Posts tagged ‘HITECH Act’

A Scanner Darkly

The awkward phase. It’s an unpleasant nebulous moment between two well-defined points. That uncomfortable time as people go from childhood and adulthood. Or that fearful moment full of panic as you go from dating to being in a serious relationship with someone else. It’s that interim state where you’re no longer A but you’re not quite B either.

Medical reporting is currently in its own awkward phase.

In the not so distant past lies Paper Based Reporting – filling out forms using pen and pencil, typewriters, printing out reports and having physical copies of every document located somewhere. This is the world of triplicate, of faxes and envelopes, of white-out and paper shredders. Paper charts physically shipped or moved from practice to practice, facility to facility. Paperland, as I like to call it, does have its advantages, though: a physical document that proves that something happened and to which people can refer; an artifact that precisely records how something occurred at that date and time, without any fear of tampering; a collection of data that cannot be wiped out by a virus or any sort of IT snafu.

Meanwhile, in the not so distant future lies Electronic Based Reporting – entering every information via computers. Using synoptic reports to enter structured data, information is culled directly from machines (think of vital signs being automatically recorded and logged), or easily entered using touchscreens, mouse & keyboard or a stylus of some sort. Electronic reports allow for faster sending of information to a wider range of places. Specialized fields ensure consistency in language and information captured. Required fields and “checklist” approaches encourage more completeness in reporting and more pertinent information is readily captured.1 However, Tronworld, as I’ll refer to it, has its own share of problems. Information can be lost or stolen without any physical backups. There’s ensuring that all systems are speaking the same language when interfacing, so there’s no loss of data or need to reformat the data every time you go from one system to another.

So, between here and there, betwixt Paperland and Tronworld, lies us currently. How are people bridging the divide between the two different modes of reporting? The answer…might surprise you.
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September 13, 2010 at 9:12 am Leave a comment

Security in the Time of EHRs

You are online right now.  I don’t just mean that you are sitting in front of your computer or using your smartphone to read this post on the internet.  I mean the majority of your “vital” information about your identity – bank account, social security, address, etc. – can be found somewhere in cyberspace right now.  You exist in the internet; and not just you, but also various versions of you complete with your interests, past transactions and other personal information that you’ve added to your social networking sites or the online store where you buy things.  All of these pieces of you are captured online and are out there in the ether of the web if someone wanted to find them.

It’s a bit creepy, isn’t it?  The fact that so much of our lives these days exist online – and therefore so much of who we are is being captured or constructed on the net – leaves many feeling unsettled.  This is especially true if you’re a person who doesn’t know much about software security, who doesn’t follow how data is captured and stored, who isn’t sure how much of the web works but you are fairly certain it will be working against you.

Now add in the idea that soon some (if not most, if not ALL) of your personal medical information will be stored on a similar system – and you understand why people are apprehensive about the idea of an Electronic Health Record (EHR).  There are those who believe that web-based data storage will only lead to security breaches or identity theft issues.  And there’s definitely the potential for such shenanigans to abound with an EHR.  While these concerns are valid and need to addressed as new systems are created, they shouldn’t stop us from proceeding with developing portable EHR systems.

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March 30, 2010 at 4:18 pm 1 comment

HITECH – One Year Later

This Healthleaders Media article examines the efficacy of Health Information Technology for Economic and Clinical Health (HITECH) Act after its one year anniversary.  Built on other Health IT initiatives originating in 2004, HITECH Act incorporates monetary incentives to encourage health professionals to adopt electronic health records and to utilize more health information technology.

In the wording of the law, “eligible professionals” must demonstrate “meaningful use” of a certified EMR in 2011 in order to receive incentive payments of up to $44,000 from Medicare and $65,000 from Medicaid per individual physician – to help cover the cost of EMR adoption.

And while there are ongoing debates about privacy issues and the effectiveness of digitization, one of the main goals of the project seems to be portability: the ability to have a individual’s medical history readily available to any physician where ever/when ever that individual seeks treatment.  This is the ideal that Dr. H. Walter Kaess and Dr. Roger Chabra spoke of when I interviewed them recently.  GE has illustrated this idea dynamically in its recent commercials for EMRs that have been airing recently.

But what does this all mean for physicians?  How is the Health IT market working with physicians to deliver on the promise of portability without any cost to caring for patients or impeding the physician’s workflow?

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March 12, 2010 at 9:01 am 1 comment

EHR – Part v. Whole

Piecemeal vs. Wholesale

The Center for Disease Control (CDC) recently released the results from the 2008 National Ambulatory Medical Care Survey (NAMCS), which is “an annual nationally representative survey of patient visits to office-based physicians that collects information on use of EMR/EHR.”  Approximately 5,200 physicians (3,200 surveys conducted in person; 2,000 over the phone) responded to this survey, which is conducted by the National Center for Health Statistics since 2001.   The survey is designed to figure out how many physicians have purchased some product to serve as the Electronic Health Records (EHRs) – also referred to as Electronic Medical Records (EMRs) – and how many are utilizing those products.

There has been a big push for adoption of electronic health records, especially since the government set a goal of having most Americans have an EHR by 2014 (set in 2004 by then President George W. Bush, and has been re-affirmed by President Obama).  Increased funding from the Department of Health & Human Services for electronic medical records and products that electronically capture health information has also led to a boom in the Health IT industry and a diversity of options for health professionals from which they can choose.

But such an abundance of choices combined with the rush to adopt EHRs has left many people wondering – what’s the best product out there? Perhaps the better question is – what’s the best approach for implementing this new system?

Survey results, rising doubts and some ideas after the jump…

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February 10, 2010 at 10:06 am 2 comments


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