Middle East Healthcare News » EHR

SEHA and Cerner Expand Partnership to Optimize Healthcare in Abu Dhabi

ICTFH — Wed, 12 May 2010 19:51:58 +0000

The Abu Dhabi Health Services Company PJSC (SEHA) and Cerner have expanded their agreement to automate and optimize healthcare in Abu Dhabi.

Consequently, 12 ambulatory healthcare clinics and multiple primary healthcare clinics, SEHA and Cerner have expanded their agreement to include the option to implement all Cerner solutions offered in the U.A.E. across all SEHA Business Entities that make up the SEHA HealthSystem.

Carl V. Stanifer, SEHA chairman, said “Our continued partnership with Cerner will help healthcare professionals further elevate safety, quality and efficiency for the more than five million patients that visit SEHA hospitals each year.”

SEHA has committed to implementing a system-wide EHR for all of its hospitals and clinics as part of its vision to create a connected healthcare system and improve the quality of care in Abu Dhabi.

Cerner Millennium solutions are being used to improve patient safety and to improve quality and operational effectiveness. Clinicians in the SEHA HealthSystem also are using Cerner Millennium solutions to document care and place orders in the EHR.

SEHA’s additional solution implementation will automate processes for women’s health, clinical trials, point of care medication administration and the critical care and laboratory departments.

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RTA Plans to Make Health Declaration A Must

ICTFH — Sun, 21 Mar 2010 20:29:59 +0000

RTA is going to make it mandatory, both professional and non-professional, to declare their health condition at the time of license procurement and renewal.

The plan could be implemented at the federal level if approved. Ahmed Behroozian, The Roads and Transports Authority’s (RTA) head of licensing, said, “This is to ensure road safety for both the drivers and pedestrians.”

“Most probably the new licensing requirements will only be for people in a certain age category,” Behroozian said. Those implanted with cardiac pacemakers and defibrillators, those with a history of alcohol or drug dependence, and those who have undergone major surgery will also need to make the declaration. Eye test reports are already a licensing requirement by the RTA.

“The drawback in such forms is that a person could be dishonest in expressing his condition,” said Sanders. “And compulsory medical tests can deprive many people of their licenses.”

A better solution, he said, would be to conduct regular driving assessments and also regulate medical centres and specialists by asking them to refer people with special conditions to the licensing authority.

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H1N1 Shots to Remain Voluntary

admin — Thu, 24 Dec 2009 13:07:36 +0000

The Ministry of Education has said that it will not make swine flu vaccinations compulsory for primary school pupils despite the low turnout during the first week of the campaign.

“There are no moves at the ministry to make it compulsory, neither are there at the Ministry of Health,” said the Education Ministry’s head of School Health, Soleiman Al-Shehri.

Al-Shehri said, however, that the public should be more aware of the importance of taking the vaccination. “We are still at the beginning of the campaign and still collecting data, and we should have information by the end of the campaign’s second week,” he said, adding that health and medical staff should make every effort to make the public aware of the vaccination’s importance.

Initial reports on the swine flu vaccination campaign show that the turnout has been very low, a fact as yet neither confirmed nor denied by the ministries of Education and Health.

A nationwide Ministry of Health survey conducted prior to the campaign suggested that 65 percent of school pupils’ parents did not intend to sign approval for their children to be vaccinated.

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End to end document capture-key to Healthcare

admin — Sat, 24 Oct 2009 09:20:54 +0000

Electronic Health Records

End-to-End Document Capture
is Key to Health Care

Healthcare organizations and governments around the globe are facing an unprecedented need to improve health care quality and cut costs at the same time. Historically, the health care industry has been viewed as and acted very “local”, based on economic, cultural and regulatory standards. But today, even with regional differences, the challenges of healthcare organizations are increasingly similar, and common themes and threats are becoming more and more obvious: cost, quality and transparency. Download Full PDF File

Undoubtedly, the globalization of healthcare has begun, with the industrialization of healthcare about to take off. Over the next decade, as in other industries, best practices based on regional initiatives will emerge and be adapted globally, such as health record management, access to information or care programs, funding models and innovative technologies. These emerging practices will be targeted at ensuring safe, quality health care and reducing cost, and will encompass governments, hospitals, health plans, health care institutes, health care payers and service organizations around the world. Download Full PDF File

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Electronic Medical Records Increase Revenues

ICTFH — Sat, 03 Oct 2009 14:19:07 +0000

The economy has been in a recessionary trend for more than a year now. Whilst the economic conditions are challenging, the insurance companies are applying a squeeze on physicians to accept lower reimbursements. Funding by way of donations from private contributions is also reducing thereby adversely impacting availability of cash to implement an EMR / EHR system.

Any investment in EMR is justified only if it can help in increasing revenues, decreasing costs or overheads, improving patient care or any combination of the above resulting in maximization of reimbursements, collections and customer goodwill.

How does EMR/EHR increase revenues?

1. Improves charge capture: When traditional paper charts are used, many services performed in a physician’s office are lost and never billed. The billing staff may either completely leave out an E&M Code or may erroneously enter fewer units, all resulting in lower billing and therefore lower reimbursements to a physician. EMR software can increase revenues by facilitating capturing of charges for all services provided by the physician thereby avoiding lost revenues. In a case study (Nick Fabrizio, July 2005, QIO Presentation quote), a family medicine physician while seeing same number of patients increased revenues by $3000 per month due to timely visit documentation and automated charge capture.

2. Maximizes Billing: When using paper charts, to be on the safe side of the law, many physicians down code (use a lower billing code), rather than use an appropriate level of code. Providers who use EMR software can increase revenues by using System recommended E&M billing codes that are based on the service accurately documented within the EMR, without the fear of an audit. Medical Economics magazine has estimated that physicians, who routinely down-code to avoid audits, lose an average of $40,000 annually.

3. Optimizes reimbursement process: EMR software allows physicians to produce adequate supporting documentation that complies with CMS guidelines and supports the appropriate level of service to be billed. Accurate coding speeds up the reimbursement process and results in fewer rejected claims from insurance companies. Even better, an EMR helps produce clean claims the first time, significantly reducing the number of rejected claims!

4. Increases Physician productivity: When physicians do not use EMR, they have to spend several minutes per encounter, first dictating and then reviewing the transcript before signing the same. With an EMR, progress notes are automatically generated which can be signed electronically from home or work, with no pulling or filing of charts. The time saved can be used to see a few more patients each day. Further, the medical records storage space released as a result of implementing an EMR System can be used to add more consultation rooms. As a result, practices are able to generate more revenue with the same fixed costs in the same amount of time.

5. Increases Services with Health Maintenance Reminders: EMR Systems provide computerized checks and reminders which enable reminders to be sent to all patients who are overdue for recommended services, or who are coming up on their annual check-ups. This helps the physician to deliver enhanced patient care, while at the same time increasing service volume and revenue.

6. Increases sources of income: Electronic Medical Records (EMR) software can allow providers to apply for enhanced sources of revenue from various payers associated with higher quality of care, such as:

(i) DOQ-IT (Doctors’ Office Quality-Information Technology is one of the Physician-focused Quality Initiatives sponsored by the Centers for Medicare & Medicaid Services (CMS).

(ii) Healthcare Pay-for-Performance (P4P) programs like Medicare Care Management Performance (MCMP), which is a 3-year, pilot P4P program that encourages physicians to follow strict quality-control guidelines for treating chronically ill patients. During the first year of treatment, physicians receive bonuses for reporting data on quality measures and in the second and third years, participating clinics receive an extra annual performance-based bonus of $10,000 per clinician plus, an additional 25% reward for using a CCHIT Certified EMR.

To participate in a P4P program, a physician will need to track and measure care, and monitor the efficiency of delivering quality care at an optimal cost. One must also document the patients’ experiences using post-exam surveys. Most EMR systems are capable of meeting these requirements while simplifying the process.

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Electronic Health Record

ICTFH — Sat, 03 Oct 2009 12:53:59 +0000

The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician’s workflow. The EHR has the ability to generate a complete record of a clinical patient encounter – as well as supporting other care-related activities directly or indirectly via interface – including evidence-based decision support, quality management, and outcomes reporting.

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Not-for-profit Collaborates to Push EHR Adoption in Vermont

ICTFH — Sun, 27 Sep 2009 08:46:10 +0000

Vermont Information Technology Leaders, Inc., a not-for-profit organization that facilitates the use of electronic health records in Vermont, has entered into a partnership to further the adoption and use of electronic healthy records in the state.

The organization is partnering with Chicago-based Allscripts-Misys Healthcare Solutions.

“Vermont leads the nation in developing a sustainable blueprint for healthcare IT adoption and backing it up with strong leadership from Governor (Jim) Douglas, state agencies, and VITL,” said Vern Davenport, the president of Allscripts’s government sector.

VITL is a not-for-profit organization that provides healthcare IT infrastructure for Vermont’s Blueprint for Health, an initiative of the Vermont Department of Health to develop a statewide chronic care information system. Made up of a broad base of providers, payers, employers, patients and state agencies, VITL is largely supported by Vermont’s Health Information Technology Fund.

By collaborating with Allscripts, VITL officials are looking to accelerate the adoption of EHR systems by Vermont-based healthcare providers. They said the primary focus of the alliance is on small practices and rural physicians and finding a way to make EHR products available to these providers at lower prices.

The Blueprint for Health looks to provides Vermont care organizations with information, tools and support to manage patients’ health. VITL officials said the initiative’s structure is based on a patient centered medical home, supported by community health teams, and looks to move the main focus of healthcare from a largely reactive treatment of symptoms to a more preventative perspective.

VITL officials also said this effort is in reaction to the HITECH Act, the healthcare IT portion of the federal American Recovery and Reinvestment Act of 2009 (ARRA). Beginning in 2011, physicians demonstrating “meaningful use” of healthcare IT will be eligible for $44,000 to $64,000 in subsidies from the Centers for Medicare and Medicaid Services.

According to Allscripts, studies have demonstrated that effective use of EHRs can lead to a reduced number of medical errors, improved clinical quality and better patient outcomes.

Douglas and Health and Human Services Secretary Kathleen Sebelius recently announced that Medicare will join Medicaid and private insurers in a demonstration project to improve the way healthcare is delivered. This new model will be based on Vermont’s Blueprint initiative.

Under the Blueprint model, private insurers work with Medicaid to set uniform standards for medical homes. VITL officials said the goal is to provide physicians with incentives to spend more time with their patients and offer better-coordinated, higher-quality medical care.

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EMRs Uninstalled in Phoenix a Look into the Future?

ICTFH — Tue, 04 Aug 2009 07:11:53 +0000

The HIECH Stimulus Act is part of President Obama’s plan for full, nation-wide use of EMRs by 2014. The act promotes Electronic Medical Record (EMR) adoption by allocating funds to reimburse physicians for purchasing and using a qualified EMR system. In addition, physicians who fail to adopt an EMR will eventually face Medicare reimbursement penalties. Although the goal is lofty, Obama hopes the act’s carrot and stick approach will encourage physicians to adopt EMRs.

However, a recent report by HealthLeaders-InterStudy indicates that Phoenix, Arizona is experiencing a high rate of Electronic Health Records (EHR) uninstalls. According to the report, the trend is due to training, functionality, or affordability issues. Both top-level hospitals and smaller providers struggle with the financial constraints of purchasing and implementing EHR systems. Arizona rapidly adopted EMR systems due to a 2005 executive order by Governor Janet Napolitano, which required that all healthcare providers install an EHR by 2010.

Does this uninstallation trend provide us a glimpse into the future? Will the U.S. share Arizona’s experience at the national level? Arizona’s executive order is similar to the HITECH stimulus act because both seek to rapidly drive EMR adoption to meet an arbitrary deadline. In both cases, physicians feel pressured to make a very important and potentially very expensive decision. Although EMRs provide many benefits, selecting the wrong system, or rushing the implementation process could lead to many problems. It seems that Arizona physicians are scrambling to remove unusable systems due to poor selection or botched implementations.

This does not necessarily mean the HITECH Act will fail. Rather, it means that physicians need to be careful and not rush into a decision they may regret. EMR system prices can reach $100,000 or more. In contrast, the stimulus act will only pay about $44,000 in reimbursements. Physicians should focus on their needs, not wants or superfluous features, and select the simplest system that fulfills their requirements. Simple systems are easy to install, easy to learn, and easy to use. Ease of use is critical; complex and difficult systems can lead to spiraling maintenance and training costs, and may ultimately be discarded.

The uninstallation trend in Arizona is a clear warning. Although well-intentioned, the HITECH Stimulus Act may encourage physicians to rashly purchase a system that will not work well in the long run. Physicians must resist the temptation throw in a system just to qualify for reimbursement payments. Instead, they should take their time to find a simple, user-friendly system that meets their needs. After all, $44,000 sounds like a lot of money, but it will probably not cover the more expensive EMR systems with monthly maintenance fees.

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Key Functions of an EHR

ICTFH — Mon, 03 Aug 2009 11:31:00 +0000

For the past few years the government has been vigorously working to improve the Healthcare Industry. Multiple committees have been preparing for the day where providers will receive financial incentives to purchase and use an EHR. Finally, in February 2009, this happened through the signing of the American Recovery and Reinvestment Act.

You now are aware of the major differences between an EMR and EHR, and understand that as a provider, you must seek an EHR.

Back in 2003, the Institute of Medicine (IOM) created a standardized EHR. The IOM established eight core functions, to improve four key issues: quality care, chronic disease management, efficiency and feasibility.

1. Health Information and Data.
The electronic chart must hold everything that is currently included within a paper chart. All information within the electronic chart must be information/data that would be used to make critical decisions. In addition, the IOM further stated that it should be a well designed interface to enable the provider to review the information efficiently.

2. Result Management.
The ability to manage all test results (from labs, radiology reports).

3. Order Management.
All prescriptions are to be written electronically to reduce medical errors due to illegible handwriting. Orders are also automatically generated.

4. Decision Support.
Warnings/reminders to enhance clinical performance. Decision support can aid in: drug interactions/prescriptions/prevention, detection of disease outbreaks, evidence-based guidelines, etc. Overall, it will assist providers in making the best decision possible for the patient.

5. Electronic Communications and Connectivity.
An interoperable system that is able to connect with multiple providers, the patient, labs, and hospitals in a secure manner.

6. Patient Support.
The ability to provide patients with educational material as well as the ability to enter data themselves concerning home monitoring devices.

7. Administrative Processes.

This is referred to as the Practice Management. The administrative process is to improve the efficiency in scheduling appointments, eliminate confusions, determine insurance eligibility, etc.

8. Reporting.
A standardized system to produce reports that are demanded by state, federal, and local levels.

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Example of Complexity for Medical Office EHR Execution

ICTFH — Mon, 03 Aug 2009 07:33:34 +0000

3Ps One of the first steps when considering purchase and implementation of an EHR is to develop an “As-Is” workflow diagram. The As-Is represents the starting point. It shows what you do in the medical office, who is doing it, and how data/information flows within and outside the office. It also describes the people who need access to that information.

This is an example of what an “As-Is” workflow might look like for a small practice that has not yet adopted an EHR or e-Prescribing system.The beige boxes represent manual processes that could be replaced by capabilities within an EHR. I will walk through each box with some explanation.

The office visit….

Reminders, Appointments: A current or prospective patient calls for an appointment. Information regarding demographics and insurance is collected and verified. A date/time is set for the appointment with the patient’s initial complaint noted (e.g. reason for the visit). Patients are contacted to remind and/or confirm upcoming appointments.
Chart Preparation & Schedule: At the end of the day, the Patient’s chart is prepared and a schedule is printed for the following day. Creation of the chart may include addition of appropriate paperwork and/or the patient’s primary complaint and reason for the visit.
Assess, Treat, Prescribe, Educate: Functions of the MD, PA, or ARNP during the patient’s visit to the practice.
Billing: Many practices have computerized billing systems. When a patient has completed their visit, the MD provides a Dx, Rx, and/or followup orders for the patient which must be keyed into the billing system. Often, here is where staff encounter problems that affect reimbursements as insurers, codes and/or payors change. If the practice also accepts credit card payments for services (either before or after the visit), additional manual entry may be required into the billing system to reflect the payment.

The follow up…

Telephone calls, inquiries, questions, documentation and notes: Here is where many practices spend significant time with patients and/or referrals or consultations that were ordered.

The results…

Voice, Paper, Fax, “Rich Media”: Currently, many practices receive information/results by voice, paper, fax, radiographic films and/or other media.

Here is where the water gets murky and where the technical complexities of data exchange lie. Data exchange between providers, facilities, and other healthcare organizations is necessary to prove “meaningful use.”

To summarize, based on the information above and the Health Outcome Policy Priorities identified in the “meaningful use” matrix, implementation of an EHR for a medical practice must start with a representation of what “you” are doing today. This should include people, process, and platform components within the “As-Is” picture.

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Middle East Healthcare News » EHR

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