Archive for May, 2009
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0 What Does the Death of 20 Polo Ponies Have to do With EHRs?
May 7, 2009. Opinion.A few weeks ago 21 horses of the Venezuelan Polo Team mysteriously died at the US Open Polo Champion Tournament in Florida. In the time since the tragic events unfolded, a Florida pharmacy admitted it created the wrong dosage of a mineral supplement for the animals. It’s unclear if the dosage mistake was due to a pharmacy error, or if the incorrect amount was specified in a prescription from the team’s veterinarian.
So what does any of this have to do with Electronic Medical Records? More than you might think. Medical errors whether veterinary or human, do happen- often with tragic consequences. What are the most common such medical errors? Improper dosages of medication, or problems with drug interactions. Ironically, these are the types of errors that can be most easily prevented through the use of EHRs.
Back in March during an emotionally charged segment on the Oprah Winfrey show actor Dennis Quaid said how having a comprehensive nationwide electronic medical record system in place could have prevented the dosage error that nearly killed his infant twins. Quaid also delivered a Keynote speech on the matter at the recent HIMSS09 show in Chicago. On the Oprah appearance Quaid tearfully described how his babies were given nearly 1000 times the required dose of a blood thinning medication, due to an illegible paper prescription. It is stories like Quaid’s that have likely lead to the only known firm criterion for “meaningful use” of EHRs as defined by the HITECH Act – ePrescribing.
Hospitals nationwide are hearing Quaid’s message. For example, all of the hospitals of the Detroit Medical Center have gone paperless. In fact they have had the kind of EHRs Quaid is advocating running in all of their facilities since 2007.
The EHR, which should be held up as an example for the nation, requires that physician’s orders, test results, and other patient records all be collected and processed online. The Medical Center claims that the technology reduces the risk of potentially dangerous medication errors by up to 90 percent, since it strictly prohibits all handwriting in the prescribing and dispensing of drugs.
The Chief Medical Information Officer at DMC said there is also a great deal of evidence to show that EHR systems reduce medical errors. He pointed to recent national studies that show that at least 7 percent of hospital patients are affected by medical errors, but effectively managed EHR systems can eliminate most of them.
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3 Virginia Public Health Organization Reports EMR Security Breach
May 7, 2009. Today.As reported here and onEHRtv.com, The Department of Health And Human Services recently announced new guidelines for controlling and reporting security breaches of Electronic Medical Records. Now, just weeks after HHS’ announcement, Virginia has revealed that the EMRs of 8 million patients may have been compromised.
Yesterday, an FBI Official confirmed that they are investigating a $10 million ransom demand by a hacker or hackers, who say they have stolen nearly 8.3 million patient records from a Virginia government Web site that tracks prescription drug abuse. The breach involves the Virginia State Prescription Drug Monitoring Program’s website, www.pmp.dhp.virginia.gov/. Virginia’s governor said state police are also cooperating in the investigation. In a statement the governor said that the breach of patient EMR data is a serious crime, and is being treated as such. As of this writing the Website is still down.
FBI officials were made aware of the potential breach when last week they were contacted by the Virginia Information Technologies Agency (VITA). Asked whether patient information is secure, the FBI Official would not say, only that an incident had occurred. “I really can’t make a declarative statement as to whether anyone’s information is in jeopardy at this point,” the official said. Apparently a message appeared on the front page of the Program’s website from a hacker who claimed to have obtained the EMR information of the over 8 million patients in the system – and would sell the data to the highest bidder if the state did not pay him or them – 10 million dollars.
Sandra Whitley Ryals, director of the Virginia Department of Health Professions, which runs the program, confirmed that a criminal investigation is underway into the potential security breach which occurred on April 30. Since the unauthorized message was posted, the department has been working “very closely and cooperatively with federal and state law enforcement to resolve the situation. “The entire DHP system has been shut down since [April 30th] to protect the security of the program data,” Ryals said in a statement released to the Press.
A spokesperson for the Virginia Department of Health, which uses different software than the Prescription Monitoring Program, said that the Monitoring Program’s website is now secure, but that “something did happen.” The records that were allegedly stolen do contain social security numbers and other information valuable to identity thieves.
Michael Fitzpatrick, president and CEO of the NCX Group, a Newport Beach, Calif.-based computer-security consulting group commenting on the incident said that many government agencies just do not have the budgets to take the best security measures to prevent sophisticated attacks by hackers.
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0 Online Tools Help Doctors Compare EHR Solutions
May 6, 2009. Today.You can use the internet to compare features and rates on anything from Health Insurance to new cars. Now doctors are finding online tools that can help them with their EHR implementation decisions.
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1 CHIME “Chimes in” on Meaningful Use of EHRs
May 5, 2009. Implementation.To qualify for Medicare and Medicaid incentives in the stimulus bill EHRs must demonstrate “meaningful use”. As readers of these pages know, “meaningful use” has yet to be officially defined. One certain criterion is e-prescribing, as systems need to already have an e-prescribing function to qualify for current Medicare incentives.
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1 Using Outsourced Services for Scanning Patient Charts
May 5, 2009. Implementation, Today.Busy medical practices that have recently transitioned to EMR (or plan to) know that they have to decide how to most efficiently integrate paper-based patient chart information into their new electronic system. The most complete and cost-effective way to realize the full benefit of electronic records in the long run is to image all the charts and make those chart images available from within the implemented EMR system. Why?
- Practices realize the continued cost burden of storage (either on or off-site), chart retrieval, print, copy, fax, and re-file.
- Paper charts or parts of them can easily get lost or misfiled.
- Paper charts take up valuable space either in storage boxes on or off-site or sitting on shelves within the Practice.
Scanning Services can deploy systems and software on-site that can efficiently digitize and produce high quality optimized images of your chart folders that can be made available within the implemented EMR system. In this way, charts will remain on-site and in your control during processing.
Scanning services can deploy high-speed scanners and software to allow the importing of charts in bulk. Utilizing barcode technology and specialized folder detection to assist with indexing, services can effortlessly process 1000’s of charts daily.
Some services can even offer secure access to intranet web applications that tightly integrate with the existing Practice database. This information is used to reconcile the status of patient charts during the scan process and can provide real-time statistical feedback to the service company and practice during scan processing.
The service staff would work closely with office administrative personnel to provide scan processing feedback as well as facilitate pulling charts during the conversion process. In this way even active charts can be scanned with no impact on the practice daily business work flow.
Outsourced scanning services are typically well-equipped to handle processing of thousands of patient charts a month. Some can additionally implement stream-lined import into industry leading vendors like NextGen, gMed, and ChartCapture or can implement quick integration solutions to most EMR systems. Actual rates are based on completion targets, equipment speed and staffing.
Practices should seriously consider complete digitization of all paper patient chart documents for maximizing the efficiency and utilization of an EMR implementation.
Michael S. Hawkins Business Development OptiScan Inc. 602-789-7800 mhawkins@optiscan.net
http://www.optiscan.net/medical.php
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0 Will EHRs and HIT Create New Jobs?
May 5, 2009. Insight.Undoubtedly you have read or heard the phrase “19 billion dollars in the Stimulus Act for Healthcare IT” several times by now. I have discussed it myself many times on these pages. Most recent posts have centered on the HITECH act and what its goal of accelerating the implementation of EHRs and PHRs will do for the practice of medicine and public health.
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0 Murphy in Effect – How reliable is your EMR?
May 5, 2009. Today.The passage of the HITECH Stimulus act made one thing clear: Electronic Medical Records are the future of healthcare. Whether physicians like it or not, they will have to adopt an EMR system, probably sooner rather than later. Moving to EMR will bring many benefits to any practice. However, there are also a few drawback associated with EMR systems. Physicians should choose a reliable, low-risk EMR that will let them see patients when Murphy’s Law rears its ugly head.
Paper charts are almost foolproof. Short of losing the chart itself, a physicians can usually see patients without too many problems. Despite their simplicity and reliability, paper charts have many shortcomings. They are almost impossible to backup; they make information sharing cumbersome, and they can be difficult to read with handwritten notes.
EMRs have a plethora of advantages over paper charts in terms of functionality and efficiency. Despite these benefits, the trade-off lies in simplicity and reliability. EMRs require computers, and in some cases, local networks, databases, servers, and internet connections. Murphy’s law states that “What can go wrong, will go wrong.” As anyone who uses computers knows, bad things can happen on a regular basis. Computers and servers crash, the power goes out, databases get corrupted, and the internet connection goes down just when you need it.
Murphy’s Law can wreak havoc with your practice. Many complicated EMR systems using ASP or client-server architecture rely on databases and internet connections. If these components fail, how will you see patients? Unlike paper charts, many EMR systems have single points of failure. If something important, like your internet connection, goes down then the entire system will fail.
The answer is not to avoid purchasing an EMR, that would be like walking rather than risking flat tire in your car. The answer is to buy a simple, robust EMR that doesn’t rely on single points of failure, like internet connections or databases. Consider purchasing a standalone EMR that can run entirely on a single computer. Standalone systems offer the simplicity of web-based EMRs, but don’t require internet connections. Standalone systems can give you all the functionality of a client-server EMR, but without clunky databases that are prone to crash.
Anyone who has experienced computer problems knows how frustrating they can be. In addition to frustrating your staff, computer problems can damage your reputation. What would happen if you have to send home a waiting room full of patients because your EMR went down? Don’t risk your practice on a complicated EMR; remember Murphy comes calling when you least expect him. Chose a system that is simple, reliable, and efficient.
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Ryan Ricks Security Officer
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1 EHRs Being Used to Track H1 N1
May 4, 2009. Spotlight.Last week I created a post that discussed how EHRs could be used to help track and suppress an infectious disease outbreak such as the Swine Flu. Today I can report on how it is actually being done!
Minnesota based Quinnian Health, announced it has partnered with Dallas’s TelaDoc Medical Services to provide remote consultations, and access to its Qhealth Platform.
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0 Is Open Source Software the Answer to Broader EHR Adoption?
May 4, 2009. Today.Rural communities are particularly underserved when it comes to Healthcare IT and EHR implementation. With all the buzz lately about incentives and the need to expand EHRs nationally, who would have thought West Virginia might be “ground zero” for the push in that direction?
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