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Infographic: Electronic Health Records & the Data of Health Care

Posted by Matthew Smith on Jun 24, 2014 12:54:00 PM

EHR, EMR, Electronic Medical Record, Electronic Health Record, InfographicThis “Electronic Health Records & the Data of Health Care” infographic from UC Berkley School of Information explores the health data revolution, the difference between Electronic Medical Records and Electronic Health Records, which states and practices adopted electronic systems, and what the future of the digital health industry looks like. 

For a larger look at this infographic, please click here and then click the image to enlarge.

EHR, EMR, Electronic Health Record, HIE

 

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, Electronic Health Records, Electronic Medical Records, Infographic

EHR Incentive Program Penalties Visualized

Posted by Matthew Smith on May 19, 2014 9:59:00 AM

EHR, EMR, Electronic Health Record, Meaningful UseAs part of the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated payment adjustments to be applied to Medicare eligible professionals who are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Programs. These payment adjustments will be applied beginning on January 1, 2015, for Medicare eligible professionals. Medicaid eligible professionals who can only participate in the Medicaid EHR Incentive Program and do not bill Medicare are not subject to these payment adjustments.

Eligible professionals who can participate in either the Medicare or Medicaid EHR Incentive Programs will be subject to the payment adjustments unless they are meaningful users under one of the EHR Incentive Programs in the time periods specified below.

EMR-penalties

 

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, Electronic Medical Records, Medicare EHR Incentive Program, EHR Penalty

Quick Illustrated Video Differentiating EHR from EMR

Posted by Matthew Smith on Jan 15, 2014 1:28:00 PM

EMR, EHR, EMR or EHR, Electronic Medical RecordsOur previous post on the differences between EMR (Electronic Medical Records) and EHR (Electronic Health Records) really resonated with our readers.

Thank you to several HD Insights blog readers for sending along this concise, illustrated video detailing the differences between an EMR and an EHR. We felt that this video is too good not to share with everyone.

Feel free to forward this post (and our previous post) as a simple explanation when someone in your department asks what the difference is between these two terms.

Topics: EHR, EMR, Electronic Health Records, Electronic Medical Records, HIT, Health IT

EMR vs. EHR – What is the Difference?

Posted by Matthew Smith on Jan 14, 2014 12:21:00 PM
Via healthit.gov


EMR, EHR, Electronic Health Records, Electronic Medical RecordsWhat’s in a word? Or, even one letter of an acronym?

Some people use the terms “electronic medical record” and “electronic health record” (or “EMR” and “EHR”) interchangeably. But at the Office of the National Coordinator for Health Information Technology (ONC), you’ll notice they use electronic health record or EHR almost exclusively. While it may seem a little picky at first, the difference between the two terms is actually quite significant.The EMR term came along first, and indeed, early EMRs were “medical.” They were for use by clinicians mostly for diagnosis and treatment.

In contrast, “health” relates to “The condition of being sound in body, mind, or spirit; especially…freedom from physical disease or pain…the general condition of the body.” The word “health” covers a lot more territory than the word “medical.” And EHRs go a lot further than EMRs.

What’s the Difference?

Electronic medical records (EMRs) are a digital version of the paper charts in the clinician’s office. An EMR contains the medical and treatment history of the patients in one practice. EMRs have advantages over paper records. For example, EMRs allow clinicians to:

  • Track data over time
  • Easily identify which patients are due for preventive screenings or checkups
  • Check how their patients are doing on certain parameters—such as blood pressure readings or vaccinations
  • Monitor and improve overall quality of care within the practice

But the information in EMRs doesn’t travel easily out of the practice. In fact, the patient’s record might even have to be printed out and delivered by mail to specialists and other members of the care team. In that regard, EMRs are not much better than a paper record.

Electronic health records (EHRs) do all those things—and more. EHRs focus on the total health of the patient—going beyond standard clinical data collected in the provider’s office and inclusive of a broader view on a patient’s care. EHRs are designed to reach out beyond the health organization that originally collects and compiles the information. They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care. The National Alliance for Health Information Technology stated that EHR data “can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.”

The information moves with the patient—to the specialist, the hospital, the nursing home, the next state or even across the country. In comparing the differences between record types, HIMSS Analytics stated that, “The EHR represents the ability to easily share medical information among stakeholders and to have a patient’s information follow him or her through the various modalities of care engaged by that individual.” EHRs are designed to be accessed by all people involved in the patients care—including the patients themselves. Indeed, that is an explicit expectation in the Stage 1 definition of “meaningful use” of EHRs.

And that makes all the difference. Because when information is shared in a secure way, it becomes more powerful. Health care is a team effort, and shared information supports that effort. After all, much of the value derived from the health care delivery system results from the effective communication of information from one party to another and, ultimately, the ability of multiple parties to engage in interactive communication of information.

Benefits of EHRs

With fully functional EHRs, all members of the team have ready access to the latest information allowing for more coordinated, patient-centered care. With EHRs:

  • The information gathered by the primary care provider tells the emergency department clinician about the patient’s life threatening allergy, so that care can be adjusted appropriately, even if the patient is unconscious.
  • A patient can log on to his own record and see the trend of the lab results over the last year, which can help motivate him to take his medications and keep up with the lifestyle changes that have improved the numbers.
  • The lab results run last week are already in the record to tell the specialist what she needs to know without running duplicate tests.
  • The clinician’s notes from the patient’s hospital stay can help inform the discharge instructions and follow-up care and enable the patient to move from one care setting to another more smoothly.

So, yes, the difference between “electronic medical records” and “electronic health records” is just one word. But in that word there is a world of difference.

Topics: EHR, EMR, Electronic Health Records, Electronic Medical Records, HIT, Health IT

Two New Rules Provide Momentum for Electronic Medical Records

Posted by Matthew Smith on Apr 10, 2013 5:28:00 PM

EHR, Electronic Health RecordsThe Obama administration has proposed two rules to extend protections that allow hospitals to donate electronic health record technology to physicians who refer patients to their facility, The Hill's "RegWatch" reports.

Background

The Stark Law bans payments that are aimed at encouraging referrals to hospitals. In addition, the federal anti-kickback law prohibits payments that are designed to influence care for Medicare beneficiaries.

However, in an effort to encourage physicians to adopt costly EHR systems:

  • CMS established an exception to the Stark Law allowing hospitals to donate EHR software to physicians; and
  • HHS' Office of Inspector General established a "safe harbor" provision to protect such EHR donations from anti-kickback enforcement, provided that the physicians cover 15% of the cost of the EHR technology.

The exceptions to the Stark and anti-kickback laws are scheduled to expire at the end of 2013.

Details of Proposed Rules

The Obama administration's proposal includes:

In addition to extending the EHR donation protections, the new proposed rules would remove an electronic prescribing requirement from the original rules and adjust language regarding the types of EHR systems that qualify for exceptions (Conn, Modern Healthcare, 4/9).

OIG in its proposed rule said, "We expect these proposed changes to continue to facilitate the adoption of electronic health recor[d] technology" ("RegWatch," The Hill, 4/8).

CMS in its proposed rule said that it is considering extending protections for EHR donations to Dec. 31, 2021, to align with the end of the Medicaid portion of the meaningful use program.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

Publication, Public Comments

The two proposed rules are scheduled to be published in the Federal Register on Wednesday.

Federal officials will accept public comment on the proposed rules for 60 days after their publication (Murphy, EHR Intelligence, 4/9).

Electronic Health Records EHR Assessment

Topics: EHR, EMR, Electronic Health Records, Electronic Medical Records, CMS, Health IT, Family Physicians, EHR Adoption

AHRQ & CMS Announce New EHR Format for Pediatrics

Posted by Matthew Smith on Feb 7, 2013 10:17:00 AM

EHR, Pediatrics, Health ITThe Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) have officially announced an EHR format for children's healthcare.

The format includes recommendations for child-specific data elements such as vaccines and functionality that will enable EHR developers to broaden their products to include modules tailored to children's health.

"Healthcare for children is a calling that carries special challenges," said AHRQ Director Carolyn Clancy, M.D. "This new children's EHR format will help software developers meet the needs of health care providers for children by combining best practices in clinical care, information technology and the contributions of health care providers who treat children every day."

The children's EHR format was authorized by the 2009 Children's Health Insurance Program Reauthorization Act (CHIPRA) and developed by AHRQ and CMS. The format is intended to improve care for children, including those enrolled in Medicaid and the Children's Health Insurance Program (CHIP), by guiding EHR developers to understand the types of information that should be included in EHRs for children. The format is designed for EHR developers and providers who wish to augment existing systems with additional features or to build new EHR systems for the care of children.

The format includes a minimum set of data elements and applicable data standards that can be used as a blueprint for EHR developers seeking to create a product that can capture the types of health care components most relevant for children. Child-specific data elements and functionality recommendations are sorted into topic areas that include prenatal and newborn screening tests, immunizations, growth data, information for children with special healthcare needs and child abuse reporting. The EHR format provides guidance on structures that permit interoperable exchange of data, including data collected in school-based, primary and inpatient care settings. The format is compatible with other EHR standards and facilitates quality measurement and improvement through the collection of clinical quality data.

AHRQ and CMS led development of the children's EHR format by multiple experts including the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians. The format is built on specifications from sources that include the HL7 EHR-S Functional Model, the HL7 Child Health Work Group's Child Health Functional Profile and the HHS Health Resources and Services Administration's Health IT for Children Toolbox. 

Next steps include testing by two CHIPRA quality demonstration grantees, the Commonwealth of Pennsylvania and the State of North Carolina. As part of the longer term vision, CMS will work toward integration of the format into future editions of the Office of the National Coordinator for Health Information Technology's EHR Standards and Certification Criteria. This would be required for achieving "meaningful use" of certified EHR technology in future stages of the Medicare and Medicaid EHR incentive programs.

For more information about the children's EHR format, please visithttp://healthit.ahrq.gov/childehrFormat

Topics: EHR, EMR, Electronic Health Records, Electronic Medical Records, Health IT, EHR Design, HealthIT

Meaningful Use Grants Still Available for Illinois Health Providers

Posted by Matthew Smith on Feb 6, 2013 7:25:00 PM

Meaningful Use Support"It felt like someone threw us a life preserver."

Registering and attesting for Meaningful Use can be an intimidating and exhausting experience. But with the right help, support and relief is well within reach.

Are you a primary care physician who has implemented an EMR but has not yet met Meaningful Use?

Are you interested in attesting for the Medicare or Medicaid incentive dollars in the next 6 months?

Do you practice in any of the following Illinois counties:

  • Cook (outside of Chicago)
  • DuPage
  • Kankakee
  • Lake
  • Will

If you answered "yes" to all three questions, you may be eligible for grant dollars that would assist you with Meaningful Use implementation and attestation.

If you're not eligible, and know someone who might be, please forward this email on to them.

The regional extension center, IL-HITREC, has a few slots available for Meaningful Use assistance for providers that qualify. This is a matched grant, so for less than $1,000, you could receive support that would lead to attestation and ultimately, the incentive payment up to $21,250 for Medicaid and up to $18,000 for Medicare.

Health Directions has been working with IL-HITREC for over a year and has attested more than 150 providers who subsequently received payment.

If you are interested in learning more, please click the button below to complete a short form to share your contact information--or--contact Sole Prete in our office at 312-218-2929.

Please act now. This is time sensitive as they are trying to fill the limited slots within the next 10 days. 

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, Electronic Medical Records, CMS, HIT, CMS Incentive Payments

Survey: 66% of U.S. Primary Care Physicians Using an EHR

Posted by Matthew Smith on Feb 6, 2013 10:10:00 AM

EHR use in primary care settings has reached 66%U.S. doctors are no longer lagging when it comes to using health information technology in their practices. But they are still more weighed down by paperwork and health care costs than many of their Western counterparts.

survey of nearly 8,500 primary care doctors in ten of the world’s wealthiest countries took a new look at health IT adoption, updating a 2009 study conducted by The Commonwealth Fund and Harris Interactive.

Two-thirds of the American physicians in a sample size of 1,012 reported using electronic health records, compared to 46% three years ago. More doctors also said their practice included e-mailing patient summaries and test results.

The Netherlands, Norway and New Zealand adopted the technologies earlier, and almost all of their physicians continued to report using EHRs since 2009. All three countries have some form of universal health care.

“Bringing in EHRs only makes sense when standards have been set,” said Cathy Schoen, a lead author of the study and senior vice present of policy, research and evaluation at the Commonwealth Fund.

Schoen said more U.S. physicians were open to transitioning from to paper to electronic records and exchanges after national policies were put into place to regulate the technology. The Centers for Medicare & Medicare Services Incentive Programs govern the “meaningful use” of electronic health records and provide incentives to physicians who adopt systems that meet specific criteria.

Dr. Jeffrey Cain, president of the American Association of Family Physicians, said primary care doctors were the first to implement electronic health records, even though the cost was high for their practices compared with that of specialty practices. He said newer physicians entering the workforce, who are generally more comfortable with technology, have added to the momentum driving EHR use.

While health IT advancements foretell more efficient practice, only 15% of American physicians thought the country’s health care system worked well, according to the study. And they blamed insurance coverage restrictions for stymieing access to care and undermining potential for change.

“It’s expensive and fragmented,” Cain said in response to complicated insurance reimbursements. He said family physicians spent an average of eight hours a week filing paperwork, because insurance companies and federal coverage plans each had a different process.

Primary care physicians are hopeful that changes advanced by the health law – including coverage expansions – could prove helpful, according to the Commonwealth Fund’s Schoen. “Right now it’s complexity without value,” she said.

Courtesy of Kaiser Health News.

Electronic Health Records EHR Assessment

Topics: EHR, EMR, Electronic Health Records, Electronic Medical Records, CMS, Health IT, Family Physicians, EHR Adoption

Meaningful Use Audits to Ask for More Documentation

Posted by Matthew Smith on Jan 30, 2013 10:24:00 AM

Meaningful Use AuditsBeginning in the summer of 2012, the Department of Health and Human Services’ Office of Inspector General started conducting a limited number of audits of organizations that have attested to electronic health records meaningful use under Stage 1.

During an educational session at HIMSS13, Mac McMillan, CEO at health information security consultancy CynergisTek Inc., will walk through the early stages of the audit program and what is to come. Audits in the initial phase were very simple as organizations were sent a list of questions they could answer without a lot of documentation--basically asking that organizations reaffirm what had already been attested.

A second phase (later in 2012) was more comprehensive with about 10 pages of questions asking for detailed information such as how an organization is using the EHR’s capabilities and how well it performs. For instance:

  • Does the EHR generate a log?
  • Can you manipulate, view and print the log?
  • Is the EHR configured for role-based privileges assigned to persons using it?

While these initial audit programs were rather simple with little or no measurement of performance, not being truthful could really hurt an organization later if it has a reportable data breach, McMillan warns. For instance, even in these basic early audits, organizations had to re-attest that they have conducted a HIPAA-mandated security risk assessment and update it regularly. “If you aren’t honest in the audit then have a breach, and the investigation shows you didn’t do the risk assessment required under meaningful use, you’re in trouble,” McMillan says.

At some point, McMillan believes, someone in government is going to say, “I want to see a real audit run,” and the program will get tougher with real teeth. That time could come with Stage 2. He sees the early audits as the start of preparing EHR users for a more comprehensive program. “You need to get serious about your attestations and your documentation around attestation so you can be prepared to document it when the audits come.”

The session during the pre-conference Meaningful Use Symposium on March 3, “Meaningful Use Audits--What Your Provider Organization Needs to Know,” is scheduled at 2:30 p.m.

To learn more about Health Directions' approach to EHR, Meaningful Use, and details concertning the audits, please contact Health Directions via the button below:

Electronic Health Records EHR Assessment

Topics: EHR, Meaningful Use, Electronic Health Records, Electronic Medical Records, Health IT, Meaningful Use Attestation, EHR Audit

8 Steps to Connecting Patients for Stage 2 Meaningful Use

Posted by Matthew Smith on Jan 22, 2013 7:12:00 PM

Stage 2 Meaningful UseThe Centers for Medicare & Medicaid Services (CMS) released its final rule for Stage 2 Meaningful Use last summer. The biggest surprise by far was the government’s decision to stand by its new core requirements for electronic patient engagement. The new Core Measures will require providers to give patients online access to their health information and communicate with patients via secure electronic messaging. What most physicians find alarming is that they will be measured on not just what they do, but what their patients do.

Under the final rule, physicians must make health information available online to more than 50 percent of patients. The “catch” is that more than 5 percent of patients need to view their information on the online portal, download it, or transmit it to a third party. Similarly, more than 5 percent of patients must actually send an electronic message to their provider.

Some large healthcare organizations have found that getting patients to use portal and messaging technology is difficult. These organizations report that patient activation rates are well under 10 percent. Meeting the 5 percent threshold will be a challenge for even the most advanced medical practices. 

How can medical groups meet the government’s targets for electronic patient engagement? The answer is to integrate portal and messaging technologies into practice workflows and begin weaving them into patient interactions.

Click the button, below, to immediately access the PDF for this article--including the eight steps will help you implement patient engagement technologies efficiently, promote them effectively, and run them smoothly.

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, Electronic Medical Records, Health IT, Stage 2

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