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Electronic Health Records (EHR)

 

What is an electronic health record (EHR)?

What are the specific clinical tasks performed by an EHR?

Can an EHR help with the business side of my practice?

Aside from the clinical tasks above, what else can an EHR do?

What is “Interoperability” and how does it work?

What are the benefits of using an EHR system?

How can an EHR help improve patient safety?

How does and EHR impact the practice bottom line?

Where can I get more detailed information?

 

What is an electronic health record (EHR)?

 

An EHR is a software application that enables healthcare providers and institutions to record, access and analyze patient medical information in a computerized digital format. An EHR contains a record of clinical notes, medication histories, lab and radiology test results and other patient health information captured over time from a variety of clinical sources and settings. In summary, an EHR captures and manages patient healthcare information in a manner that is far more efficient, accessible and secure than traditional paper-based medical record systems.

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What are the specific clinical tasks performed by an EHR?

 

An EHR provides functionality that supports all the clinical tasks that occur throughout the cycle of care – such as computerized physician order entry (CPOE), real-time, point-of-care clinical decision support; maintenance of problem and allergy lists, ePrescribing (eRx) with automated Drug Utilization Review (DUR), vital sign charting and tracking, lab and radiology test results reporting, automatic generation of clinical summaries, and clinical care reminders.

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Can an EHR help with the business side of my practice?

 

Almost all EHRs are directly tied to a practice management system (PMS) that supports the administrative workflow of the practice. Most EHRs can also integrate with an existing PMS, but most EHR users will also use the EHR vendor’s embedded PMS. Some of the functions of an EHR include:

 

  • Patient registration
  • Check-in and appointment scheduling
  • Insurance eligibility checking
  • Diagnosis and procedure coding
  • Claims scrubbing and submission

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Aside from the clinical tasks above, what else can an EHR do?

 

  • Report events relevant to public health and safety
  • Enable the secure, authorized exchange of patient medical information between healthcare systems
  • Offer providers secure “anytime, anywhere” remote access to medical records
  • Provide a “Patient Portal” to enable patient control of personal health records and facilitate patient / practice communications

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What is “Interoperability” and how does it work?

 

Interoperability refers to an EHR’s ability to transmit and receive data using standardized data protocols. When health information systems are able to securely and reliably exchange information, they are considered interoperable. Uniform standards enable interoperability by encoding health information using a common, universally-recognized and agreed-upon language. “Certified EHRs” are compliant with national standards for interoperability, security and patient privacy.

 

Achieving interoperability across the continuum of care represents a significant challenge. Intel has identified six major factors governing the success of interoperability within industries:

1) Exiting demand for interoperable applications
2) Standard protocols and definitions
3) Business conditions that encourage the development of interoperable applications
4) Guidelines that facilitate the understanding of interoperability standards
5) Independent testing and verification
6) The promotion of interoperability by key stakeholders

 

The implementation of standards for electronic transfer of protected health information will enable key healthcare stakeholders – including providers, hospitals, long term care facilities, labs and ancillary services – to access and manage medical information in a secure, seamless fashion.

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What are the benefits of using an EHR system?

 

An EHR enables ubiquitous access to medical information in both clinical and remote settings, facilitates a detailed analysis of patient medical conditions, improves practice workflow efficiency and provides real-time, point-of-care clinical decision-support. The consistent use of an EHR results in improved clinical outcomes, increased patient satisfaction and significant return-on-investment (ROI).

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How can an EHR help improve patient safety?

 

An electronic medical record system improves patient safety through the reduction of errors related to illegible handwriting on paper treatment orders and/or prescriptions, inadequate or incomplete patient information, or a lack of specific knowledge required to make a fully-informed clinical decision at the point-of-care.

 

For example, by performing a fully-automated Drug Utilization Review (DUR) based upon a patient’s comprehensive medication history, the ePrescribing (eRx) functionality within an EHR can eliminate adverse outcomes related to negative drug-to-drug or drug-to-allergy interactions or dosage errors attributable to illegible handwriting. Such errors are currently estimated to result in up to 96,000 preventable deaths in the U.S. alone.

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How does and EHR impact the practice bottom line?

 

A study reported by The American Journal of Medicine found the net financial benefit of implementing a full electronic medical record system was $86,400 per provider over a 5 year period. Of this total, savings in drug expenditures made up the largest proportion of the benefits (33% of the total). And almost half of the total savings came from a combination of decreased radiology utilization (17%), reductions in billing errors (15%), and improved charge capture (15%).

 

In addition, The U.S. Government is providing compelling financial incentives for the adoption of EHR technologies. Provisions within the American Recovery and Reinvestment Act of 2009 (ARRA) – known as the Health Information Technology for Economic and Clinical Health Act (HITECH) – authorized CMS to offer financial incentives payments to eligible physicians for the “Meaningful Use” of Certified EHRs. Beginning in 2011, providers certified for “Meaningful Use” can receive up to $63.750. The exact amount is dependent on the provider’s volume of Medicare and Medicaid.

 

Furthermore, eligible physicians using ePrescribing and participating in the Physicians Quality Reporting Initiative (PQRI) can receive an additional $6,000 to $8,000 annually.

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What is the Physician Quality Reporting Initiative?

 

The Physician Quality Reporting Initiative (PQRI) is a physician quality reporting system that offers government incentive payments for eligible physicians who satisfactorily report data on quality measures for covered professional services furnished to Medicare beneficiaries. In order to receive the benefit payments physicians must provide PQRI quality indicators to CMS for a specific reporting period. EHRs are designed to automatically track PQRI quality indicators, thus facilitating physician participation in the program – and improving the quality of care.

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How is patient health information protected in an EHR?

 

Certified EHRs are required to comply with privacy and security regulations mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients various rights regarding control of that information. The Privacy Rule has also been designed to enable the appropriate sharing of personal health information with authorized stakeholders involved in patient care.

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I want to learn more about EHR Implementation. How can I dig a little deeper?

 

NYeC recently hosted an eight-session education series, designed to enhance and support EHR implementation and adoption across New York State. The sessions, led by expert consultants and clinicians, followed a curriculum based on the "EHR Implementation Value Chain". Below you will find the materials from all the sessions.

Content and Recordings for this Series is Available here.

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