The ABCs of EHR: electronic health records are coming--here's how to be ready.It seems like everywhere you turn, there is talk about electronic health records (EHR (Electronic Health Records) Computerized medical records that bring patient care into the digital age and save time, money and lives. The push to adopt comprehensive electronic documentation between doctors' offices and hospital settings intensified after the RAND ), from the President's State of the Union address “State of the Union” redirects here. For other uses, see State of the Union (disambiguation). The State of the Union is an annual address in which the President of the United States reports on the status of the country, normally to a joint session of Congress (the , to legislation and government panels, to the pages of The Wall Street Journal. Is it just a lot of hype hype 1 Slang n. 1. Excessive publicity and the ensuing commotion: the hype surrounding the murder trial. 2. , or are EHRs a reality for long-term care long-term care (LTC), n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. ? Here's how to get started on your path toward a functional EHR. The typical long-term care facility long-term care facility n. See skilled nursing facility. has a variety of software applications within its organization, often including a billing and clinical information system--an application that includes the MDS MDS, n See temporomandibular pain-dysfunction syndrome. MDS 1 Maternal deprivation syndrome, see there 2 Myelodysplastic syndrome, see there and several other features and documentation modules. However, our industry--like the healthcare industry in general--continues to rely on paper-based recording systems. With a thoughtful, realistic, and systematic approach to implementing technology, long-term care and the population it serves will achieve the benefits of using EHR systems. How do I get started? Will EHRs fulfill ful·fill also ful·fil tr.v. ful·filled, ful·fill·ing, ful·fills also ful·fils 1. To bring into actuality; effect: fulfilled their promises. 2. their promise? Healthy skepticism skepticism (skĕp`tĭsĭzəm) [Gr.,=to reflect], philosophic position holding that the possibility of knowledge is limited either because of the limitations of the mind or because of the inaccessibility of its object. and restraint are good things, particularly when the vision sounds expensive and requires cultural changes. What may be easier to accept is that the platform supporting healthcare's business model is changing. The vision, fully realized, is likely five to 10 years away, but planning and implementation must start now for a number of reasons: 1. There won't won't Contraction of will not. won't will not won't will be a big bang big bang Model of the origin of the universe, which holds that it emerged from a state of extremely high temperature and density in an explosive expansion 10 billion–15 billion years ago. effect happening with EHRs--all you need to do is buy the right system. The implementation will be a slow, incremental Additional or increased growth, bulk, quantity, number, or value; enlarged. Incremental cost is additional or increased cost of an item or service apart from its actual cost. migration over the course of several years, not months. 2. The implementation of widespread technology is a major culture change that could take years to accomplish. 3. Organizations must develop their own plan for implementing EHRs and personal health technologies, creating a foundation to build from and pay for over time. The first step in this process is having a vision and a plan for your organization: a vision in which organizational leaders embrace the role technology will play in day-to-day operations. This vision is also one that recognizes the business impact of utilizing technology and, even more important, recognizes the negative business impact of not keeping up with technology in healthcare. A solid EHR plan will provide for stability, incremental changes, and fiscally sound decision-making decision-making, n the process of coming to a conclusion or making a judgment. decision-making, evidence-based, n a type of informal decision-making that combines clinical expertise, patient concerns, and evidence gathered from over time. A team approach Implementing an EHR system is more than a one-person endeavor. Form a steering committee steer·ing committee n. A committee that sets agendas and schedules of business, as for a legislative body or other assemblage. steering committee Noun that includes decision-makers within the organization. In a typical long-term care facility, the steering committee might include * the administrator * the director of nursing * the business office manager * the health information/medical records manager * a representative for staff development Include other members of your staff who champion the switch to EHR technology--they will help to keep the group focused and on task. The steering committee establishes the organizational vision, devises the migration path, and oversees the implementation of the plan. An organization may choose a larger steering committee and include members from all disciplines affected by an EHR, such as social services social services Noun, pl welfare services provided by local authorities or a state agency for people with particular social needs social services npl → servicios mpl sociales , nutrition services, activities, the medical director, and therapy. Or, it may choose to include the disciplines in project-specific workgroups and keep the steering committee small. Workgroups can be formed underneath the steering committee to tackle specific applications and implementation. Typically, someone from the steering committee is the leader of the workgroup. If EHR and health information technology (IT) hasn't been part of the organization's culture, the steering committee should educate itself on what is happening in the industry by reading articles, attending seminars, benchmarking against other facilities, etc. Watch for opportunities to bring in staff with an interest and skill level in health IT. With staff turnover in key positions, take the opportunity to update the skill level and competencies that support the organization's migration to EHR. Some personnel will need to acquire additional expertise. It is critical to have a healthcare information management (HIM) professional with electronic HIM skills in place to manage the EHR system once it is implemented. Buying an EHR system The process of investigating and purchasing a system is complex and requires a planned approach. You might want to consider the HL7 EHR System Functional Model standard as a framework for development. The standard identifies the type of functionality that long-term care EHR vendors should strive to provide over time. It is important to recognize that no system will meet the HL7 EHR standard today--it is a framework as healthcare moves toward standards for clinical content and interoperability The capability of two or more hardware devices or two or more software routines to work harmoniously together. For example, in an Ethernet network, display adapters, hubs, switches and routers from different vendors must conform to the Ethernet standard and interoperate with each other. . It is just as important to understand a vendor's plans for tomorrow as it is to know what it offers today. Consider a migration path (see "Why do I need a migration path for the EHR" on p. 22), which will provide another tool to help you evaluate a potential vendor and the partnership you will have over time as the EHR system unfolds. Why do I need a migration path for the EHR? Once you realize that implementation of an EHR isn't done in one giant leap, but in a thorough process that evolves over time, it is easier to recognize that you're on a migration path, on which you take strategic, planned steps toward your goal. The following table, an example of the phases of a migration path, illustrates the concept.
Phase I Phase II Phase III
Migrate all Document imaging Interface with tab,
facility-generated and workflow pharmacy, and acute
documentation technology care hospital and
to the EHR to digitize provide patient/
external documents representative access
and financial records to lab tests and other
key clinical
documentation
through a patient
portal
Phase IV Phase V
Computerized Connect to local
physician order health information
entry from remote exchange
location/clinic with
clinical decision
support
The advantage of a migration path is being able to plan for new or upgraded technology and infrastructure associated with a new phase. It also helps to keep you from reacting to the "hot" trends of the day. The migration path above shows an organization moving systematically toward the vision for an EHR. The phases may vary in length and should address network infrastructure needs, user interfaces, and facility operations.--Michelle Dougherty Michelle L. Dougherty, RHIA RHIA Registered Health Information Administrator (formerly Registered Records Administrator; American Health Information Management Association) , CHP CHP Chapter CHP Combined Heat and Power CHP California Highway Patrol CHP Cumhuriyet Halk Partisi (Turkish: Republican People's Party) CHP Chemical Hygiene Plan (OSHA) CHP Community Health Plan , is director of practice leadership for the American Health Information Management Association The American Health Information Management Association (AHIMA) is a non-profit association for health information management professionals. The organization was founded in 1928, and has 51,000 members. . In her role as director, Dougherty provides professional expertise on health information practice issues. She also serves as coordinator and project manager for a number of task forces. Contact her at michelle.dougherty@ahima.org. |
|
||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion