The Paperless Healthcare Provider
From the Editors of CIOSC
The pressure is on for all healthcare providers -- from hospitals to private practices -- to invest in an electronic health record (EHR) system. A growing body of evidence supports the belief that EHR use improves the overall quality of healthcare, in part because it reduces medical errors and lengths of hospital stays, and increases efficiency and timeliness of care.
After years of lagging behind other industries, healthcare is picking up the pace of its technology adoption, and finally investing more money in it. According to Forrester Research, hospital IT spending is finally approaching the same rate as other industries, with providers expecting to spend 5.5 percent of revenues on IT this year. (The average industry amount is 6.4 percent.) Forrester has also predicted that EHR sales to physician practices will increase from $816 million in 2003 to $1.4 billion in 2008. In the same time period, expenditures will more than double among small physician practices, from $366 million to $829 million. Forrester indicates that by next year, and for the first time, sales to small practices will surpass those to large practices.
Making the transition to an EHR-based office clearly requires significant upfront funding, coupled with ongoing support by all personnel, because the EHR will change the way a healthcare organization operates.
Many healthcare providers are already experiencing confusion -- from sorting through all of the EHR offerings available, to knowing what to call the electronic systems in the first place. The terms EHR and EMR (for electronic medical records) have both been used to describe a catch-all of tracking and processing health or medical records.
Getting started
Some healthcare providers have initiated their processes by utilizing computerized physician order entry (CPOE) to enter orders into a computer instead of handwriting them, and have since moved on to a multi-featured EHR that performs order entry, and more. There is no single, perfect EHR system for every healthcare organization, as not all the features will be applicable or helpful to every practice. In many cases, the interface and usability of an EHR system will be a major deciding factor.
Decisions should be made based on the practice size and needs, work style, patient load and budget. The EHR is a tool with a broad set of features and capabilities that are used in many different ways across varied physician offices. Following are some of the more common capabilities:
- Scheduling
- Detailed clinical documentation and notes
- Prescription ordering
- Lab and test ordering and result reporting
- Ordering and receipt of diagnostic test information
- Online access offering evidence-based healthcare guidelines
- Secure and confidential patient access to health records
- Instant super bill creation with the correct CPT, HCPCS, and ICD codes that are commonly used by the practice
- Coding advice to physicians for accurate documentation of a visit's level of complexity
- Public health reporting and tracking
- Mapping to clinical and standard code sets
- Generation and tracking of physician referrals
- Interface capability with leading practice management software
- Issuance of bills and tracking of claims
- Measurement of physician and staff productivity
Why EHR makes sense
EHR systems done right will reduce costs by eliminating copies of documents created for insurance companies, lawyers, other physicians and various other constituents with need for access to the data. They will also cut down on time spent rifling through storage units to find a patient's file, freeing up physicians to actually be physicians. Such administrative time and tasks extend throughout hospitals, where the support staff spends time and resources copying, transcribing, managing and retrieving files, and obtaining authorizations. Perhaps best of all, there are monetary incentives involved. Insurance companies believe EHRs will catch errors, eliminating malpractice risks; and insurance payers are beginning to offer financial incentives to providers that use EHRs.
Increased privacy with access control
CIOs likely need the least amount of convincing when it comes to adopting this new technology. The Health and Information Portability and Accountability Act of 1996 laid the foundation for a secure and private healthcare computing environment. EHRs simply extend that mandate further across the organization and industry. EHRs contain a wealth of sensitive patient data that must remain secure at all times. They require individual login verification and the servers that house the data must have the proper security controls in place to ensure 24x7 availability and accessibility of the data. In addition to enforcing tight permissions on the server, security patches must be applied immediately (if not automatically), and daily backups of the server should be made.
Benefits
In its fully realized form, the EHR offers a wealth of benefits for payer, physician, and -- most important of all -- patient. It means more time for the healthcare providers to spend with their patients, and more informed decisions being made with better documentation, and built-in clinical decision support available at the point of care.
|
