Jerry Fahrni

Tag: EMR

  • EMR software optimized for Windows 8

    EMR & HIPAA: “Yesterday at the Digital Health Conference I had the chance to catch up with George Cuthbert from Medent. He’d emailed me a few months back about the potential benefit of Windows 8 in the EHR world and the deep integration of Win 8 that they’d been working on to leverage the unique abilities of Windows 8 for their EHR users.

    I admit that since I’ve become more of a health IT blogger and less of a techguy, I haven’t kept close track of all that was happening with Windows 8. I knew that it was designed to incorporate touch as a major focal point of the new Operating System and I knew that it was Microsoft’s attempt to integrate the best of touch together with the advantages of data input using a keyboard and mouse.

    Based on the short demo that George did for me of Win 8 and the Medent EHR, it has some real promise. In fact, as the title suggests, I think that if an EHR vendor does it right this could solve the issues that so many EHR vendors have of trying to create an iPad EHR application.”

    I’ve always thought that the Windows OS would be ideally suited over iOS and Android for EMR/EHR use because it is the native platform used by a majority of healthcare systems in the United States. Why continually reinvent the wheel when all you do is delay innovation? That’s what’s been going on in healthcare for the last several years when it comes to using tablet technology. Everyone has fallen in love with products that offers less functionality today than my tablet PC did nearly a decade ago. It’s odd when things turn out like that. People tend to get easily distracted by shiny objects. It happens.

    The EHR software described at the EMR & HIPAA site can be found in the Microsoft Store. It’s called EMR Surface. More information can be found at the Pariscribe website. It looks interesting, but one can never tell whether or not something is usable by simply looking at it. I’d be interested to hear whether or not anyone has used it and what their opinion is of the system.

  • EHRs may not be all that after all

    The New York Times: “Computerized patient records are unlikely to cut health care costs and may actually encourage doctors to order expensive tests more often, a study published on Monday concludes.

    …research published Monday in the Journal Health Affairs found that doctors using computers to track tests, like X-rays and magnetic resonance imaging, ordered far more tests than doctors relying on paper records.

    The use of costly image-taking tests has increased sharply in recent years. Many experts contend that electronic health records will help reduce unnecessary and duplicative tests by giving doctors more comprehensive and up-to-date information when making diagnoses.

    The study showed, however, that doctors with computerized access to a patient’s previous image results ordered tests on 18 percent of the visits, while those without the tracking technology ordered tests on 12.9 percent of visits. That is a 40 percent higher rate of image testing by doctors using electronic technology instead of paper records.”

    I can’t say that I’m surprised by this. I remember something similar when I was working as the night pharmacist at Salinas Valley Memorial Hospital in Salinas, California. Physicians that were using pre-printed order forms to admit patients – now considered the standard of practice – almost always wrote for more PRN medications than those that didn’t use pre-printed order forms. We used to call them “don’t call me orders” because they covered every possible what-if for the patient, i.e. what if they have pain, what if they get a fever, what if they get indigestion or constipation, and so on. And why did they do that? Because it was easy to check a box, that’s why.

  • Shareable Ink plus EHR equals interesting alternative

    EMR Daily News: “Shareable Ink®, an enterprise cloud computing company that transforms paper documentation to structured data, today announced three new partnerships with leading EHR vendors that will further the company’s reach in delivering a reliable, portable and easy to implement electronic data capture solution that works with existing physician workflows. The agreements with Greenway Medical Technologies, Inc., NextEMR, VoiceHIT, and an existing partnership with Allscripts, signal the demand within the physician practice marketplace for a flexible technology that can be used in any care setting to help compliance with Meaningful Use (MU) requirements.”

    I think highly of Shareable Ink. I like the concept and think it provides a nice bridge between where we are today and where we need to be. I first mentioned Shareable Ink back in November 2009. It was a good idea then, and it’s a good idea now.

  • Accurate Assessment of Adherence (man vs. machine) [abstract]

    A recent article in Chest1 demonstrates the value of electronic data collection in medication adherence. In this case it was inhalation therapy in cystic fibrosis patients. This type of article is important as we consider the future of electronic health records and where the data for such records should come. Remember, people are notoriously unreliable historians while computers don’t lie.

    (more…)

  • EHRs may not be the panacea many are hoping for

    Selected excerpts from post-gazette.com article:

    More and more studies are questioning the efficacy of electronic health records, and the U.S. Food and Drug Administration has begun collecting reports involving electronic health and IT errors, some of which have resulted in death…

    “The thing about these systems is that it doesn’t really look like they’re getting any cheaper,” he said. “And the upgrades and the upkeep represents a very significant cost, especially in outpatient clinics.”

    Of those, 163 contained mistakes that could have led to “adverse drug events.” Most errors were mistakes of omission — a doctor left out an important piece of data.

    Notably, this “is consistent with the literature on manual handwritten prescription error rates,” the report said. But the larger point is computerized systems do not automatically outperform paper ones. [referring to: Errors associated with outpatient computerized prescribing systems. JAMIA, 2011; DOI: 10.1136/amiajnl-2011-000205]

    For an industry that relies on data and evidence-based measurements to make decisions on the clinical and pharmaceutical side, there isn’t a lot of evidence supporting the notion that electronic health records produce cheaper care or better outcomes.

    I think the article outlines some of the significant problems that need to be addressed before a truly effective EHR system can be utilized. We’re forcing the healthcare industry to implement a technology that they’re simply not ready for. The IT infrastructure in healthcare is built on marbles and is still years behind the consumer market in all but the most advanced facilities. In addition we continue to struggle to standardize information. We first need to understand what the information will look like before we begin forcing everyone to use it.

    There’s no question in my mind that sharing information across the healthcare continuum is paramount to providing safe, efficient, cost effective healthcare. However, there are some key pieces of the puzzle missing. Without those pieces we’re not going to get the whole picture, and that’s a problem.

  • Patients still not diggin’ the idea of an EHR

    EHR outlook: “Patients are still worried about how secure their data will be when stored in an EHR systems, a new study suggests. Xerox Corporation found that of 2,720 poll respondents:

    • 80% were concerned with stolen personal information
    • 64% were concerned with lost, damaged or corrupted files
    • 62% were concerned with the misuse of information”

    I’m not surprised by the numbers. In general people are afraid of change and the unknown. With that said, I think all you need to do is walk a patient through the paper processes that we use now to give them some insight into how bad things really are. Stolen and lost personal and medical information is a major problem within the current healthcare system. It’s not uncommon in any given week to hear about patient records that have been lost or stolen. And as far as misuse of information, well lets just say that’s all too common as well.

    The advantages to an EHR outweigh the concerns listed above. Just sayin’.

  • Revisiting the idea of Shareable Ink

    EMR and HIPAA: “The interesting thing about Shareable Ink is that they provide such an interesting middle ground between a technical solution and continuation of paper. I remember about 5 years ago when I heard someone describe the perfect clinical documentation system. It was completely flexible. Required little to no training. Supported every possible documentation style. etc etc etc. Then, they acknowledged that what was being described was the paper chart. It was then that I recognized that while EMR can provide some benefits that paper charts can’t provide, paper charts also had some advantages that would be difficult to provide using an EMR.

    I think this background is why I found the Shareable Ink approach to documentation so fascinating. I really see it as an interesting way to try and capture the benefits of granular data elements and electronic capture of the data while still enjoying the benefits of paper.

    My simplified explanation of the Shareable Ink technology is as follows. You print out a form that you want to use for the patient visit. Each page that’s printed out has a unique background (although it just looks like a colored page to the naked eye). When you use the Shareable Ink pen to write on the printed out page, the pen uses a camera to record what you wrote on that page and where you wrote it. Then, once you sync the pen it recreates the document you wrote on in the system.”
    (more…)

  • Practice Fusion EHR gets allergy alerts

    I am a fan of web-based healthcare applications, including EHRs. I especially like the web-based EHR available from Practice Fusion. The application is full featured, easy to use and free. I spent a little time playing with it back in June 2010. One of the things I noted during my review was that “there appears to be no cross checking between allergies and newly entered medications.” As a pharmacist this was pretty important. Well, I’m happy to say that allergy checking no longer appears to be an issue.

    EHR Bloggers: “We’re excited to bring you a major new feature for your EHR account today: drug-drug and drug-allergy interaction alerts. It’s a frequently requested enhancement and also a big step towards Meaningful Use. And, like all our features, this clinical decision support system (CDSS) is entirely free.

    Drug Interaction Alerts
    You will now be automatically alerted when a drug you are adding, prescribing or refilling interacts with another drug or with an allergy listed in the patient’s chart. The following video shows you how to set permissions, heed alerts and override alerts. “

    To gain access and begin using the Practice Fusion EHR simply sign up for a free account here. I would encourage any practitioner that needs a robust, easy to use EHR system to give Practice Fusion a look. It’s a solid application.

    I was going to try the new feature for myself, but forgot my credentials; how embarrassing.

  • Integration of medical device data into EMRs

    EMR Daily News: “Recording and charting changes in vital signs has been identified as one of the core areas that will be measured for meaningful use incentives. The new Intelligent Medical Devices HIMSS Analytics white paper, sponsored by Lantronix (NASDAQ: LTRX), and posted on the HIMSS Analytics website, details progress on these efforts. The research suggests that just one-third of hospitals in the HIMSS Analytics sample on medical device utilization indicated they had an active interface between medical devices at their organization and their electronic medical record (EMR).”
    (more…)

  • EMR data exchange with web services (article)

    I came across an interesting article recently in the International Journal of Biomedical Engineering and Technology1. The article discusses the difficulties in designing an EMR system capable of providing optimal access to data elements while remaining efficient and user friendly.  It was a good look at the current state of healthcare data exchange.

    Abstract:

    This paper discusses how to share medical information between heterogeneous applications via web services. Our design theory is based on a real-options framework, performance analysis and experience building iRevive, a working web-services-enabled pre-hospital documentation application. The trade-offs between efficiency and flexibility are examined in the context of exchanging information based on emerging standards in the healthcare world. These trade-offs are quantified using a real-options approach. We illustrate the importance of uncertainty in deciding the architecture enabling an application to access medical information from Electronic Medical Records (EMRs).

    (more…)