A recent article in the Houston Business Journal, titled, "How EMRs will save health care" looks at some of the benefits of EMRs and how the technology is aiding many in the healthcare industry. 

 One physician group, the Southeast Texas Medical Associates LLP, was featured in the article as an example of a physican-owned health care organization that finds EMRs to be beneficial. James Holly, CEO of the physician group (SETMA) said that EMRs "play a big role in making the process more efficient for patients." His group uses EMRs to send data between specialists and primary care physicians within the network, according to the article. 

Holly went on to discuss just how important he finds EMRs to be, and as the head of a physician group, how he thinks EMRs are changing health care as we know it. He says that he thinks EMRs can only improve in the future, saying " I think in 10 more years, we're going to be in a much more robust position than we are now...I think the (health care information exchange) will be mature, and most practices, if not all, will be integrated through the HIE."

While Holly is forward-thinking and seems to embrace the technology, that is not the case with mnay physicians. Also, Holly is optimistic towards the HIE, which in theory is a groundbreaking idea. But, in reality, many physicians and healthcare workers are skeptical of the HIE, and worry that a lack of communication many occur between different health care systems and different physicians and hospitals. Another question that many physicians and healthcare workers alike are raising is the question of errors in reporting when using EMRs.

As for the fear of, and the room for errors when using EMRs, there are many options to prevent errors. Medical scribes can assist in this space and can allow for more accuracy and less room for error when using EMRs. Scribes work side-by-side with the physicians and serve as personal assistants and data entry specialists when it comes to the EMRs. This allows physicians more time for patient care, and this also prevents physician data entry errors on EMRs. 

It seems that EMRs are here to stay, especially with Meaningful Use requirements coming up and the need for electronic documentation of patient records. Scribes can help doctors, especially since there is such a high learning curve for these clinicians. Doctors prefer to care for their patients, and they want to provide quality care; physicians do not want to type into EMRs all day long. EMRs and the HIE still have some kinks to work out, but as with any new technology and concept, it takes time to enact and adapt to change. Healthcare workers, be it physicians, physician assistants, nurses or nurse practitioners need to embrace change in order to increase efficency, and many can do this using a medical scribe.

Recent reports show that ICD-10 may not break the bank as badly as the AMA once predicted, but the new code set still presents a number of challenges to financially vulnerable healthcare organizations. 

America's doctors are burned out. Well, America's healthcare workers are burned out as a whole. 

Just how burned out are American healthcare workers? According to an article by Kimberly Palm on LinkedIn, 50% or more of doctors, nurses, and other health care workers are burned out; in stating this, Palm is referring to the latest research. 

Palm cites reasons such as builtup stress that lingers from med school into residency into practices. She notes that often times "doctors are not prepared to take on the stresses and responsibilities of running a business". 

We get it. Palm is right when she says that doctor burnout can be attributed to the difficulties of running a business, something doctors learn nothing about during med school. 

Another stressor that Palm doesn't mention: data entry into EMRs. 

Add EMRs to the long list of reasons for doctor burnout. But, there is a solution and an easy fix to help keep our gifted doctors practicing and doing what they love. 

Scribes can be the solution. Medical scribes can take away the additional stress that EMRs may cause for doctors today. 

As you all know, EHR is present in modern health care, and it is here to stay.

That being said, it is not being welcomed by all, and many are criticizing EHR. Some doctors are less than thrilled with EHR capability and ease of use. But, while there is criticism, like with any new tool introduced into an industry, EHR is useful and changing modern health care for the better. Yes, EHR can be overwhelming and too much to handle at times for the physicians, but that is why medical scribes exist. Hiring scribes can help.

One doctor in particular discussed his thoughts on EHR in a recent article, and his comments were interesting and important, because they help us understand the physician perspective.

Dr. Danny Newman discussed EHR with Georgia Health News. He realizes that electronic health records are here to stay, and he has seen firsthand some of the benefits of replacing paper charts with electronic ones. He said that one advantage of EHR is electronic prescribing of medications, which he says reduces mix-ups caused by illegible or messy handwriting.

But, as mentioned above, we all know that physicians are still not thrilled with EHR, despite seeing some of the benefits associated with going electronic.

Newman highlights his frustration, saying, “They’re (EHR) supposed to be more efficient...but I think they’re less efficient”. According to the article, for Newman a patient visit now produces five pages of notes, instead of a single page in the pre-EHR days, and it takes about five minutes to fill in the EHR for one visit. Newman is pretty clear in his frustration with EHR, when he says, “It’s taking away time from my patients".

As Newman says, nowadays “Many doctors feel like they’re data entry clerks”.

But they don’t have to be, and there is a helpful solution: scribes.

Use of electronic medical record systems is associated with considerable loss of free time per clinic day, according to a research letter published online Sept. 8 in JAMA Internal Medicine.

This does not make EMR look like a good data managment method to adopt.

But, EMRs are the way of the future, and can be very beneficial...with the help of a medical scribe. 

Doctors should treat patients; they shouldn't be typing all day and trying to use new technology. 

Clement J. McDonald, M.D., from the National Institutes of Health in Bethesda, Md., and colleagues surveyed the American College of Physicians' national sample of internists to examine the extent of EMR-associated time loss. Data were obtained from 411 respondents (mainly attending physicians).

"The loss of free time that our respondents reported was large and pervasive and could decrease access or increase costs of care," the authors write.

Meaningful Use was created in order to create infrastructure for the health information system in American medical industry today.

The various stages were thought out and decided upon in order to ensure successful EHR use to establish an electronic health information network in the United States.

• Stage 1 - this stage was established for data capture and sharing to start taking place

• Stage 2 - this stage, began in January 2014, and intends to advance processes

• Stage 3 - this stage leads to improved outcomes

Requirements for Providers:

When looking at requirements for providers, these must be broken down into Medicare program requirements and Medicaid program requirements.

• Medicare program meaningful use requirements include 13 core measures that must be met and 5 of 9 optional measures. A 90 day reporting period to execute against goals of the program is also required.

• Medicaid program requirements include showing proof that the practice has purchased and installed a government certified EHR and after 1 year the practice must then meet the medicare requirements also with the 13 core measures.

Meaningful Use and its requirements intend to allow for progress tracking and more connectivity.

While using EHR will improve connectivity and is the way of the future, it is a lot of work for practices and physicians. But, it doesn't have to be! Scribes can help.

• Our medical scribes here at Scribe Solutions perform all the data entry work but also can assist in other services such as tracking labs, transcribing radiology reports, attending to patient needs, and helping physicians organize data.

• Scribe Solutions understands the demands that physicians face and offers a low cost, innovative approach to significantly improve the process of patient care.

As most of you probably know, Meaningful Use is rooted in the HITECH act. If you don't already know or understand the HITECH act, here is a "snippet" from Health and Human Services website:

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology.  Subtitle D of the HITECH Act addresses the privacy and security concerns associated with the electronic transmission of health information, in part, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules.  

HITECH act allows for financial incentives for EHR use. The goals behind these incentives include the desire by the U.S. Government to have an efficient and centralized National Health Information Network and better quality care for patients. 

To qualify for government's financial incentives, the practices need to demonstrate meaningful use and purchase and use of a government certified EHR system. Physicians must meet all meaningful use requirements to qualify for incentives from the government. 

See more info here at CMS.gov 

EHR Benefits are Visible

It is now becoming even more apparent that EHR as a whole is positively impacting the healthcare industry.

Specifically, when it comes to EHR alerts, these benefits are highly visible. Now, with new EHR alert systems in place, results are being seen in a variety of areas. One area is HIV testing. The implementation of EHR alert and documentation has increased regular HIV testing rates at multiple facilities. Two places that have seen astounding results from EHR alerts are New Orleans and New York City. This news of increased HIV testing rates due to EHR alerts can only bolster the health IT industry and lead to more screening of this disease, but also others. There is a clear, strong, future for the use of EHR alerts in modern health care.

See some results from the use of alerts in New Orleans and New York:

• LSU Hospital - in the emergency dept. rise from 17% in 2012 to 26% in Dec. 2013 for HIV screening 

• In New Orleans urgent care center - rise from 3% in 2012 to 17% in Dec. 2013

• Urban Health Plan with 16 facilities in New York City saw an increase in HIV testing from 8% to 56% over a three year period 

Patient Satisfaction & Thoughts on Improvement

Hospitals can always improve when it comes to patient satisfaction.

Administrators and consultants are always looking for ways to become an even better provider to their patients. With ever changing technology and new requirements for documentation, it can make it even more difficult to achieve high patient satisfaction. As a writer for MedCity News put it, “ I’ve felt that there’s not been enough next-generation tech being applied to the low margin, high volume business of hospital supply management.” Supply chain automation is important to gain higher patient satisfaction, and even though it is often viewed as being the responsibility of the administration, it is directly tied to patient and nursing satisfaction.

• Supply chain expert Harold Richards explains that thinking about patient satisfaction and supply chain can be compared to ant hill management:“You may have had an ant farm as a child and marveled at the cooperative efforts and precisions of the ants as they went about their daily activities...so it is with the hospital supply chain, full of hard working individuals who run into daily challenges just as ants do. Both rely on excellent systems of communication to get things accomplished. However, ants do not have to deal with bureaucracy, integrating of mismatched systems, missing supplies, and other time-wasting system failures (at least not as far as we can tell).”

The ant farm comparison seems to be on point when it comes to managing busy ER departments and the like. Today more than ever, patients are converging on emergency rooms across the country seeking treatment for their ailments. Resulting from this is - you guessed it- overcrowded ERs filled to capacity and short staffed in many cases. According to the USA TODAY, some hospitals are faced with spikes as high as 12%.

It is apparent that an increase in volume can cause problems, and without proper planning and supply chain management, there could be inefficiencies such as shortage of staff and medical supplies in emergency situations. So, look at hospital management from the ant farm perspective if you will...it might just make it a little clearer...and little more fun to analyze efficiency. Make sure you know what is happening in your ant hill.

Meaningful Use & Dealing With Technicalities

Meaningful use is using certified electronic health record technology for a number of tasks in health care. Technology plays a clear role not only in day-to-day life, but also in the way business is done. In terms of healthcare, this means that technology and the medical world are intrinsically linked. EMRs and EHRs are more popular and readily available.

But just having these systems in place is not the only piece to the puzzle. Providers need to take control of their Health IT plans to ensure that data is reported properly. Correct reporting to the Centers for Medicare & Medicaid Services (CMS) is key in order in order to collect incentive payments. This could be complicated if proper planning and management isn’t in place.

Without proper planning and management, a breakdown in coordination could lead to failure to properly report data. This is particularly important for critical access hospitals. Health IT consultant Marcia Cheadle, who is Senior Director of Meaningful Use and Advanced Clinicals for Engage, explains “The CAHs in particular are challenged there because of the way the government views their cost accounting...They also have to go to the fiscal intermediary related to the depreciation of assets required for each of the stages.

The landscape of the Health IT industry is constantly changing and thus it is important to keep up with meaningful use news and maintain planning and coordination efforts at your organization.

Technology is strongly present in meaningful use, and it is imperative that it be properly administered to allow for efficiency in reimbursement.

Stage 2 Meaningful Use has made it obvious that the administrative function of your organization must flow in an organized manner in order to flourish in the current healthcare environment.