I worked for Jim Gargiulo, Executive VP at Netsmart Techonologies for a number of years, and he would become frustrated when we discussed the EHR in static terms. “It’s a journey!,” He’d exclaim. 
The Office of the National Coordinator is taking this evolving view for the EHR.
The ONC promises that the requirements of certification will need to be updated as times, treatment methods and tools evolve, and change seems to be the only real constant in this universe.
The ONC says that some policies and standards will come into play, then later be phased out or replaced. In order to accommodate this way of doing business, the software industry has included tools to modify your EHR to suit a changing environment. The tools are sometimes inadequate. Some companies don’t want to give up control of your EHR. Usually tools would work fine to whip up a screen and include a report to reflect new policies & standards, as long as you have somebody on staff who has the wherewithal to use them. When they’re inadequate, you pay money for a programmer to help, and her baby needs shoes, Billy needs braces, and Sally’s going to college next year.
Wake up, my friends. Provider agencies need somebody working for them who can do a few things: • Design forms and reports (and if tools enable it, Electronic Data Interchange files) • Include workflow processes at all levels of the agency in updates • Implement using a rapid cycle change methodology or something like it • Incrementally update and implement the design when changes come • Roll out changes EFFECTIVELY to staff requiring them, and be savvy in convincing the staff to look forward to changes
If you need help with this, click on “About Terry McLeod” above…my contact information is at the bottom of that page.
Installment 5 of this series will discuss more about certification options and your decision to maintain an enterprise system or opt for a modular approach.
Read more →There are three stages in proving Meaningful Use of your EHR to the Office of the National Coordinator and CMS in order to receive Medicare and Medicaid incentives amounting to around $100,000 per provider over a five year period.
Stage 1: In my MU 1 post, I shared this needs to be addressed in 2011. That means getting ready this year, and the year’s 25% gone, and depending on where you are in your evolution to the EHR and how your vendor responds, it could be a big job.
Next year your EHR will need to be not only collecting the demographics and services rendered that are usually in place for billing purposes, but also tracking and electronically communicating patient clinical matters (like assessments, treatment plans, notes and medications). Moreover, you will need to be using your EHR for clinical decision support.
Stage 2: In 2013 the EHR will need to expand into areas like order entry for medication and other practitioners orders. This is a big concern; a number of software vendors in our sector are just getting around to developing these modules, and they can be clunky for the users in their first iterations. The system will need to provide electronic transmissions of data like using approved formats for labs, pharmacy and other ancillary services used in patient care.
Stage 3: On a national scale, elements of healthcare come into the spotlight on a regular basis. Beginning in 2015, these concerns will need to be tracked. The EHR will also need to expand to include quality improvement (and proof thereof), and provide patient access like the portals you see in Microsoft Health Vault and Google Health. Software vendors have been developing these tools for patient use for a while, and that development has already expanded into our sector.
It’s only rocket science, and we’ve done that.
Contact me if you need help.
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