Term Paper: EMR Electronic Medical Records (EMR)

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EMR

Electronic medical records (EMR) are the records involving a single healthcare event and is often used in conjunction with the electronic health record (EHR) which is the computerized entire medical history of an individual from all involved healthcare providers seen by the individual (Definition of EHR, 2010). For the basis of this paper, the EMR is the system being evaluated and examined.

As a future healthcare professional, the necessity of learning and utilizing the EMR is of the most importance. In the literature review, there will be numerous categories to help ask the right questions and get the best system for the facility.

Each healthcare facility will be different and have various factors that will need to be examined before an accurate EMR system can be gotten. The size of the practice, number of physicians and providers, and more will have to be taken into consideration. This section will be broken down into several topics in the hopes of gathering the most accurate assessment of the literature.

Selecting the right EMR for Practice

In regards to the 2009 stimulus package funded by the federal government, regional extension offices are to be opened to walk it through the entire process of choosing a system, implementing it, mapping work flows and optimizing the system to help achieve meaningful use. For current EMR users, the centers can help create a plan for optimizing current systems to meet meaningful use guidelines according to Pamela Dolen (Dolen, 2010, ¶4). The centers are not responsible for choosing a system for the healthcare provider but only as assistants in the evaluating, choosing and developing strategies for the particular office.

To get an accurate idea of the system and how it operates, the prospective buyer can request a product demonstration be performed by the vendor. The Healthcare Information

and Management Systems Society (HIMSS) recommends the following:

• Plan on spending about two hours with the vendor for the meeting and demo.

• Minimize distractions. Turn off pagers and cell phones; go off site for the demo if necessary.

• Make sure the right people are in the room. If you're not knowledgeable about billing, coding, compliance issues or scheduling functions, invite those who are to help you properly evaluate the product.

• Use your scorecard to keep track of your thoughts.

• Be proactive in telling the vendor what you want to see. Be the director of the show! Walk the vendor through a routine patient visit and see how easy the product is to use.

• Remember that often, non-clinical sales staff are not adept or comfortable with producing clinical documentation, which is the most important function to you, the provider.

Work hard to keep the vendor on track.

• Ask if you can keep a demo copy or ask the vendor to allow you to enter data. it's a good idea to develop a typical clinical scenario ahead of time and have the vendor show you how to enter that data.

To ensure that small practices do not disregard the benefits of having EMR, in the article, "EMR Electronic Medical Records Software for the small practice - the EMR Puzzle," the author declares

So, in our experience in helping over 15,000 physicians make the transition from paper to electronic, there are five key reasons for the ongoing "EMR Conundrum." These reasons significantly limit small practices from undertaking an EMR. Clearing up these issues will pave the way for a clearer process for each practice:

1. The EMR Process is Confusing: With a dismaying array of products claiming similar capabilities at a variety of price points, how can a small practice evaluate so many possibilities? And what are the odds of finding the RIGHT EMR for the practice? The key here is for physicians to spend as much effort finding a vendor that brings the right "process" of implementation to the table, as well as finding the right EMR program.

2. Lack of Thought-out Selection Criteria: Most practices have not implemented an EMR before. As such, identifying all the right questions at the beginning of the process is crucial. Product, process and vendor selection criteria are often given less consideration than merely acquisition and start up costs. "Total cost of ownership" (TCO) looks at costs over a three or five-year period, not just a purchase price assessment. Vendors who use subscription-based pricing or ASP (remote-hosted) models have an attractive purchase price, however, the costs are almost always higher in the long-term. Gathering product information is easy; but making a decision based on the needs, priorities and constraints of the practice with TCO fully understood is more essential to a successful process. Having a process that "starts with the end in mind," as author Steven Covey suggests, may be the most critical part of the EMR decision. That vision must include TCO and support as important considerations.

3. Uncertainty of Interfacing with Existing Systems Office Technology: Some vendors try to convince physicians that it is in their best interest to abandon the current technology in their office in favor of an integrated office solution. Replacing an existing technology such as practice management system (PMS), billing software, etc. can create a variety of problems. First, it means retraining front office staff on a new system in addition to their role with a new EMR. Second, this can often lead to a "rushed" implementation and/or running two systems parallel until fully transitioned. This is a huge burden and a source of great frustration for office staff. In addition, the practice must continue to run smoothly and patient scheduling must be maintained. Third, replacing a practice management system (PMS) often results in lost or inaccurate billing data, corrupted files and accounts receivable inconsistencies. Not only is replacing a PMS that is already performing risky and time-consuming, it may also ultimately result in settling for a new system that isn't as good as the one you had. All-in-one products have been designed around one application, with the others being far less functional than many "best of breed" products. With growing HL-7 industry standards and increasing partnerships among healthcare it vendors, interfacing between multiple programs has already been achieved. This, in turn, enables physicians to select whatever "best of breed" products are best suited to their practice.

4. Lack of an Implementation and Training Plan: In our opinion, the chief culprit in the majority of failed attempts at EMR implementation lies in trying to rush the installation and declining formal training. Additionally, there is not a solid implementation plan for every worker in the office. Many physicians labor under the mistaken assumption that EMR described as "easy to use" and "easy to learn" translate to "little training required." Feature-rich products that are easy to customize require training, as does learning any new technology. This, however is a small price to pay for freedom from dedicated it staff or constant vendor interference. Still, the key element in having such a powerful, flexible tool that will transform your clinical data-gathering process, is to give extra attention to "process" in the initial stages of implementation. Involving everyone in the office from the beginning and establishing a workable plan will lead to a smooth and successful implementation.

5. Fear That it is Not Worth the Effort: Most small practices feel that their "paper process" is working satisfactorily. Many consider occasional administrative glitches and problems tolerable. This is a costly assumption if providers are unaware of the tremendous impact an EMR will have on the three major axes of 5 any offices' success: financial performance of the practice, quality of care for patients and quality of life for physicians. These issues are addressed in more detail in a subsequent white paper in this series.

Advantages and disadvantages

One advantage of the EMR is the reduction in paperwork that has to be stored or filed. No more piles of records waiting to be filed and less worries about misplacing or losing a patients file.

The American Medical Society and the United States Department of Health and Human Services give the following benefits to the utilization of EMR and HER systems:

Replace paper-based medical records which can be incomplete, fragmented (different parts in different locations), hard to read and (sometimes) hard to find. Provide a single, shareable, up-to-date, accurate, rapidly retrieveable source of information, potentially available anywhere at any time. Require less space and administrative resources.

Potential for automating, structuring and streamlining clinical workflow.

Provide integrated support for a wide range of discrete care activities including decision support, monitoring, electronic prescribing, electronic referrals radiology, laboratory ordering and results display.

Maintain a data and information trail that can be readily analysed for medical audit, research and quality assurance, epidemiological monitoring, disease surveillance, etc.

Support for continuing medical education (Electronic Medical Records, 2010, Benefits of EMR Section).

The main disadvantage of converting to the EMR system relies on the competence of the medical office to convert the paper charts to the EMR system without losing or changing any information. Lost information… [END OF PREVIEW]

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EMR Electronic Medical Records (EMR).  (2010, June 15).  Retrieved December 7, 2019, from https://www.essaytown.com/subjects/paper/emr-electronic-medical-records/16728

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"EMR Electronic Medical Records (EMR)."  Essaytown.com.  June 15, 2010.  Accessed December 7, 2019.
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