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Questions about EHR adoption?
e-Reports, June 11, 2012
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When it comes to selecting, implementing and using electronic health record systems, you may have plenty of questions, or maybe you aren’t even sure what questions you should ask. But you can find the information you need, plus resources, tips and more at a Regional Extension Center (REC) – and Indiana has two of them.

The Purdue Regional Extension Center is helping thousands of health care professionals in Indiana achieve meaningful use of their electronic health record systems (EHRs), including specialty physicians. Learn more about this REC here or (765) 496-1911.

The TriState REC, working with Bloomington’s HealthLINC, assists practices in south central Indiana counties achieve meaningful use. Learn more and view a map of the counties the REC serves on the tristaterec website or call (513) 469-7222 x4.

Recently, the Purdue REC hosted a roundtable discussion of EHR issues, giving physicians and others an opportunity to ask questions. Some of those questions may well be questions on your mind, too. Here is a sampling of the exchange.

How many EHR vendors are there and how do I pick the right one for my office?

Today, about 800 certified EHR vendors have products for independent practices. In Indiana, several systems are rising to the top, such as EPIC, Allscripts and GE Centricity. The question to ask is: Does the system meet your needs? The RECs have tips and handouts to help you ask the right questions when you meet with vendors.

Do I need to adopt the same system used by the hospital where I’m on staff?

You don’t need to adopt the system used by the hospital; information does not necessarily flow better if you are on the same system. Often, the hospital will lease a practice an EHR product, but offer the practice staff no help to use it. That’s a disadvantage. If your billing company is using a certain system, it may make sense to consider that one.

Don’t I need to be sure I can connect with the hospital so I can get data like lab reports?

Exchange of health information is one of the meaningful use objectives and can be accomplished through connection with one of Indiana’s health information exchanges. Our state is leading the way on developing robust health information exchange capabilities.

Besides the system itself, what other things should I look for in a vendor?

Ask if they have user groups so you can network and learn best practices, tips, etc. Ask what technical support the vendor offers. Try if possible to identify one vendor support person and stick with that person who can then get to know your practice.

I’ve heard productivity will suffer at first; is that true?

Yes, your practice may experience an initial loss in productivity during implementation. However, preparation and training will certainly help minimize any production loss. The REC staff can help you think through work flows to minimize that loss. One idea is to use scribes.

I’m a specialist. Do specialists need to answer all of the problem list in their specialty?

To achieve meaningful use, you need to enter only one problem list, but the Purdue REC suggests the best practice for using a problem list involves listing all of a patient’s current and active diagnoses. That way, each person caring for the patient has ready access to this important information.

How should we deal with errors from the hospital?

Everyone has a responsibility to correct errors, especially when a patient identifies something that is wrong from the visit summary. Errors may be easier to detect now with EHR systems than with those huge paper charts.

What should be done with all our paper charts once we adopt the EHR?

The PurdueREC suggests practices consider performing chart abstraction prior to the patient visit. That involves entering known problems, medications, allergies, etc. in the structured EHR fields. Scanning other pertinent documents may be helpful as well and may eliminate the need to bring the paper chart into the exam room. One way to accomplish chart abstraction is to dedicate resources to it before the patient arrives.

How much time will training take?

Allow weeks – not days – for training. Do not take shortcuts. Have technical support at your elbow the day you go live and consider rolling out the EHR to a few doctors in the practice at a time.

What about doctors who are struggling with the technology?

All kinds of products are available to help, like tablet computers that allow doctors write their notes on a screen and then upload them to a docking station. PurdueREC staff can help you explore hardware options to meet your needs.

Find more information about security, meaningful use and other EHR topics on the ISMA website.

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