EMR & EHR Blog for Physicians

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Now that the HHS has issued two sets of long-awaited and much-anticipated federal regulations on list of "meaningful use" criteria that healthcare providers must meet to qualify for federal IT subsidies and the standards and certification criteria that those EHRs must meet for their users to receive the EMR incentives, one is left wondering what is the real value of CCHIT certification and do those EMR vendors who went in for CCHIT certification and spent over $40000 each for the certification without waiting for the meaningful use get any headstart?

Here is a summary of an article that was published by Modern Healthcare today:

CCHIT may have had close ties to HHS in the past but that is history. David Blumenthal, the current head of the ONC, in a meeting was responding to a question about existing CCHIT certifications of Electronic Health Records and HHS' prior recognition of CCHIT as a certifying body.

Blumenthal mentioned that to qualify to receive incentive payments, the EHR would have to be certified by a body certified by the Office of the National Coordinator and that ONC is working towards creating a process to recognize that body.
Blumenthal mentioned that even though CCHIT was recognized in the past as a certifying body, its future status will be governed by the regulatory process that is ongoing right now. He termed as premature the talk about the implications of any particular set of certification criteria that CCHIT or anybody else has put forward or will put forward.

Mark Segal, Vice Chairman of the Electronic Health Record Association of HIMSS said the stimulus law, gives the ONC the authority to go ahead and retroactively accept any EHR systems certified under the old CCHIT process as certified under the new stimulus law provisions.

The ONC rule-makers explained the rationale behind this decision to scrap the previously accepted certification criteria and process. HHS, they wrote, decided not to accept CCHIT certification criteria due to "our approach of aligning adopted certification criteria with the proposed definition of meaningful use."

Segal said there still are "a reasonable expectation that CCHIT will be one of those" organizations that will again be recognized by the ONC. He also mentioned that CCHIT certification criteria come quite close to matching those new criteria being developed by the ONC. As a result, if an EHR is already certified up until now means it already has a lot of the functionality in place.

I do believe that the EMR Vendors who spent the time and financial resources in advance of the recent formal release of regulations, they are at an advantage as compared to a large number of vendors who do not have any certification, whatsoever. A number of smaller EMR vendors got certified in 2006, but as the competition is heating up, are already on the way to getting their EHR certified under the CCHIT 2011 Certification Program.

As I have earlier mentioned in another blog of mine, just because a Physician implements a Certified EMR does not mean that it is used in a meaningful manner, one of the EHR selection criteria must therefore include the ease with which the EHR allows demonstration of meaningful use to CMS.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Now with the Obama administration pumping in money in healthcare by incentivizing Physicians implementing certified EHRs and demonstrating meaningful use, many EMR vendors are again proclaiming the demise of Medical Transcription stating that after implementation of EMR / EHR Software, the Physicians can eliminate use of Medical Transcription services altogether.

While I agree that the role and nature of medical transcription will change in the new world, I do not believe that physicians and clinics can stop using medical transcription services altogether.

EMR solutions are based on point and click templates and capture data as discrete data elements. However, to any one intimately familiar with the nature of dictations and transcripts, it is obvious that there is a narrative part of the medical note which tells what the doctor is thinking during the patient encounter. How will this narrative be captured as part of eletronic medical records?

It has been shown that such narrative contributes to a detailed electronic medical record and supports meaningful use of the EHR. The narrative can either be produced in real-time using speech recognition software like Dragon, or it can be produced on the back end using traditional digital medical transcription services and input into the EHR by the transcription editors.

In a survey carried out, over 75% of the respondents indicated that they are interested in productivity aids that would help doctors to better document care within an EMR (beyond the standard point and click). Even though the accuracy of speech recognition software has improved significantly and it can be trained, most physicians find it a distraction - imagine the physician seeing the software wrongly transcribing and repeatedly interrupting his dictation to correct the transcript using keyboard and mouse - and do not want to take on the editing responsibilities.

Speed of charting has been one of the main sticking point with the physicians who complain that the EMR slows them down. Dictation is still the preferred method for physicians to document encounter notes. A possible solution that partly alleviates the concern of the physicians is to have the Medical Transcription Company introduce XML tags (in a semi-automatic manner), make the data elements ready for abstraction and then load the same into the EMR Software's database as discrete data elements. I would like to get feedback from readers if they have seen this technology solution successfully deployed.

According to Jay Cannon, EHR vendors need to work closely with the Medical Transcription service providers to deliver "hybrid clinical documentation solutions" that give physicians flexible choices for input, along with discrete, reportable data output for the EHR. I completely support this philosophy.

Our recommendation would be for prospective EMR customers to ensure that the EMR Software allows for an easy and unobtrusive interface for the provider to dictate and for the Medical Transcription Company to come in and transcribe right into the EMR or load final and structured documents into the EMR.

Do let us know of your comments and / or experience with implementing such a solution successfully.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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What is the difference between an EMR and EHR? Aren't they essentially the same?

It is easy get confused by the inconsistent way these terms are bandied about in the industry.

• Nextgen mentions both EMR and EHR in its home page title, but the product is called Electronic Health Records.
• GE Healthcare calls its product as Centricity EMR.
• Greenway characterizes its PrimeSuite product as an EHR.
• Aprima's PRM product was initially labeled EMR but is now described as EHR.
• eClinicalWorks continues to refer to its product as an EMR.
• Allscripts mentions both ‘Electronic Medical Records (EMR)' as well as ‘Electronic Health Records (EHR)' in the title of its home page, but their solution is called ‘Electronic Health Records'.
• CCHIT certifies EHR (Electronic Health Records) products, but the list of CCHIT-certified EHR products includes a number of ‘EMR' products.

As is clear from the above, vendors have been using the two terms - Electronic Medical Records (EMR) and Electronic Health Records (EHR) - interchangeably in their communication even though these two terms are technically different with different sets of features and capabilities.

Chris Hobson in a article published in ‘Advance for Health Information Executives' says that the difference between the two terms more than semantic and is crucial for health IT decision-makers to understand the difference.

So what is the difference between EMR and EHR? Let us review the distinction portrayed by three authorities in their own rights:

1. Chris Hobson:

The essential difference between EMR and EHR lies in how the (electronic) data will be used or shared - within the confines of a single office or practitioner or will it be shared across a wide range of different providers, such as specialists' offices, labs, insurance providers and government agencies?

Chris relies on the definition advanced by HIMSS and accordingly, an EMR is a set of applications and workflow tools that digitizes the creation, collection, storage and management of patient information "within the confines of a single organization". It may touch clinical data repositories, lab applications and patient information management systems, among others -- but all within the reach of a single organization.

EHR, on the other hand, is a longitudinal, complete and unified view of electronic record of patient health information produced by clinical assessments in one or more care settings drawn from across a wide region corresponding to all the providers who are seeing the patient -- the totality of his/her personal data, state of health and delivered care.

According to Chris, while both EMRs and EHRs provide some similar benefits -- cost savings through improved workflow and paper reduction, improved delivery of care accuracy -- EMRs provide those benefits only within a single organization. EHRs, because they are shared across the irrelevant geographic or otherwise defined region, increase the efficiency of patient care and improve patient outcomes, disseminate information rapidly between care providers, help with research efforts, and cut costs throughout the entire system more promptly and reliably.

2. National Alliance for Health Information Technology (NAHIT):

NAHIT while offering the following definitions, generally supports a similar distinction between EMR and EHR:

EMR (Electronic Medical Records) is an Electronic Record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization.

EHR (Electronic Health Records) is an Electronic Record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.

3. Healthcare Informatics:

EMR is a computerized legal clinical record created in Care Delivery Organizations (CDOs), such as hospitals and physician offices, and used and owned by the CDO. It becomes an EHR (Electronic Health Record) when:

• Reports and histories (labs, pharmacy, radiology, consults, etc) are electronically added;
• Items in the record are electronically exchanged with other providers, and
• There is a personal health record (PHR/PMR) component which allows patients to participate in documenting and creating their medical history and communicate with their provider.

EHRs represent the ability to easily share medical information among stakeholders and to allow it to follow the patient through various modalities of care from different CDOs. Thus EHR offers a holistic approach to patient care where continuity of care is emphasized.

EMR vs. EHR - What does it mean to you?

Regardless of whether vendors call their products EMR or EHR, what should your first priority be?

When selecting an EMR or EHR, ask your vendor to explain how its solution will support your vision for interoperability and rapid exchange of data between care providers, in order to provide a holistic perspective on delivering health to your patients. It's that simple. You can safely make this your criterion for choosing a system, and forget about what the vendor calls its product. For your purposes - providing efficient, effective care - the name is totally irrelevant.

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Read our related blog on Top 12 EMR Software Selection mistakes often committed by Physicians.

Contact Us for free no-obligation EMR / EHR Selection Consulting and Demo.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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Web-based EMRs have been touted as a nice way to implement EMR solution with low initial investment. Web-based and client/server EMR systems have unique advantages and disadvantages. Which model you should choose for your practice will depend on your special requirements.

Despite the obvious advantages of web-based EMR (access from anywhere, remote hosting, etc.), there are some important points you should consider when deciding whether to implement a web-based system:

1. Don't imagine that a "high-speed" Internet connection is all you need to run a Web-based EMR. It's important to find out if you'll actually have the bandwidth required to send, receive, and exchange data efficiently. Consult the EMR vendor about its requirements, and talk to your Internet service provider about its available bandwidth options.

How much bandwidth you need will depend on the number of users and the volume of data flowing between your practice and the hosted Web- based EMR. If the data increases, you may need additional bandwidth, and you'll need to be prepared. Carefully review the EMR vendor's recommendations before you sign up for a bandwidth plan.

2. How reliable is your Internet connection? This is critical - and also, your upload and download speeds may vary depending on the time of day and how much bandwidth is being used by nearby businesses. You'll want to plan for extra bandwidth to avoid slow-downs in charting your patient encounters.

If you share an Internet pipe with other businesses in the same complex, your data transfer speeds may fluctuate dramatically, depending on how the others businesses are using the connection. We recommend asking your Internet service provider for documented evidence of the uptime you can expect. Depending on the answers, you may want to consider getting a dedicated pipe for your clinic. Work with the EMR provider to develop a backup system for charting on paper if the system goes down, and develop your office processes accordingly

3. What if your EMR vendor folds its tent? Will you be able to retrieve your data from the vendor's servers? Will the data be in a format that you can use/convert/transfer?

After deciding on a web-based EMR vendor, treat the vendor as your partner. You should be able to discuss every possible scenario with the vendor's sales reps. Better yet, work with an experienced EMR consulting company who'll help you communicate with the EMR vendor. Consider asking the vendor to provide data-backup files on a regular schedule.

4. Unlike a client/server environment, where you have local control over the server and EMR software, a web-based EMR makes you dependent on the vendor's customer support. Will your vendor reliably and promptly support you and your staff by phone, IM, email, or chat? Will the vendor be available to quickly help you solve urgent or critical issues? Talk to the vendor about its support structure, especially outside normal working hours.

5. What will happen if you someday decide to move from a web-based to a server-based EMR? Does your vendor offer that flexibility? If so, how seamless will the migration be? How much will it cost? Even if you don't believe it will ever happen, it's in your best interest to discuss it with the vendor today, and get an in-depth understanding of the process.

We've seen many successful web-based EMR systems. They do work well for most physicians. By understanding the handful of caveats we've outlined above, and preparing accordingly, you'll stand a better chance of implementing a successful web-based EMR system for your practice.

Learn about the top 10 EMR Software features that you should be looking for. Download our free article on Top 10 Electronic Medical Records features for every physician.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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1. Not taking the staff into confidence before starting the EMR selection process.

Your staff will be most impacted by the changes in your clinical environment. Hence it is imperative that you help remove the fear of the unknown from the mind of your staff by explaining how implementation of the selected EHR Software will make them more efficient and effective in their day to day operations.

2. Not drawing up the criteria for your decision making process that is objective with a measurable metric rather than basing it on gut feeling.

Criteria should be appropriately grouped and weighted so that you can arrive at a weighted score for each EMR being evaluated. If you are evaluating three or four EMRs and do not have the criteria well defined, chances are huge that some irrelevant issues will cloud your vision and impact your decision making.

3. Not following through with the references or not doing a thorough job with the references.

You may often believe that all references are going to speak highly about the EMR since they have been handpicked by the vendors. However, as we all know, physicians are a closely knit community and it is not difficult for you to validate or repudiate what the references told you about their experience with the EMR Software or Vendor.

4. Accepting at face value what EMR vendors tell you about all their EMR Software features and functionality.

For example, we have found some of the key differentiators claimed by some vendors had actually been decommissioned because they did not work as intended and were back to the drawing board for a re-work.

5. Assuming that larger and well known EMR vendors will be technology-wise more advanced, and customer-support-wise friendlier to your individual needs and situation.

This assumption could be quite misplaced because bigger is not always better as many of these vendors are too busy working on tying up bigger alliances with hospitals and IPAs trying to rope in hundreds of providers in one scoop. Thus, ramping up customer support for small practices almost always takes a back seat and therefore you may be left out in the cold when you need help right away. Larger vendors are less likely to hear you out in regards to your individual needs and even more importantly, make changes to the software to meet your genuine requirements.

6. Selecting a vendor who says that their EMR Software does not need much training and it is easy to pick up.

If you and your staff do not get adequate training, you will not be able to utilize the software to its full extent. There are no plug and play systems that can be implemented in a few minutes, few days, or even few weeks. Negligible amount of training built as part of initial implementation proposal is nothing more than a contrived method to win your business.

7. Being too focused on price early-on in your search or believing that there really is such a thing as Free EMR Software rather than focusing first on what you need for optimizing your clinical processes and workflow.

A lowest cost approach does not typically translate into saving a lot of money and a lower Total Cost of Ownership. Once you determine what you want and need, you may start drilling down into pricing the EMR Software alternatives you are considering. Don't get pushed into making a decision, be patient.

8. Selecting an EMR on the basis of current requirements alone and not considering your foreseeable or possible future needs.

Growth is generally inevitable and you may take on new providers (multi-specialty?), offer new services, or use devices that need to interface with the EMR.

9. Believing that you or an appointed member of your practice has all the time, knowledge, and experience to handle almost a monumental responsibility for undertaking the research, screening, selection, negotiating, and implementation of the best suited EMR Software for your practice without guidance from an experienced EMR consultant. There are too many decisions to be made and if you stop and think about it, you may realize that you truly do not know all about the good, the bad and the ugly, about EMR selection, implementation, price negotiation, hardware selection and more. Engage with an EMR Consulting company to assist and work with you.

10. Not having a true picture of how the EMR will help create a true paperless office and what components will or will not be addressed by the vendor directly as part of implementation.

You must ask the EMR vendor to adequately demonstrate that their EMR Software will in fact increase efficiency and translate into increased revenues.

11. Not taking enough time to discover and evaluate the initial and recurring costs of implementing EMR.

This also includes understanding the technology underpinnings required to support the selected EMR. It would also greatly help if you define and require the line items expected on the proposal from every EMR vendor you are considering so that you can make the best apples to apples comparison between different EMR Software.

12. Not clearly understanding what the vendors always mean by that or this is included at no additional charge.

A good example of this is not clearly defining what they mean by a bi-directional interface with labs. There are actually two costs involved in setting this up and usually EMR Vendors mean that their side of the cost is included and that they can accommodate the connection but, someone (you) will have to pay for the other side of the connection.

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We would like to keep revising this list for the benefit of our future readers. Hence if you believe that there are other blunders made often by Physicians in EMR selection process, please do leave your comments. We will have an updated list avaialble for free download soon.

Learn about the top 10 EMR Software features that you should be looking for. Download our free article on Top 10 Electronic Medical Records features for every physician.

RevenueXL can not only help you select the right EMR Software, but also guide you in implementing your chosen EMR Software a.k.a. EHR Software.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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While there is a lot of talk these days about stimulus incentive for this and stimulus incentive for that, the fact is, many specialties are not really included in those Medicare offerings.  Take a look at Pediatrics for example, how many Medicare patients do you see sitting in a Pediatrician’s exam room waiting to be seen? That’s right, Zero! So why then are so many Pediatricians transitioning to EMR Software and at perhaps, an even faster rate then some other specialties whom have a big financial incentive from Uncle Sam to do so?  The answer is quite simple really, technological evolutionary progress, and after all , that is the American Free Enterprise way, right?  Right!

So, in the words of a famous sports ware maker, Just Do It!  And that is exactly what Pediatricians are doing when it comes to adopting well-developed Pediatric EMR Software.  This is especially noteworthy because unlike most of the more prevalent Baby Boomer generation specialties, Pediatrics has some pretty unique requirements that not many EMR vendors can satisfy, but those that can, are, and needless to say, they are extremely busy.

Here are the Top 11 Pediatric EMR Software features that Pediatricians are looking for when selecting an EMR Software for their practice:

1.  Easily access and incorporate into your chart notes age andgender specific growth charts with a single click.

2.  Immunization tracking.  See what has been given and what needs to be given. Health Maintenance and Preventive Care reminders and reporting for improving patientcare.

3.  Able to quickly print out consent forms and capture parent’s signature electronically.

4.  Perform well child exams through the use of knowledge-based templates or pre-populated intuitive learning software design.

5.  Easily document and access developmental milestones.

6. Document and review birth history and prenatal history.

7.  Fully integrated access to up to date pediatric dosage calculator and drug interaction checking and alert system to ensure appropriate patient treatment and safety. Prescriptions can be printed, faxed, or electronically sent to the pharmacy of choice including an updated national pharmacy database.

8. Fully integrated bi-directional electronic lab interface for ordering labs and receiving results that are easily attached to patients electronic chart. Lab orders can also be printed or faxed.

9.  Easy access to printable return to school forms, camp physical forms, or sports physical forms, all at the click of a button.

10. The ability to electronically chart notes or input vitals and other data with several on-the-fly ways including, point-and-click, voice recognition, handwriting recognition, or through the use of customizable and printable patient and doctor specific forms.

11. Interface with State Vaccine administrations for participating States.

As a 'by the way, but of course' #12, is that your EMR Software must have fully integrated electronic Medical Billing including easy tracking, posting, reporting, A/R management and, the option to process paper billing. 

So how do you find an EMR Software with all these qualities?  My advice, find a good EMR Consultant to help you select the best-fit EMR Software for your Pediatric Practice.  In fact, find one that will do this at no cost to you. 

CLICK HERE to find and speak with a reputable EMR Consultant who, at no cost to you, will help you find and select the best-fit EMR Software for yourPediatric Practice

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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I was reading an interview with the CEO of a company which offers EMR Software on SaaS (Software as Service) basis. The CEO of that EMR vendor company mentioned that theirs was the only real SaaS EMR, others who claim to be SaaS are really only ASP EMRs. I have seen this term used interchangeably in the past and therefore thought that it would probably help to clear the air a little bit.

In a hosted solution (whether ASP or SaaS), the customer does not have to buy the software or the server infrastructure. The EMR vendor hosts the application on a server that is securely hosted in a data center that is accessed over the internet by the users. These are low-cost ways for businesses to obtain rights to use software as needed. Also known as 'on-demand' licensing, the customer does not have to deal with the associated complexity and potential high initial cost of licensing the application, installing it on expensive hardware and paying for annual maintenance.

We have known many EMR Software solutions that have been offered on a hosted basis for many years.

So what excatly is the difference between ASP and SaaS offerings?

SaaS applications differ from ASP applications in that SaaS solutions are developed specifically to leverage web technologies such as the browser, thereby making them web-native. The database design and architecture of SaaS applications are specifically built with 'multi-tenancy' in mind, thereby enabling multiple tenants (customers or users) to access a shared data model.

An ASP application on the other hand in most cases is a typical Client-Server application (meant for a single client) that is accessed over the internet and therefore includes an independent instance of Database that is specifically meant for your medical office.

So, as a physician, does it really matter to you if the solution is offered as an ASP or as SaaS? Really not. As an end customer, it has no impact on how you interact with the EMR application. It does not matter to you that from EMR vendor's perspective, it is expensive to create multi-tenancy based SaaS solutions but at the time more cost-effective to host and support them.

However as a customer of hosted EMR solution, you need to unambiguously understand as to who owns the data and whether the vendor of the hosted EMR software has the right to sell the patient and physician data (howsoever anonymized it may be) to third parties like data mining vendors. Also, if and when you decide to move on to an alternative EMR solution, how easy it is for you to get access to 'your' data (including all master data) in a format that can be imported into the new EMR database.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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If you are out there trying to take on the daunting task of researching and finding an Electronic Medical Records Software solution (EMR) all on your own, the prognosis is bleak, the toll is high, and you will have a very bumpy road to travel. There is good news though, and all you have to do is take the Easy Street exit, just ahead. That's where you will find the right professional help to guide you through your EMR Selection Process, and save you a lot of time, money, and frustration. Good EMR Consulting Companies are hard to find, simply because there aren't many.

So, don't be fooled by some of the internet based so called EMR consulting companies that list dozens of EMR Vendors on their web site and claim that they will match you up with a list of EMR Vendors that will meet your needs. You cannot and will not find the best-fit EMR for your practice by checking off a bunch of little questionnaire boxes about your practice and what features you are looking for.

Once you get a list like that, then what do you do? Which one do you start with? How long will it take to go through the list and see a Demo of each one to find the best one? How will you know about all of the features and functionalities that are available, and which ones are appropriate for your practice? How will you know what an EMR costs? What about set-up, training, and implementation launch, hardware, software, and this list goes on and on.

The reality is, you are really no better off than when you started, as you might as well have done a simple google search, and wound up with virtually the same list, and most likely, you probably already did that anyway.

So my advice, find a good Independent Certified EHR or EMR Consulting Company to help select the best fit EMR for your Practice.  In fact, find one that will do this, at no cost to you.

Want to learn more?  Visit www.revenuexl.com and get the experienced help you need in finding the best-fit Electronic Medical Records Software solution for your practice and, at no cost to you.  

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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2006 marked the beginning of an era for soaring demand at record setting paces for the adoption of Electronic Medical Records Software by Pain Management Physicians. This record growth can be attributed in part to a combination of several factors including, technological innovations, greater efficiencies caused by product innovations reducing costs and increasing revenues, market and political pressures, and now, government tax and payment incentives. Since this time, tens of dozens of EMR software vendors have been popping up everywhere jockeying for a piece of the pie by claiming that their solution can best meet the Specialty EMR needs of Pain Management Physicians and their practices.

Pain Management Physicians who are working with a good EMR Consultant are experiencing smooth, timely, and successful selection of the best Electronic Medical Records Software for their practice. At the opposite end of this EMR software selection process are those physicians trying to take on this daunting task on their own, and they are quickly finding themselves in a rather precarious situation and learning things the hard way by going through tumultuous EMR software search that engulfs a tremendous amount of their time and resources, not to mention, all of the frustration, confusion, and headaches that accompany trying to ride solo through the EMR software selection maze.

Those Pain Management Physicians who have managed to make their un-assisted way through the EMR selection maze say that, if they had it all over to do again, they would have brought in some professional help and saved a lot of time, headache, and money.

One thing all of those Pain Management Physicians who manage to make it through and find the right Electronic Medical Records software for their practice is that they tend to really like the EMR software that offers a operational foundation that is a combination of having pre-defined and customized templates or intuitive or "smart learning" abilities and related software design. Then comes the other key EMR software features and functions Pain Management Physicians are getting when they find the right Electronic Medical Records Software for their Practice. The vast majority of those are listed here:

• Pre-loaded pain management specific conditions and nomenclature
• The software must be well developed with Specialty templates and built-in intuitive or smart-learning capabilities, and have encounter scripts and key equipment integration points ideal for Pain Management Practitioners.
• The technology must enable plug and play integration with most Pain Management medical equipment.
• Easily accessible and interactive built-in diagrams or images for documenting precise location of pain, numbness, tingling, burning on extremities, neck, back, shoulder, face.
• Ability to upload and use additional diagram, images, and drawings specific to your practice.
• Interactive diagrams (extremities, body, etc.) for documenting pain locations
• Pain management patient education
• Pain management specific HPI complaints and ROS with systematic documentation of pain effect on daily activities, previous treatments tried and their efficacy, investigations undergone in the past, expected outcome of the present pain treatment.
• Operating Room Vitals Monitoring Integration
• Templates for Multiple Procedure, Back/neck pain, Selective nerve block, Lumbar puncture, Epidural steroid injections, Trigger point injections, Facet injections, Bursa injections, Botulinum injection, Epidural Steroid injections, Intrathecal cath / pump placement, Stimulator implantation, Opioid trials for chronic pain, Anesthesiology, etc.
• Quick glance face sheet to view patient's medical history in details including allergies, past/present medical problems, family and social history, surgery history, current medications, all previous prescriptions, stopped medications with inbuilt drug-to-drug, drug-to-allergy contraindication warnings or alerts.

There is no doubt that the search and selection process is quite an undertaking and the demand for EMR software by Pain Management Physicians is expected to continue to soar. So your best bet is to find and engage the services of a good EMR Software Consultant. This will save you a lot of time and this is important because right now the longer it takes you to find that right-fit EMR Software, the longer you can expect to wait in line for your turn to get started in implementation and then "go-live". Another important thought regards your timing has to do with being properly up and running in order to be qualified and eligible in time to receive the Stimulus Incentives.

Click here to find a good and experienced EMR Consultant who will provide you a free 30-minute EMR needs assessment, selection, and next steps Consultation for your Practice.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.

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With the experience of working and speaking with hundreds of physicians behind me and reviewing dozens of EMR Software options, here is my list of top 10 must-have features that every physician would do well to require when evaluating the 300+ EMR solutions available in the market today (not listed in any particular order of importance as the sum of their value in whole, is greater than their value individually):

1) A fully Integrated EMR Software System as opposed to interfaced systems

Replacing an existing Practice Management application in favor of an integrated EMR Software and Medical Billing software may seem scary at first especially if a physician has been using a medical billing and practice management application for several years, but I believe that it is very important for the EMR software system to be integrated with the Medical Billing or Practice Management software application. Integration really means that they share the same database and there is no need for different data elements being pushed out from one system to another on the basis of defined business rules using an interface based on an API (Application Programming Interface). Interfaced applications work but occasionally cause for both systems to become out of sync due to buggy interfaces. Go ahead and take that desired step.

2) Integration of EMR Software with ePrescription to receive bonus payments

In 2009 and 2010 providers who use a qualified Electronic Prescribing system can earn a Bonus Payment equal to 2% of their total allowed charges through Medicare part B. By using a Certified Electronic Medical Record (EMR) which has in-built e-prescribing capability, medical practices can experience dramatic efficiency gains and enhanced patient safety. You can choose a stand-alone ePrescription application but it will mean creating yet another avoidable interface or reduced efficiency because of extra data entry operation. It is best to go in for an EMR System with inbuilt ePrescribing capabilities. Did you know that the average physician saves $15,700 a year by using their properly integrated ePrescribing feature?.

3) Electronic Medical Record Software that supports PQRI Automation

CMS continues to expand the scope of PQRI (Physician Quality Reporting Initiative) with increased bonus payments. Physicians who satisfactorily follow PQRI guidelines and report quality-measures data for services furnished January 1, through December 31, 2009, will earn a single consolidated incentive payment of 2.0% of the estimated total allowed charges for services covered under Medicare Part B in mid-2010. These requirements are complex, and different measures will apply to each practice. The EMR Software that you select should have a built-in ability that automates the additional documentation while you are examining your patients without any additional work, or creating special reports, or cost. Additionally your EMR Software should make it easy for you to modify and add customized metrics for your practice as required.

4) Electronic Medical Software with adaptive learning

Adaptive learning refers to the ability of the EMR Software to remember how each physician documents and allows previous data entry to suggest steps in treatment and documentation going forward. In essence, the EMR Software keeps track of how all users document within the system and "remembers" lists and assessments such as frequently used lists, previous patient generated lists, and prompts physicians based on previously documented diagnosis/ assessments by the physician...the system adapts to each provider's practice patterns, configuring itself automatically. The more you use the EMR Software, the more it learns and the more accurate, faster, and well documented your patient encounters become, saving you time and money.

5) Secure Portability and access to your electronic medical records even without an internet connection

Typically, physicians should have access to patient data anytime, anywhere either by using their own laptop or tablet pc, or an off-site desk top by accessing a server over a secure internet connection. However, there may be many instances when the physician is making trips to hospitals, satellite clinics, at a conference, or traveling where internet access may not be available or you lose internet connectivity at your Clinic, or your server goes down. Thus, your EMR Software application must be able to save selected data including, charts for that day's or the next few week's appointments and your most active or recent patient records, on the provider's tablet pc or laptop. This critical function allows you and your medical staff to continue working and seeing patients, charting, writing Rx's, review patient records, and then, once you return to your main Clinic, or your internet access is restored, your portable device should easily or automatically synchronize right back up with your server. Essentially, you never skip a beat. As an added note, it is imperative that you have the appropriate security measures in place in order to safeguard access to all of your portable devices.

6) Integrated patient portal - Keeping more in-touch with your patients

Your EMR Software needs to provide your practice with an integrated patient portal that allows patients to connect with your practice in ways that will improve their loyalty and compliance, and have access to key personal health information. Patient portals (or secure patient access to information you authorize) have been traditionally thought of as just allowing patients to provide access to their medical records to other consulting physicians but now, you need an EMR Software that supports a patient portal that also allows for appointment scheduling, re-fill requests, exchanging secure messages with physicians and other clinical staff, patient education and other health information, and much more. Your patient portal should also be able to be extended and integrated with a website that is customized to your specific needs and helps you to generate new patients on a daily basis.

7) Electronic Medical Record Software that does not box you into rigid templates

Many Electronic Medical Record Software solutions provide pre-defined templates that can only be changed by the vendor or IT personnel. However, a growing number of EMR solutions are now template free which is because they are driven by 'Chief Complaint(s)' . Since the system is "CC-driven", it allows the doctor to "chart at the speed of thought" without being tethered to a template or form that may not fit the particular patient that is being charted. This is proven to offer significant speed in charting over template based systems, especially at point-of-care since the physician can navigate to any screen or function at anytime without having to leave a template.

Look for Electronic Medical Record Software that offers the best of both worlds : it is template free but can also use templates, known as COMMON PROBLEM PALETTES. This allows physicians to use predefined templates or forms to document very common and repetitive procedure and visits.

8) Document and Image Management

Your EMR Software should go beyond simply scanning and attaching documents and make sure it provides a complete records management system built into the application. Your EMR Software must be able to either copy documents into the EMR database or link to files without copying. This can be particularly helpful with PACS images and other very large files. Your EMR Software must also enable attaching documents and images to a patient chart at the click of a button and then, make sorting and searching for any kind of document, image or even video as simple as using your email or cell phone.

9) Integrated with voice recognition and handwriting recognition

Integration of speech recognition technology in the EMR Software is not an option anymore. When we talk about speech recognition, we implicitly talk about compatibility with Dragon NaturallySpeaking software. With advancement in technology, it is possible for a physician to achieve 98%+ accuracy rate which is at par with the accuracy that is achieved by a human medical transcriptionist. Speech recognition is traditionally utilized to capture the historical portion of the medical health record since pre-designed templates can not anticipate the full spectrum of facts presented by the patient.

Your EMR Software must also allow the physicians to follow their own preferences for documentation method - handwriting recognition, point and click with stylus, typing or a combination. As you become more comfortable with using your stylus, you will find that it is much easier for you to write on your tablet PC (just as you would scribble on a writing pad) and the handwriting recognition capabilities of the EMR Software converts natural handwriting into ready for use digital information.

10) Meets all regulatory and compliance requirements

Your EMR Software must satisfy all mandatory Federal and State regulatory and compliance reporting, general reporting requirementsg, and appropriate coding documentation.  The other upside of requiring that these features be built-into your Electroni Medical Records Software, is that this is extremely important to qualifying each provider in your practice to receive all the incentives available for EMR from Federal and State agencies.  Additionally, many malpractice insurance carriers offer Physicians a substantial discount for having an Electronic Medical Record software with these functionalities.  

11) OOPS! One more important point. If all you did was to require these top 10 must-have EMR Software features from a vendor, you can rest assured that you will also get all of the other essential, most up-to-date, and easy to roll-out and use functions, found in the leading EMRs today, as well.

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RevenueXL Inc. assists medical practices in the assessment, selection and implementation of Medical Software including EMR Software (also called EHR Software), Patient Portal, and Practice Management or Medical Billing software. RevenueXL offers a free consultation session to review your current challenges and answer open questions revolving around EMR and revenue cycle.