Electronic Health Records are important to healthcare organizations because they store and organize patient health information in a digital format. These records are produced by medical professionals, hospital staff, or other healthcare providers and can be accessed electronically for analysis of clinical trends. Medical professionals use EHRs to provide better care for their patients as well as improve healthcare outcomes through evidence-based medicine. EHRs also play a critical role in medical billing and revenue cycle management as the single source of truth for claim data.
Data managers play an integral role in the process of maintaining these records because it is their job to ensure that all parties have access to them whenever needed while protecting privacy at all times. The goal of this article is to explain how Electronic Health Record systems impact a healthcare organization and present challenges faced by the data manager when dealing with these records. A good system in place will lead to organizational excellence and improved healthcare for all.
Types Of EHR Systems
There are 4 main types of EHR systems, each one providing different levels of functionality depending on the capabilities required by a specific facility.
1) Physician-Hosted
If your EHR system is physician-hosted, then all your medical history is stored on servers within your facility. Advantages include the ability for physicians to directly access records which can save time and increase efficiency by eliminating the need to communicate with other staff members. The downside is that this type of system requires additional IT support because there are technical errors that are more common.
2) Remotely Hosted
The servers for a remotely hosted EHR system are based outside of your practice. This type of system gives you access to a larger variety of tools that can improve efficiency and provide comprehensive care. It also requires a smaller IT team because there are fewer technical errors within the system. Advantages include being more cost-effective and knowing where your data will be stored in the future. The downside is that this type of system does not offer as much flexibility for patients because it has been designed by the data manager who will dictate what information they can see.
3) Subsidized Remote
Subsidized remote EHR systems are hosted on servers within your facility. However, the data is encrypted and accessed through a third party or by using an app on mobile devices. Customers can buy healthcare services at a cheaper rate because they are subsidized by participating providers under this system. This type of system has the advantage of giving you all the tools needed to provide superior patient care, while still saving you money. This system also has the advantage of giving you access to your medical records wherever you are, but data managers will have more control over who can use it and how they can use it.
4) Cloud-Based
Cloud-based EHR vendors store all your medical history in the cloud. This provides you with many benefits including reduced hardware, security, and storage costs. Cloud-based systems also offer increased data accessibility, scalability, and portability. Disadvantages of this type of system include the lack of physical control over customer data. You may also have access to fewer tools without upgrading to a more expensive package.
In the United States, most medical facilities use one of the four different types of EHR systems listed above. All of them provide different levels of functionality based on the needs required by a specific medical facility.
How To Choose An EHR System?
When choosing an EHR system, know these steps that you will go through in order to find the perfect one for your organization.
Step 1: Identify Decision Makers
A good first step is to identify your decision-makers within the organization. In many cases, this will be a physician or group of physicians who have been practicing at your facility for over a year. This person or group of people is needed because they know all about your medical practice and what you need from an EHR system that will help you successfully deliver patient care.
You should also consult your revenue cycle management manager or if you outsource, you should speak to your RCM vendor. For example, Enter has integrated with a variety of EHR systems and could provide in depth counsel on which EHR would best fit your needs. If you’re interested in discussing EHR vendors, email us at sales@enter.health.
Step 2: Clarify Goals
At this stage, you should summarize all of your goals and how you can implement them with an EHR system. This list should include everything from the systems that are currently working for you to specific things that must be included in your next EHR system.
Step 3: Write A Request For Proposal
A request for proposal is a list of requirements you will send to vendors. When you do this, each vendor will submit a proposal that outlines how their system meets your needs and which specific features will best serve your medical practice.
When sending your request for proposal, here are some things you should consider including:
● Functionality - What specific features does your EHR need? Include everything from workflow to specific modules such as radiology and lab order entry, care management tools, and more.
● Training - How much training will it take to implement the new system? What kinds of support will you receive?
● Key Factors: Data Sharing - What must your electronic health record system be able to do in order for you to share patient data seamlessly with other facilities?
● Security - How secure is your EHR system and how will it handle PHI, including ePHI (electronically protected health information)?
The biggest mistake people make when writing this type of document is not including enough detail in their request for proposal. If you want to receive the best proposals, be sure to include everything - especially any specific requirements you have that are not included in other EHRs.
When writing your request for proposal, always be sure to specify if you are looking for a hosted or on-premise system.
Step 4: Selecting The RFP Recipients
When selecting the RFP recipients, you'll want to choose vendors who are well-established. This step is particularly important if you are looking to build a public-facing EHR, especially when deciding which vendors should be recipients of the RFP.
You should receive proposals from four to five vendors. When you do, you should compare each proposal based on the following criteria:
○ PMS Interface
PMS stands for the practice management system. You want a proposal that clearly details how well the EHR will connect to your current PMS so you can transfer data between systems quickly and easily.
○ Practice Size
Consider the size of your medical practice. This should be a major factor in which system you ultimately choose because it will directly affect how well the EHR will meet your data-sharing needs. If you have just started up or are looking to expand, for example, there may be specific modules included with the system that will help you do so.
○ Industry
There are many EHR systems to choose from, but not all of them are good for every industry. Whether your organization is a hospital or clinic, you will want an EHR that can handle security protocols specific for your industry.
○ EHR Ratings
A good place to start when choosing a system is checking out EHR ratings. The most accurate and well-respected rating systems include those from the Office of the National Coordinator for Health Information Technology (ONC), CMS, and KLAS Research.
Step 5: Review The RFPs
When summarizing your goals, make sure your EHR system is designed to meet all of them. Always compare prices and services with the other systems you are considering. You'll want a system that will offer everything you need for a fair price. If one vendor really stands out from the rest, feel free to choose it alone - but you should only do this if you are confident that it will meet all of your needs.
Step 6: Attend Vendor Demonstrations
Before you choose a system, you'll want to attend vendor demonstrations if they are offered.
These presentations will give company representatives the chance to show you their products firsthand and create a personalized demo based on your specific needs. If possible, try to schedule different vendors at different times so that you can compare and contrast what each has to offer.
If your EHR system is current, you may want to ask the vendor if they are able to upgrade it for you so that different health care providers can share data with each other more efficiently. If possible, try to set up demonstrations between two vendors so you can compare them side by side. Always ask questions and be sure to schedule a time after the demo to verify that you fully understand how everything works.
Step 7: Check References
If you are interested in a specific EHR system, make sure to ask for references. The more information the vendor provides, the better. Don't hesitate to call any of their past clients and ask about their experiences with the company itself as well as the product itself.
Make sure you also review customer reviews online - on blogs or rating sites.
Step 8: Rank The Vendors
Once you have all of your data, try to rank the vendors on a scale of 1-5 based on their proposals. In this step, you'll be able to more accurately review each vendor and compare them side by side. This may also help give you an idea of which one is best for your health care practice.
Ranked them based off of:
○ Functionality
A good EHR system will meet all of your personal practice's needs in an intuitive and efficient way. Make sure the software is easy to navigate, not overly complicated or hard to learn, and that it meets or exceeds industry standards for security.
○ Total Cost
The price you pay for an EHR system will vary based on the specific features included with the program. Try to find a vendor that is upfront about their costs and offers different options so you'll have some flexibility when choosing your package.
○ Vendor Characteristics
Not all EHR systems are created equal. Some may be better suited for a hospital or clinic while others will be more efficient in a consulting office. In addition to checking out different systems, make sure you're choosing a vendor that has the resources to provide exceptional customer service and quick resolutions when problems arise.
Step 9: Conduct Site Visits
Before choosing a system, you'll want to do a site visit. This will give you the opportunity to check out their existing setups and determine if they can meet your needs.
Step 10: Selecting A Vendor
If you are happy with your evaluation, it's time to choose a vendor. This is the part where you make the decision of selecting one EHR system over another. You should never feel pressured into choosing a system if you're not confident that it will meet all of your needs.
There are many different factors that can impact the success of an EHR system. The best way to avoid issues is by choosing a vendor that has the resources and experience necessary to provide you with fast and effective customer service.
Step 11: Solidify Organizational Commitment
If you are planning on switching to a new EHR system, it's essential that everyone is on board with the decision. Once you have chosen your vendor, let your staff know about all of the benefits they will gain by working with this company.
If possible, try scheduling training sessions so they can familiarize themselves with the software in advance. Make sure everyone is on the same page and fully understands how their jobs will change, if at all.
Step 12: Negotiate A Contract
Now that you have chosen a vendor to work with, it's time to negotiate the contract. Ask them about their satisfaction guarantee and make sure you go over any potential issues in advance. Of course, there should be penalties if either party violates the agreement so make sure this is outlined in the fine print before signing anything.
Take your time when going over a contract and read it carefully before signing anything. If any terms only become effective in the future, don't agree to them. Make sure that everything is clearly defined in writing so that there are no misunderstandings down the road.
After all of this work, you should have a great EHR system in place and everyone will be on the same page. The best EHR vendors will provide you with everything you need to run a successful practice and support all of your staff members.
Remember, don't rush into any decisions and make sure everyone is supportive of the decision before switching to a new system.
EHR VS EMR
The EHR system is a software application that automates the electronic storage, retrieval, and management of patient medical information. The EHR system correlates all information from various sources into a single medical record for each individual. By combining data from the various sources into a single medical record, the EHR system enables providers to have access to a more complete medical history for each individual without retrieving this detail from disparate systems.
The EMR (electronic medical record) is an online tool that can be used by doctors like an EHR but it will not contain the same features. It is still accessible by healthcare personnel and it is designed to reduce or eliminate some of the errors and extra work related to records and insurance claims. It has a simple task and it is designed for healthcare personnel only.
The biggest difference between the two is that the EHR system consists of software used to manage patient medical information. An Electronic medical record is only an online tool, similar to an ERS (electronic record storage) that can be used by doctors like an EHR but will not contain the same features. There is still a need for an EHR in RMC. This type of software is designed to reduce or eliminate some of the errors and extra work related to records and insurance claims. It is a simple task that can be used by doctors with electronic medical records.
Benefits
The benefits of using an EHR system include:
● Easier Data Formulation
The data is available at the point of care and it is easier to recall the information immediately. Physicians will never have to worry about delays in recording important patient information which can lead to a more holistic approach when examining a patient.
● Easier Information Access
Information is readily available and can be accessed from any device. Physicians can retrieve vital information that will help them make better decisions regarding diagnosis, treatment, and prognosis for the patient data.
● Efficient Utilization of Time
Time is saved by having all information at hand during a patient encounter instead of searching through records. In addition, the process of transferring information to another health care provider for consultation is simplified.
● Enhanced Patient Care
Patient care is improved and physicians can spend their time diagnosing and treating their patients instead of making sure that patient information is correct. This also leads to a reduction in malpractice claims due to mistakes made during transcription.
● Reduced Costs
Once implemented, electronic health record systems can help reduce costs associated with operating a physician's office. These savings are the result of time saved by physicians and staff members through improved efficiency, lower malpractice insurance premiums due to reduced risk of lawsuits, and reductions in operational costs because of improvements in data management.
● Increased Awareness Of Dangerous Drug Interactions
An electronic health system will alert you if you prescribe medications that could interact dangerously with one another. This is beneficial because if they do interact, this can be potentially harmful to the patient.
● Efficient Communication
Electronic health systems help to ensure the swift delivery of patient information from one party to another. The interoperability of EHR systems makes it possible for any health care practitioner to access a patient's medical records and communicate with other parties involved with their care through an electronic portal. Interoperability allows clinical staff members and physicians, as well as patients and caregivers, to collaborate more effectively by exchanging and sharing information electronically. Furthermore, the possibility of accessing a complete medical record at any time will decrease the chance that important data will be overlooked during diagnosis and treatment.
Government EHR Incentive Program
The EHR incentive program is designed to reward eligible professionals who demonstrate meaningful use of certified electronic health records (EHR). The government offers generous reimbursement and incentive programs to encourage healthcare professionals to adopt and use the Electronic Health Records (EHR) in order to improve clinical quality and safety, reduce medical errors, and ultimately improve patient care, all researched by NCBI.
The program initially launched in 2011 and has since then evolved through three stages:
Stage 1: Data Recording
At this stage, physicians were required to demonstrate that they could use their electronic health records system to record at least 60% of patients' demographics, medication lists, allergies, and other vitals which must be recorded within 24 hours. This was the first step towards demonstrating meaningful use.
Stage 2: Emphasis On Quality Improvement
At this stage, physicians were required to adopt an electronic health record system that is capable of reporting on quality measures that are collected for public health updates. The quality measures collection was initially scheduled to begin in 2013 but later rescheduled to start in 2014. Physicians who successfully demonstrated meaningful use of certified EHR systems gained incentive payments through the Medicare EHR incentive program. Physicians who successfully demonstrated meaningful use for two years are also exempted from the Medicare EHR payment adjustment in 2015.
Stage 3: Promoting Interoperability Programs
This stage focuses on promoting interoperability and information exchange between providers. The program encourages physicians to share patient medical records electronically with other practitioners involved in their care, as well as patients and caregivers. Physicians are required to exchange at least one type of health information through an electronic exchange by 2015 or demonstrate that they are using certified EHR technology to meet the definition of a 'meaningful user'. Physicians who successfully demonstrate meaningful use for two years are exempted from the Medicare EHR payment adjustment in 2016.
● Eligibility Criteria
To qualify for the program, physicians must meet all three of the following criteria:
1. Successfully adopt and meaningful use certified EHR technology
2. Transmit information to public health agencies electronically
3. Exchange patient medical records electronically with other practitioners involved in their care, as well as patients and caregivers
4. Report on quality measures for public health updates
5. Use certified EHR technology to meet the definition of a 'meaningful user'
The program's reimbursement and incentive payments have been designed to expand over the next few years. The government is spending a total of $25 billion on the program from 2011 through 2015 and estimates that this will be sufficient to cover about 90 percent of physicians in the United States.
Summary:
In conclusion, It's inevitable that the digital age will change how we manage our health records. The question is, are you ready to take on this responsibility? As a data manager for your organization or company, it’s up to you to make sure all of the necessary information about an individual patient is stored and accessible. This includes everything from insurance details to medical history. If you need help getting started with electronic health records (EHR), check out Enter.health for some excellent systems! Whether they're cloud-based or not, we can track every aspect of your patient's healthcare needs without impacting their privacy at all. At Enter.health, we believe everyone deserves access to quality care regardless of where they live or their socioeconomic status.