EMR/EHR Integration

  • Introduction to EHR

    An EHR (electronic health record) is a digital variant of a patient’s paper chart. EHRs are real-time, patient-centred records that make patient’s health information available instantly and securely to the authorized user. While an EHR does contain the medical and treatment histories of patients, however, it is a system built to go beyond standard clinical data collected in a provider’s office including a broader view of a patient’s care. 

    EHRs are a vital part of Health IT and contains: 

    • Patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
    • Allow access to evidence-based tools that health care providers can use to make decisions about a patient’s care
    • Automate and streamline provider workflow

    The most prominent feature of an EHR is that the health information of a patient can be produced and managed by accredited health care providers in a digital format, capable of being shared with other providers across more than one health care organization. 

    EHRs are developed to share information with other health care providers and organizations such as pharmacies, laboratories, medical imaging facilities, specialists,  pharmacies, emergency facilities, and school & workplace clinics. They contain data from all clinicians involved in a patient’s care.

  • Core Functions of an EHR:

    Over the years, EHR technology has developed to include an array of functions that exceed the fundamental functions that the early EHR products on the market possessed. The improvements in functionality have been inspired by a combination of advances in technology and by consumers demands for more sophisticated features that improve performance and quality of care. Despite the introduction of more advanced features, an effective EHR product still have a robust set of core features that serve as the backbone for other more ancillary features.

    • Health information and data: An EHR’s core mission rests on collecting clinical data regarding patients’ diagnoses, allergies, lab test results, and medications. It must also be able to process and collect these data in a way that can be easily recovered, analyzed, and transmitted.  
    • Result management: To effectively allow clinicians to give quality care, an EHR should allow all providers cooperating in the care of a patient in different settings, to quickly access new and past test results within the EHR system. 
    • Order management: As a further measure to enhance care coordination and to ensure patient safety as care is provided across multiple settings, an EHR should allow clinicians to enter and store orders for prescriptions, tests, and other services to enhance legibility, reduce duplication, and improve the speed with which orders are executed.
    • Decision support: Using notifications and decision-support systems would help improve compliance with best clinical practices, ensure regular screenings, and other preventive practices. Decision support not only serves as a tool to enhance clinical decision making it also acts to improve patient population health by ensuring patients are reminded to take advantage of preventative care.
    • Electronic communication and connectivity: Under Incentive Programs to the Promoting Interoperability Programs, care coordination, and patient engagement through improved messaging systems provide the ability to send and access secure information among providers and patients. 
    • Patient support: Patient support tools facilitate patients the ability to access to their health records, offer to provide patient education material, and assist providers in home-monitoring for patients with chronic diseases and allow patients to conduct self-testing to improve the self-management chronic conditions.  
    • Administrative processes and reporting: Administrative processes and reporting tools refer to features such as scheduling systems, to improve efficiency and provide more timely services to patients. Practice management features that automate many of the day-to-day administrative work conducted in healthcare, such as billing, patient outreach, scheduling, and time management are included. 

    These core features should be treated as a baseline for when deciding on the functions of the EHR system.

  • Goals for implementing an EHR:

    Establishing realistic, measurable goals and objectives for EHR implementation is critical to determine whether or not an implementation was successful. These guidelines include examples that can be used to assist with a goal and objective development. They also outline several dimensions upon which a practice can establish goals and objectives.

     

    EHR System – Once developed the EHR system should provide the organization with the following fulfilment of objectives. 

    • EHR system must fully integrate with your Patient Engagement Software.
    • EHR system must be reliable with virtually no down-time.
    • The system should be very fast and secured with the wireless intra-office connection.
    • The system must be congruent with systems used by hospitals, consultant specialists, labs, and imaging facilities with easily adaptable interfaces.
    • EHR system must be compliant with contemporary technology standards for reporting of data to MCOs and Medicare.
    • The system must be expandable to a multi-site use and allow for growth in the size of the practice.
    • The system must be equipped with disaster recovery procedures that could be easily accomplished.

    Billing- It is one of the most complex procedure that a healthcare organization has to deal with. With the implementation of the integration of EHR, the following goals should be achieved.  

    • EHR billing system must provide easy coding assistance and provide documentation to support codes.
    • The system should be user-friendly and allow holistic reports to track trends in charges, payer mix, denials, etc.
    • The system should facilitate “clean claims” and limit denials.
    • EHR system should adapt easily to changes in requirements for future claims submission.

    Office Staff- The implementation of EHR is supposed to help the office staff with advance collaboration between peers and easy management of day to day duties. The EHR system should satisfy the below-mentioned objectives. 

    • EHR should allow seamless communication with patients, medical specialists’ offices, labs, imaging facilities and MCOs, performed electronically. 
    • The system should be user-friendly and require minimal training for new employees.
    • EHR should be efficient with very few clicks to most-frequently-used screens/functions.
    • EHR should support multi-resource scheduling easily and efficiently.
    • It should improve workflow for all operational functions including patient check-in, prescription refills, management of referrals, record requests, appointment scheduling, etc.

    Providers and Clinical Functions- Some of the functions required to perform are tedious and repetitive tasks, which intern leads to human errors. EHR system should lighten the load on care providers and satisfy the following functions. 

    • EHR visit documentation should be user-friendly and easily adaptable to provider preferences.
    • The EHR documents should be easy to read with useful document structure.
    • EHR should allow remote access from any computer with an internet connection without the need for loading any software.
    • The EHR system should have software that supports multiple visit types as well as visits in which multiple problems are addressed.
    • It needs to have a system by which attending doctors can see and review results.
    • EHR system should allow providers to block their inbox (at least for urgent messages) when they are not in the office.
    • The EHR system should provide efficient means for communication with specialists.
    • The EHR should streamline communication with patients and allow for electronic reporting of results.
    • EHR should interface with labs for electronic receipt of results as well as electronic order entry.
    • EHR should allow for easy use of digital photography for patient identification as well as documentation of exam findings.

    Clinical Data Management- One of the most crucial parameters for an EHR system is clinical data management. The developed EHR should satisfy the following requirements. 

    • EHR should have flexible systems for disease management and programs targeting improvements in-patient care as well as pay-for-performance goals.
    • EHR should easily create reports of patients by diagnosis, visit type, demographics, etc.
    • EHR should provide for easy reporting of data to MCOs, Medicare, and PHO.

    Medical Records And Document Management- Easily the most difficult task in a healthcare organization is document management. However, an apt EHR Solution should be proficient in the following:

    • EHR should allow for fast scanning of documents.
    • EHR should create work notes, school excuses, immunization records, etc.
    • EHR should provide for efficient completion and management of multiple forms from external agencies that need to be completed by our providers, such as WIC forms, PT1 transportation forms, DMV forms, school physicals, etc.
    • EHR should allow for managing a patient education “library” with materials that are easily accessed and printed for patients.

    Patients- In today’s time, even the patients want to have the ease of access their health records and want their treatment to be good as well as they want a good experience which the healthcare provider. The EHR should do the following: 

    • The EHR system should improve patient access to services.
    • The EHR system should improve the patient’s level of satisfaction.
    • The EHR system should encourage patients to undertake all communication with the office electronically if they choose.
    • The EHR system should enable patients to give insurance, demographic information, and eventually some clinical history online before their office visits.

    Costs- While installing an EHR system, organization have to think about the cost involved for the installation of the system and the cost of using the system in the long run. The EHR system should satisfy the following: 

    • EHR system should assist us to save transcription costs.
    • EHR system should save on payroll costs eventually as system efficiencies are achieved and the workforce contracts by attrition.
    • The system should reduce the cost of supplies, courier services, and paper management.
    •  The system should boost revenue through MCO and Medicare incentive programs.

    Vendor- While selecting an EHR vendor, the organization should keep in mind a few pointers, which are mentioned below.  

    • The EHR vendor must be a financially stable/viable company with a firm presence in the local healthcare community and experience with small, primary care practices.
    • The vendors must have a reputation for exceptional customer service and support.
    • The vendors must provide sufficient training of present and future staff in an efficient, cost-effective manner.

     

  • Questions to ask EHR vendors

    Choosing the right Custom Healthcare Software Development system for your medical practice is a big decision. There are many software in the market today and it can be difficult for healthcare organizations to find one that’s the best fit for their practice.

    In order to make the best choice, it’s important to ask the right questions and have an accurate conversation with the EHR vendor about their software. Where do you start? The following is a list of questions healthcare organizations should ask before making the switch. This list is a collection of the most commonly asked questions we hear from our prospective customers.

    • Does the platform integrate with other systems?
    • Does it work on mobile devices?
    • Is the system configurable to meet customization needs? At what cost?
    • How does this system help patients flow?
    • How often is the software updated? How do updates roll out?
    • How long does implantation take on average?
    • What training do you provide during and after implementation?
    • How is data migrated from previous systems? Does it come at an extra cost?
    • How do you keep data secure?
    • What does the startup cost? What are the recurring costs?
  • Common Roadblocks for EHR Integration

    The adoption of digital health technology will be on an upward trajectory over the next decade, with a forecasted market exceeding $379 billion by 2024. This projected growth makes the need to integrate these tools into the EHR increasingly critical for health systems. EMR/EHR software development & integration brings forward and leverages data and insights from digital health tools to provide important information, alerts to warnings and opportunities, and financial and operational guidance at the point of care.

    Removing Interoperability Roadblocks- Getting different IT and software applications to interact and share data effectively remains a hurdle as healthcare providers seek to achieve interoperability, but the advancement is being made. There is likely no aspect of health IT that presents more of a challenge than interoperability. Achieving interoperability is often viewed as the top priority when it comes to health IT, in that it represents leveraging and sharing data in ways that lead to better patient care and outcomes while creating significant cost and time efficiencies for providers.

    Maintain data interoperability- Achieving true healthcare interoperability across the care continuum is a top priority for providers, payers, and other key industry stakeholders. The adoption and use of health data standards form the basis for enabling interoperability across organizations and between electronic health record (EHR) systems. There are three levels of interoperability: foundational, structural, and semantic.

    • Foundational interoperability is the ability of one IT system to send data to another IT system. The receiving IT system does not necessarily need to be able to interpret the exchanged data — it must simply be able to acknowledge receipt of the data payload. This is the most basic tier of interoperability.
    • Structural interoperability is “the uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data are preserved and unaltered,” HIMSS states. To achieve structural interoperability, the recipient system should be able to interpret information at the data field level. This is the intermediate level of interoperability.
    • Semantic interoperability is the ability of health IT systems to exchange and interpret information — then actively use the information that has been exchanged. Semantic interoperability is the highest level of interoperability.

    Implement adaptable & scalable integration –  EHR technology has penetrated several hospitals and patient-care facilities. It helps healthcare providers offer better-managed patient care and enhanced facilities. Soon, hospitals are going to get more dynamic, and without a scalable EHR, it will be difficult to manage all the aspects of integrated care.

    • The Shift Towards ‘Smart’- There has been a shift from conventional to smart hospitals, which are all about clinical outcome excellence as well as delivering the best possible patient experiences using the latest technologies. Smart hospitals also aim at increasing operational workflow efficiencies. Think of connected healthcare facilities, IoT, and wearable devices. 
    • Demonstrable High-Quality Care- Hospitals are fast becoming the core of high-quality patient care, with patients expecting celestial experience and high-quality care from the word go. EHRs lead to improved customer satisfaction by giving instant record access, reduced turn-around time, quick allotment of services, fewer visits, and improved delivery of equipment, etc. 
    • Integrated Patient CareWith the right EHR system, healthcare institutions can offer better integrated patient care, which is an amalgamation of primary care, behavioural health, and other patient needs. While it is known that it helps offer a seamless patient/provider experience, some EHRs, at present, are not up to date for managing all the aspects of integrated care. 
    • Demand for Low Cost of CareNowadays, several organizations are coming up with strategies to tackle rising healthcare costs in 2020. They aim to do this through price transparency along with consumer-focused initiatives. Healthcare providers are tweaking their workflows using certified EHR technology. This, in turn, can help them align all their goals and streamline the processes, resulting in faster and improved clinical outcomes.
    • New Form of Care NeedsAccording to a report, the global telehealth market over the forecast period of 2015 to 2020, the market is estimated to grow at a CAGR of 24.2% from $2.2 Billion in 2015 to $6.5 Billion by 2020. With remote monitoring technologies becoming more commonplace, the demand to cut down healthcare costs is going to be the order of the day. Remote monitoring is facilitated by Bluetooth-enabled devices, patient-generated health data, and various FDA-approved mobile apps. All these allow better health care, preventative measures, and instant services at a lower cost.

    Turn data into insights – The push toward value-based care has amplified the need for quality patient information that directly contributes to improved care. In the continual quest for long-term sustainability, access to data from disparate sources and multi-tiered systems are increasingly important within, and between, provider networks and healthcare organizations. The healthcare industry is ramping up efforts to use data, from multiple sources, in a more meaningful and efficient manner, and is developing strategies for comprehensive, whole-person care for any circumstance that could affect health.

    The emergence of electronic health records (EHR) drew an incremental step in digitizing healthcare. The next iteration of the technology is directed at helping healthcare stakeholders handle large, and increasing, volumes of data. “Data and insights platforms” help providers navigate data from multiple sources, analyze data, turn insights into action, and capture feedback for continual improvement. Analytics presents summarize and highlight data. Insights enable decision-makers, based on the analytics, to understand what is going on, why it is going, and what is next. Insights are a derivative of analytics; they are the result that enables changes in actions or responses.

    Meet healthcare compliance & standards- The Healthcare Information Portability and Accountability Act (HIPAA), passed in 1996 and implemented in 2003, spurred the need for healthcare compliance across the industry. HIPAA mandates (among other things) industry-wide standards and processes for the protection and confidential handling of patient health information.

    Healthcare is one of the most regulated industries in the United States, making healthcare compliance a crucial and expanding field within the industry. The Health Information Technology for Economic and Clinical Health Act (HITECH) promotes standardized electronic health records (EHR). The act was implemented in 2009 to address the privacy and security concerns of patient data, EHR files and how they’re shared. HITECH strengthens the enforcement of HIPAA’s protected patient information rules, requiring the Department of Health and Human Services Office for Civil Rights to conduct periodic provider audits and stiffening penalties for breaches of information, meaning a provider or facility found non-compliant can face a fine of up to $1.5 million.

  • API Technologies for Seamless EHR Integration

    The misplaced chart, poor communication between providers and fully secure patient records are all common medical concerns that technology was meant to solve.   

    However, as in most aspects of healthcare, not everything comes with ease, and many providers have been left wanting when it comes to their technological needs in regards to patient records. Below mentioned are some medical practice management solutions one should look into for easy and efficient integration.

    Redox

    Redox, the leading interoperability platform for healthcare data exchange. Connection with Redox allows members to have broad access to exchange with any Carequality Connection and the ability to integrate data using deeper direct connections with more than 900 healthcare organizations within the Redox network.

    Companies that want to leverage the Carequality framework for care coordination and integrate with other healthcare data sources can use the Redox application programming interface (API) to eliminate integration complexity and speed up time to value. Redox standardizes healthcare data with a vendor-agnostic API and a cloud network where organizations can exchange information with their partners. This network interoperability approach simplifies the way organizations exchange healthcare data by eradicating the issue of inconsistent data formats and redundant connections. Messages may be transmitted and/or received in any message format associated with the healthcare entity’s existing EHR system.

    The Redox API can currently be used to support Basic Carequality capabilities, and Redox has two other programs in development, Gateway, and Responder, each of which will reduce an organization’s technical overhead. The Gateway program will intercept queries and pass along only those relevant for that organization. In the Responder program, Redox will not only intercept queries but will respond to the organization’s behalf.

     

    Eligible

    Eligible, a medical billing platform designed with revenue cycle experts, patients, and developers in mind. Eligible is accredited with both the Healthcare Network Accreditation Program (HNAP) and the Cloud-Enabled Accreditation Program (CEAP) from the Electronic Healthcare Network Accreditation Commission (EHNAC). Together, the CEAP requirements, Eligible’s operating practices, and the extensive EHNAC auditing process establish a framework for trust between all stakeholders exchanging healthcare information with Eligible. These accreditations assure both patients and providers that Eligible has accomplished the strictest compliance with privacy and security best practices while processing millions of healthcare cases each month.

    Eligible is SOC2 certified. SOC2 is a certification developed by the American Institute of Certified Public Accountants (AICPA) that provides a way to measure the operating effectiveness of a company’s controls as they relate to Availability, Processing Integrity, Confidentiality, or Privacy. The measurements ensure that service organizations are providing a mature, robust, and secure product and are actively creating an organization that supports these goals.

    Most medical service providers still rely on a highly manual, error-prone process for Patient and Insurance billing. You can use Eligible’s dead simple APIs for Estimations, Statements, and Claims, into your apps.

     

    ScriptSure- Daw Systems

    ScriptSure, is an E-Prescribing, EMR & Scheduler are applications that give you access to affordable clinical office tools. ScriptSure is designed for simple use and quick customization so you can work the way you need to while providing all the features you need to meet industry standards and practise efficiently. 

    From reception to check out, ScriptSure allows users to customize the application throughout. You can store your favourite medications, create custom triage fields and screens, tailor note templates and quick text selection lists to reflect how you document. Choose from hundreds of templates in general format or specific to diseases or create your own. Simple SOAP notes and dictation recording areas are included as well.

    ScriptSure E-Prescribing software is a GOLD Certified Solution Provider & White Coat recipient. Daw Systems, Inc. achieves EHNAC’s Cloud-Enabled accreditation program. Daw Systems, Inc. achieves prestigious EPCSCP-Prescribing (e-Prescribing of Controlled Substances Certification Program for Prescribing Applications).

     

    Nextgen

    Nextgen’s integrated solutions help increase clinical productivity, enrich the patient experience, and ensure healthy financial outcomes. Their comprehensive, integrated technology and services platform supports ambulatory and speciality practices of all sizes.

    Get high-quality, personalized care with their comprehensive clinical solutions that you can customize to suit your practice. Automate patient intake, streamline clinical workflows, and leverage vendor-agnostic interoperability that support you in achieving quality measures and qualifying for incentives.

    Comply with ever-changing regulatory, documentation, and compliance requirements with NextGen’s Health Quality Measures (HQM). NextGen HQM empowers you to gather the data you need for reporting and prove the value of the care you deliver. When combined with NextGen’s Adaptive Content Engine (ACE), you can achieve rapid tailoring to local rules and needs.

    HQM workflows make gathering the data needed for reporting and regulatory compliance a natural part of your clinical workflow. When combined with the power of the ACE, you can even meet unique or local requirements quickly and easily.

  • Conclusion

    Our world has been completely reconstructed by digital technology – smartphones, tablets, and web-enabled devices have reshaped our daily lives and the way we interact. 

    A comprehensive and seamless flow of information within a digital health care infrastructure, created by electronic health records (EHRs), includes and leverages digital progress and can transform the way care is delivered and compensated.

    With EHRs, patient’s health information is available whenever and wherever it is needed.