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EHRs must support two distinct types of care, Partners CIO says

Ever notice how so many examples of how EHRs can improve care focus on diabetes? That’s because diabetes care has many clear protocols, copious amounts of scientific evidence that gets included in clinical decision support and clear quality measures. But not all care is like diabetes care, as Partners HealthCare System CIO John Glaser notes in Hospitals & Health Networks. “The outcomes of a stroke are variable and difficult to measure. There are often no crisp guidelines for treating the fragile, elderly patients with multiple chronic diseases. And it would be a challenge to adequately structure the documentation of the clinician’s thought process for a patient with a rare disease that is eluding diagnosis,” Glaser writes in one of his regular columns for the magazine. According to Glaser, healthcare can be broken down into iterative care–making diagnoses–and sequential care, which involves following widely accepted patterns of treatment. “The EHR must accommodate this diversity within an organization as well as for an individual clinician (a clinician may see this diversity daily) and for a patient (any patient may move from iterative care to sequential care and back again),” he writes. From an IT perspective, each type of care calls for different types process re-engineering. “While there is a core set of EHR capabilities in both classes, the needs are different. Structured documentation may not be helpful for iterative care patients. Collaboration tools may be little help for patients with straightforward, acute conditions. Introducing EHR tools that are relevant in one class into the other class may interfere with rather than assist in the delivery of care,” Glaser explains. “If we introduce systems and implementations designed for one class into the other class, it is assured that the EHR won’t fit the workflow or support the way we think.” To learn more: - read Glaser’s article in Hospitals & Health Networks

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CSC tells providers to press their vendors on EMR certification readiness

Posted by admin | Posted in Healthcare EMR | Posted on 01-07-2010

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Hot on the heels of a Computer Sciences Corp. report telling private health insurers to get with the federal EMR and quality-reporting incentive program, the same consulting firm has issued a paper advising hospitals and doctors to start assessing whether their chosen systems will meet newly published rules governing EMR certification in the short term.

“Given that the process of certifying systems will start soon, providers should ask their vendors when they plan to apply for certification,” write Erica Drazen, managing partner of CSC’s Healthcare Group, and Jim D’Itri, a partner in the Falls Church, Va.-based company’s Healthcare Strategy and Operations Group. “Because meaningful use incentives require a currently certified system, and the requirements will increase in 2013, system purchases and implementation plans should consider current and expected future requirements,” they add.

“For example, bedside medication administration with bar code verification was not proposed as a Stage 1 requirement; however, it is almost certainly a future requirement for meaningful use incentives. Therefore, this capability should be included in any IT strategy or selection. Any vendor contracts should have provisions that include updates to meet future certification criteria as part of regular covered maintenance.”

Providers must use certified technology to earn Medicare and Medicaid bonus payments.

ONC two weeks ago issued final rules for a temporary program that will govern EMR certification through the end of 2011. Private entities, including the Certification Commission for Health Information Technology, must apply to be authorized certification bodies based on ONC’s testing criteria. National health IT coordinator Dr. David Blumenthal expects the first batch of certified EMRs to be ready by the fall.

For more:
- see this CSC “Update on Certification” issue brief (.pdf)
- take a look at this Healthcare IT News story

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