Monthly Archives: September 2014

EHR Wish List

EHR Wish List

A number of articles recently decry the impact of EHRs on physician’s happiness and satisfaction. While there are only a few physicians out there who still contend the superiority (in terms of completeness, safety, and connectedness) of the paper chart to the EHR, most physicians concede the necessity of EHR, with only a few grumbles and complaints. Many still wonder why Google and Amazon both surpass the EHR in terms of connectedness, ease of use, and all-around technological goodness. For any EHR technologists or engineers out there, here is a list of wants and must-haves, for an “in-the-trenches” practicing physician:

  1. Help me recognize my patients. I cannot easily remember the names and faces of thousands of patients. I forget who they are married to, what they do for a living, and even our last conversation. It would be great if the EHR featured the same type of technology that allows those pop-ups when I am on my computer that are personalized to the last thing I was shopping for online.
  2. Allow me to communicate better with pharmacies. I have no way to “cancel” or “discontinue” a medication through the pharmacy other than picking up the phone and calling. This leads to medication errors and confusion all around. If TripIt, my travel app, can search my e-mail inbox and remind me of the details of an upcoming trip, why is the EHR unable to sync with the pharmacies and adjust the medication list in real-time?
  3. Reduce the need for my wet signature. If money can be moved electronically in vast sums with reasonable security, why can’t I electronically prescribe controlled substances? Surely it is easier to forge a paper prescription than an electronically generated secure fax.
  4. Allow for more than just plug and click technology for online scheduling of appointments. At my salon, I can choose from several dozen different services online — from facials to massages — with a dozen different therapists and aestheticians, and get the correct appointment for the correct “procedure” reliably. Plus, I get a text message alerting me to the appointment!
  5. Integrate more smart-software that supports my clinical decision making. My EHR has perfected the warnings that indicate a potential interaction if I prescribe an antibiotic to a patient with blue dye #5 allergy, which is almost never clinically relevant, but rarely will help me problem solve with decision trees and algorithms. In order to remain relevant, EHRs must redesign how they function to support physicians in their professional endeavors, the way technology supports us in the rest of our life.

 

Source: physicianspractice.com

Patient Portals

Patient Portals

One in three patients confirmed they have access to a patient portal, however, thirty-three percent of patients simply don’t know anything about the possibility of online engagement at all.  When asked by Software Advice about their online interactions with providers, those patients who have attempted to use portal systems generally expressed frustration, confusion, and annoyance with both the technology and the people behind it. Far from providing convenience and reassurance to patients, portals seem to be falling short of consumer expectations and providers may be partly responsible.

  • Thirty-four percent of patients said their top frustration with portals was unresponsive staff who didn’t communicate effectively, leaving patients to abandon the computer and pick up the phone.
  • Twenty-two percent also cited automated emails as a chief complaint, calling them impersonal and annoying.
  • Patients were also dissatisfied with the interfaces that patient portals present.  A third stated that it was difficult and confusing to find the information they wanted.
  • Eleven percent found that their records were stuffed with medical jargon when they did manage to locate their data.

The survey suggests that providers should spend more time explaining the benefits of portals to their patients, and pay special attention to educating patients about the availability of online access to their data.  When choosing a portal, providers may wish to focus on simple interfaces that can provide consumers, especially the elderly, with a user-friendly experience.  As healthcare organizations adapt to the increasing levels of patient engagement required by the EHR Incentive Programs, they may also wish to educate staff members about effective communication strategies and timely, helpful responses to patient inquiries that arrive through the portal systems.

Source: ehrintelligence

Six accountable care strategies to reduce 30-day readmissions

Six accountable care strategies to reduce 30-day readmissions

Six simple accountable care strategies can help reduce preventable readmissions of heart failure patients, according to finding presented by Yale School of Public Health researcher Elizabeth H. Bradley, PhD.  In the Journal of the American Heart Association, Bradley writes that accountable care initiatives already incentivized by Medicare and other health plans, can slash the number of Medicare beneficiaries costing about $15 billion a year for their return to hospitals within 30 days of discharge. Up to 20% of heart failure patients return to the hospital within a month of discharge.

By surveying almost 600 hospitals trying to reduce their readmission rates, Bradley was able to codify effective strategies to extend the continuum of care and support patients during their recovery. Communication between providers, and between providers and patients, are critical to make patients aware of the importance of adhering to medication regimens, lifestyle changes, and other factors that will keep them in better health.

The six key factors for Accountable Care are:

  1. Partnering with community physicians and physician groups
  2. Partnering with local hospitals
  3. Having nurses responsible for medication reconciliation
  4. Arranging for follow-up visits before discharge
  5. Having a process in place to send all discharge or electronic summaries directly to the patient’s primary care physician
  6. Assigning staff to follow up on test results after the patient is discharged

“Many of the strategies associated with lower readmissions are consistent with the widely endorsed belief that better integration of hospital care and primary care is needed to reduce readmissions,” Bradley acknowledges.  “Overall, our knowledge of the factors that affect readmissions is still in an early phase.  Recognition of the importance of readmissions as a measure of quality is still very recent. We may need to use engagement with outpatient organizations, to understand which complex interventions are influential and in which settings they are most effective.”

 

Source: ehrintelligence