There has been a lot of buzz in the US Healthcare Information Technology context, about the implementation of the EMR/EHR within a healthcare organization. In fact achieving stage 1 of meaningful use of the EHR will make you eligible to receive incentivized payments from the federal government under either the Medicare Incentive Program or the Medicaid Incentive Program which amounts to 44,000$ and 63,750$ respectively. In fact, the carrot and stick method also penalizes you if you do not achieve stage 1 of Meaningful Use by 2015/2016.
From an emerging market perspective without applying the constraints of defining the EMR under stage 1,2 or 3 of meaningful use - An EMR is an electronic version of the patient’s medical records or a digitized version of the paper chart or in lay terms a document repository which would contain - Vitals Charts, OP Case Sheets, Case Forms, Treatment Summaries, Discharge Summaries, Doctor/Nurse’s Clinical Notes, Lab/Radiology Reports, Images, OT Reports, Consent Forms, Service Reports, Clinical Scorecards and manually and uploaded scanned documents across patient Out-Patient, In-Patient, Day-Care or Emergency encounters.
To capture all the plethora of patient data be it - demographic, clinical, medical or operational data requires a well integrated EMR Solution.
Transitioning from the former paper based way of working for a provider is a pain staking challenge considering the resistance from the staff to change and is a process re-engineering effort in itself. But the outweighing benefits of implementing an EMR as are listed below are pushing the healthcare providers to adopt the change.
a) Cost Savings: The most debatable aspect of EMR Implementations is the cost savings, considering the software and hardware costs involved. But with cloud and web-based applications built using open source technology bringing down the TCO (Total Cost of Ownership) , are giving the corporate organizations and their enterprise class software built on older client server architectural model a run for their money.
Apart from that there are savings in terms of real estate costs, considering that the space required for record keeping and the Medical Records Department can be significantly reduced. You may even consider renting out that additional real estate space to a retail shop or another revenue generating option.
The Implementation of the EMR Software also gives you as an Organization to take into consideration some process changes to improve the overall workflow processes and introduce more efficient processes.
The Process Improvement Initiative gives an opportunity to identify redundant and non value adding processes that can be done away with. There have also been cases where employees have been asked to leave since the implementation of the EMR made their work redundant.
b) Data Accessibility: With an EMR, the clinician can instantly pull a patient’s medical record remotely from the comfort of his home on a tablet and revert on a case immediately. The managers have a better tab on the statistics of their respective department real time such as Turn-Around-Times in a Laboratory, Patient Stats for a Hospital Administrative, Inventory status alerts for a Store Manager, real time Bed Occupancy Rates etc.
Quick access to patient medical record helps improve the coordination of activities within the work/process flow of the hospital. Imagine the time saved for discharging the patient if all the information regarding to the patient’s treatment is well documented and in place for the billing user as well as the clinician who prepares the discharge summary.
An emerging trend in India has been with private hospital management firms investing in hospitals in rural areas and taking over the management control of the hospital. They could be sitting in an urban setting several kilometers away but having a thorough detailed analysis of the running status of the hospital.
c) Increased Patient Participation in their care: With the availability of Patient Portals and Mobile based Applications, Patients can be given secure access to their Electronic Medical Record over the web. Some EMR software also provides the patients the ability to book appointments online and view e-prescriptions.
d) Improved Quality of care: The Quality Council of India which certifies hospitals with the NABH standards has a chapter dedicated to the implementation of IT (Chapter 10) which underlines the fact that the use of an efficient EMR/Hospital Management System works as a key enabler to improving the overall treatment experience of the patient. With the availability of EMRs clinicians are aided with alerts in life-threatening circumstances and integration with Decision Support Systems alerts the clinician on drug-drug, drug-allergy interactions and reduced medication errors. In fact it is well documented that avoiding readmissions and hospital acquired infections gather maximum priority and EMRs can work as an effective tool to help identify causative reasons and avoid/improve on them in the future.
e) Improved Employee Productivity and Satisfaction: EMRs help raise the productivity of care givers so that they can concentrate on their clinical activities and worry less about the administrational activities and documentation. Time is of the essence for care givers who are often overloaded with tasks and activities and EMRs have built in Messaging tools that help serve as reminders for tasks, patient visit alerts, appointment scheduling etc.
f) Data Security: There seems to be a justified phobia amongst the healthcare community with regards to the security of confidential data such as patients with bio hazardous diseases, can data be accessed securely and can it get hacked into.
A 100% guarantee cannot be granted that the data will not be hacked into but preventive measures can be put in place, such as having notifications sent on unsolicited entry, external attacks, data saved in encrypted format and firewalls built to slow down the hackers. But a 100% guarantee can be given with regards to ensuring that the data is backed up and complete recovery possible in case of a disaster. Isn’t that more secure than having the data saved up in the storerooms of the medical record department and risk losing it all in a fire?
The EMR offerings in the market seem to be quickly evolving with the available technology option and healthcare seems to be braced for an exciting IT revolution that typified the 90s and the 2000s in the retail, banking, insurance and finance industries.
Passionately solving healthcare problems with IT solutions for over a decade is the Product Owner for Insta HMS by Practo.
February 12, 2014
February 12, 2014