69 Percent of Physicians Say Speech Recognition Makes EHRs Faster and Easier to Use

Nuance Communications, Inc. announced results from a new study that shows how Nuance`s Dragon Medical® software, the healthcare industry`s most widely used real-time speech recognition software, can significantly accelerate the transition to, and utilization of electronic health records (EHRs).

As EHRs have risen to the forefront of the healthcare information technology (HIT) agenda at the physician, provider organization, government and consumer levels, Dragon Medical software is increasingly recognized as an essential component to successful EHR rollout. According to a survey completed by 1,255 physicians who have adopted Nuance`s Dragon Medical software:

• 83 percent said that it improved the quality of their electronic patient
  notes;
• 81 percent said that it significantly reduced transcription spending; and,
• 69 percent said it made their EHR faster and easier to use.

Despite strong endorsements for EHRs, their adoption is lagging. Today, less than two percent of U.S. hospitals have fully switched to EHRs, according to a study from the New England Journal of Medicine that was released on March 25, 2009, and a third of the 3,000 hospitals surveyed cited reluctance among doctors to change work habits as a leading hurdle. To facilitate EHR migration further, Nuance is collaborating with leading EHR vendors, such as EHR Doctors, to launch the Dragon Medical EHR Certification Program. While Dragon Medical software already works “out-of-the-box” with VistA, the Certification Program is designed to optimize clinician use of EHRs by introducing a new standard of speech recognition interoperability.

Our physician clients have embraced Dragon Medical as the primary and best means of speech-enabling their electronic health records, because Dragon Medical helps them to quickly and easily create high-quality, real-time patient documentation. Speech is a key component of the electronic healthcare revolution, and Nuance’s certification program will ensure that physicians have a reliable list of electronic health records that will optimize their use of this vital clinical capability.

As part of the Dragon Medical EHR Certification Program, EHR vendors complete a Nuance-managed evaluation during which they work with Nuance engineers to further optimize The Dragon Medical software`s interoperability with their EHR. By adding this additional layer of interoperability, physicians and healthcare organizations can confidently make their EHR migration, knowing speech recognition is not only possible, but has been pre-tested and optimized for utmost clinician efficiency.

Dragon Medical and the EHR, Accelerating the Transition

The biggest challenge facing the roll-out of electronic medical records contemplated in the American Recovery and Reinvestment Act is achieving meaningful use without adding to physicians` documentation burden. This can be ccomplished by closely coordinating voice entry with structured notes, rather than treating voice and structured entry as an `either-or` proposition,” said Wes Rishel, vice president and analyst in Gartner`s healthcare provider research practice.

As the Health and Human Services Department works to define “meaningful use” of an EHR, Nuance believes that Dragon Medical software can help physicians and organizations move toward complying with what will ultimately be considered “meaningful” EHR use, by ensuring that clinicians actually utilize the EHR and that the physician narrative is not lost during the documentation process. As proven by the more than 100,000 physicians already using Dragon Medical software to dictate the narrative component of their patient visits, speech-driven
clinical documentation is available in real-time, notes are more complete and patient care is improved.

“Today, more than 20 percent of all physicians in North America use speech solutions from Nuance to generate over 800 million electronic medical records a year,” said Peter Durlach, senior vice president of marketing and product strategy, Nuance Healthcare. “Dragon Medical is increasingly recognized as an essential component to EHR rollout as healthcare provider organizations work to implement, and effectively utilize EHR systems to comply with the federal government`s five-year adoption goal, as well as earn their fair share of incentive payments from the American Recovery and Reinvestment Act.”

Dragon Medical software is proven to make clinicians up to 25 percent more efficient with an EHR when compared to using a non voice-enabled system. And, as supported by a May 2007 report issued by KLAS, 76 percent of clinicians using “desktop” speech recognition - to directly control an EHR system - report faster medical report turn-around time, better service to patients, sharply reduced costs and increased productivity. Benefits for healthcare organizations that provide physicians with a speech-enabled EHR include:

• Reduced Transcription Costs - By enabling clinicians to dictate directly into
  the EHR system with real-time speech recognition, healthcare provider
  organizations can eliminate significant operating costs associated with
  traditional manual transcription.
• Faster Medical Report Creation - Using speech, physicians can create patient
  documents at the point of care, resulting in faster turn-around times and more
  accurate, thorough patient records.
• More Detailed Documentation - According to physicians, the narrative is the
  most important part of a patient note. A medical record that combines
  point-and-click EHR templates with dictated physician narrative promotes ongoing
  higher quality care.
• Increased Overall User Productivity and Satisfaction - By using speech
  recognition to navigate and dictate directly into the EHR system, clinicians can
  eliminate hours of typing, clicking and scrolling, allowing them to spend more
  time providing high quality patient care and increasing their satisfaction with
  the entire documentation process.

EHR Doctors is your web resource for Vista EHR, NHIN Connect, Mirth HL7, Dragon Medical and other related health information technologies that can take your pracitice to the next level of EHR meaningful use.  Enjoy our site, and when you are ready to speak with someone knowledgable on EHR and how to do it best at the lowest possible cost, give us a call.

The HIT Policy & Standards Committees of the Health and Human Service Office of the National Coordinator for HealthIT is one step closer to the regulations for meaningful use.  As expected a phase approach with yearly goals and outcome measurements are defined by the matrix which can be viewed here.  EHR Doctor’s service will enable you to meet these criteria as they come due.

The ONC now maintians a meaningful use page on their website.

CCHIT to unveil certification program for meaningful use of EHRs

The Certification Commission for Health IT announced it will release in October a set of criteria that could help health care providers achieve certification for “meaningful use” of electronic health records by 2011. The commission said its certification program will allow hospitals and providers lacking a comprehensive EHR system to prove meaningful use by certifying e-prescribing and other modular health IT products and services.

Recently the team at EHR Doctors embarked on a journey to take VistA Electonic Health Records into the Amazon Ec2 cloud computing platform.  Delivery of an Electronic Medical Record system into the Cloud requires a steadfast focus on security and data privacy.  Our developments started with the Amazon HIPAA whitepaper.  For those who want to see other examples in action, a number of HealthIT companies have already made Amazon eC2 HIPAA compliant applications including DiskAgent.  Amazon has a good data security whitepaper on securing a server by closing ports and using ssh keys to connect.  We started off using a customized and standardized version of VistA EHR as the base for our Ec2 setup.  We ensured data security by installing OpenVPN to make sure all data is encryped with SSL from client to server.  We can now provide secure VistA on the Amazon Ec2.  Contact us for more details.

HOW DOES HAVING EHR HELP MY MEDICAL PRACTICE?

Electronic Health Records (Recent Changes): $19.2 billion allocated for the health IT program. Physicians are now being paid to implement and show meaningful use of a CCHIT certified EHR Software. Physicians not using an EMR / EHR will be penalized by a 5% reduction in reimbursement.

WORKFLOW:
•    Share patient information everywhere assessment, diagnosis and treatment decisions occur.
•    Reduce or eliminate the costly tasks of creating and managing paper charts
•    Decrease or eliminate labor-intensive chart pulls and re-files
•    Provide rapid access to information when needed - fewer misplaced or duplicate charts
•    Communicate key information better and with more accuracy
•    Provide rapid responses to chart/record requests and audits
•    Improve and track overall processes
•    Improve the accuracy of coding at the appropriate level
•    Minimize the issues of incorrect or conflicting drug prescriptions.

ADMINISTRATIVE
•    Reduce costs by shortening billing cycles and other core administrative and clinical operations - including storage and copying costs of medical records.
•    Create higher quality documentation (auditable, legible and organized charts and records).
•    Document visits to a consistent level of quality/service.
•    More complete records helps clinicians and staff to avoid mistakes and to manage the cost of malpractice insurance.

IMPROVED BOTTOM LINE

•    Increase Return on Investment (ROI)
•    Fewer personnel are needed if clinicians enter some of the information - also save on transcription  costs
•    Direct data entry by clinicians and staff greatly reduces transcription costs.  ( Ask about EHR                                                Doctors   Dragon add on which eliminates costly transcription services)
•    100% write off on expenditures the first year
•    Physicians using a CCHIT certified EHR will be eligible for $44,000 Medicare, and $65,000 Medicaid
•    Combining a voice recognition program to EHR software will eliminate on average $1500 per month of transcription costs

EHRDOCTORS IS CCHIT CERTIFIED:

•    Software has been in use for 27 years
•    Used in VA hospitals, Department of Defense, Indian Health Services
•    Now implementing in Doctors offices
•    Customized templates for each physicians practice management style

Now is the time to call EHR Doctors to set up an in office demonstration and proposal. Time is of the essence to make a decision and have the office up and running in a meaningful manner by January 2011.   Contact us for more details.

Doctors Want to Know, Why the Government is Pushing Electronic Health Records?

ESTABLISHMENT – There is established within the Department of Health and Human Services an Office of the National Coordinator for Health Information Technology Purpose - The National Coordinator shall perform the duties under subsection (c): in a manner consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information.

Governments Top Ten Reasons

(1) Ensures that each patient’s health information is secure and protected, in accordance with applicable law;
(2) Improves health care quality, reduces medical errors, reduces health disparities, and advances the delivery of patient-centered medical care.
(3) Reduces health care costs resulting from inefficiency medical errors, inappropriate care, duplicative care, and incomplete information.
(4) Provides appropriate information to help guide medical decisions at the time and place of care;
(5) Ensures the inclusion of meaningful public input in such development of such infrastructure;
(6) Improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information;
(7) Improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bio terror events and infectious disease outbreaks.
(8) Facilitates health and clinical research and health care quality;
(9) Promotes early detection, prevention, and management of chronic diseases;
(10) promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services and improves efforts to reduce health disparities.

EHR Doctors, Inc is working to Promote, facilitate, and support, the development of health information exchange systems which provide inter-operability among health care providers. EHR Doctors, Inc uses a (CCHIT) certified electronic health record software, including a fully informed electronic prescribing functionality.

First Look: Meaningful use under ARRA

The meaningful use workgroup of the HIT Policy Committee has released its initial recommendations for a definition of “meaningful use” of electronic health records. The definition is important because under the American Recovery and Reinvestment Act (ARRA), providers must “meaningfully use” EHRs to receive financial incentives from Medicare and Medicaid.

The Committee’s initial recommendations do not include a formal definition of meaningful use. There is a long way to go before a final definition of meaningful use is achieved.

The workgroup’s initial recommendations include 22 objectives–most covering inpatient and outpatient care–for EHRs in 2011. These include, among others:

* Use CPOE for all order types including medications;
* Implement drug-drug, drug-allergy and drug-formulary checks;
* Maintain an up-to-date problem list;
* Generate and transmit permissible prescriptions electronically;
* Maintain an active medication allergy list;
* Send reminders to patients per their preference for preventive and follow-up care;
* Document a progress note for each encounter;
* Provide patients with an electronic copy or electronic access to clinical information such as lab results, problem list, medication lists and allergies;
* Provide clinical summaries for patients for each encounter;
* Exchange key clinical information among providers of care;
* Perform medication reconciliation at relevant encounters;
* Submit electronic data to immunization registries where required and accepted;
* Provide electronic submissions of reportable lab results to public health agencies;
* Provide electronic surveillance data to public health agencies according to applicable law and practice; and
* Comply with federal and state privacy/security laws and the fair data sharing practices in HHS’ Nationwide Privacy and Security Framework, released in December 2008.

The HIT Policy Committee will make the final recommendations on meaningful use definitions to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services.

HHS is mandated to publish an interim final rule for standards, implementation specifications and certification criteria of EHRs that qualify for financial incentives by the end of 2009. CMS will develop the formal definition of meaningful use to support the incentive programs. CMS will go through the full administrative rules process with a proposed rule, public comment period and a final rule.

The recommendations from the meaningful use workgroup include a matrix of objectives for 2011, plus enhanced objectives for 2013 and 2015. The workgroup will refine the initial recommendations for 2011 and 2013 within three months.

The meaningful use workgroup also has laid out an “achievable vision” for benefits to be realized by 2015. These include reductions in heart attacks, medical errors, and preventable hospitalizations.

More Information from Health Human Services Health IT Policy Center

Meaningful use Preamble

Meaningful use matrix

Paying for Your Electronic Medical Records Just Got Easier.
Certified EHR Software + Deduct purchase with Tax Section 179 + Federal EMR Stimulus = An EMR that will save you money and time.

Many medical practices that elect a Client/Server EMR Software model choose to finance their electronic medical records software and hardware investment over a 1-5 year period. EMR financing and leasing options are available to ensure that your electronic medical records system is an affordable and cost-effective replacement of your paper charts.

Using Section 179, medical practices can realize huge tax savings in addition to qualifying for the federal EMR software stimulus if they purchase and begin implementation of their EMR software in 2009.
Step 1. Purchase a Certified EMR like WorldVistA.

The federal EHR stimulus signed into law on 2/17/09 calls for up to $63,750 per provider in Medicare/Medicaid reimbursement bonuses for providers who are ‘meaningfully using’ a certified EHR by 2011. WorldVistA has its CCHIT™ Certified status.

Step 2. If necessary, obtain financing to cover the initial software and training expenses.

Even if you obtain a loan for your electronic medical records system using an Equipment Finance Agreement (EFA), you can still take the Section 179 deduction.
How Does Tax Code Section 179 Apply to Our Practice?

* SIGNIFICANTLY! The Economic Stimulus Act of 2008 increased the small business expense for qualified property in 2008 to $250,000. The Section 179 deduction has been extended through December 31st, 2009. This means for 2009 the write-off amount is up to $250,000 with a bonus 50% depreciation.
* Expense the full cost (up to $250,000) of your equipment/medical software purchase that is purchased by 12/31/2009. Prior to the Economic Stimulus Act, the expense limit was $128,000.
* For example, your practice can expense the full amount of a $75,000 EMR software purchase including software and hardware - and reduce your practice’s taxable income.
* If your taxable income is $100,000 prior to your EMR purchase of $75,000, your taxable income is reduced to $25,000. Typically your practice can depreciate any medical software or hardware that exceeds $250,000 over the next 5 years.

Examples of Cost Savings Under Section 179 in 2009

* Example 1
o Purchase Price: $150,000
o Write Off Amount? The FULL $150,000.
* Example 2
o Purchase Price: $300,000
o Write Off Amount? $250,000.
o 50% Bonus Write Off of $25,000
o 1st Year Total Write Off is $275,000

Step 3. Plan to purchase and implement your EMR in 2009.

In order to qualify for the highest incentives through the federal EHR software stimulus package, your practice must be able to substantiate that it is ‘meaningfully using’ a certified EHR system in 2011. Because of the backlog in EMR implementations even today, experts are advising that practices DON’T delay purchase and implementation until 2010. Doing so might mean that you lose out on the first and largest of the payments scheduled for 2011.Under the federal stimulus package, 2015 is the deadline to implement a certified EHR system to avoid facing additional reimbursement cuts.

The Obama administration is now devoting billions of dollars to promote electronic health records (EHR) for doctors. Existing office management software on the marketplace answers the billing and patient management needs but falls short of a truly paperless office.

The promise of a paperless office is certainly seductive. The notion of physicians and patients having access to their medical records from any computer would improve medical quality and efficiency. Every doctor knows how frustrating it is to see a patient in the emergency room when the relevant medical records are sitting in the primary doctor’s office or in a hospital across town. Conversely, EHR permits the primary physician, who may not have been the hospital treating physician, to be easily updated after hospital discharge when the patient returns to his office.

Many patients today don’t know their medications and can’t recall prior illnesses or even operations.   This can create big problems for physicians who prescribe medication without knowing the patients drug history including adverse reactions and potential mal-interactions.  EHR solves this issue.

EHR also permits easy analysis of patient data to track important medical benchmarks including colon cancer screening, Pap smears, immunizations, mammograms and other preventative tests. Many Doctors who still use paper, rely on old fashioned methods to track who is due for a screening colonoscopy. EHR technology could permit Doctors offices to contact all patients who reach the milestone age of 50 alerting them that their colon cancer screening experience is due. This would be superior to our current manual mail & call technique.

EHR also eliminates the frustration of a missing medical chart. Electronic files are also more current, since data is entered much faster than paper reports. Sending medical records to other physicians’ offices could be accomplished with a keystroke, which traditionally can take weeks. EHR also eliminates the inscrutable penmanship of physicians, which at times needed CIA code breakers to decipher.

With EHR, patients could have their complete medical data, including EKGs and actual x-ray images on a personal flash key. With this technology, a doctor on a cruise ship could see your chest x-ray from 2 weeks ago.
Over time, EHR saves money by improving office efficiency, reducing repeating medical tests and reducing postage expenses.

If this system promises physicians a medical utopia, then why doesn’t every doctor sign up? The New England Journal of Medicine reported in their April 16, 2009 issue only 17% of physicians are using some degree of EHR in their offices.