Patient Portals – Going beyond Meaningful Use

By Amanda Scanlan | Published: December 15, 2011

As the final rules to support Meaningful Use have been clearly defined, it is guiding everyone to patient centered healthcare. Patient Portals are making it possible through real time communication solutions and efficient health information exchange.

It would not be an exaggeration to say that Patient Portals could eventually evolve into personalized Facebook-like platforms for doctors and patients. Two-way messaging and content sharing is already on the go but there is fear of data breaches and privacy infringements which is holding its integration in a more collaborative style.

On the surface, it seems that Meaningful Use measures are designed specifically to set right Electronic Health Record systems (EHRs) implementation but many of its core and menu objectives cannot be met without using Patient Portals.

For instance, one of the Meaningful Use core objectives requires that providers supply their patients with an electronic copy of their health information upon request, within three days. On the other end, HIPAA privacy and security requirements want this electronic information exchange encrypted and following safety instructions. Patient Portals serve this purpose by empowering patients with real time access to their health records. Let us preview it in a loop by comparing features of a Patient Portal and Meaningful Use objectives.

Patient Portals and Meaningful Use in the loop

Providers can share with the patients electronic copies of health literature and send them online test result reports via Patient Portals. Likewise, one Meaningful Use core objective requires submitting a summary of more than half of the clinical visits in three business days. Patient Portals that are well integrated with EHR and EMR systems update it automatically; and a patient can view a summary of these visits.

Patient Portals have intensified the urgency level required in critical situations and fatal diseases; patients are notified immediately about follow-ups through alerts and reminders.

Patient Portals are outperforming Meaningful Use objectives.
Patient Portals endure the convenience of work at flexible hours. Patients can send appointment requests and a summary of their symptoms while providers can schedule the appointment and ensure that the clinical resources are in place ahead of time. Moreover, prescription renewals and refills used to involve telephone calls and faxing on both ends. The process has been made easier by Patient Portals where the providers review and authorize the refill request online. Another perk to the Patient Portal is that patients can pay using their credit or debit card allowing them to remain up-to-date on payments and current balances. There is a lot more to expect from this promising technology, this is just the beginning.

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EHRs and Patient Portals Technology to Lower Overhead Costs

By Amanda Scanlan | Published: December 13, 2011

Patient Portals combined with electronic health systems (EHRs) work to induce ease of access to health information at reduced cost. Patients can log-in to their portals, set up a meeting with the physician, update their health records, request a prescription renewal and pay bills. Similar are the benefits for providers who can virtually visit and communicate their patients online.

However, healthcare providers today are working with narrow profit margins. They are working intensely to deliver the best quality at a minimal fee to their patients. An increase in their earnings is only possible if they treat more patients in less time. It requires a reduction in the time of waiting, diagnosis and treatment. Using patient portals, one can achieve all this by engaging patients in managing clerical tasks.

“Patient portals empower individuals to become more involved in their own care, which may lead to better outcomes and lower costs”, a statement by The Office of the National Coordinator for Health Information Technology (ONC) summarizes.

Time is money
Providers are required to spend a lot of time discussing symptoms with their patient’s and for those still using papers, filling in charts. Similarly, they have to spend time maintaining and retrieving patient’s records for every visit. This time and effort is not something that healthcare providers are paid for. Through online patient portals, patients can fill out the initial information from their homes and their physicians can peruse at their convenience. In addition, when the patient visits the provider, their electronic health records are available beforehand. At average, four to five minutes of a clinical visit are saved in this way.

When patients send a request for visit, management can adjust time slots and resources accordingly. Similarly, when a physical visit by the patient is not required, the physician can give virtual advice, saving costs on both sides.

Patient portals eliminate spending on data entry
Data entry clerks, working for a healthcare provider used to cost around $25,000.00 annually. This huge cost is saved when patients themselves update their health records via the online portal and enter their basic information on eForms.

Print & postal expenditures are saved
Sending patients the registration packets bears the cost of printing and dispatching. It generally takes up to 2 days for the packet to reach the patient; the issue arises in that the provider needs that material in order to execute tasks. Now patients fill in the required information online by signing in to their health record page and can view reports from anywhere without requiring a printed copy.

Similarly, electronic versions of health education literature are shared on patient portals so that patients can stay informed about specific diagnosis’s.

Savings on telephone and fax bills
It has significantly reduced telephone and faxing expenditures by harnessing the power of e-messaging. Even sharing health information with a referral doctor is achieved electronically through EHRs and the patient portal technology which otherwise required information to be printed on paper and hefty faxing.

Prescription refill & renewal authorization on personal computers
It is easier to keep track of updates in a secure patient portal environment. Patients are provided with passwords and logins, which they can use to access their portals, regardless of time and space limitations. Request and authorization for prescription refills can be handled from the luxury of one’s home on a personal computer – the only requirement is a computer connection to the internet, which if not available can be done on a kiosk terminal.

Billing and payments made easier, reducing processing cost
Billing and payment has never been that easy. Payment options available in patient portals are not only quicker, it also diminish third party processing charges.

Money saved is money earned. EHRs and patient portal technology are saving monies through less expensive modes of communication and scaling down overhead costs. It is a simple, one-place solution, which is infusing resilience and value to healthcare.

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EHRs and a more harmonious workplace

By Amanda Scanlan | Published: December 9, 2011

We want to live in a connected world: songs, videos, photos all at one’s fingertips. This user behavior is prevailing at doctor’s office as well. EHR systems have polarized health record repositories and communication nodes, interchanging health records.

When Google’s co-founder Sergey Brin posted on his blog that he carries an inherited gene that could predispose him for developing Parkinson’s disease, everyone was shocked by the revelation. His mother was diagnosed with the Parkinson disease and Brin discovered that he also possesses the same gene, which caused the disease. This high-profile disclosure made us believe in the marvels of health information exchange (HIE). How connected reservoirs of electronic health records center on one and work to improve healthcare.

Medical facilities equipped with an EHR system, betters workplace practices. It automates clinical procedures and increases venues of communication. Effective communication is the key to harmony at any workplace. Clinical staff interacts with each other even when placed in different departments; they tend to work as a cohesive group.

EHR systems are embedded with advanced tools of communication. One can check emails and messages sent by patients and co-workers, right into an EHR system. Instant messaging improves two-way communication between staff and providers. Clinical staff can access an integrated EHR application on multiple computers where content entered on one automatically updates on every screen. Via an integrated patient portal, patients can send personalized messages, schedule visits and request medical records. By logging on an EHR system, medical staff can view daily rosters and tasks assigned to them.

Setting priority to tasks and scheduling ensued by an alert system, organizes staff at every level. At an EHR installed workplace, tasks are assigned electronically according to the roles, job responsibilities and time-shifts. A vigilant flow of clinical procedures evades possibility of lagging assignments.

It is easier to keep track of mistakes and errors. Figuring out the origin of an error; who made the incorrect entry is easily traceable through EHR systems, leaving less space to blame subordinates or colleagues of a wrongdoing. Everyone is clear about responsibilities and chores to perform, working through an EHR system, with zero chance of clash with one another.

Proper training in a technology driven work environment brings everyone to an equal level of skills and practices. EHR systems are enriched with customizable panels and intuitive decision support functionalities that help maintain the standards and unanimity. The learning curve when using an EHR system as a beginner might feel cumbersome, but as with the experience, its well-organized templates help improve the efficiency of workflow.

The use of an EHR can decrease the workload within a practice in many ways. Office environments and workplace dynamics can affect the performance of employees. For instance, record keeping used to consume a major portion of a hospitals resource with it being quite an expensive liability in addition to the filing cabinets consuming huge spaces. EHR systems have redesigned the whole concept of the setup in a medical office.

Harmony comes to a workplace when everyone performs in perfect balance. Contributing to each other and leaving no room for workplace inefficiencies. EHR systems combine all the constituents of a healthcare facility and gear them together to an optimized workflow.

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Paper-based Records to EMR: A Transition in Context

By Amanda Scanlan | Published: November 29, 2011

From Paper to EMROnce you have decided to switch to an EMR system, conversion of paper-based records to digital formats would take a major part of your resources and efforts. First thing that troubles the management of a healthcare facility is finding the most efficient way of achieving this goal. Healthcare facilities that have been functioning on paper-based charts are going to have a plethora of papers that need to be scanned, converted to digital copies and successfully transfused to an EMR system.

Individual practitioners tend to have a more convenient time deciding which documents to scan and what to leave. However, hospitals and large healthcare facilities usually embroil up at this stage, therefore it is better for them to take poll the majority and decide appropriately. An all-inclusive approach in turn would scan every piece of paper which would be extensive and requires a lot of time and money. To some providers it would become a task worth $100 million. Partial scanning of health records is a more workable approach. A recommendation is to start with active patients and visitors and then move on to older, stagnant entries. Scanning the most urgently required records such as reports and charts of the scheduled patients in the coming weeks and their basic information should push start this process.

Outsourcing this hefty task can be helpful in many ways as it removes the potential burden of charging your employees with the task. Secondly, data entry companies that have established a presence in the industry are experts in tackling such tasks and would execute the tasks more professionally. The key is to ensure that the digital formats are as per the EMR system requirements so as to demonstrate a successful integration.

One must be careful that the electronic medical records meet universal standards set by the industry. EMR systems are not targeted to operate in isolation, interoperability and exchange of health records is among the core objectives. Standards and requirements set by organizations such as The American National Standards Institute (ANSI) and HL7 Clinical Document Architecture (CDA) are helpful to ensure accurate conversion and integration of health records into the system.

Note that when the scanning has been completed, it is not the end of process. The papers still hive the bulky shelves of the storeroom. What should a practice do with them? How long should they retain them? What are safe ways to dispose of them? Every State has different laws about keeping records; some prefer that a healthcare facility retains them for five to seven years. The Center for Medicare & Medicaid Services (CMS) does not require a practice to keep the physical paper chart as soon they are digitally archived. However, they should be retained as long as they are required for legal issues and until the practice is confidently working with their EMR system. Ultimately, paper shredders or waste incineration machines should end the fate of paper-based records.

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Advantages to an Electronic Health Record (EHR)

By Jamil Ahmad | Published: November 29, 2011

When it comes to “the highest attainable standard of health”, there is a consensus that adopting EHR technology is a step in the right direction. It is true that change can be difficult to adopt, but as soon healthcare practioners are exposed to phenomenal EHR advantages, it becomes difficult to continue with old practices.

There are countless reasons to adopt an EHR system, take for instance a hospital in Missouri that was hit by a tornado, damaging it to the extent that they had to evacuate every one hospitalized. The worst thing that happened was to the backup of records on paper that were found as far as 72 miles away from the hospital. However, just three weeks before this catastrophic storm, an electronic version of the health records had been maintained and transferred to an EHR system, helping hospital administration start again at a mobile facility in less than a week.

“Anyone who has doubts about the benefits of electronic health records, when they see how quickly we had access, and the greater security we have with EHRs, they’ll see you can’t beat it,” said Dr. Tracy, a family physician at Missouri. This is just one benefit realized in the aftermath of a crisis; EHR systems are improving the quality of practice at every level.

  • An EHR system offers greater access to records and increases communication possibilities between healthcare providers and patients.
  • It is easier to maintain, update and backup electronic health records through an EHR system than by previous practice of keeping records on papers and filing it in huge cabinets.
  • Drug-drug and drug-allergy interaction alerts functionality in an EHR system is pivotal in helping doctors reach the right medication through clinical decision support system.
  • E-prescription and medication management are the hallmarks of EHR technology, connecting pharmacies and healthcare units.
  • An EHR system streamlines administration and management of health care workers through customizable panels, reminders and scheduling.
  • Health information exchange (HIE) and interoperability of data has made possible much avowed patient centered care through ease of access to health records, regardless of time and space.
  • Computerized physician order entry (CPOE) capability of an EHR system has added functionalities, which range from electronic forms to end result reporting.
  • An EHR system reduces errors, ensures accurate coding and minimizes cost.
  • Adoption of an EHR system is helpful in meeting national standards and health laws.
  • And what is it meant for? An EHR system improves quality of healthcare, automates clinical procedures and decreases operational cost.

Advantages to an EHR system are diverse in proportion and effect. Fruits of this promising technology can only be relished in its complete form if utilized properly and after appropriate training. Without a doubt, the adoption of an EHR system is the doorway to achieve the next level of healthcare.

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Best Practices for Improving Operational Performance of Healthcare Providers

By Jamil Ahmad | Published: November 22, 2011

Technology has raised performance metrics for everyone and healthcare providers are no exception. It has equally affected medical practitioners who now greatly depend on health information technology for most of the clinical tasks. However, these fully computerized healthcare facilities have raised the bar for quality and the operational performance of employees.

Organizations are encouraging healthcare workers to experience the benefits their overall productivity will have with the use of Health IT. Optimum levels of operational performance require them working at par with their computers and produce the best results.

  • Healthcare providers want to benefit from government incentives and affiliate programs by providing quality of care.
  • Ratings and self-accountability is pushing organizations to deliver their best, otherwise a subsequent cut to their earnings will be incurred.
  • Patient centered healthcare systems require full satisfaction of their patients.
  • Due to enhanced integration and automation of clinical tasks, the negligence of one can affect others.
  • Efficient clinical workflow achieved through meaningful use of health information technology.
  • Handling maximum number of patients in the shortest possible time and with more accuracy.
  • Saving costs by complying with best practices.
  • Avoiding medical errors by using intuitive decision support system.

Technology adoption can have its down side as well. It is generally assumed that switching to an electronic healthcare system initially disrupts the practice; affecting performance and efficiency.

Adoption of an EHR system does not guarantee the quality of medical practice. Many adopters found that adoption was quite similar to taking one step forward and two steps back in their practice. Best practices, however, can improve operational performance and quality of healthcare.

A form of best practice is a well-maintained patient portal, which improves access to health information, speeding up communication between doctor and patient. A couple of benefits for the patient; they can decide on their appointment time and correspond with their provider via a messaging system. The portal has shifted the convention of hosting patient’s health information by the physician to a mutually shared platform. Some benefits for the provider are that they can send prescriptions renewals, lab results and bills using it.

Healthcare providers should exploit the best use of medical practice management tools. Integration and automation of all departments at a healthcare facility increases efficiency.

  • Computerized physician order entry (CPOE) followed by electronic submission of lab results help the physician reach a quick diagnosis.
  • A well-structured decision support system (DSS) improves operational performance.
  • Using an electronic medical record system, physicians can now experience hassle free billing and coding.

Training and support at every stage is crucial to maintain performance. Only a well-trained staff can contribute to the success of an organization and allow them to work together as a team. Complete understanding of all the procedures imparts satisfaction and passion to work.

Adjust accordingly, update yourself and staff with policy changes, new laws and technologies. Read health blogs, forums and the latest news in the industry. Interact with others in the community and learn from their practices and experience. Listen to the officials from organizations, such as, The National Quality Forum (NQF) who are striving for quality improvement.

There is no alternative to a skilled and knowledgeable workforce, and in the present healthcare system, performance is dependent on a collective team effort.

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Legally protecting providers who use EHRs is the goal of a House Bill

By Jamil Ahmad | Published: November 17, 2011

Dubbed as Safeguarding Access for Every Medicare Patient Act, the new legislation gives legal protection to covered Medicare and Medicaid providers who use certified EHR technology. Besides monetary incentives, providers are ensured that this government initiative will legally protect them.

“HR3239 is a two-pronged attack against rising health care costs: It provides legal protection to providers while encouraging the use of health information technology which has been shown to reduce costs,” said Tom Marino, U.S. Rep. in a press release.

Most providers are reluctant to participate in the EHR meaningful use program due to vulnerability of an EHR system. Fear of litigation caused by EHR-related adverse events is keeping providers stuck with their age-old practice. Legal protection in case of malfunctioning is an incentive convincing enough to opt for meaningful use compliant EHR system.

The bill requires reporting potential errors to Patient Safety Organizations. These organizations would serve as buffer zones between providers and The Office of the National Coordinator. At one end, the organizations would ensure timely intimations of the error. Later on, they would furnish de-identified health information to the Office of the National Coordinator along with their findings on the issue.

Medical malpractice litigation contributes to rising health care costs. An estimated 2.4% of U.S. healthcare budget was paid to plaintiffs and lawyer as fee last year. The bill would help minimize these expenses and would save providers from extended litigations. The bill enacts time limits of filing a lawsuit against a covered entity. One cannot claim damages three years after the date of manifestation of injury or one year after the claimant discovers.

If a provider modifies or amends functioning of a certified EHR system, it could not be used to corroborate lawsuits against it. It is quite a pragmatic approach, giving more space to rectify an evolving healthcare system in a transparent mode.

Only clear and convincing evidence would make healthcare providers liable to pay punitive damages. This proof requirement by the bill would discourage fishing expeditions and would impart legal protection to healthcare providers.

Similarly, health information exchange (HIE) is considered a core value of EHR technology. Should there be a malfunction of the HIE, it could be problematic for healthcare technicians who bear responsibility for sending and receiving data. The bill provides immunity to employees, agents and representatives of the covered entities from civil action for libel and slander, arising from entries made in the EHR system or mistaken data exchange (if the incident was simply a mishap and was performed in good faith).

By all means, the legislation would pacify the heightened concerns of the healthcare providers over risks attached with implementation of EHR systems. It addresses issues upfront; reducing healthcare costs and prompting a value added incentive to participate in the EHR meaningful use program.

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HIPAA 5010 Implementation: Timeline, Levels and Testing Readiness

By Jamil Ahmad | Published: November 17, 2011

It has been eight years since the HIPAA 4010 transaction standards were implemented in 2003. Since then, the industry has asked for more than 500 changes to correct errors and fulfill new requirements. The new regulations are a systematic approach to reform the health system with a pristine timeline. The regulations were introduced in 2009 and by January 1, 2012, all covered entities are required to submit claims, remittances, status responses and referral authorizations meeting 5010 standards.

The Centers for Medicare & Medicaid Services (CMS) identified two levels of HIPAA 5010 testing:

• Level I of 5010 implementation ended on December 31, 2010. It is labeled as internal testing which covers gap analysis, design, development, etc.

• Level II of 5010 implementation dates December 31, 2011. After that, only 5010 compliant systems are allowed to work.
All covered entities are required to integrate ICD‐10 coding system by October 1, 2013.

Is your organization ready to demonstrate error free flow of healthcare data? As the deadline to meet the second level of HIPAA 5010 electronic transactions standards is fast approaching, if you find yourself completely lost in the testing process for HIPAA 5010 compliance, then The American Medical Association (AMA) has formulated guidelines to test your readiness. Another suggestion is to hire a consultant.

HIPAA 5010 transactions compliance is applicable to covered entities that are healthcare providers, payers of the health cost, clearinghouses and pharmacies. To be perfectly compliant, all the stakeholders require working on different areas outlined below:

HIPAA Administrative Requirements: At the administrative level, the covered entity should analyze possible violations of HIPAA regulations and plan to eradicate them. For instance, access to patient’s health information by an employee should be under strict scrutiny. As soon as the employee leaves the organization, the access to information is barred. Exchange of information with partner organizations should be well defined and with the exchange of a signed agreement. Make sure that every employee is properly trained about security and privacy of the data. They must use passwords to login and report efficiently in case of a security breach or data loss. In case of an emergency, there should be a backup of data that can be restored later.

HIPAA Physical Requirements: Ensure the physical safety of those within the facility through locked doors, security cameras and human surveillance. Access to a room or department should be role defined. Design policies and plans for repairs and modifications. Proper measures should be followed to dispose data.

HIPAA Technical Requirements: Every user should be provided with a unique identity. Similarly, implement procedures to share information during emergencies. An EHR system should demonstrate the capability of automatic logoff if not used for a specific period of time. Moreover, data should be encrypted before sending to another network. Preventive measures should be strictly followed to establish integrity of health information that could secure it from possible damage.

Due to an impending deadline of the HIPAA 5010 compliance, it is time to hit the nail on the head. Test your EHR system and resolve any issues that occur in a timely fashion, before it is too late. Send test transactions to outer entities (clearing houses, billing companies) and check if they are also complying with the standards. If your system were able to send and receive transactions in compliance with HIPAA 5010 transactions standards, only then would it be considered operational and standardized.

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SequelMed Patient Portal

By Amanda Scanlan | Published: November 1, 2011

Bringing Together Patients and Care Providers, Improving Communication and Access to Information, and Boosting the Standard of Care

SequelMed Patient Portal, is helping to improve and speed up communication between physicians and patients, giving patients instant access to their personal health information, and allowing physicians and other healthcare providers more time to focus on delivering the best possible care.

The American Recovery & Reinvestment Act is mandating that healthcare organizations adopt and demonstrate the use of a certified EHR in order to get a piece of the stimulus pie. During the transition from paper-based to fully electronic environments, it is vitally important to not only create system efficiencies, reduce medical errors and improve outcomes, but also to create a communication and education platform between patients and their providers.

SequelMed Patient Portal provides physicians with an additional tool which allows for quick and efficient communications with patients online. It also ensures that the patients have real-time care and access to information that helps them to stay connected and actively involved in their own health.

“The Patient Portal integrates seamlessly with our existing SequelMed EHR installation, we were up and running quickly and experiencing time savings that allow us to better serve the patients who depend on us faster than with other solutions,” said Dr. Peter Deane, principal, Allergy Asthma Immunology of Rochester (AAIR).

In today’s technologically advanced healthcare society, a patient portal provides the perfect way for providers and patients to connect and engage while ensuring that everyone has an equally important role in the care process. SequelMed Patient Portal is designed as a user-friendly, simple application that facilitates online communication between patients and their providers. Built with patient convenience in mind, SequelMed Patient Portal integrates seamlessly with SequelMed EHR and electronic medical record (EMR) solutions.

With SequelMed Patient Portal, patients can:

  • Request appointments with their care providers
  • Receive reminders and alerts
  • Complete patient registration and necessary health forms
  • Manage referrals
  • View physician information developed specifically for patients
  • View their personal health records
  • Request and conduct eVisit consultations
  • Renew and refill prescriptions
  • Access lab results
  • Pay their bills online
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EMR Implementation – Critical Success Factors

By Amanda Scanlan | Published: October 27, 2011

Considering EMR products for your practice can be a big challenge due to the amount of EMR vendors in the marketplace. The challenge is figuring out what to look for when evaluating a potential product and vendor that best fits your practice. Every physicians practice operates differently; therefore one cannot assume that workflow for one office is the same as another. The same goes for EMR’s. When physicians find themselves in a group discussion about EMR’s and their experience with what they are using, it is human nature to consider following the path of another. However, physicians must remember that one size does not necessary fit all. The EMR that a fellow physician adopts and is satisfied with, might not be suitable for your practice.

Before making a final decision, you should conduct thorough searches and perform detailed research on potential vendors and their product offering prior to considering them. In order to maximize ROI, one should choose the right EMR vendor which will ensure an easy and successful implementation. The following steps should be taken in order to make sure that the appropriate vendor is selected:

Practice “Champion”

Selecting a member of the practice who is familiar with the goals and requirements the practice is looking for from the EMR they adopt will be beneficial to the practice. This person will champion the search for the right vendor and product and should have insight pertaining to all of the operational processes that are involved in the practice.

Educate practice staff on the benefits and convenience of the EMR
For the majority, change is not something that is easily accepted. The practice champion will need to remind the practice staff of the benefits and convenience of the EMR system. By analyzing workflow and understanding tedious tasks that employees dislike, the practice champion will be able to explain how the EMR system will help alleviate the dislike of those tedious tasks.

Devote time for training

The key to a successful implementation is the devotion of time taken for training and gaining familiarity with the software’s features. Switching from paper-based charts to an EMR system is a significant change and the complexities can be underestimated. Regardless of the vendor partner that you choose, only the professional staff members in the practice are responsible for a successful transition to an EMR system. Upon choosing the right champion within the practice, the focus should be on the employee’s needs and communication, creating a detailed plan and devoting time for training – with that the implementation should be a success.

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