Professionals who need an Electronic Health Record (EHR) for a private practice have a number of options, and the trick to finding software that works for the individual practice is settling on one of them.
My advice is to get a list of as many products as possible with a little information on each of them off the web and read it. Then, narrow the field to a half-dozen or so based on initial research and check their web sites out. This can be a complicated matter, what with the myriad of opinions on software out there and the temptation to just buy what your pal Joe uses in his practice. Don’t do that. Do the research, or hire a professional (like yours truly) to do the research and the satisfaction level will certainly be higher once the money’s spent.
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A newsletter I subscribe to from an industry publication had a link to a practice management software package, and I’ve been threatening myself with tackling reviews of software for solo and small practice software for well over a year, so I took a look.
The product is called TheraQuick, and there’s a video on the website that gives a pretty concise overview. As with all overviews, this stimulates questions for me.
StarQuick Solutions is the small California company that manufactures TheraQuick. I was immediately encouraged to see the staff is comprised of varied disciplines, including a rocket scientist, a psychologist, and an expert in software interfacing. Depending on the charisma and personalities involved, there is at a fair chance that the software will be a balance between the needs of the users and a vendor’s business realities. I look for a practical development approach that keeps an eye on affordability for elegant features and functionality. That pragmatic statement is all about survival of the current software and the vendor’s business.
My overview of the product is positive; however I have almost no substantive knowledge of the company. If I were buying for a solo practice, I’d want to see more of the product and have some in-depth conversations with a couple people at StarQuick. I would like to know how long they’ve been in business, how many customers they have and to talk to some of those customers. It’s not out of line to ask those customers about their relationship with the company, hoping they aren’t the programmer’s aunt.
Here are the pros and cons I saw in a brief overview:
A lot of good: The software covers a lot of bases, and the more your primary software system does, the less a professional needs to get from some other source. • Billing, due to insurance requirements, is inherently difficult; a module is included, as well as basic accounting for services rendered and credit card charging. • The software seems pretty simple to operate. • I didn’t get an in-depth look at the customizing features, but the product enables the user to modify a “Dashboard” to suit their needs; Dashboards are a one-screen view and access point to whatever the user would use most – consumer record access, treatment history, billing, etc. • Professionals can minimally modify the session note to suit their particular style and needs; I’m not sure how far this goes, but regardless, it’s a positive feature. • Scheduling looks good, and there are a number of similarities to MS Outlook; I like to see all my tasks and appointments for the day, week, and month at a glance, and the product allows me to do this. • The system can be set up for different office locations for the professional who travels around (there are many folks meeting this description); this is a plus and in some states a requirement.
I’d Like More: Like all software packages, there’s always more work that can be done. • I’m a stickler for workflow. If the documentation doesn’t fit in with the daily work, it creates work because you have to come back and do it later. If, instead of collaborative documentation and treatment planning with the consumer, the professional writes nothing down and makes no follow up steps with the consumer to advance treatment, the documentation becomes an added step in accounting for what happens. I didn’t see much attention paid to concepts like these. • I’d like to see a treatment plan. Now, I’ve worked with treatment organizations for a long time, but haven’t really spent much time in solo practices…perhaps treatment is not planned with the consumer in this environment, but it seems reasonable to me that a treatment plan should be part of working with the consumer to resolve the problem by meeting short-term objectives and establishing roles and “rules of the road” for the treatment relationship. • I’d like to see a stronger Report Writer…I demand robust report writing capabilities, and as a Crystal Reports writer, perhaps I expect too much. An overwhelming majority of the folks I’ve talked to over the years about the Electronic Health Record (EHR) really want reports to look a certain, special, individual way. Sometimes that’s due to local or state regulations, sometimes a Joint Commission (JCHAO) or other accrediting, licensing or auditing agency; sometimes just because they’re happy with a format they’ve used for a long time. The point is without a very robust report writer, you just can’t make the reports look the way important people want them to look.
I think that anybody in the software manufacturing business who can sell their product to 100 people, continue to provide effective support and still grow probably has a product that will work for a bunch more people. Where a number of professionals drop the ball is in investigating the company they will be working with for a number of years. A little research pays off for the life of a practice, which is why busy professionals contact me.
Read more →My mom was big into psychics…not that she believed them, she was merely intrigued. Right?
Predictions regarding the Electronic Health Record (EHR) for the year are out, and not that I believe them, but I’m intrigued.
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Let’s start with Marla Durben Hirsch, a contributing editor for FierceEMR. She has five predictions, and the one I’m most interested in is software vendors using cloud technology. Cloud technology is a marketing term that encompasses a bunch of services offered by an EHR vendor. Sometimes referred to as an ASP (Application Service Program), it includes using the server, gobs of disk space, and great services like automatic updates to the latest, greatest software enhancements. From a vendor standpoint it’s easier to maintain and support because the vendor has control of the technology. Sometimes professionals and the organizations they work for tend to cut corners on technology to save a few bucks. From a professional’s viewpoint, cloud technology may be good because they’d rather not become a technology expert or have to hire a local consultant to handle all the jobs involved in maintaining a system. The core of this provision of the EHR is that it’s deployed on the web.
The first worry that usually surfaces is the security of consumer data and confidentiality of a consumer’s health information.
I’ve talked before about security, and SSL, or Secure Socket Layer is the most common method of securing a connection between a professional and their data when the EHR is housed and maintained elsewhere. Another security method is Citrix, which is supposed to be even better security than SSL. There are more methods of securing the confidentiality of consumer records, and anybody who sells an EHR system must offer good data access security these days, or else the HIPAA police will get very upset and there will be consequences to pay. So, since this was all worked out years ago, data security is generally not an issue when a professional uses a web-based EHR; people buying software still ask about it, so I address it.
Cloud technology is especially valuable to solo professionals (products like practice fusion) or small organizations with under 100 employees (products like Foothold Technology’s AWARDS System. Professionals really need to be treating consumers, not troubleshooting server problems or wondering if a backup is available after a system crash.
InformationWeek has its predictions published already. I like number seven. I think what they’re talking about is providers of one product (like lab or pharmacy services) delivering web-based EHR modular software solutions to woo more customers into using their primary product or service.
One significant drawback to a solution of this sort is that it’s a module. Both professional and consumer are better off with a total solution where session notes (including breakthroughs and next steps) and mutually developed treatment plans can be attached to everything else in the consumer’s record. Still, the prediction is for this sort of modular approach to software in mental health and addiction treatment is on the upswing for 2012.
Healthcare IT News has a different take, and I find it quite interesting. For example, since the growth of Healthcare IT has been a major focus of the American Recovery and Reinvestment Act (ARRA), and the gains have only been modest, I agree that will played up quite heavily in the presidential election. This sort of thing can be spun to either create controversy, or used as evidence of doing a great job, depending on which side of the fence you’re standing on.
Politics. Sheesh.
Whether you accept the predictions that are coming at us like popcorn as valid or not, it is at least fun and educational to check in with what people in the world out there think.
Enjoy your day, and don’t sweat the predictions…unless you believe in psychics.
Read more →“It slows me down!”
A lot of professionals complain about entering their notes and other consumer care documents into the Electronic Health Record (EHR), saying it slows them down, or they don’t have time, or something of that ilk. My experience with this issue is that once the EHR is properly in place, it saves time and the professionals actually start to like it. I even hear comments from consumers that they like the idea of collaborating on their treatment plan and knowing what the next steps are going to be when they show up for their next session (a handy use for the EHR).
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It’s true, however, that the EHR can slow professionals down for at least a few reasons:
The good news is that all these shortcomings can be avoided.
Process Analysis is simply following a consumer through treatment and seeing how the professionals’ documentation is captured before the EHR comes into play. Process Design for efficiency uses the analysis and needs a couple very important tools to enable the EHR to work to the advantage of the professional: The screen designer and the report writer (other tools like treatment team and consumer communications software are great, but these two tools are the foundation of designing a working system). Process Implementation actually pulls together an EHR design that makes documenting services less time and effort consuming.
So, if the EHR really can save professional time, provide treatment team communication and help deliver better treatment to the consumer, how come so many professionals resist using it? I’m sure there are hundreds of excuses and a number of valid reasons not to use the EHR, many related to specific technology problems that could be remedied for a price. Other than that, professionals would rather treat consumers than learn to use an EHR…or improve their keyboarding skills.
There are a bundle of solutions out there to address professional resistance to using the EHR, and one is a marriage of low-and-high tech: The Remote Scribe.
Imagine, if you will, you’re in a session with your psychologist, and there’s a large screen on the wall that displays your EHR. You answer questions in an assessment, or talk about the plan to treat your difficulty, and the screen starts displaying the assessment selections or typing magically appears during the session. Interesting.
The high-tech portion of this solution is the simple presence of the EHR in the first place. The low tech portion of the solution is that the notes are relayed via a headset and microphone to a “Remote Scribe” (a human being). So, another data entry person is on the payroll. Not a new twist, this is getting the same old documentation solution back into the healthcare arena. The scribe has been called a transcriptionist for many decades, and some professionals would rather retire than move away from this sort of medical treatment documentation service. I suppose it’s a valid way to keep technology resistant professionals working, but it strikes me as paying double for documenting services, which is the data entry bummer. Even if the Remote Scribe delivers a return on investment, it’s still adding a task into the mix that doesn’t need to be there if the EHR is designed and implemented with efficient and effective professional workflow and with the consumer’s best treatment in mind.
The simple solution, and a much more valid one for my money, is to follow the direction of the EHR that’s moving us toward National Health Record and better care for consumers with the help of technologies enabling electronic sharing of consumer records in order for professionals to treat the person as a team.
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