4.       Expert Advice: Technical Doctor attends and continues to interact with all major EHR vendors across conferences, meet-ups, special training sessions etc. During these meetings Technical Doctor gets time to assess each EHR vendor, their product, their support ability, the product and company longevity, and their certifications. This insight translates into expert advice for the Medical Practice in helping them select the EHR. 

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RISK ASSESSMENT BASICS AND DO EXPERTS HELP?

What is a HIPAA Risk Assessment?

Title II of HIPAA, known as the “Administrative Simplification provisions”, requires practices to follow a set of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. A HIPAA Risk Assessment is a process that helps ensure that the practice is following the set of national standards. These standards cover everything from the IT side to the physical layout of the practice and to the administrative side of the practice.

Why do a HIPAA Risk Assessment?

As stated within the requirements for Meaningful Use, a practice must “conduct or review a security risk analysis and implement security updates as necessary and correct identified security deficiencies as part of its risk management process”. This means that in order to meet the requirements for Meaningful Use, your practice must conduct at least one security assessment to prove that your practice is HIPAA compliant. Your patients will feel more comfortable as well knowing that their medical records are safe with you. The cost of not being HIPAA compliant can be devastating, with a maximum penalty of $250,000 and 10 years imprisonment.

How can a partner get you prepared for an actual audit?

Technical Doctor has completed 20+ different types of risk assessments with 100% satisfaction from all of our clients. We break down every aspect of your practice and inspect every possible security flaw in your practice. After the assessment, we will provide you with documentation that proves that your practice has met all of HIPAA’s requirements as well as documentation stating what your practice needs to actively do to stay HIPAA compliant.  In the event that your practice is audited, you will have all of the documentation you need to prove that you are HIPAA compliant on hand.

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