Posts Tagged ‘EHRs’

Infographic: Doctors Call for Overhaul of Electronic Health Records

July 6th, 2018 by Melanie Matthews

Physicians want substantial improvements in the way electronic health records (EHRs) work, according to a new infographic by Stanford Medicine based on a survey conducted by The Harris Poll.

The infographic examines how physicians would like to see EHRs evolve.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare’s aggressive migration to value-based payment models and MACRA’s 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS’s 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results documents the accomplishments of CHS’s 24 ACOs under the MSSP program, the crucial role of data analytics in CHS operations, and the many lessons learned as an early trailblazer in value-based care delivery.

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14 Protocols to Enhance Healthcare Home Visits

January 20th, 2015 by Cheryl Miller

Use of telemonitoring equipment, electronic medical records (EMRs), a staff dedicated to monitoring home visits and engaged caregivers are just some of the protocols used to enhance home visits, according to 155 respondents to the Healthcare Intelligence Network’s most recent industry survey on home visits.

Following are 10 more protocols used to improve the home visit process:

  • Inclusion of home visiting physician in hospital rounds; and the collaboration of home visit physician with primary care physician (PCP) and complex case managers.
  • Using our medication management machines with skilled nursing follow-up to increase medication compliance.
  • Proactive phone calls to determine if a patient’s condition is worsening and in need of home visits.
  • Daily workflow management algorithms with prioritization and mobile access to electronic case management records.
  • Using teach-back to assure comprehension.
  • Easy to use/wear multimodal, advanced diagnostics telemonitoring allowing patients total mobility and continuous real-time monitoring.
  • Medication reconciliation is crucial in eliminating confusion for the patient, and our electronic medical record (EMR) accurately reflects what the patient is taking, including over-the-counter (OTC) and supplements.
  • Hospital coach gathers information and prepares the patient for discharge, coordinates with home visit staff, home visit team (coach and mobile physician) and completes home visit.
  • Portable EMR to document and review medical information on the spot.
  • EHR-generated lists, community-based team, community Web-based tracking tool, telehome monitoring devices, preferred provider network with skilled nursing facility/long-term acute care (SNF/LTAC), home health and infusion therapy.

Source: 2013 Healthcare Benchmarks: Home Visits

2013 Healthcare Benchmarks: Home Visits examines the latest trends in home visits for medical purposes, from the populations visited to top health tasks performed in the home to results and ROI from home interventions.

2 Performance Improvement Tools Help Physicians Work Smarter, Not Harder

February 13th, 2014 by Cheryl Miller

In light of health reform, physicians need tools to help them work smarter, not harder, says Mark Shields, MD, MBA, senior medical director for Advocate Physician Partners (APP) and vice president of medical management for Advocate Health Care. Among the tools the organization has introduced since 2004 is the eICU®, which enables physicians to monitor ICU patients 24/7. If physicians engage in this sophisticated tool at the highest level, they can change course or therapy if clinically appropriate.

You have to give physicians tools to re-engineer their practice and improve performance. We are not talking about working harder; these are clinicians who are already working very hard. Instead we are talking about working smarter. Many of those tools are technology tools.

Between 2004 and 2010 we added more technology tools to assist our physicians. We used disease registries — online tools to track patients with a given condition to drive outcomes. They were a key tool for us long before we had electronic health records (EHRs). We do not have EHRs fully deployed across our independent physicians. Therefore, an enormous amount of change can occur with other tools without the full EHR. Sometimes physician groups feel that they must have such a record fully deployed before they can change clinical performance, and that is not true.

We also introduced the electronic intensive care unit (eICU) — a sophisticated tool that supplements bedside staffing in ICUs. Every adult ICU bed is connected to the eICU command post, where intensive physicians and intensive care nurses work 24/7 using electronic and visual monitoring of the ICU patients, with computerized prompts and reminders. It is very important that physicians engage in this at the highest level, so they agree that physicians or the intensives and the ICU can change course or therapy if clinically appropriate.

Excerpted from Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Clinical Integration and Data Sharing.

Adapting 3 NCQA Standards for the Patient-Centered Medical Home

January 24th, 2014 by Cheryl Miller

Coming from a group of innovators who had adopted EHRs early on and were not afraid of data, participants in the Hudson Valley medical home transformation project decided to concentrate on three out of nine NCQA standards: access and communication, inpatient self-management, and performance reporting, explains Paul Kaye, MD, medical director at Taconic IPA.

Let’s move on to the nine standards of NCQA. All of them are available at NCQA’s Web site. We found that we needed to concentrate primarily on the areas of access and communication, inpatient self-management and performance reporting. It’s not to say that the other pieces don’t warrant a challenge, but many of them reflected EHR use and the ability to report on that use rather than a radical transformation of practice.

Initial steps were to require all of our practices to take TransforMED’s medical home IQ self-examination. Then a practice work plan for each practice was created. There was a staff-wide kickoff with each practice. Scheduling that was a challenge for busy private practices, as well as for the community health centers. Regular contact occurred between the coaches with timetables and deliverables that were there for particular elements and standards that had to be met.

Our medical council met once a month. The council included the physician and non-physician leadership of each practice. We highlighted a different standard at each meeting, shared best practices and came to an agreement on the three conditions that one needs to identify for NCQA medical home recognition. There was agreement across the practices that diabetes was an important condition in our area and there was also agreement on adopting practice guidelines, which had already been worked on at the statewide level, so that was a non-controversial area to be able to tackle. We also had two full-day workshops called learning collaboratives, and continue to have these every six months. For these workshops, outside speakers of national prominence came to talk about the medical home and some of the changes that needed to be done.

With all those areas of success, we had no difficulty agreeing on a clinically important condition and on defining a few more to pick from. Agreement on practice guidelines again came easily because of work that had already occurred. Most of the practices found that the standards that required documentation of an EHR functionality, while challenging to document on a piece of paper, were already present and didn’t require much radical change in their practice. These are the low hanging fruit, and showing some of this early on started to build the spirit of cooperation among the providers.

Excerpted from Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Data Sharing and Clinical Integration.

Healthcare Business Week in Review: Post-Surgery ER Visits Up; Medicare Spending Debate; EHRs and Diabetes

September 20th, 2013 by Cheryl Miller

Nearly one in five older adults who have common operations will end up in the ER within a month of their hospital stay, finds a new study from the University of Michigan Medical School.

There is also wide variation among hospitals, with some having four times the rate of post-surgery emergency care for their patients than others, suggesting that hospitals should be graded based on their performance on this measure.

But researchers agree that further study is needed before post-surgical ED visits join such measures as hospital readmissions and infections in assessing the quality of hospital care, researchers note. More inside.

Experts and the public disagree on whether Medicare spending should be reduced in order to lower the federal budget deficit, according to a special report in the New England Journal of Medicine. In fact, a majority of the public says they will vote against candidates who favor the reductions.

Americans feel that Medicare recipients have prepaid or are paying for the cost of their healthcare, and that the benefits they do receive are the same or less than what they paid during their working lives. But experts maintain, among other issues, that one of the most important reasons for rising Medicare costs is unnecessary care provided to patients.

There is widespread agreement that the use of EHRs in clinical settings can decrease ER visits and hospitalizations for patients with diabetes, according to researchers from Kaiser Permanente (KP).

Following the implementation of HealthConnect&#174, the organization’s comprehensive EHR system, KP researchers found that diabetic patients visited the ER 29 fewer times per 1,000 patients and were hospitalized 13 fewer times per 1,000 patients annually after the implementation.

Do you input EHR data for health risk assessments? Sophisticated analytics behind today’s health risk assessments or health risk appraisals (HRAs) provide employers, payors and providers an aggregate view of population health and the raw material for the development of prevention and lifestyle change programs. Tell us how your organization uses HRAs to improve population health in our e-survey by October 15, 2013 and get a FREE executive summary of the compiled results.

Women’s Health Must be Priority for States’ Health Exchanges

March 13th, 2013 by Cheryl Miller

Women are finally getting the respect they deserve.

According to a new report from the George Washington University School of Public Health and Health Services (SPHHS), women’s health issues are key to the health of the nation and should be a major consideration when policymakers design and set up new insurance exchanges. And states need to maintain transparency so women can know up front what their coverage includes, including enrollment processes, scope of benefits, out of pocket charges and exemptions, so they can best provide for themselves and their families.

Transparency is also key to HHS’s aggessive list of health information technology (HIT) goals for 2013. Among them: at least 50 percent of physician offices will be using EHRs, and a majority will use electronic exchange among providers, ensuring that patients’ health information will be accessible wherever they access care. These goals are considered crucial to reducing healthcare costs and improving care quality, HHS officials say.

Increased access is behind a new primary care medical home (PCMH) certification from the Joint Commission. Designed for hospitals and critical access hospitals that have ambulatory care services that include primary care services offered by clinicians, the certification is considered beneficial to patients because it provides them increased access to the clinician and interdisciplinary team, and care from other clinicians and facilities is tracked and coordinated and regulated by evidence-based treatment protocols.

And increased virtual access is welcome to the majority of consumers, says a new Cisco Customer Experience Report recently released at the Healthcare Information and Management Systems Society (HIMSS) Conference.

Consumers and healthcare decision-makers across the globe were surveyed on sharing personal health data, participating in in-person medical consultation versus remote care and using technology to make recommendations on personal health. Results showed that the majority of Americans favored the increase of technology and remote care.

Three-quarters of consumers find access to care more important than face-to-face contact with their clinician, and are comfortable with the use of technology for medical interaction. The bottom line: consumers will overlook cost, convenience and travel, in order to be treated at a perceived leading healthcare provider to gain access to trusted care and expertise.

And don’t forget to take our new online survey on care transitions in 2013. Describe how your organization strategizes care transitions and you’ll receive a free executive summary of survey results once it is compiled.

These stories and more in this week’s issue of the Healthcare Business Weekly Update.

Infographic: Electronic Health Records Growing in Importance

December 10th, 2012 by Melanie Matthews

The rise of EHRs is one of the most critical evolutions currently occurring in the field of medicine, particularly within the Veterans Administration and Department of Defense health systems.

An IronMountain infographic provides background data on the scope of the VA and DOD EHR system as well as integration challenges.

When the VA and DoD have a fully integrated EHR, they will be able to see the full medical history, creating the Virtual Lifetime Electronic Health Record (VLER).

Electronic Health Records Growing in Importance

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