Electronic Medical Records – Most Doctors Say No

The Obama administration will be devoting billions of dollars to promote electronic medical records (EMR) for doctors. Today, EMR vendors run in and out of doctors’ offices trying to hawk their software. Each one claims to be the holy grail of electronic records. I admit that the concept seems intoxicating.

The promise of a paperless office is certainly seductive. The notion of physicians and patients having access to their medical records from any computer would improve medical quality and efficiency. Every doctor knows how frustrating it is to see a patient in the emergency room when the relevant medical records are sitting in the primary doctor’s office or in a hospital across town. Conversely, EMR permits the primary physician, who may not have been the hospital treating physician, to be easily updated after hospital discharge when the patient returns to his office. Many patients I see today in my office don’t know their medications and can’t recall prior illnesses or even operations. EMR solves this issue.

EMR also permits easy analysis of patient data to track important medical benchmarks including colon cancer screening, Pap smears, immunizations, mammograms and other preventative tests. Doctors like me who still use paper, rely on old fashioned methods to track who is due for a screening colonoscopy. EMR technology could permit our office to contact all patients who reach the milestone age of 50 alerting them that their colon cancer screening experience is beckoning. This would be superior to our current manual mail & call technique. EMR also eliminates the frustration of a missing medical chart. Electronic files are also more current, since data is entered much faster than paper reports. Sending medical records to other physicians’ offices could be accomplished with a keystroke, which traditionally can take weeks. EMR also eliminates the inscrutable penmanship of physicians, which at times needed CIA code breakers to decipher.

With EMR, patients could have their complete medical data, including EKGs and actual x-ray images on a personal flash key. With this technology, a doctor on a cruise ship could see your chest x-ray from 2 weeks ago.

Over time, EMR saves money by improving office efficiency, reducing repeating medical tests and reducing postage expenses.

If this system promises physicians a medical utopia, then why doesn’t every doctor sign up? The New England Journal of Medicine reported in their April 16, 2009 issue only 17% of physicians is using some degree of EMR in their offices. Hospitals are much further behind in acquiring these systems. Chances are that your physician hasn’t pulled the EMR trigger yet either.

Michael Kirsch, MD is a full time practicing physician and freelance author. He writes about the joys and challenges of medical practice including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he is not writing, he is performing colonoscopies. For more articles on this subject, visit: http://mdwhistleblower.blogspot.com/

Virginia Death Records

Tracing a family tree is such an interesting task to do nowadays. It even becomes more interesting if you had the right sources to make good use of. With regard to that, one of the best files that you can delve into is Virginia Death Records. Through the Freedom of Information Act, the state government is now making this information available to all members of the public.

In Virginia, this document can be found at the Office of Vital Records and Health Statistics, State Health Department. It also accepts payments that are made through checks or money order. Only those files that are dated from 1853-1896 and June 14, 1912 to the current time are accessible in this office. Any accounts that are dated between 1896 and June 14, 1912 are only available in selected cities like Hampton, Newport News, Norfolk, and Richmond.

In this particular state, only the immediate family members are allowed to access the information. That does not include the aunts, uncles, cousins, in-laws, grandparents, and others. They, as well as the other members of the public, can only view it after 50 years. It is important that you include in your request some relevant details such as the name on the death record being requested, the date and place of death, your relationship with the person, the reason for your request, your daytime telephone number with area code, mailing address, and signature.

Still another venue where this document is obtainable is at the Library of Virginia, Archives Division. It houses files for deaths that occurred since 1853-1896, as well as death certificates for 1912-1939. The only thing is that it doesn’t offer any kind of service. Therefore, it requires your physical appearance for you to get what you need. Otherwise, you may request someone to do the search for you or you may also search over the Internet.

The Office of Vital Records has provided three easy ways in obtaining this document. First, you can make a request to their office through mail. In this method, the normal waiting time period before you’ll receive the result that you need is at 1 to 4 weeks. The second option is by walk-in. Basically, this is the fastest among the three methods. It only requires you to complete an application, pay the necessary fee, and provide a valid photo I.D. In return, it guarantees to give you the result on the same day that the request was made. The third option is through Government Registry.

Therefore, before making an assumption that an individual is already dead, it is important to conduct Obituary Searches. In the advent of time, the Internet now houses various service providers which can help you with the process. Fee-based services are worth trusting for since they ensure to provide quality-type of service. Moreover, for just a one-time fee, they offer the most accurate, dependable, and immediate report.

If you are in the market for Virginia Death Records, visit us at Free Public Death Records for specialist information about them. Also learn about marriage records over different states nationwide and Florida’s other public records.

Selecting the Right Fit EMR Software

What is the right-fit EMR (Electronic Medical Records) for your practice? Since an estimated 10% of private medical facilities do not use a full EMR system, it’s safe to assume that most of these offices do not see any need to upgrade to a higher system. It’s easy to say that electronic medical record software is a necessity in this day and time, but in all actuality, only you know your profession and what type of system you require in order to do business.

Let’s be honest about some things though. You well know that running an office with a small staff of people can be expensive. You have to pay for full time or part time workers and also have to carry the burden of error with you, meaning, that if your human secretaries and data entry specialists make an error you have to cover for that mistake. It’s not always wise to turn things over to a computerized system. Using a spreadsheet or a basic money managing program may only complicate things for you.

Herein lays the advantage of EMR software. Electronic Health Records software is specifically made for the medical profession. Instead of templates or blank items to contend with (or heaven forbid, program yourself) you are working with charts, invoices, appointment scheduling and e-prescriptions. This is software programmed, not for the IT consultant you bring in twice a month, but for you-the physician who doesn’t have time for computers but still needs a modern day system that is completely searchable, updateable and easy to use.

Of course, all physicians have their own preferences as to what electronic health record software is right for them. You may have your own list of features that that is vitally important to you. Some of these EMR selection criteria may be so specific and important that a program’s exclusion of such a feature would render it useless. Keep in mind that the best certified EMR programs are customizable, as they are made for physicians who work in a fast-paced environment.

That said, let’s consider 10 of the most important features of EMR software.

1. Web-Based and Secure Portability

2. Complete Integration With Other Medical Systems

3. E-Prescription Compatibility

4. PQRI Automation Automation

5. Adaptive Learning (System Memorizes Data)

6. Patient Portal Accessible From Anywhere

7. Flexible, Non-Template Based Systems

8. Electronic Document Management and Imaging

9. Voice Recognition and Handwriting Recognition

10. In Compliance with Federal and State Regulations

As you can see, EMR software should be, and for the most part is, highly flexible and customizable to your needs. These are just some of the features that may help your business.

RevenueXL Inc. provides Healthcare Revenue Cycle Management Services and Medical Software including EMR Software or Electronic Medical Records (EMR), and Medical Billing software and systems. To learn how you can optimize your revenue cycle and reduce operating costs, accelerate cash-flow, and increase net revenues, visit Revenue XL Inc.

The Causes of EMR System Implementation Failure

Recently I met with some colleagues: physicians practicing Neurology & Family Practice, both of whom haven’t yet gone to EMR. There are two main reasons for this:

1) They’re not sure where to begin. Several of their friends have tried unsuccessfully to implement EMR at the practice. In most cases, it was a strong effort; some teams gave up as time went on, and others went down for the count. Some lost money and time on the project, then calling for ‘no more.’

2) The rate of failure among electronic medical records projects is estimated at between 30 and 50 percent. At first I was startled at this high rate. But, asking around you’ll find someone who’s had a bad experience, or someone who has. It’s difficult to calculate a true failure rate, especially when determining the difference between abandonment – a stopping of use with the EMR system, or true failure – often reported by a software vendor.

Regardless of whether a situation is called an abandonment or a ‘true’ failure, there is the same result: Money, time, heartache, and a practice which falls back into using charts on paper exclusively.

The primary causes fall into a few major areas:

Lack of Commitment or Leadership

Is there a champion physician at your practice? Physician groups need to reach consensus and keep things moving, and without this the smallest bump can have serious repercussions. The champion need not become an enthusiastic proponent of EMR, but they must buy in with the project. Once a staff starts to sense a lack of unity among the level above, things may begin to break down, with splits into different camps, either pro- or anti- EMR.

Ultimately, if the project fails, the entire team fails – not just the single person who initially championed the cause. There’s the chance of a mutiny spreading among the group. There could be a single physician or staff member who is purposefully thwarting the project. They could be spreading doubt among the neutral, or attempting to escalate problem situations. The champion must discover and re-organize these influences before they travel too far into the organization. The champion also must be sure that communication lines are working, with scheduled meetings before and following a date to go live, so a system can quickly be set straight before a particular user gets frustrated and gives up.

Bad Planning & Implementation

This category covers the entire gamut, from hardware and software issues, to setup design, and on to roll-out implementation. Either an IT staff person should be on-board, or an outsourced technology consulting firm should be involved in both planning and implementation. This could include planning, planning training, as well as the product design, and implementation stages. A dynamic schedule or another work breakdown structure should be in place, to keep things on track. A simulation day is another true test. Together these components nurture success, especially in a crisis. Expect to have at least one.

The Internet Technology advisor is also able to assist with network hardware purchases, while trying to control the overall costs of the system. Of course, that doesn’t recommend buying the cheap stuff, either. Controlling the costs of physical infrastructure can turn on you in the end. Unless your office is small, consumer equipment available in retail stores may not be advisable. Obtain and keep up with service and maintenance agreements, including backup switchers and servers. Failure to do so could reduce your practice’s effort.

Having no Purpose

Some electronic medical records projects are in trouble from the very beginning. If the goals for the future system are not described or understood, the chances that a successful plan can form is low. Unrealistic expectations and unclear objectives further reduce the chances of success. Often, practices which don’t maintain a clear understanding of the situation or fail to get expert help could have avoided the problem of no purpose. What do you want the EMR system to do? If you’re not sure of what you ultimately want, you won’t be able to understand what the EMR system needs. If you’re swept up into some software system at a meeting at the Academy, but without understanding the product or company first.

Change Management Problems

Ask any expert dealing with implementation of major technology projects. No matter which industry or business area, they all talk about the ‘people factor’ as being a top cause of project failure. Electronic medical records isn’t any different. Many new doctors have grown with technology, having even trained with institutions already using an EMR system. They won’t skip a beat. The same is true of younger staff members accustomed to social networking and texting. But some of the older physicians make have to make a greater adjustment. They may even have only recently using the Internet, or suffer from technophobia. The resistance to technology can appear in many ways, including refusal and withdrawal. Providing proper training for these employees, preferably by their co-workers, is key in preventing a learning curve that is too steep to be accomplished in advance of the day to go live.

Some of the older staff members could need substantial training. A process should identify those who are falling behind, requiring more re-training. Your practice can’t afford to lack critical buy-in from staff or a lack of ready skill that’s necessary to implement a project successfully.

Workflow processes are also involved in change management. Inefficiencies in care of patients will only be exacerbated on a digital platform. The go-live date is not the date to discover that the new EMR system doesn’t live up to the way they’ve always done it before. Proper technical planning can also help ensure there is proper ‘fit’ between the practice needs and the EMR solution. This can mitigate such failure factors as unrealistic expectations about the time it will take to get the EMR working properly, loss of productivity in the clinic, and inadequate customization. All of these can lead to abandonment of the software system and in a perpetual search for the ‘perfect’ EMR solution which is never realized.

By the way, do you want to learn more about implementing EMR in your own practice? Download my free report “Getting Through The EMR Maze.”