Health 2.0 speaker says 'find a way to build a business model'

“Health 2.0 has the promise to change the healthcare industry,” the conference’s opening keynote speaker Mark Smith, president of the California HealthCare Foundation, told the audience on Monday.

Smith also asserted that health reform is necessary for innovation and vital to the success of Health 2.0 entrepreneurs’ business model because the current system is set up to pay for volume.

[See also: 11 health IT startups go for the money.]

Launched in 2007, Health 2.0 stages an annual conference focused on innovation and on tools aimed at helping consumers manage their health and connect to care providers.

California HealthCare Foundation (CHCF), a nonprofit grant-making philanthropic organization, has set up an innovation fund so companies can “innovate, spread and change the world,” Smith said. The fund was created, he said, because “I’m tired of seeing successful pilots die on the vine.”

Despite the success of a grant-funded pilot, academic entrepreneurs often move onto the next grant opportunity, according to Smith. CHCF hopes its efforts will help entrepreneurs “try to find a way to build a business model.”

[Q&A: Todd Park on the bridge between HHS' Health Data Initiative and meaningful use.]

The good news is that technology is maturing and policy to support these initiatives is evolving, Smith said. The bad news is that technology is not the obstacle. Rather, guild rules, payment rules and culture are the obstacles. The other bad news is that the industry is running out of time, he said. Despite widespread bipartisan agreement that the system is broken and needs to be fixed, the cost of healthcare is continuing to escalate and the fiscal future of the country relying on healthcare reform.

Smith offered areas of opportunities for innovators:

• Solutions should address cost, but they shouldn’t merely shift cost. Until reimbursement reform eliminates the “perverse incentives” for payment, entrepreneurs need to understand which stakeholder’s money is being saved.


• Entrepreneurs should innovate in a way that makes the healthcare system more convenient for patients. They need to understand, however, that the value proposition of patients may “represent a threat to the existing order,” Smith said. He cited Kaiser Permanente’s shift of educating and marketing its electronic health record system from the providers to the patients because the EHRs delivered value for patients.


• Solutions that enable rapid learning for providers addresses the under-learning problem that currently exists because there is so much data being generated that is taking providers too long to consume. Being able to turn massive data into information and then learning “is a big priority,” Smith said.


• Finally, the enrollment of the uninsured – numbered around 35 million – beginning in 2014 creates huge challenges for payers. Solutions will be called on to address when and how the newly ensured will want to sign up.

“Health 2.0 is on the verge of taking off,” Smith said, because of the mature technology. Affordability, accessibility and improved quality and outcomes will drive Health 2.0 solutions, he concluded.

10 Hilarious Medical Transcription Errors

Medical transcription is a very important process when it comes to the business of saving lives. Those are the seemingly indecipherable notes on your patient sheet that your doctor will look over to help decide which medicines and treatments you will need to become a functioning human being again. Unfortunately, a lot of these notes are written in haste and words can be misspelled, forgotten, or switched around.

You might be shocked to hear that doctors goof up on those notes, especially when receiving wrong doses or entirely wrong medicines can do much more harm than good. While medical transcription errors are best avoided, not all of them spell doom for a patient. In fact, a lot of them are hilarious. Here are some of the best medical transcription errors that have found themselves leaked onto the Internet.

Transcription Error: The patient was breathing heavily with no signs of respiration

Hmm. This sounds like the kind of case that only House M.D. could solve, with a mixture of snark and common sense. I guess the twist ending would be chest spasms without lung compression. Or House would just call whoever wrote this note an idiot.

Transcription Error: The baby was delivered, the cord clamped and cut and handed to the pediatrician, who breathed and cried immediately

Doctors spend years and years in school, learning how to do doctor things. After these years and years of school, they have to go through years of on the job training. This is quite understandable, as anybody with a decent chance of being elbow deep in somebody’s intestines should know what they are doing. The downside of this is doctors don’t learn sentence structure. Or this was just the world’s most emotional M.D.

Transcription Error: Exam of genitalia reveals that he is circus sized

This is the type of note that we all wished our doctors would write for us. Forget those cheesy pick-up lines. Whenever you are at the bar you would just pull out this official documentation from your doctor, show it to the woman of your choice, and have the night of your life. This is of course assuming that the note is accurate, which this example certainly wasn’t. It was just the best accidental compliment of that patient’s life.

Transcription Error: Bleeding started in the rectal area and continued all the way to Los Angeles

That sounds terrifying. The specific level of terror depends on the distance between the patient’s rectum and Los Angeles, but it is arguable that the phrase “bleeding started in the rectal area” is terrifying enough on its own.

Transcription Error: She is numb from her toes down

Alright ladies, if these are the problems that you are seeing the doctor for then you have officially lost all rights to make fun of guys about refusing to see doctors. We at least wait until that numbness reaches our ankles. Tough guys will wait until it hits the knees. Or else the doctor forgot to address the serious matter of toes growing out of a woman’s forehead.

Transcription Error: Social history reveals this 1 year old patient does not smoke or drink and is presently unemployed

On second thought, this might not be an error. The news is always talking about how fast kids are growing up these days, what with all the hormones put in our cheeseburgers and all. Maybe doctors are actually concerned about alcoholic chain smoking infants. Maybe this medical transcription is proof that we will finally see a baby born with a glorious mustache.

Transcription Error: Patient called and left word that he had expired last week

This patient wins the award for most courteous zombie of all time. Of course the doctor probably meant that the patient’s health insurance or something had expired, but a polite zombie apocalypse is a far more interesting theory.

Transcription Error: On the second day the knee was better, and on the third day it disappeared completely

Everybody has memories of falling down and scraping their knee when they were little. You would sit there and cry over what was a horrific injury in your mind, but actually barely qualified as a boo boo. It was at this time a supposedly funny uncle or dad would joke that they had to amputate. After all, if you don’t have the knee it won’t hurt anymore. This is what happens when somebody gives that funny uncle/dad a medical license.

Transcription Error: Discharge status: Alive but without permission

It is not unheard of for doctors to get a God complex since their jobs are literally life and death. It is a little weird to see one so blatant about his need to control everything. Most doctors would be glad to see a patient breathing, let alone healthy enough to leave the hospital. It sounds like this doctor wants to track down this patient and take away his clean bill of health with his bare hands.

Transcription Error: The patient is tearful and crying constantly. She also appears to be depressed

Sherlock Holmes is not only the world’s greatest detective, but also the world’s greatest physician. His bedside manner leaves a little to be desired, though.

This article was originally posted at  http://ping.fm/7BBrs

Diabetes care improves with EHRs

Care for patients with diabetes improved appreciably when their physicians use electronic health records (EHRs) extensively, according to a recent study.

Physicians who participated in the Massachusetts eHealth Collaborative from 2006 to 2008 significantly increased their ability to generate and use registries for laboratory results and medication usage. The more actively physicians used their EHRs, the more they used registries, particularly for care of patients with diabetes.

Researchers looked at the use of registries in the years immediately before and after the Massachusetts eHealth Collaborative program installed free EHRs for participating physicians. In 2005, 44% of physicians could generate a laboratory results registry; by 2009, 78% could.

 

In the same period, the percentage of physicians who could generate a medication registry increased from 33% to 83%. The ability to generate a diagnostic registry remained stable at just under 90% for practices of all sizes.

 

The use of registries "is considered a measure of physicians' engagement with [EHR] systems and a proxy for high-quality healthcare," according to the researchers. Registries are lists of patients with specific health risks, diagnoses, laboratory results, or medications that enable physicians to assess their own quality measures. The ability to generate registries is one measure of meaningful use of EHRs used by the Centers for Medicare and Medicaid Services.

In another study looking at the role of technology in managing diabetes, use of a mobile application was found to reduce A_1C levels in patients with type 2 diabetes by nearly 2% over a 1-year period.

Participants received cell phones preloaded with diabetes management software and were asked to enter their blood glucose levels when they tested. The app analyzed the reading, sending a text message coaching the patient on ways to quickly moderate their blood sugar levels if they were too high or low.

The study involved 26 primary care practices with 163 patients. At the end of the year, patients who used the mobile app with provider decision support had a mean drop in glycated hemoglobin of 1.9%. Patients in a control group experienced a decline
of 0.7%.

This article was originally posted at  http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Diabetes-care-improves-with-EHRs/ArticleStandard/Article/detail/739113?contextCategoryId=44687

4 tips to boost hospital efficiency

Implementing new technology can be tedious, and the work doesn't stop once go-live occurs. Constant changes are needed to keep IT systems up to speed and better improve their performance.

But luckily not every update requires hours to complete. Edna Boone, senior director, mobile initiatives at HIMSS, gives us four quick and simple IT tweaks to improve hospital efficiency.

[Q&A: How meaningful use is clashing with ICD-10.]

1. Embrace best practices. Boone suggests considering tried and true best practices – such as total quality management, business process reengineering and Lean and Six Sigma – and applying those concepts to your IT department. By employing Lean Sigma Six concepts, for example, an organization can streamline IT functions and increase customer satisfaction through proven techniques.

2. Involve your users. "Engage key stakeholders and end users of your system and process in your workflow and efficiency analysis," said Boone. The additional opinions could open your eyes to improvements. "Implementing small, incremental changes while working on large-scale plans can have big results as well," she added.

[See also: The top 3 takeaways from National Health IT Week.]

3. Look for additional resources. Consider an automated workflow modeling application, Boone said. In addition, look to the Process Management and Workflow section of the HIMSS Management Engineering and Process Improvement Toolkit. The section contains tools and tips regarding ways to simplify processes, implement Six Sigma to determine risk management and improve IT implementation and operations.

4. Consider the customer's perspective. Boone recommends taking on the role of the customer and completing a walk-through of your processes to identify both barriers and opportunities. "Start by calling for an appointment," she said. "Then try to find the department in the hospital. What is the environment like? Is the staff friendly and welcoming?" Next, take a look at your admission process. "Is it quick, complicated, too invasive, lots of paperwork, or easy to maneuver?" Boone said. "And finally, what are the procedures? How did the staff interact with the client?"

This article was originally posted at  http://ping.fm/fEcOI

Top 5 green health IT trends

If properly executed, green IT can mean healthcare organizations see fewer bills, contribute lower levels of carbon emissions, and enjoy an easier transition into mandated practices. But it has to be done right. Noble and potentially cost-efficient, but embracing the "go green" trend isn't simple.

Jerry Buchanan, account director Healthcare Technology and Services at eMids Technologies, shares five powerful green IT practices for healthcare.

1. EMR: Paper trails have met their match with the creation of one of the most popular green IT practices: the electronic medical record. "Anyone can remember going to the doctor and seeing a huge file filled with paper,” said Buchanan.

[Q&A: Between the lines of NEJM's EHR report, 'trust trumps tech' authors say.]

An analysis conducted by Kaiser Permanente, published in the May 2011 issue of Health Affairs (subscription required), estimated that EMRs have the potential to reduce carbon dioxide emissions by as much as 1.7 million tons across the United States. The same study, which looked to 8.7 million users of Kaiser Permanente HealthConnect, showed that using an EMR avoided the use of 1,044 tons of paper for medical charts annually. It all resulted in a positive net effect on the environment.

2. Telemedicine: Although telemedicine has existed for more than 20 years, its benefits are just now coming to light, especially in rural communities. "People don't have to drive all over for specialist referrals and things of that nature,” noted Buchanan. In addition to cutting down on gas emissions, telemedicine has been shown to better manage chronic diseases; improve the care of elderly, homebound, and physically challenges patients; and improve community and population health.

3. Server Virtualization: Server virtualization continues to be one of the most common ways organizations are going green. By virtualizing servers in their data centers, organizations are reducing the number of physical servers used. In turn, this cuts physical hardware costs and the data center's carbon footprint. A report by The 451 Group titled “Eco-Efficient IT” found that each server eliminated through virtualization can reduce power consumption in a data center by up to 400 watts, which is the equivalent of about $380 per year, per server.

[See also: GAO pushes for better federal green IT efforts.]

4. Desktop Virtualization: Desktop virtualization doesn’t just lower energy costs – it can also increase productivity and decrease capital expenses on PC hardware. The technology promises thin-client computing by centralizing management of all user desktop environments on a single platform. In 2009, Forrester Research published a report comparing thin clients to desktops and found thin clients consume between five and 60 watts per device, compared to the 150 to 350 watts used by a desktop PC.

5. Virtual Collaboration: Web conferencing, instant messaging and other software all come into play when promoting virtual collaboration. By partaking in virtual employee meetings and other collaborative efforts, travel and other expenses are cut dramatically. Employing virtual collaboration increases efficiency and enables employees to access information and applications anywhere at any time. Additionally, using this technology can increase productivity and teamwork.

What is your organization doing to go green?  Leave your comments below.

This article was originally posted at http://ping.fm/oixsi

Dictating From Anywhere ? Violation of HIPAA Privacy Rule?

Digital voice recorders, mobile phone aps, or even speech recognition may violate the HIPPA Privacy Rule when physicians go mobile with dictation.

Health organizations are required to protect patient privacy under the guidelines set forth by the Health Insurance Portability and Accountability Act (HIPAA). Medical transcription services utilize secure servers and encrypt files to protect against privacy breaches, but doctors can easily violate the HIPAA Privacy Rule, create poor audio quality dictations and cause transcription errors when dictating from “anywhere.”

Protecting Patient Privacy and HIPAA Compliance

Physicians who transmit patient data electronically must comply with the HIPAA privacy rule to protect patient privacy. The Office of Civil Rights Privacy Rule describes “protected health information” (PHI) as being “individually identifiable information” that is transmitted by any media between the physician and his business associates within or outside the HIPAA-covered entity.

Therefore, if a physician is dictating a clinic note in the hallway outside the exam room and that information can be readily overheard by other patients, the doctor is not HIPAA compliant. If the physician uses a digital voice recorder without password protection or encryption and the recorder is left unsecured, this would also be a HIPAA violation. Doctors should take steps to ensure HIPAA compliance when dictating.

Digital Voice Recorders and Poor Quality Audio

Portable devices such as digital voice recorders and mobile phones, when used in public places, pick up background noise that obscures the dictator’s voice. Even simple movement of the recorder can cause static; and a doctor dictating in a car might as well be dictating in a wind tunnel if he has the window down or AC going. Dictating on the move increases the chances of background noise, changes in volume, and other interruptions that compromise sound quality. These same distractions are likely to result in poor dictation habits and incomplete dictations.

Dictation Errors Become Transcription Errors

While dictating on the move can seem convenient to the busy physician, it is not the best way to improve accuracy and rarely results in organized and concise medical documents. When on the move, physicians are not likely to have ready access to necessary patient information which leads to misinformation and/or incomplete dictations. Rushing from one location to the next with recorder in hand, breathlessly dictating amid heels clicking and doors squeaking, is a poor dictation habit.

Dictation practices that follow a routine will save time, not those that are crammed in between other activities. Not only does dictation multi-tasking lead to transcription errors, it also leads to the possibility of recording personal conversations and even restroom visits when distracted physicians accidentally leave their recorders on.

Mobile Dictation for Emergencies Only

Modern technologies provide physicians many options for dictating, but dictating on the go should be reserved for emergencies only. Stat dictations that need to be done immediately for the welfare of the patient are often called in to a service and are not done with the daily dictations.

For everyday dictating, it is much more efficient to establish a routine. This will save time, protect patient privacy, and result in quality medical documents done right the first time. Very few physicians are trained in the art of dictation, but it is a valuable skill for the busy physician to master.

http://ping.fm/XAy7t

Day-Long HIPAA Boot Camp Targets HIM Professionals

The 2011 annual convention of the American Health Information Management Association, Oct. 1-6 in Salt Lake City, features a series of in-depth post conference educational sessions on the 6th, including an eight-hour HIPAA Privacy and Security Boot Camp.

The camp is designed for health information management directors, other professionals with little or no privacy experience who is taking on a new role as a privacy officer or would like to, and existing privacy officers who want a better understanding of regulations and issues.

"I'm not going to assume they know too much," says Kelly McLendon, the presenter and founder of HIXperts, a Titusville, Fla.-based consultancy. "I'm not going to leave anyone behind, but at the same time will go beyond the basics."

McLendon will cover the tools of HIPAA privacy compliance, such as policy templates, spreadsheets and other forms for specific functions, such as cataloging records systems with protected health information. He'll cover expected requirements in a final omnibus HIPAA rule expected this year covering the privacy, security, breach notification and enforcement rules, and also cover privacy regulations from the HHS Substance Abuse and Mental Health Services Administration.

"This is a very deep view of HIPAA for HIM and privacy professionals, but we will start from the basics and make sure everyone understands from the ground up," McLendon says. More information on educational session 7004, "HIPAA Privacy and Security Boot Camp," which starts at 9:00 a.m., is available at ahima.org.

This article was originally posted at  http://ping.fm/J7wro

HIPAA at 15: HITECH Tightens Health Care Data Privacy Laws

Fifteen years after Congress enacted the HIPAA data privacy laws, health care IT is adapting to guidelines made more stringent by the 2009 HITECH Act.

With 2011 marking the 15th anniversary of the Health Insurance Portability and Accountability Act, health care providers and IT companies continue to evaluate how to keep electronic health data secure.

On Aug. 21, 1996, President Clinton signed into law a set of rules detailing who can access personal health information. Under HIPAA, health information may not be disclosed without a patient's consent unless disclosure is necessary to administer benefits, payment or health care.

Under HIPAA, providers must regularly disclose privacy practices to patients, and parties must also disclose information to the Department of Health and Human Services if they're under investigation.

"It does give patients rights to their records and the rights to know who's seen their records, and that's important," John Moore, an analyst at Chilmark Research, told eWEEK. The law doesn't tell hospitals what to do with the data, however, Moore added.

HIPAA has also influenced the passage of the Obama administration's 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which made penalties for data breaches more severe. Data breaches can now cost companies up to $250,000, Moore noted.

The 2009 HITECH Act widened the scope of privacy protection under HIPAA following criticism that the privacy laws had not been rigorously enforced, according to Amit Trivedi, health care program manager for ICSA Labs, a division of Verizon. ICSA tests electronic health records (EHRs) to see if they satisfy federal mandates on meaningful use.

Under HITECH, "business associates," or third parties such as a billing company or cloud provider, now must follow the HIPAA privacy laws by protecting patient information and reporting data breaches, Mike Gleason, director of information services at Scottsdale Healthcare, in Scottsdale, Ariz., told eWEEK.

"That wasn't as clearly spelled out in the initial HIPAA law but was in HITECH provisions," Gleason said.

Concerns about HIPAA rules have resulted in some companies avoiding the health care IT space altogether, according to Moore.

"You need to jump through hoops to make sure a solution is HIPAA-compliant," Moore said. "So some companies say we're just not going to go there, particularly now that they've strengthened HIPAA rules and [implemented] big penalties for those that have violated HIPAA."

Meanwhile, HIPAA privacy laws have led to opportunities for vendors such as Proofpoint, a software as a service (SaaS) company that provides email archiving to large enterprises.

In an email, Proofpoint's service can spot identifiers, such as Social Security numbers or the name of a disease, that could be in violation of HIPAA laws, Rami Habal, director of product marketing at Proofpoint, told eWEEK.

"We spend a lot of time in R&D defining what HIPAA compliance is," he said.

For health care, HIPAA has served as an example for other industries to follow as far as data privacy, Habal suggested.

"It's sort of an important thing to recognize that HIPAA is almost at the forefront as far as best practice in ensuring privacy in business communication, and you have more and more organizations abiding by it," he said.

In addition, providing access to health care data in the cloud has made HIPAA compliance easier, Habal said. "You can have a more secure HIPAA compliance infrastructure in the cloud than what you get on premise," Habal said.

To keep data secure, Scottsdale Healthcare, in Arizona, uses Proofpoint's email archiving service, Microsoft Vergence (formerly Sentillion) single-sign-on technology, Barracuda Web-filtering and Entrust RSA token IDs to authenticate remote access.

In addition, the hospital system conducts annual threat assessments and tests to ensure that the network remains secure and to guard against unauthorized access, Scottsdale Healthcare's Gleason said.

"Security is a layer that needs to be there, it needs to be stringent, and it needs to be adhered to, but it cannot be an obstacle in providing information," he explained.

HIPAA laws have brought a greater awareness for health care providers that data security is important, Gleason said. The privacy laws have impacted the agenda of Scottsdale compliance committee meetings and have made hospital employees more careful as far as how they communicate with one another and have led to increased auditing of who's viewing data records.

"I think there's much more awareness, not only in our employee population but also our patient population," Gleason said. Awareness of HIPAA laws means "you can't just kibitz with your co-worker," he added.

This article was originally posted at  http://ping.fm/YA9K8

 

Data Security in Healthcare Industry Shows Strength Through Cloud Computing

Since the advent of the Health Information Portability and Accountability Act of 1996 and the more recent Health Information Technology for Economic and Clinical Health Act of 2009, healthcare providers have worked to create effective and creative solutions to oblige new regulatory compliance requirements. The proliferation of electronic medical records systems gives hope to security and compliance success.

Fierce Markets recently published an article explaining how cloud computing-based EMR systems may have advantages over traditional, in-house storage practices and technology. According to the source, healthcare providers have increasingly turned to the cloud-based solutions to keep up with policies such as HIPAA compliance and encryption regulations, and many have seen success.

Some studies show EMR and emails are often less likely to be encrypted when handled entirely internally compared to the rate at which private EMR systems providers execute this practice, the website reports. To ensure a successful partnership with EMR and email security solutions providers, healthcare officials need to carefully analyze each prospective vendor, the source adds.

According to the American Medical Association, HIPAA compliance violations can cost helathcare providers up to $1.5 million in penalties annually, while the maximum penalty per occurrence is $50,000.

This article was originally posted at  http://ping.fm/Nrh8m

Students can avail the benefits of our quality based and low cost transcription services

It is almost a difficult task for the university students to transcribe their lectures especially when they have minimum time to devote on additional burden of their studies. Mediscribes inc., through its unique service features offers a team of professionals that provide top priority lecture notes transcription. Innumerable educational institutes, universities and schools have utilized the services of our company that is identified as unique and the most distinct site from other sites in the competitive market.

Our expert’s helps to support the students transcribe their notes irrespective of their degrees, since we have people who are employed from varied fields and sectors to service our clients at the level best. The entire task of converting digital audio recording to analog recording is handled in the most accurate and precise manner by our expert transcription team.

One of our best features is that we never tend to outsource the service of our Academic Transcription to the low income and wage countries as most of our competitors do in the competitive market. Our service helps to make our students achieve their targets and goals much easily by providing them quality lecture notes.

We also undertake to transcribe the most expensive source materials like professional, university, lecture and educational transcriptions at the affordable rates. However, our lower rate never tends to affect the kind of quality service that is provided to our clients.

Our experts can convert audio into textual form and compile all the research documents in to the customized formats as desired by our clients. We have a team of qualified transcribers that strictly adhere to the deadlines and thus ensure to submit all their transcribed projects in time.

Students can submit their audio and video files and presentations made in PowerPoint or other softwares. We also offer the interview transcription services in order to meet urgent or immediate requirements of our clients as our team is well trained to undertake the these kind of urgent requirements on day to day basis.

Transcribing documents involve a lengthy procedure to first transcribe the documents and then carry on the entire proof reading process over the transcribed documents. With our quality team of experts, we are able to handle any number of transcriptions in a day, while ensuring timely and accurate submission of the lecture notes.

About Mediscribes

Mediscribes, Inc. is one of the fastest growing transcription & document management systems providers in United States, based in Metro Louisville. Mediscribes is an ISO 9000-2001 certified company, rendering cost-effective consolidated transcription solutions to major hospitals, clinics, and other healthcare facilities in United States. Mediscribes is the most value-providing organization in the market today with a strong presence in America and offshore locations. The firm specializes in providing highly accurate transcription adhering to ADHI guidelines in unbeatable turnaround time with robust & proven document management system as its vantage point to its esteemed clientele.

Mediscribes provides end-to-end transcription solutions as its primary offering. For our customers, we focus on dictation systems, both ASP as well as enterprise level solutions, with the help of our most valued asset ezVoiceIntelligence (ezVI), providing specialty-specific qualitative transcription along with a “whole nine yards” document management system. Mediscribes specializes in EMR data integration as well. Our data dispatch department is highly proficient in integrating transcribed reports into any type of EMR. Healthcare facilities that do not have EMR get the option to use our web-based file monitoring interface called eTranscribe for global access to their data. eTranscribe has special features of E-signing, E-faxing, auto-printing, and user-friendly document search criteria.

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The 5 traits of a usable EMR

There are several factors inhibiting EMR adoption, but the concept of usability is often at the root, and rightfully so. Although effective training and implementation methods affect user adoption rates as well, poor usability has a strong impact on productivity, error rate, and user satisfaction.

And usability should be considered more than just user satisfaction, according to Rosemarie Nelson, principal of the MGMA Consulting Group. The concept is far more complex, and to Nelson, it’s synonymous with workflow integration. “Too much attention is given to the number of clicks and screens, when what should be considered is how and when information is presented,” she said.

Dr. Steve Waldren, MD, Director of the American Academy of Family Physicians’ Center for Health IT, explained that when it comes to understanding usability, it’s essential to consider utility as well. “Usability is subjective in many ways,” he said. “It has to do with the functionality of the system. Utility is making sure the system does the things you need it to do.”

[Q&A: Between the lines of NEJM's EHR report, 'trust trumps tech' authors say.]

So what determines if an EMR is useable? Better yet, how can prospective users ensure a system won’t result in headaches over lost productivity? According to Nelson, the first step is to recognize no system is perfect.

“The problem for most providers is they, nor their vendor implementation team, look for that commonsense template: the one that fits a majority of patient visits, not the ‘perfect’ template that allows visits for all patients to be documented. There is just too much variation to expect 100 percent.”

With that in mind, here are five additional elements to consider when it comes to EMR usability.

1. Supportiveness: According to both Waldren and Nelson, the system should support workflow. “It’s not about a single user,” said Waldren. “It’s about an entire practice.” Waldren suggests presenting vendors with three clinical scenarios: the most common instances at a practice, the most challenging instances at a practice, and the most number of interactions among staff. That way, it’s evident how the system supports specific workflow. “I suggest doing two sets of the scenarios,” he said. “One that you present the vendor ahead of time, and the second during the demo. Then you can see the system’s flexibility to take care of each scenario.”

2. Flexibility: Nelson considers flexibility to be key, not just within the system, but also with those using it. “Usability is all about integrating a tool into a provider’s day,” she said. To illustrate, she suggests considering the evolution of the phone. “We started with one phone, then we add extensions,” she said. “Then, we came up with portable phones because our work is mobile. We found that we needed phones to follow us, not us having to go to the phone.” Since usability can become complicated, she said, the way a provider uses the tool might evolve as he/she becomes comfortable with improvements in workflow and operational efficiencies. Therefore, it’s essential to change how he/she interacts with the device and the software.

Continued on next page.

3. Ease of Learning/ Naturalness: Is the system burdensome and clunky? To be sure it isn’t, Nelson suggests providers take a close look at how they interact with their nurses when using the EMR in the demo. This goes for both patient encounters in the office and on the telephone, as well as incoming documentation, like test results and correspondence. “If it appears cumbersome or redundant, [physicians won’t] achieve the intended benefits because [they] just won’t use those features,” she said. “The best way to observe and understand the dance between nurse and provider is by taking a trip to see the EMR in operation at a practice.” Both the nurse and the provider should visit the site, said Nelson, to fully experience the change they’ll have to adapt to in their own office setting.

4. Effectiveness: Although an EMR’s effectiveness to streamline workflow is obvious when considering its usability, Waldren said providers should also consider the changes taking place in healthcare. “The current is based on volume: patients, procedures, etc.,” he said. “Patients aren’t connected. The future is value-based and consumer directed. Clinical data will be used to measure quality.” With that in mind, Waldren says it’s essential to find a system that will effectively straddle both worlds.

5. Efficiency: To Nelson, an EMR should save time, and even the smallest aspects of a system could mean wasted hours. However, some EMRs do a good job of allowing a nurse and a provider to easily work on the same computer station with fast log-out/log-in.
“This keeps the active patient online to allow for the concurrent work of the provider and nurse. Even something as simple as keeping the electronic chart ‘open’ on the desktop can be a boon to workflow; a nurse or provider is often in one patient’s chart when a phone call interrupts their work, and they need to open another chart. But, of course, they don’t want to lose the one they are working on.”

One thing is for certain when it comes to EMRs and their usability: it’s an evolution that’s essentially controlled by the user. “EMR usability must evolve similarly in that as we try to use it within our day, we can see where improvements can be made,” said Nelson.

This article was originally posted at http://ping.fm/JJNpF

Medical Transcription: Advantages of Outsourcing it From a Service Provider

When it concerns transcribing the medical records of a healthcare facility, there are several options in front to them. They could opt to go in for a transcription department or contract Independent contractors, or engage the services of an expert medical transcription company. Sometimes healthcare providers decide to have a mixture of all three.

However, outsourcing medical transcription needs on a total basis to a medical transcription company has a lot of benefits. Once the expertise of the service provider has been verified in terms of correctness, turnaround time, HIPAA compliance, technology and the pliability of services, there are many advantages to outsourcing the work

Given here are some of the benefits of outsourcing medical transcription:

Reducing time: By outsourcing, the administrative staff of the hospital as well the healthcare professionals can structure their limited time better to concentrate on the main business; that of providing healthcare.

Conserving resources: Outsourcing transcription liberates resources like technology, office space, working capital, management personnel etc. These resources can then be utilized for maximum benefit.

Savings on overhead: Having transcription in-house would require infrastructure like space, computers, power etc, which would have to be used to perform medical transcription. By outsourcing, outlay on this infrastructure could be saved.

Decreased efforts: A lot of inputs are needed from teams at every level, when transcription needs are executed in-house or through the use of independent contractors. Activities like hiring and training require a lot of effort. Outsourcing ensures that these efforts are used more productively.

Decreased strain on internal resources: Due to raising costs, declining percentage of payments, and constrained budgets, it has become increasingly challenging to manage internal resources. Outsourcing transcription lessens the burden on internal resources.

Leveraging from the knowledge of the provider: Outsourcing has the advantage of the hospital gaining from the skills of the service provider. The know-how and expertise of the service provider add to the other advantages of outsourcing.

High level of service: As more and more resources of the healthcare facility are liberated, the focus on delivering quality services would get better, thereby enhancing the quality of service.

Flexibility of choice: One of the major advantages of outsourcing medical transcription is the adjustability of services provided. The responsibility of having to arrange medical transcription services for varying influxes of patients, holiday transcription and weekend transcription needs is on the service provider.

Enhance shareholder value: With the decrease of expenses, gains are maximized thus enhancing shareholder value.

Streamlined and improved operations: With one of the vital contributors in the healthcare process being taken care of, the administration of the clinic is free to focus on other areas. This helps streamline and enhance operations.

Staying competitive: The ability to reduce expenses without affecting the quality and prompt delivery of patient records gives a competitive advantage to the healthcare facility.

Enhancement and expansion of services: With enormous cost cutting benefits and improvement in efficiency by outsourcing, the healthcare facility's improvement and future plans become a reality.

Increase in cash flow: Medical transcription is the primary stage of the receivables cycle. Outsourcing ensures that the turnaround time is quicker, thus quickening the receivables cycle. This in turn improves the cash flow.

Apart from all the above long-term benefits, outsourcing transcription needs to a professional transcription company has benefits like quality services at fair prices, done by expert transcriptionists with a very prompt turnaround time executed through secure HIPAA and HITECH compliant channels, with very superior levels of accuracy and all this with technology that is advanced but simple in usage!

This article was originally posted at  http://ping.fm/jO3DV

Government task force aims to expand health IT to rural areas

The Departments of Health and Human Services and Agriculture have signed a memorandum of understanding linking rural hospitals and clinicians to capital loan programs to help them purchase software and hardware needed to implement health IT.

On Aug. 16, the White House publicly announced the Administration's commitment to this agreement.

[See Obama's new rural jobs initiative includes health IT.]

HHS'  Rural Health Information Technology Task Force, has been working with the Department of Agriculture (USDA) to ensure that rural healthcare providers can use USDA's Rural Development grants and loans to support the acquisition of health IT.

The Office of the National Coordinator for Health Information Technology and the Health Resources and Services Administration make up the task force.

Two key USDA Rural Development programs that can help expand health IT infrastructure in rural America include the:

• Community Facilities Program, which provides direct and guaranteed loans as well as grants for community facilities projects in rural areas. This program may help offset the costs of electronic health records implementation for rural health care providers.


• Distance Learning and Telemedicine Grant Program, which may provide grants to help bring telemedicine services to rural communities.

This article was originally posted at http://ping.fm/L4e7k

White House sponsored meetings connect health providers, innovators

The White House's Startup America Initiative is sponsoring a series of meetings between local healthcare providers and health IT innovators who are close to the proof-of-concept stage in developing their ideas. The Office of the Chief Technology Officer of the U.S. and the Office of the National Coordinator for Health IT (ONC) are co-presenting the sessions.

The first such meeting was held in May in Philadelphia, where 10 innovators met with 10 area healthcare organizations. Similar events are planned for San Francisco later this month, Indianapolis in October and New England, also in October.

Writing on ONC's Health IT Buzz blog, Wil Yu, special assistant, innovations, for ONC's office of the chief scientist, offered these potential benefits for the meetings between tech visionaries and providers:

• Healthcare organizations that participate can identify potential future developers that they wish to collaborate with from a host of candidates in a single day, substantially lowering their search costs.


• Innovators can find potential partners by presenting to a dozen organizations at once--saving precious time and accelerating their development timelines.