Question

Can you Please do analysis and evaluation of the alternatives? please do as soon as possible. Thank you.

Alternatives/ Recommendations

Cost solution: The infrastructure required to host an EMR is expensive, and third-party servers are not always cheap either. Therefore, PHS could eradicate third-party servers that entail an up-front cost, opting instead for a system with monthly fees. If PHS converted current LMR/CPOE systems to a cloud based service with such a monthly fee, small offices will be better able to handle these costs. Time solution: To minimize wasted time spent navigating the EMR system, PHS should streamline their system to where there is as much automation as possible. EMR Systems should provide templates and easy-to-use organizational structures within a minute. This way, doctors will be able to enter vital patient information into the system quickly and efficiently. Data entry solution: The fewer the movements, the more efficient and ergonomic. Templates should be provided by the EMR system so the doctor can easily record entries with a few clicks rather than extensively using the keyboard. For example, if a doctor enters the patient's name on the note, then the name should automatically be generated in other forms, such as the prescription and encounter form. This will save a lot of time and makes data entry very efficient.Integration solution: Real-time communication between a scheduling system and an EMR can get complicated. There may be glitches or lags when the two systems try to work simultaneously. Therefore, perhaps incorporating the two systems consecutively would be beneficial. For example, have a team that takes the patient demographics from the scheduling system and have them enter that data into the corresponding EMR for that patient at the end of every day. Any additional data entries for that day will have to be manually entered into the EMR by the patient using a device such as an iPad so that staff can use their time to serve a larger population, increasing access to a larger population without compromising the quality of care. This would also help them in serving the cost related issue of the patients who are unable to afford the expensive therapies. The system would generate the best optimal solution and the therapy for the patient according to the patient budget, which is a true reflection of an intelligent system. Implementation solution: implement an EMR system that is intuitive and easy to learn. The system shouldn’t seem excessively complicated and messy. It should be organized and have only the features that are necessary. It is a waste of resources for the staff to spend a considerable amount of time and effort to learn about a system that’s meant to boost efficiency.Cons: Doctors were hesitant to adopt the latest technology, as they were trained to write prescriptions manually. They also lacked the resources to finance this implementation and maintenance. Traditionally, the authority was assumed to be the central figure but after this, implementation was assumed to be decentralized. Therefore, a change needed to be done.

Key Decision Criteria

Partners Healthcare System did well in integrating their healthcare delivery system. Their hospitals, primary care clinics and specialty practices achieved quality delivery through the system wide adoption of information management. However, in terms of a suitable alternative, PHS needs to steer their focus on maintaining satisfaction throughout their healthcare system. Therefore, the alternative EHR must: 1.Be cost-effective for small offices 2. Require a minimal technological infrastructure to operate 3. Be easy for providers to navigate 4. Improve provider satisfaction 5. Require minimal interaction from providers so they can focus more on their patients than entering information into the system during appointments 6. Be capable of handling a hospital’s patient volume 7.Have frequent, high-speed updates to ensure the accuracy of information regarding drug interactions and governmental rules 8.Have a reliable backup in case the system crashes

Answer 1

Differences between EHR and EMR

EHR (ELECTRONIC HEALTH RECORDS)	EMR (ELECTRONIC MEDICAL RECORDS)
- A digital record of health information	- A digital version of a chart
- Streamlined sharing of updated, real-time information	- Not designed to be shared outside the individual practice
- Allows a patient’s medical information to move with them	- Patient record does not easily travel outside the practice
- Access to tools that providers can use for decision making	- Mainly used by providers for diagnosis and treatment

EMR Is:-The EMR or electronic medical record refers to everything you’d find in a paper chart, such as medical history, diagnoses, medications, immunization dates, allergies. While EMRs work well within a practice, they’re limited because they don’t easily travel outside the practice. In fact, the patient’s medical record might even have to be printed out and mailed for another provider to see it.

EHRs is:-Electronic health record (EHR) systems have the potential to transform the health care system from a mostly paper-based industry to one that utilizes clinical and other pieces of information to assist providers in delivering higher quality of care to their patients. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which is part of the American Recovery and Reinvestment Act (ARRA) (aka “stimulus package”), was signed into law with an explicit purpose of incentivizing providers (eg, hospitals and physicians) to adopt EHR systems. However, given that a bare-bone EHR system provides only partial benefits to patients and society,6 the HITECH Act requires that providers adopt EHRs and utilize them in a “meaningful” way, which includes using certain EHR functionalities associated with error reduction and cost containment. How exactly do EHRs improve care? And what is the current evidence that certain EHR “meaningful use” functionalities will translate into benefits? Answering these questions is the purpose of this paper. Stated explicitly, the purpose of this study is to review the literature on the impacts of EHR. Impacts include both benefits and drawbacks, and, as such, we discuss the advantages and disadvantages that have been identified by researchers and other experts. Overall, we expect that any reader interested in understanding the current state of the knowledge base with regard to EHR benefits will find this paper useful.

EHR vs. EMR usage trends:-While both EHR and EMR are commonly used terms, the term “EHR (electronic health records)” is now referenced more frequently. This is likely due to the Centers for Medicare & Medicaid Services (CMS), as well as the Office of the National Coordinator for Health Information (ONC) preference for the term “EHR”. The CMS when speaking of health care reform, always uses the terminology, “meaningful use of an EHR”. The ONC exclusively uses the terms “EHR” and “electronic health records”, explaining that the word ‘health’ is more encompassing than the word ‘medical’. The term “Medical Records” implies clinician records for diagnosis and treatment, while the term “Health Records” more broadly denotes anything related to the general condition of the body. A Personal Health Record known as PHR is just that: personal. It is those parts of the EMR/EHR that an individual person “owns” and controls.

According to the 2014 Black Book Ranking report, 31% of practices have adopted an EHR. A fully functional EHR system goes beyond basic functionalities such as clinical notes and documentation and incorporates more of your practice workflows. With a fully functional EHR, your practice is more seamlessly integrated with other members of the healthcare community, helping to:

Improve coordination of care

Increase patient participation in care

Improve the quality of care

Increase efficiencies and cost savings

Advantages of an EHR versus an EMR

EHR and EMR software systems have some disadvantages as well.

• Compared to paper records, a digital patient-record (EHR) system can add information management tools to help providers provide better care by more efficiently organizing, interpreting, and reacting to data.

• EHR software can provide clinical reminder alerts, connect experts for health care decision support, and analyze aggregate data for both care management and research.

• The more interactive an EHR system is, the more it will prompt the user for additional information. This not only helps collect more data but also enhances their completeness.

• EHRs are the future of healthcare because they provide critical data that informs clinical decisions, and they help coordinate care between all providers in the healthcare ecosystem.

• EHR systems focus on the total health of the patient. EHR software is designed to reach out beyond the health organization that originally collects and compiles the information. They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care.

• The information moves with the patient—to the specialist, the hospital, the nursing home, the next state or even across the country. EHR systems are designed to be accessed by all people involved in the patients care—including the patients themselves.

Disadvantages of an EMR versus an EHR

EHR and EMR software systems have some disadvantages as well.

• They are typically much more expensive to implement initially, as providers must invest in the proper hardware, training and support on top of the software unless their using our EHR.

• Unless properly built, there’s also the chance the system will malfunction, destroy all data

Benefits of an EHR versus an EMR?

The EHR is the future of healthcare because they provide critical data that informs clinical decisions, and they help coordinate care between everyone in the healthcare ecosystem. An EHR has the following benefits over an EMR:

• Health information and data. The system holds what‘s normally in a paper chart – problem lists, ICD-10 codes, medication lists, test results.

• Results management. An EHR lets you receive lab results, radiology reports, and even X-ray images electronically while ensuring tests are not duplicated.

• Order entry. No more prescription pads. All your orders are automated using secure e-prescribing technology.

• Decision support. Offer access to evidence-based tools to support clinical decisions. An EHR is smart enough to warn you about drug interactions, help you make a diagnosis, and point you to evidence-based guidelines when you’re evaluating treatment options.

• Electronic communications and connectivity. You can talk in cyberspace with patients, your medical assistant, referring doctors, hospitals, and insurers—securely. Streamline the workflow of providers as your system interfaces with everyone else‘s. Interoperability is the key word.

• Patient support. Engage your patients by allowing to them to receive educational material via the EHR and enter data themselves through online questionnaires and home monitoring devices.

• Administrative processes. The system lends a hand with practice management and helps avoid delays in treatments. Patients can schedule their own appointments and staffers can check on insurance eligibility.

• Reporting and population health management. How many patients did you treat for tuberculosis in 2014 How many of your diabetics have their HbA1c under 7? An EHR can provide the answers, thanks to a searchable database.

CONCLUTION

In this paper we discussed several advantages and disadvantages associated with an EHR adoption. Many of the benefits accrue to patients and society overall. For these benefits to be realized, the US Government has embarked on an ambitious journey to transition a maximum number of providers toward EHR adoption and “meaningful use”. Without ubiquitous use of EHR technologies, experts believe that many efficiencies in the US health care system cannot be realized.15 The financial incentives built into the HITECH Act are designed to defray some of the costs associated with EHR adoption, especially for smaller organizations where these expenses serve as a major barrier. The financial incentives in HITECH, which are made available through the Medicare and Medicaid programs, are also an attempt to correct some of the misalignment of incentives associated with EHR as discussed previously, especially because the US Government, through the Medicare and Medicaid programs, is the largest insurer in the country.