EHR Helps Track Cancer Cases

EHR is now being used to track cancer cases in the state of Kentucky. The University of Kentucky has developed a model that allows EHR to track and submit cancer cases to the state’s cancer registry.

The Lane Report, which broke the story today, reports that Kentucky has the highest rates of cancer than any other state. This model will allow oncologists to submit data to the registry and see real time results of cancer trends in the state.

The benefits are profound. Researchers will now have access to real-time cancer trends and statistic. Physicians will also be able to use this data to make better diagnoses and customize treatment. This real-time reporting might also help researchers identify why so Kentucky has so many cancer cases.

The model was officially launched October 19; five new cancer cases in Paducah, Kentucky were securely reported and submitted to the registry by Dr. Halden Ford using the Team Chart Concept EHR system. The Kentucky Cancer Registry is currently partnering with 43 other cancer centers to create a network of EHR reporting.

Physician reporting of new cancer cases is part of Meaningful Use, but won’t become a requirement until 2014. Kentucky has become a leader in this application in EHR, and I’m sure many other states will end up modeling their efforts after this system.

New USB Stores Patient EHR

Here’s a nifty new development for you: SmartMetric just released a biometric USB keyring, called KeyringMedicalRecords that stores a patient’s electronic health records. The card is activated by the patient’s fingerprint; once their print is scanned, doctors can have access to all their records through a PC’s USB port. The device means that patient records can now be extremely portable.

The fingerprint scan  makes the device extremely secure; even if it’s lost, health records can’t be used by another person. Essentially, it’s “locked down” without the right print to open it. This also makes it more secure, in some respects, than the cloud. Many patients are hesitant about having their records on the cloud, and with good reason. The data breaches that plague some companies aren’t an issue with this device.

Of course, the device lags behind the cloud in that it likely won’t be updated as often. Patients are responsible for updating the device, which means that it could quickly become irrelevant and outdated for some people simply because they’re not updating their information.

One feature to the biometric card can even save lives. In the event of an emergency when the patient is unconscious, physicians can use an emergency on/off button to display the patient’s blood type, allergies, current medications, and any medical conditions.

Another feature I really like is the space; the USB device has 128 GB. This is enough room for doctors to store high resolution scans and video, as well as images like X-rays and mammograms.

So what do you think; is SmartMetric’s new biometric USB keyring a positive development, or do you think that it’s ultimately doomed to irrelevancy because patient’s won’t keep their health records up to date?

Using Your Kindle Fire for EHR

If you’re like me then you probably had to blink twice when you saw that title. Over the past few weeks, there have been several articles (like this one on Zdnet) published around a surprising innovation: some physicians are using their Kindle Fire to run EHR programs.

When you think about it, it makes sense, especially for small or micro practices. The Kindle Fire is half the cost of an iPad, it’s smaller, and it’s very easy to use.

So how does the Fire handle something like patient check-ins? Check out the video below; it’s published by a company called drchrono. They make EHR mobile apps that can be used on the iPad, as well as an Android device.


What’s nice about the drchrono application is that it’s meaningful use certified. And the best part? It’s completely free. With the free version, you get e-precribing, patient check in, custom clinical forms, and online payment capabilities. More advanced versions of the app have third-party lab integrations and advanced patient access capability. For this, you’re going to pay $399 per provider or more.

Now, using the Fire for patient management isn’t going to be for everyone. Large and mid-sized clinics will likely need a more robust system. But what about a small family practice? This is a good option, especially when you’re on a tight budget.

The problem with the Fire is security; if you have a savvy in-house technician (like most mid to large sized clinics and hospitals do) they can make sure the fire, and patient data it contains, is kept secure. However, most small clinics don’t have someone on staff to take care of this for them. So the Fire’s biggest weakness is going to hit the people who need it most the hardest.

However, the Fire does give you access to electronic medical journals (like the New England Journal of Medicine) that you can’t access on the iPad. So, that’s a small plus, however, not one that’s big enough to sway a final decision.

In the end, I think the Fire could be useful in very specific, limited situations. But right now, security is still too much of an issue for me to recommend it for small practices. Perhaps in a year or two? We’ll have to see.

Study Finds that EHR Really Does Improve Patient Outcomes

Those of you who work closely with EHR, and directly with physicians, already know that EHR can dramatically improve patient care. This includes care for specialized conditions such as diabetes, which is the fastest growing disease in this country according to the American Diabetes Organization.

The good news is that we now have new data to back up this belief. According to a Kaiser study released today, EHRs really do improve patient care.

The study was published in the Annals of Internal Medicine. And it demonstrates that EHRs allow physicians to better target treatment changes and follow up tests, especially for specific groups like diabetics. Although this particular study only examined physicians treating diabetic patients, I believe these benefits run across the board no matter what type of patient or illness you’re treating.

According to physicians queried for the study, EHRs were also linked to:

  • Better managing disease risk factors.
  • Greater improvement in patients with poor control of diabetes symptoms.
  • Alignment of quality measures and controls for treatment.

Another important finding in this study, as explained in InformationWeek Healthcare, is that because information is readily available decisions are readily supported, and order-entries are easy, physicians are better able to identify patients who need drug treatment intensification and retesting.

More Good News…

Another closely-related, positive piece of news comes from the American College of Physicians, along with the Bipartisan Policy Center and Doctors Helping Doctors Transform Healthcare. Together, they released a study today showing that an overwhelming majority of physicians believe EHR has a positive impact on patient care, the ability to coordinate care, as well as the ability to participate in third-party reporting.

Of course, as usual there are still numerous challenges that must be overcome. According to the ACP study, more than 70% of respondents cited the lack of interoperability as the biggest hurdle to overcome, along with cost. And, respondents also stated that in transition of care, access to medication lists and relevant laboratory images are high priorities for EHR.

You can see the full ACP study here.

Final Word

Both of these studies contain some good news for physicians and the EHR community. As these third-party organizations prove more often how effective and beneficial EHR is, more doctors will hop on board. And, patients will get more comfortable with EHR technology. As their comfort level rises, they’ll likely be more willing to take an active role in their healthcare. And hopefully, this will make it easier for them to make some positive changes.

EHR Vendors Taking Steps Towards Interoperability

According to an article published in Forbes Magazine last week, EHR vendors are now quietly taking steps towards making their systems work with each other.

Two vendors, Epic Systems and Cerner, are working with Greenway Medical Technologies to link their their EHRs together in order to exchange patient information. Yeah. Wow, right?

The reason is because the government is pushing to break down these information exchange barriers. These barriers not only complicate patient health care, but they increase health care costs. However, think of how effective, and less costly, healthcare would be if you could access patient information throughout any EHR.

Previously, Epic and Cerner both maintained closed legacy EHRs. And they both marketed their systems to large hospitals. But teaming up with Greenway, who has turned interoperability into a distinct advantage, means they can both market to smaller firms.

In the meantime, everyone wins because these systems will be able to communicate and share information. And, Walgreen’s just announced they’re about to use the Greenway EHR system in 8,000 of their locations next year.

Interoperability just makes sense. The demand on our healthcare system is going to grow tenfold over the next 20 years. If hospitals and clinics can’t exchange information because systems can’t talk to each other effectively, the people who will ultimately suffer are patients, both in quality of care and cost. Greenway states that their system can be easily customized to connect with other vendors.

Personally, I see this as a huge jump forward with EHR. The only way we’re truly going to improve patient care, and reduce the staggering cost of healthcare, is working with each other. And, this is a great first step!


EHR Training in Med Schools Coming Up Short

As any physician can tell you, med school is no cakewalk. The amount of information students have to learn is extraordinary. And, they learn even more during their residency once they’re done.

Today’s medical schools have the new burdon of teaching the next generation of physicians about electronic health records on top of their medical training. And according to a study published in Teaching and Learning in Medicine, many med schools are coming up short.

According to the journal, 64% of medical students allow students to use EHRs, and two-thirds of those schools allow students to make notes in the records. However, only 27% of the schools allowed students to view and write patient notes, and enter orders to be co-signed, while 41% of respondents said students could view and write notes, but not make orders.

Allowing students to take patient notes has long been an important part of their learning experience. And in many schools, students are getting less of this experience because of the lack of full access with EHR.

So why aren’t schools investing more into EHR training for students? Well, the study found a number of barriers. One of these is the lack of training and experience of the faculty; there just aren’t enough qualified instructors to teach EHR, at least at this level.

Other barriers found were concern for billing challenges, lack of computers available for EHR instructional use, lack of mechanisms that allow faculty or residents to review student order entries, and the possibility of student errors going undetected.

These are valid concerns, to be sure. But just like anything, these concerns could be overcome with dedicated attention, monetary investment, and additional safeguarding of data.

Providing More Experience

Fortunately, the study published a separate report that medical schools can use to give their students more experience with EHR. These guidelines are:

1. Students must document in the patient’s chart and their notes should be reviewed for content and format.

2. Students must have the opportunity to practice order entry in an EHR—in actual or simulated patient cases—prior to graduation.

3. Students should be exposed to the utilization of the decision aids that typically accompany EHRs.

4. Schools must develop a set of medical student competencies related to charting in the EHR and state how they would evaluate it.

I think it’s incredibly important students get as much time using EHR before they leave school. Knowing how to navigate these systems effectively is now an essential skillset that doctors didn’t have to have just 15 years ago. And students who don’t get access to this knowledge until they’re out of school have one more hurdle to jump over.

Average Patient Not Keen on EHR

Ask most physicians and hospital administrators about EHR (after the often-hectic GoLive is a distant memory, of course), and you’ll likely hear the same thing: EHR enhances patient care, improves patient safety, reduces costs long-term for the practice, reduces the need for excess staff, and makes the office more efficient overall. In short, when it works, EHR is a real benefit to the medical industry.

The problem is that most American patients don’t see it that way. According to a new poll by Xerox, only 26 percent of Americans want EHRs. The findings come from the third annual EHR online survey of over 2,400 adults, conducted by Harris Interactive for Xerox.

According to findings, only 40 percent of respondents believe that EHRs will help doctors deliver better care. And, 85 percent of respondents expressed concern about EHRs. The main reason they stated was a fear their information will be stolen by hackers.

The good news about these grim statistics is that it highlights how important open and clear communication is between hospital and clinic support staff, and the patients they serve. The more that staff members, including doctors and nurses, educate patients on the benefits and security of EHR, the more these percentages will go down.

Educating Patients about EHR

There are several ways to communicate the benefits of EHR to your patients. If you’ve already selected a vendor and scheduled your GoLive date, send out an announcement (via email or regular mail) four to six weeks ahead of time, letting patients know about the changeover.

In your announcement, take time to talk about why EHR will benefit the clinics, and the steps you’ve taken to ensure patient information security is a top concern. If possible, include statistics from outside, reliable sources that demonstrate the security of your system, or EHRs in general.

Last, make sure doctors, nurses, and support staff continue to talk about EHR security. Invite everyone who walks in the door to ask questions and raise concerns. Only with open communication and continuous education will patients start to feel more comfortable with EHR technology.