Electronic Health Records (EHR, EMR)

The Centers for Medicare and Medicaid Services and the Office of the National Coordinator announced Monday that CMS would extend the deadline for commenting on quality reporting and certification of EHR products. CMS posted the extension notice on the Federal Register. As first outlined in the request for information, which was posted on the Federal Register on Dec. 31, 2015, CMS and ONC seek public comment on several items related to the certification of health information technology. [Also: CMS, ONC seek feedback on quality measures reporting] These include EHR products used for reporting to the EHR incentive programs and certain CMS quality reporting programs such as – but not limited to – the Hospital Inpatient Quality Reporting Program and the Physician Quality Reporting System. CMS and ONC want industry perspective how often to require recertification, the number of clinical quality measures a certified health IT module should be required to certify and ways to improve testing of certified health IT modules.  [Like Healthcare IT News on Facebook] That feedback will help inform CMS and ONC about what factors may need to be considered for future rules relating to the reporting of quality measures under CMS programs. The two agencies note the request for information is part of the effort of CMS to streamline and reduce the burden around government requirements for eligible professionals, eligible hospitals, critical access hospitals and health IT developers. Twitter: @HealthITNews

Physician adoption of electronic health records rose steadily between 2013 and 2014, with nearly 75 percent of doctors going digital, according to the Centers for Disease Control and Prevention’s National Electronic Health Records Survey. The CDC’s four key findings based on the survey: In 2014, 74.1 percent of office-based physicians had a certified electronic health record system, up from 67.5 percent in 2013. The percentage of physicians who had a certified EHR system ranged from 58.8 percent in Alaska to 88.6 percent in Minnesota. In 2014, 32.5 percent of office-based physicians with a certified EHR system were electronically sharing patient health information with external providers. The percentage of physicians with a certified EHR system electronically sharing patient health information with external providers ranged from 17.7 percent in New Jersey to 58.8 percent in North Dakota. Access the full CDC report here.

MidMichigan Health, a nonprofit health system affiliated with the University of Michigan Health System, is ready to replace a mixed bag of technology with an electronic health record from Epic Systems, which will provide the clinical, administrative and billing software. The goal: to connect its hospitals, physician practices and outpatient care facilities on one platform for medical records, registration, scheduling and billing. Contract cost: $55 million. MidMichigan Health executives say they expect to recoup that investment within six years through efficiencies gained. They've named the endeavor the One Person, One Record project. [See also: 11 Epic stories worth reading again.] The health system's leaders announced the decision in a January 26 post on the MidMichigan Health website. The EHR rollout is one of several initiatives the health system is undertaking to put patients and their families at the center of care while enhancing safety and quality, patient experience, employee and provider engagement and financial stability, officials noted. Project team members have already begun traveling to Wisconsin for Epic training and will begin configuring the system in early 2016. MidMichigan anticipates the system will be fully operational at its hospitals and doctors' offices in April 2017. A second phase of the project in late 2017 will connect MidMichigan Home Care and other newly owned subsidiaries to the rest of the health system. "Our current state of multiple vendor systems requires us to maintain a large number of custom interfaces," said Dan Waltz, CIO. "This has simply become unsustainable, both in terms of the cost to maintain those systems and the potential risk and confusion that it introduces." [See also: Epic scores EHR contract from Vanderbilt University Medical Center, beats Cerner.] There is more to the project than setting up new technology. "As part of the process, we will be evaluating all of our workflows, comparing them to industry best practices and making improvements," said Pankaj Jandwani, MD, MidMichigan Health's CMIO, in the news release. "It's an opportunity for us to think differently about how we work and to design our tools and our processes around what patients and their families need. Jandwani added the changes would also help improve productivity and satisfaction, with tasks and roles "dramatically transformed." As a result of the project, patients will be able to schedule appointments online and self-check-in from home or at on-site kiosks. The health system will also offer virtual care options such as telemedicine and e-visits, and the ability to view and pay MidMichigan Health bills from one account.

For the sixth straight year, Epic has secured the top spot for Overall Software Suite in the Best in KLAS: Software & Services report, which is compiled based on feedback from healthcare providers. Epic was also named the best Overall Physician Practice Vendor and received Best in KLAS awards in seven segments. The Verona, Wisconsin-based behemoth also won for best acute care EMR, ambulatory EMR, and patient portal. Epic also notched a win in the health information exchange category, for its Care Everywhere technology. Impact Advisors, meanwhile, was tops in the Overall IT Services Firm category for the fourth year running, also winning Best in KLAS for IT Advisory Services. Also, with a 20 percent score increase from last year, Medicity won recognition as the overall most improved vendor for its population health technology. Among vendors who received multiple Best in KLAS awards, Merge earned three for cardiology, radiology and VNA/image archive; athenahealth, CareTech Solutions, CureMD and Galen Healthcare each earned two awards. "As healthcare continues to evolve, it is imperative that we seek innovation and constantly address the needs of a shifting market," said Adam Gale, CEO and president of KLAS in a statement.  "KLAS is honored to work with talented healthcare providers who willingly share their experiences with us and make the Best in KLAS report possible," he said. "We also commend all the vendors who strive to improve their products and services in order to provide the best possible healthcare." Here is the full list of winners: Award Category Recipient Award Category Recipient SEGMENT LEADERS: SOFTWARE Acute Care EMR Epic EpicCare Inpatient EMR (Large - Over 200 Beds) SEGMENT LEADERS: SOFTWARE Ambulatory EMR (1-10 Physicians) CureMD EMR (1-10 Physicians) SEGMENT LEADERS: SOFTWARE Ambulatory EMR (11-75 Physicians) athenahealth athenaClinicals SEGMENT LEADERS: SOFTWARE Ambulatory EMR (Over 75 Physicians) Epic EpicCare Ambulatory EMR (Over 75 Physicians) SEGMENT LEADERS: SOFTWARE Business Intelligence/ Analytics Dimensional Insight The Diver Solution SEGMENT LEADERS: SOFTWARE Cardiology Merge Cardio SEGMENT LEADERS: SOFTWARE Claims and Clearinghouse ZirMed Clearinghouse SEGMENT LEADERS: SOFTWARE Community HIS MEDITECH C/S Community HIS (v.6) (Small - 1-200 Beds) SEGMENT LEADERS: SOFTWARE Document Management and Imaging Hyland OnBase SEGMENT LEADERS: SOFTWARE Emergency Department Wellsoft EDIS SEGMENT LEADERS: SOFTWARE ERP Oracle PeopleSoft Enterprise SEGMENT LEADERS: SOFTWARE Global (Non-US) Acute EMR InterSystems TrakCare EPR SEGMENT LEADERS: SOFTWARE Global (Non-US) PACS Sectra PACS (Non-US) SEGMENT LEADERS: SOFTWARE Global (Non-US) Patient Administration Systems Cerner Millennium Patient Administration System (Non-US) SEGMENT LEADERS: SOFTWARE Health Information Exchange (HIE) Epic Care Everywhere SEGMENT LEADERS: SOFTWARE Homecare Thornberry NDoc SEGMENT LEADERS: SOFTWARE Laboratory McKesson Lab SEGMENT LEADERS: SOFTWARE Long-Term Care PointClickCare SEGMENT LEADERS: SOFTWARE PACS Sectra PACS (Large - Over 200 Beds) SEGMENT LEADERS: SOFTWARE Patient Access Experian Health eCare NEXT (Passport) SEGMENT LEADERS: SOFTWARE Patient Accounting and Patient Management Epic Resolute Hospital Billing (Large - Over 200 Beds) SEGMENT LEADERS: SOFTWARE Patient Portals Epic MyChart SEGMENT LEADERS: SOFTWARE Population Health IBM Population Health Management Suite (Phytel) SEGMENT LEADERS: SOFTWARE Practice Management (1-10 Physicians) CureMD PMS SEGMENT LEADERS: SOFTWARE Practice Management (11-75 Physicians) athenahealth athenaCollector (11-75 Physicians) SEGMENT LEADERS: SOFTWARE Practice Management (Over 75 Physicians) Epic Resolute/Prelude/Cadence Ambulatory (Over 75 Physicians) SEGMENT LEADERS: SOFTWARE Radiology Merge Unity RIS (DR Systems) SEGMENT LEADERS: SOFTWARE Speech Recognition - Front End Dolbey Fusion SpeechEMR (EMR) SEGMENT LEADERS: SOFTWARE Surgery Management Epic OpTime SEGMENT LEADERS: SOFTWARE VNA/Image Archive Merge iConnect Enterprise Archive SEGMENT LEADERS: PROFESSIONAL SERVICES Application Hosting (CIS ERP HIS) Cerner Application Hosting (CIS/ERP/HIS) SEGMENT LEADERS: PROFESSIONAL SERVICES Extended Business Office Navigant Cymetrix SEGMENT LEADERS: PROFESSIONAL SERVICES Extensive IT Outsourcing CareTech Solutions SEGMENT LEADERS: PROFESSIONAL SERVICES HIT Enterprise Implementation Leadership Navin, Hafty & Associates (NHA) SEGMENT LEADERS: PROFESSIONAL SERVICES HIT Implementation Support & Staffing Galen Healthcare SEGMENT LEADERS: PROFESSIONAL SERVICES IT Advisory Services Impact Advisors SEGMENT LEADERS: PROFESSIONAL SERVICES Partial IT Outsourcing CareTech Solutions SEGMENT LEADERS: PROFESSIONAL SERVICES Revenue Cycle Transformation Deloitte Consulting SEGMENT LEADERS: PROFESSIONAL SERVICES Technical Services Galen Healthcare SEGMENT LEADERS: PROFESSIONAL SERVICES Value-Based Care Advisory Services Premier SEGMENT LEADERS: PROFESSIONAL SERVICES Value-Based Care Managed Services Lumeris CATEGORY LEADERS: SOFTWARE 340B Management Systems Macro Helix 340B Architect CATEGORY LEADERS: SOFTWARE Acute Care EMR (Community) Cerner Millenium PowerChart/CommunityWorks Clinicals CATEGORY LEADERS: SOFTWARE Alarm Management Connexall CATEGORY LEADERS: SOFTWARE Anatomic Pathology Cerner CoPathPlus CATEGORY LEADERS: SOFTWARE Anesthesia Epic Anesthesia Information Management System CATEGORY LEADERS: SOFTWARE Cardiology Hemodynamics Merge Hemo CATEGORY LEADERS: SOFTWARE CDI Software Chartwise CDI CATEGORY LEADERS: SOFTWARE Chargemaster Management Craneware Chargemaster Toolkit CATEGORY LEADERS: SOFTWARE Claims Management MedAssets Claims Management CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Care Plans Zynx Health ZynxCare CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Order Sets Zynx Health ZynxOrder CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Point of Care Clinical Reference VisualDx (Logical Images) CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Surveillance Wolters Kluwer Pharmacy OneSource Sentri7 CATEGORY LEADERS: SOFTWARE Computer-Assisted Coding Optum Optum360 Enterprise CAC CATEGORY LEADERS: SOFTWARE Decision Support - Business Strata Decision StrataJazz Decision Support CATEGORY LEADERS: SOFTWARE ECG Data Management Epiphany Healthcare cardio Server CATEGORY LEADERS: SOFTWARE Enterprise Advanced Visualization Philips IntellisSpace Portal CATEGORY LEADERS: SOFTWARE Enterprise Scheduling Streamline Health Looking Glass Enterprise Scheduling and Resource Management CATEGORY LEADERS: SOFTWARE Image Exchange DICOM Grid DG Suite CATEGORY LEADERS: SOFTWARE Infection Control and Monitoring BD MedMined (CareFusion) CATEGORY LEADERS: SOFTWARE Integration Engines Corepoint Health Integration Engine CATEGORY LEADERS: SOFTWARE Interactive Patient Systems TVRC pCare CATEGORY LEADERS: SOFTWARE Labor and Delivery Clinical Computer Systems OBIX Perinatal Data System CATEGORY LEADERS: SOFTWARE Laboratory (Small/Ambulatory) Orchard Harvest LIS CATEGORY LEADERS: SOFTWARE Medical Device Integration Systems Capsule DataCaptor CATEGORY LEADERS: SOFTWARE Medical Records Coding 3M Codefinder CATEGORY LEADERS: SOFTWARE Mobile Data Systems Ingenious Med impower & MedAptus Pro Charge Capture CATEGORY LEADERS: SOFTWARE Oncology Varian ARIA CATEGORY LEADERS: SOFTWARE PACS (Ambulatory) INFINITT PACS CATEGORY LEADERS: SOFTWARE PACS (Community) INFINITT PACS CATEGORY LEADERS: SOFTWARE Patient Accounting and Patient Management (Community) MEDITECH C/S Patient Accounting CATEGORY LEADERS: SOFTWARE Patient Flow TeleTracking Capacity Management Suite CATEGORY LEADERS: SOFTWARE Patient Privacy Monitoring Iatric Systems Security Audit Manager CATEGORY LEADERS: SOFTWARE Pharmacy - Outpatient (Retail) QS/1 NRx CATEGORY LEADERS: SOFTWARE Point of Use Inventory Management PAR Excellence Systems CATEGORY LEADERS: SOFTWARE Quality Management Nuance Clintegrity 360 Quality Management Solutions CATEGORY LEADERS: SOFTWARE Secure Messaging Imprivata Cortext CATEGORY LEADERS: SOFTWARE Single Sign-On Imprivata OneSign Single Sign-On CATEGORY LEADERS: SOFTWARE Speech Recognition - Back End Dolbey Fusion Speech CATEGORY LEADERS: SOFTWARE Staff/Nurse Scheduling GE Healthcare API Healthcare ShiftSelect CATEGORY LEADERS: SOFTWARE Talent Management Halogen Software TalentSpace for Healthcare CATEGORY LEADERS: SOFTWARE Time and Attendance Kronos Workforce Timekeeper CATEGORY LEADERS: SOFTWARE Treatment Planning Varian Eclipse CATEGORY LEADERS: SOFTWARE Urgent Care Practice Velocity VelociDoc Tablet Urgent Care CATEGORY LEADERS: SERVICES Business Solutions Implementation Services Xerox CATEGORY LEADERS: SERVICES CDI Services PwC CATEGORY LEADERS: SERVICES Go-Live Support Apex Systems CATEGORY LEADERS: SERVICES Outsourced Coding Oxford Healthcare IT (On Assignment) CATEGORY LEADERS: SERVICES Release of Information MRO Corp CATEGORY LEADERS: SERVICES Revenue Cycle Outsourcing MedAssets CATEGORY LEADERS: SERVICES Transcription Services FutureNet Twitter: @MikeMiliardHITN

Many accountable care organizations are still struggling to overcome the challenges associated with health information technology integration, patient management and drug selection to improve care outcomes, according to a new study from the Pharmacy Benefit Management Institute.  In fact, fewer than a third of ACO providers use a single electronic health record system while 59 percent are on multiple systems and find it difficult to streamline and integrate them. Remarkably, PBMI found that 23 percent of ACOs still use paper charts. [Also: Behavioral telehealth key for ACO success.] PBMI surveyed 101 ACO providers, who cover over 30 million patients, specifically to analyze current practices in pharmacy management, the use of pharmacists in ACOs, the state of care management and patient engagement, clinical integration and future goals. The study found most ACOs use support tools in their practices: 90 percent utilize quality reporting tools, and 60 percent use point-of-care decision tools. However, only 34 percent of these respondents found these tools easy to use. "ACOs represent a critical and growing part of the solution to help improve value, quality, and care in our nation's healthcare and pharmacy plays an important role in achieving those goals," Jane Lutz, PBMI executive director, said in a statement. [Also: Steward Healthcare: ACO success hinges on IT strength] Almost all ACOs, 93 percent, said managing population health is very or extremely important, while an even greater majority of 98 percent said their focus on population health will increase in the next three to five years. The role of the pharmacist will be front and center, they said. Additionally, more than 60 percent of respondents said the use of biologics and specialty products and they expect genome testing will increase in the next three to five years [Like Healthcare IT News on Facebook] But health IT utilization among ACOs needs to increase for these goals to be feasible, the report said. Additionally, the pharmacist's role needs to be more prominent to support management goals to improve adherence, reduce inappropriate utilization and drug selection for better clinical outcomes. But only 57 percent of the ACO respondents currently employ or contract clinical pharmacists. More than half of the respondents said ACOs can decrease the cost of prescription drug therapy and another 69 percent said ACOs can increase the quality of prescription drug therapy. "Pharmacists are underutilized as trusted advisors to patients, physicians and other providers," according to the report. "Their patient-facing role can be very powerful in education and motivation, providing a potential solution to the lack of patient engagement and commitment to self-care." Twitter: @JessiefDavis

Where does former National Coordinator Farzad Mostashari, MD, spend his time since leaving ONC? Back in the world of clinical issues, practice management, and talking to physicians. Only this time he’s an entrepreneur.

While electronic health records have been shown to improve patient health, safety and care coordination in many ways, what is less documented is how EHRs can also cause harm, and even leave healthcare professionals open to malpractice suits.

Electronic health record executive said he will still be involved in the business.

While the market for inpatient electronic health records is mature, there's still plenty of upside for ambulatory systems as accountable care organizations and patient-centered medical homes struggle to function seamlessly across the continuum of care, according to a new report by Frost & Sullivan.

Thirty-one top health systems, hospitals and clinics are urging the Department of Health and Human Services to think again about pressing forward on Stage 3 meaningful use. Among them are Beth Israel Deaconess Medical Center and Partners HealthCare in Boston; Geisinger Health Systems in Pennsylvania; Henry Ford Health System in Michigan and Intermountain Healthcare in Salt Lake City. In a January 14 letter to HHS Secretary Sylvia Burwell, the organizations say they are concerned that Stage 3 might even thwart much needed improvements to electronic health record systems. [Also: Meaningful use will likely end in 2016] “We recognize that the MU program has successfully driven the adoption of EHRs, with over 80 percent of hospitals and physicians now using these systems,” they write, adding that now is the time to make sure all practices “have high-functioning technology to achieve interoperability across all care settings.” Their pleas come on the heels of CMS chief Andy Slavitt’s claim that meaningful use would come to an end in 2016, a statement he made January 12 at the J.P. Morgan Healthcare Conference in San Francisco. He gave few details beyond that, except to say the program would be replaced by something better. John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston, posted the letter on his blog. Halamka had already called for a halt to the program back in November. [Also: Did meaningful use spawn or stall EHR innovation?] “In particular, the MU program has diverted clinician, staff, and other resources away from activities with greater patient benefit and has forced technology to develop in a way that limits innovation,” the healthcare organizations said in their letter to Burwell. Also, the group points to the meaningful use program as the driving factor behind the poor design of EHR technology. “We believe Stage 2 EHR design requirements have been a fundamental drag on interoperability and that Stage 3 will worsen these problems,” they said. “The Stage 3 final rule, like its predecessor rules, is too focused on pass-fail requirements and lacks emphasis on outcomes. By maintaining this flawed structure, we do not believe Stage 3 will support movement towards more innovative care models or encourage continued participation.” [Like Healthcare IT News on Facebook] Robert M. Wachter, MD, a professor and the interim chairman of the department of medicine at the University of California, in a Jan. 16 opinion piece in the New York Times pointed to several measures that he said have failed doctors and teachers. “Of course, we need to hold professionals accountable,” he wrote. “But the focus on numbers has gone too far. We’re hitting the targets, but missing the point.” Twitter: @HealthITNews