Electronic Health Records – Patient Privacy

Electronic Health Records (EHRs) provide an opportunity for hospitals and clinics to capture medical information in a standardized format that allows for ease of access, storage, and sharing within the same clinical system. This standardization in record keeping is extremely important when trying to complete a complex diagnosis, and when used correctly, can also prevent adverse events such as the delivery of an incorrect medication or dosage.

A huge benefit that has received little attention is the increased patient privacy that can be expected through the use of electronic medical records. Two immediate areas where patients can see this is in the hospital and clinic setting where they are being registered, and in the patient room where healthcare workers are able to gather and record information in privacy. In the first instance, patients are no longer required to sign in on a piece of paper where their name can be seen by strangers. In the second instance, patients can answer questions in the privacy of their own hospital or clinic room where healthcare workers record that information on a portable or wall-mounted computer. No paper files leave the room, so there is no danger in the inadvertent loss of protected patient information.

One of the most important areas where privileged patient information is now protected by an Electronic Health Record is in the gathering of statistical data that is sent to municipalities, state vital statistics departments and independent research facilities that gather information for ongoing studies. The EMR provides researchers with an enormous database of information from which to conduct research that would otherwise be tedious and involve enormous cost to separate from its owner and be provided in data form that does not violate HIPPA.

The commenting period for the proposed stage 2 meaningful use rules has closed, but until the final rules are released, doctors, EHR vendors, and others will continue to debate about the most controversial of requirements proposed by ONC: patient engagement.

As the rule stands, physicians must provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the EP. Access to records must be provided to more than 50 percent of patients, and 10 percent of those patients must view, download, or transmit their health information to a third party. ONC proposed other requirements to encourage patient engagement, but this is the one that most of the debate centers on.

The reasoning behind this requirement actually makes a lot of sense; the more involved patients are in their care, the more effective US healthcare will be. Patient portals, telecommunication, and apps designed for smartphones and tablets make it much easier for patients to be involved and for doctors to share information.

However, few patients are taking the initiative to view and download their records, especially if they are healthy. The requirement, then, that 10 percent of patients must download their records is a bit unfair for doctors, who will not be able to qualify for meaningful use incentives if their patients don’t meet this requirement for them.

Both sides have strong arguments, so it will be interesting to see what ONC ultimately decides to push forward.

It is always best to be prepared, though, so there are a few steps doctors can take to ensure their patients will already be engaged in their care when it comes time to comply with stage 2 requirements. It is crucial that a practice have a patient portal; without it, providers will not be able to qualify for meaningful use, simple as that. Doctors would be wise to start inviting patients to patient portal now, so that by the time 2014 rolls around (or whichever year stage 2 begins for the provider) there will already be patients “engaged” in their own care. Target the younger patients, as they seem to be most willing to try out digital tools.

Not all providers have to be power users of their EHR, but the patients whose doctors use digital tools will be more likely to use similar tools on their own time, so make sure you are using your EHR fully.

In some areas, patients are already using the tools available to them—primarily the internet—to research their own health problems. Health-related queries are the third-most searched items on the internet, which means that patients are interested in information that affects their health. A lot of patients aren’t aware that their doctors have information that could benefit them. For instance, family members might want to monitor whether their elderly parents are attending all of their appointments and taking their medications. The public needs to know that these types of options are available; it is the doctor’s job, then, to make sure patients know about them.

The doctor-patient relationship is slowly shifting toward one of partnership, in which both parties work together to provide care solutions. Using technology to engage patients in their own care is still a relatively new practice, but it’s the way the future is headed. Regardless of whether ONC requires patient engagement under stage 2 MU rules, patients will eventually be taking a much more active role in their care than they are even today.

When you’re running a busy practice, efficiency is king. Between providing excellent care and performing administrative duties, practices can’t afford to slog through procedures that could be better performed by EHR and practice management systems.

Increased efficiency is a major selling point of electronic health records, but you may hear the following caveat: “you will see a drop in productivity for a period of time, usually about six months, before you reach the level of productivity you had before implementation”. Don’t be fooled by this promise; an EHR that takes this long to learn and incorporate into your workflow is not likely to aid productivity in the long run.

Despite other powerful benefits of EHR (cost savings, quicker access to charts and other records, enhanced communication), an EHR that reduces productivity is not be a winning choice. An EHR that allows doctors to go home on time every night, however, scores a big win.

An EHR will require new responsibilities, though, which may require some adjustments to your workflow. Electronic devices require different procedures to keep the data safe, and the practice staff must be trained on how to use the software and update information in the correct fields. These changes shouldn’t be difficult to master; practices employing a well-designed EHR usually return to their normal flow very soon and at a higher efficiency.

Switching from paper to digital office technology far outweighs the burden of new responsibilities. Doctors can chart their notes much faster (in as little as 90 seconds), so rather than working through a big stack of notes at the end of the day, doctors can finish their notes as soon as the patient encounter is finished, while information is still fresh. Practices that use good speech technology will be able to eliminate all their transcription costs, and the front office staff will greatly appreciate the automated tools in practice management.

A good EHR will allow you, sooner than you might think, to see more patients, and even to go home on time every night. There is so much to be gained from a productivity-enhanced EHR; don’t sacrifice your productivity for an EHR that requires more of your time.

EHR adoption has doubled since 2008, but some doctors still delay implementing electronic health records. The logic behind EHRs is strikingly clear, and the industry as a whole knows that eventually all doctor’s offices will be digital. Despite this, doctors still hesitate.

This hesitation can be summed up in one word: fear. Fear that implementation will fail, fear that the change will negatively impact patients, fear that workflow will never resume its normal efficiency. Practices don’t want to begin the long and arduous process of EHR implementation, assuming that their experience will be just as disastrous as those they’re hearing about on the news or among colleagues. Further, it seems that for every study touting the benefits of EHR, another one is published refuting those claims.

But the EHR implementation process isn’t about someone else’s experience, or the conflicting “evidence” released by the press; it’s about what is best for a practice. Doctors risk losing patients if they don’t have digital office technology. Practices could be penalized for not demonstrating meaningful use. Healthcare was slow to switch electronic medical records, but its current rate of progress threatens to leave unprepared practices behind.

With the government offering up to $64,000 to qualifying physicians for demonstrating meaningful use of certified EHR technology, there is no better time than now to make the change. Practices that are adequately prepared for the change are much less likely to experience setbacks during or after implementation.

The best way to prepare for an EHR change is to do your research: narrow your options down to two or three vendors and ask those vendors for referrals. Involve your entire staff in the selection process and make sure your selected vendor offers the training you need.

Fear of potential problems will not stop the inevitable—widespread EHR adoption—but doctors can learn from the experiences of others to prevent problems before they happen. Most importantly, however, is that an EHR is a crucial piece to the healthcare of not just the future, but the present.

The medical industry has come a long way from where it was in years past, and one of the most prevalent changes in the industry is the use of electronic health records. There are so many benefits to the use of these electronic medical records; it is a wonder that not everybody has implemented them into their daily office operations.

One obvious benefit is the elimination of paper product waste. Imagine not having to store or shred piles and piles of copy paper every week. Even with recycling, the amount of paper thrown out each week from medical facilities around the world is staggering. With the use of electronic health records, gone are the days of the spiral-bound appointment book and all of its erasures. An appointment can be scheduled quickly and cancelled just as fast. The flow of information through computerized medical facilities is nearly one hundred percent smoother than just ten years ago and is more readily shared office to office.

Any medical practice would benefit from using electronic health records. From the small podiatrist office to the large ophthalmology practice, all would find some benefit to using such technology. Patients would certainly feel better not having their vital stats on paper that could wind up in the hands of just about anybody. Why not have the patient fill out their forms electronically? There would be no paper needed to make copies of different forms to fill out. For their insurance cards and photo identification, simply scan these cards into the patient’s electronic chart and eliminate the need to make photocopies.

A medical practice that has several locations in addition to its main office would have the added benefit of being able to see a patient’s information from any location in the practice. No more interoffice envelopes needed to send paper records back and forth. Gone are the days of the doctor calling a receptionist in another office and having them fax a patient’s chart note over. The physician can open up the patient’s electronic medical records and see everything at a glance.

These are just few of the many benefits of electronic health records.

When starting your medical practice or expanding your existing one, it becomes necessary to find the correct medical practice management software. A medical practice is a unique business, and software solutions intended for other industries will never be able to meet the needs of a thriving practice.

Practice management software includes everything that you need to run and grow your medical practice: scheduling, billing, record storage, patient registration, and more. With good practice management software, no information will ever get lost, and your day-to-day operations will run smoothly.

Scheduling can be an extremely complex task with a medical practice, especially if more than one physician is on call. Scheduling software ensures that no one is ever double-booked, receptionists can easily find open time slots for specific medical personnel, and the schedule can be kept filled with a minimum of downtime. It also helps for doctors that keep more complicated schedules, such as those who have multiple locations that they attend to during different times of the week.

Practice management software is also vital to billing, collections, and insurance claims. Billing can be extremely complicated for a medical practice, with some clients requesting special payment plans, a variety of different types of insurance carriers, and late payments. Practice management software automates the accounting side of your practice by keeping track of late payments and even scrubbing insurance data to ensure lower claim rejection rates.

Finally, practice management software fulfills the vital need of keeping all patient records in one safe place. By using practice management software, the complete history of every one of your patients is only a few clicks away. With the appropriate software security and office protocols, there is no safer or easier way to store your patient data.

Doctors swimming in the EMR realm repeatedly bring up this argument: electronic medical records de-personalize care. And it’s true; we humans love stories, but computers love structure. This is one of the barriers doctors hit when trying to fit electronic systems into their already-established workflow.

Technology can be demanding and distracting, particularly when lots of sensitive data is involved. But the beauty of technology is that, if the need is great enough, technical requirements will fuse with user preferences to make something better.

For example, for years physicians have been dictating their notes with electronic devices and most clinics have been using some sort of practice management system to help manage billing and scheduling. Both systems do their jobs well separately, but problems arise when the clinical and administrative sides cross paths.

This is how many point-and-click EMRs were born: an electronic medical records system that was built from a practice management system. The interoperability problem in the practice is solved, but at the cost of productivity and even job satisfaction.

An art form that doctors miss when they chart their notes in a point-and-click EMR is the clinical narrative. To help speed up the documentation process, most EMRs have macros that you can copy and paste into similar patient encounters. This simplifies the chart documentation process, but it makes a lot of your notes look the same, a problem that can have legal ramifications as well as personal ones.

In healthcare, the solution that caters to both the technical and human needs is natural language processing (NLP), the software that allows doctors to continue to dictate their notes without having to employ a scribe. Rather than spouting out blocks of free text, the software separates this data into discrete data elements, filling in those checkboxes and drop-down menus that point-and-click EMRs love so much. Some EMRs even allow you to navigate through the software using voice, eliminating the need for mouse and keyboard almost entirely. NLP is coming ever closer to achieving that delicate balance to satisfy both technical capabilities (structure) and human preferences (storytelling).

Sometimes technology requires a change in mindset before the full benefits can be realized, but the best tools should solve your problems in a natural way, without forcing you to change how you work. Doctors are kept plenty busy taking care of patients, so it is crucial that EMRs aid, not hinder, doctors as they practice medicine.

Apple has taken the world by a storm as it releases product after product that enhances consumers’ abilities to complete tasks: surf the internet, listen to music, take notes, track health, pay bills, etc. Many doctors are using smartphones and tablets to complement their daily tasks, and this trend will likely escalate as EHRs continue to develop in the mobile sphere.

Even though Apple has not tapped into the electronic health records market, EHRs and EHR apps have demonstrated the same creativity and innovation that Apple products are known for. An EHR powered by voice technology is nearly as easy to navigate as an iPad application and is a useful—no, necessary—tool to improve physician productivity. Just as the smartphone allows even a kid to quickly find directions to the nearest McDonalds or Google the answer to a trivia question, an EHR allows a provider to quick access patient charts and send referrals. An EHR should do more than eliminate paper; it should speed up routine procedures like note documentation, referral reply, and e-prescribing, among a variety of other tasks.

Realistically, any EHR will require some training before go-live. But it is reasonable for doctors to expect to make basic use of the EHR right away and to be able to find and use all of its functions soon. Doctors will be able to navigate through a good EHR on their own after a short demo. The EHR should already do the things doctors need it to do, and learning the technology should have minimal impact on productivity during the familiarization period.

If a doctor can’t figure out how new technology like an EHR fits with their workflow, they are looking at the wrong EHR and they obviously won’t realize the complete benefits. Even government stimulus money won’t change the fact that some EHRs don’t help doctors.

The best EHRs are akin to revolutionary Apple inventions in their benefits for medicine and their ease of use. Apple hasn’t designed an EHR, and they don’t need to; good EHRs designed from the bottom up with constant physician input already take full advantage of technology to aid doctors and office staff every day.

Electronic health records are becoming more common in hospitals and practices throughout the United States. The reason for the popularity of EHR is easy to see: electronic health records save money and improve patient safety and overall satisfaction. EHRs can improve staff productivity and the quality of work done, leading to better patient care and more streamlined practice functions.

Many hospitals and practices may shrink away from implementation of electronic health records when they see the numbers for initial installation, but the system is worth it in the long run. Incentive programs for those hospitals and providers accepting Medicare and Medicaid patients help to alleviate many of the initial costs of electronic records. Doctors should begin implementing an EHR as soon as possible because, beginning in 2015, any EP or eligible hospital not working toward implementation of electronic health records will face an adjustment in their Medicare reimbursement rate.

There are many ways for hospitals and practices to save money with electronic health records. For example, transcription and file room costs can be nearly eliminated. With a file room no longer needed, the space can be used for revenue-generating purposes. The true benefit of EHR is the improved safety it offers to patients; with medication requests sent directly to the pharmacist through the computer, errors in distribution can be reduced, and the system also helps keep track of medication conflicts and patient allergies to help prevent errors. Moreover, EHRs improve billing systems and help doctors and administrators avoid costly mistakes. With all of the benefits, it is easy to see why electronic health records are on the rise.

Medical office administrators utilize practice management software to optimize all of their financial and administrative activities. With the software in place, offices can save time and money by having efficient computer records and by streamlining their billing so that nothing is filed incorrectly or overlooked. Claim reports and remittance advice reports can easily be made available to medical coders and billing personnel. You will see many benefits when PM software is set up and used effectively at your office.

The software installed at a physician’s office allows for streamlining of all processes: the speedy exchange of information leads to faster remittance of invoices; electronic medical records eliminate the need for keeping paper files; office personnel can get on with their jobs treating patients instead of worrying about charting or digging up patient histories or billing information; and office functions that were performed by secretaries and assistants to IT personnel can be consolidated, leading to greater cost effectiveness and increased efficiency for all of the day-to-day office activities.

Features of practice management software include processing accounts receivable and patient collections that require an insurance payment. With the software, office personnel will be able to quickly verify insurance information provided by a patient, as any information can easily be accessed and transmitted using the internet. Updates to codes used for billing eliminate the need to refer to coding books and other redundant information.

Practice management software is available for any size or specialty practice and can be installed on any computer that has a connection to the internet. With the right system in place, and a little training for the staff, practices can avoid the billing, charting, and filing problems of the past.