In a recent article in the New England Journal of Medicine titled “Escaping the EHR Trap – the Future of Health IT“, Dr. Kenneth Mandi and Dr. Isaac Kohane present a strong argument for disruptive change in the EHR space as follows: “Health IT vendors should adopt modern technologies wherever possible. Clinicians choosing products in […]
Author: EmrAdmin
Paper, Paper Everywhere but Not a Drop of Ink
A recent article on medium.com titled “UCSF Nurses Want Someone To Build These Products” By Fiahna Cabana, Desiree Matloob, and Priyanka Agarwal includes the following: ‘Frontline nurses attend to almost all of a patient’s basic needs. In doing so, they often juggle up to 25 pieces of paper with critical information. Ideally, nurses could use […]
VA Ready to Junk Vista
For as long as anyone can remember, the US Dept. of Veterans Affairs (VA) has managed patient data on VistA, their EHR system that was started in the 1970s. VistA consists of 180 different applications for clinical, financial, administrative and infrastructure functions in the VA. The Computerized Patient Record System (CPRS) represents the common clinical graphical […]
Garbage in Ratings Out
As CMS continues to evolve quality reporting requirements for hospitals and nursing homes, the law of unintended consequences can come into play as administrators struggle to raise their ratings. In a recent article on Bloomberg News titled New CMS Nursing Home Ratings Don’t Solve Accuracy Issues, Senator Michael Williamson reports the following: “Increasing the number of measures […]
Goldilocks and the Three Bears
In a recent article on emrdailynews.com titled “EHR Re-evaluation and Replacement is on the Rise”, Stephen Campbell reports that the replacement market for EHR systems is being driven by ‘systems that are too complex (in form and function)’ and the trend to cloud-hosted systems that run on mobile devices. He defines the ‘Goldilocks’ Principle as […]
Meaningful Mess?
Since first announcing that Meaningful Use (MU) would go the way of dinosaurs in January of 2016, CMS has been less than forthcoming in defining what the world might look like for hospitals after MU. While the MACRA program has begun to define how clinicians will be paid, hospitals remain in limbo with CMS stating […]
A Picture is Worth 1,000 Words
Many patient conditions are difficult to describe accurately but can easily be captured by a digital photo. While most hospital EMRs will accept photo files, the process can be very cumbersome. A digital camera has to be found, the picture taken, then uploaded to the hospital EMR system through a PC. This not only takes […]
When in Doubt, Scan It
Whenever we visit the grocery store, we hear the constant beep of scanners from the checkout counter. In our travels in the developing world, and even in many US hospitals, we find very little scanning being used. A recent visit to a small hospital in Guyana was instructive of the digital divide between healthcare and […]
Medical Necessity in the ER
Of all the criteria for a receiving a payment by Medicare, MACRA requirement to establish medical necessity seems to generate the most questions and discussion. With the introduction of ICD10 and the added complexity of coding for medical conditions, the debate over what constitutes medical necessity and how it should be documented runs high. Discussions […]
Order Sets on Steroids
Building and maintaining physician order sets can be one of the most important steps a hospital can take in making the use of EMR systems more efficient and creating a culture of structured care. In his book The Checklist Manifesto, Atul Gawande makes a clear case for the use of checklists in all aspects of […]