EMR - Are You Ready?

Faced with a governmental mandate to migrate all medical records for U.S. residents to be in an electronic format by 2014, healthcare organizations are aggressively moving ahead with electronic medical record (EMR) initiatives. The 2006 HIMSS Leadership Survey of healthcare information technology (IT) executives revealed that 61 percent of those surveyed felt implementing a paperless EMR is the most important application in the next two years.

Critical, but Painstaking
Clearly, there is consensus on the importance of EMR for transforming the healthcare system.  However, as Healthcare IT News Editor Bernie Monegain acknowledged in a January 2007 editorial, “… the work is not glamorous.  It’s painstaking -- and critical.”

Indeed, some healthcare organizations are experiencing delays and cost overruns.  One CEO of a West Coast health system reported their system was two years behind, in large part, because they needed to undergo a workflow transformation before implementing a new IT system. His comment: "You don't automate inefficient systems. You transform the work processes first, then automate."

A Foundation for Success
Healthcare CIOs agree -- a successful EMR implementation must be built on a foundation of sound document practices and processes.  Those who have neglected the prerequisites of document management have had to retrace steps and incur additional cost to re-implement.
So where do you begin?   Standard Register’s healthcare technology team has identified a list of eight, common practices, documents and process deficiencies that impede the flow of information today and represent serious obstacles to hospital efficiency, effective risk management and EMR readiness. They’re a good place to start before you move forward with your EMR initiatives.

Eight Obstacles to Efficiency & EMR Readiness

1. Antiquated embossing or “blue card” systems present a host of problems during patient registration and beyond.  In addition to the poor image they project, they often result in illegibly-printed information on documents and labels, which can put patient safety at risk.  They also offer no automated means of data collection, slowing access to data by departments that need it. 

2. Manually-assembled admission kits impede the registration process and can present compliance issues, if staff isn’t properly trained.  Is the admissions clerk grabbing the most current, compliant preprinted form?  Are all the necessary documents included in the kit?

3. Preprinted consent forms frequently go unsigned and pose compliance problems. Moreover, as JCAHO and regulatory requirements change, preprinted forms become obsolete, representing further expense.

4. Plastic wristbands with poorly written, embossed or labeled patient information provide no automated means of data collection and project a poor image.  Without photo or sufficient information, patient safety is at risk.

5. Registration processes typically lack effective controls for deterring insurance fraud, heightening the hospital’s risk of non-reimbursement.  What’s to prevent an uninsured patient from “sharing” an insurance card with a friend or family member?

6. The practice of photocopying driver’s license/ insurance card provides no automated way to integrate information into the system and projects a poor image to incoming patients who are left to wait.

7. Clinical forms present additional challenges.  Constant change results in costly obsolescence and raises compliance issues if preprinted forms aren’t fully purged from each department.  

8. With a proliferation of documents, little standardization among them and no bar codes, there’s no effective means of capturing and indexing data.  Posting documentation to the correct EMR patient folder is labor-intensive and error-prone, creating its own set of HIPAA, legal and financial issues.

Of course, there are likely to be other obstacles.  Every healthcare organization is unique. As hospitals are finding, the migration from paper-based records to fully electronic medical records requires close examination of existing documents and processes within every sector of their delivery systems, looking at document content, control and accessibility.

If you would like assistance in developing an EMR readiness plan, contact us.