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Off the charts [Hernando Today, Brooksville, Fla.]


Oct. 06Traditionally, hospitals and physician practices process their billing of services electronically, but maintain paper charts for their patients.
Paper charts are gradually becoming a thing of the past.
Electronic billing and medication prescribing were the initial steps to bringing this part of healthcare into the 21st century.
Electronic medical records (EMR) and electronic health record (EHR) is one part of the federal mandate to reduce paperwork and adopt and implement secure, confidential, electronic methods to exchange health information between patient, doctors and health care facilities.
The ‘M’ in EMR refers to medical information, for diagnosis and treatment.
EHR is the newer and more accurate term to use, as the ‘H’ refers to health information, covering more subject matter.
EMR more commonly refers to the digital version of a medical chart on a patient and includes tracking data, preventative care and follow-up appointments, checking the progress of a patient for blood pressure or other tests, and an overall monitoring of a patient’s care.
EHR includes everything within an EMR, but offers much more of a total health record. These are built to go beyond health care organizations to share with other providers, for example specialists. EHR is a gathering all of the information from all health care providers involved in the care of a patient, and allows authorized access by these health care providers regardless of location.
The process for implementing EMR and EHR is part of the Affordable Care Act (ACA) with the first part of the regulation to take effect Oct. 2012.
However, the path for health care providers to begin transitioning itself off of paper began many years ago, prior to ACA passing.
Electronic medical records provide the benefit of portability for patients and health care providers, plus reducing errors and increasing patient safety. These advantages are evidenced in health care facilities who have implemented EHR processes.
In becoming HER compatible Oak Hill Hospital strives to stay ahead of the game.
hCare an EHR program established by HCA, Oak Hill’s parent company, is designed to "improve quality, enhancing regulatory compliance, connecting physicians and facilities across our health care system, and ultimately ensuring that the communities we serve receive the best possible care."
Mickey Smith, CEO of Oak Hill Hospital, described the different ways the patient’s quality of care has increased as a result of establishing EHR throughout the facility.
"Technology has improved patient safety and expedites care when using a computer-based system. This includes scanning armbands to verify patient’s medication before being administered. The new processes dramatically reduced the time when placing and processing orders," said Smith.
The next frontier of EHR implementation is in physician practices. The majority of physician practices still use paper files as the main record keeping for patient information. However, electronic prescribing of medications and access to patient information through a portal has been in place for several years.
Comparing a health care facility and physician office, establishing an EHR system in the physician’s practice can be expensive.
Dr. Jude A. Pierre, M.D., internal medicine practitioner with Health Link Associates, LLC helped to develop an open source electronic health record created by Phyaura, LLC, a health care IT (information technology) company, where EHR programs are available. PHYAURA EHR Community Edition is free software available for all physicians, nationwide.
"With a community of developers, using base software enables physicians to afford to connect and establish EHR in their offices," said Pierre, "training and support fees are minimal when compared to proprietary or non-open source software."
The system is compatible with HCA’s hCare system.
Dr. Sanjay Navadia, M.D., internal medicine practitioner is also a primary care physician who has implemented EHR into his practice, using E-clinical and also interfaces with Oak Hill’s system.
"When ordering labs, there is no paperwork to be sent as it is done electronically, using my iPad," said Navadia. "I can access my chart for a patient, make notes and sign them electronically.
This increases accuracy and shortens wait times, which benefits the patient, Navadia added.
"Physicians are leading the way toward a patient centered model, which is a shift from before being a provider centered model," Smith said.
An example of faster care for a patient is evidenced in the radiology department.
A radiology report could take up to 24 to 48 hours on average depending on the volume of the report to be transcribed, printed and conveyed to the patient.
With the EHR system, time is cut to about an hour or less as the image is sent electronically with voice recognition transcribing and electronically signed.
"Reports, orders and follow-up with patients is made easier," said Navadia.
"EMR is proven to be a better way to practice medicine," said Pierre.
Patients are seeking physician practices offering EHR, being proactive in their own care, added Pierre.
Navadia described how patients can access their information through patient portals over the internet. "Patients can have limited access to his or her file flagging a physician for a medication refill, routine lab reports, or scheduling an appointment."
This empowers the patient and it is easy for everyone to use, he added.
"Patients have limited access with the capability to make an appointment online with available times for office visits," said Navadia. "My patients love the patient portal access online."
A concern people have with everything going electronic is privacy.
"Everyone could look at a paper chart who could access it," said Pierre. "EHR programs time and date stamp who accesses the information, preventing individuals from freely accessing medical information who should not be."
"With electronic records, if there is a natural disaster, the paper files do not need to be recovered, as the system is backed up in several ‘safe’ locations," said Smith.
Same as how banking is done, added Smith.
"Many were nervous when banking went electronic, but the benefits far outweigh the risks," Smith said. "The same can be said for EHR."
One concern is whether all these EHR programs will ‘talk’ to each other.
Navadia said, "Patients can have a CD made with their health information on it to be viewed on a computer."
With existing files, we scan the documents to view them to integrate the information into an electronic chart, Navadia added.
The best part of EHR is the reduction of medication errors.
"Monitoring drugs and drug interactions has become much easier with the EHR system," said Pierre.
"Being able to view several medications and be alerted to possible side effects or complications helps physicians to prevent harm to a patient," said Navadia.
"The complexity of medication and medication interactions is difficult for patients too," said Smith. "EHR is an added tool to prevent hurting a patient."
It is exciting to see improvement of patient care, Smith added. (352) 544-5286
(c)2011 the Hernando Today (Brooksville, Fla.)
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