Presentation
Course details
Presentation of attendies

Difference between EMR & EHR
History & Background
Why EMR? - Folds financial and clinical “sides”
together.

Improving the efficiency and effectiveness of
healthcare operations
Improving patient care
Changing trends in EMR and its future
• Mobile
• Cloud
• Big Data
• Analytics

Standardization
• Interoperability -Exchange of
information/data across
platforms/applications/devices
• Lab - As true data not “pictures of the
reports”
• Imaging
• Referrals (incoming and outgoing)
• ePrescription
• Health Ministry (local,regional, national),
i.e. diseases outbreaks (eg. Ebola case)
• Devices (EKG, spirometer, glucometer,
Holter, etc.)
• Chart Notes, Other Health Data
• HIPAA Privacy and Security
• EHR Safety Alerts
• FDA's Role

Sinister / parasitic
• Control over 1/7th of the economy
• Easier to convict fraud/abuse
• Governmental agencies get the ability to
access your info
Should government be involved? (Debate)
• Positive
• Deepest pockets
• Centralized control/command/authority,
one entity gets to decide

• Negative
• Centralized control/command/authority,
possibility of abuse
• Getting hundreds of independent entities
to agree on anything is near impossible

Vendor flexibility/capability
• interfaces to outside systems (dictation,
accounting,document management...)
• FHIR Interoperability (API)
Forward thinking
• Solves tomorrow’s problems before they
become today’s crisis
Makes use of public domain data
• NPI database
• USPS database
• CCI edits
• Medicare fee schedule RVUS
Who owns/maintains the data ( and has access
to it)
• what about when you leave
• Can you get a “readable” data backup? At
what cost?

Should I import the data from my old system?
Registry
• Reporting to agencies
• Diseases: STDs, SARS, Ebola
• Vaccination status
What about free EMRs?
Bridge the EMR to PACS/Implementing &
Integrating PACS system into EHR
• Integration of PACS & EHR system
• Clinical impact of PACS
• Future of PACS with EMR

Why do physicians need a governmental
incentive to do something that ultimately
benefits physicians
• Historical pricing...EMR costs have
plummeted from their $100K price (~2003)

• $44K via Medicare ~ 63K via Medicaid
Meaningful Use
• You can’t just buy/rent an EHR and expect
to get incentive
• Definition of Meaningful Use
• Like any government-run program....it’s
fairly complicated
• Why require “Meaningful Use”?
• Stop physicians from buying/renting
software (that maybe doesn’t even work)
to get the incentive money
Components of Meaningful Use
• Core measures
• ALL of these measures must be satisfied
• Menu measure
• Practice chooses which of the measures
to participate in
Mechanics of Meaningful Use
• Why bother?
• Carrot - 18K incentive - It can cover your
cost of implementation
• History of EMR/EHR costs
• Stick - 1% penalty for NOT participating
in Meaningful Use (Growing to 3%)
Hospital systems vs physician systems
• Why so different?
• DRG (event) vs CPT (encounter) driven

Localization of EHR system
How to create venue specific workflows to
simplify EMR use
Fully functioning multilingual; EHR system
User friendly systems
Customization and intuitive embarked
technology in EMR system design

CPOE and referrals save employees
Duplication of efforts & resources
• Data entry
• Paper storage, square footage
• Security - protecting items you don’t really
need
Referral process (both inbound and outbound)
• Most offices have half an employee per
physician to manage referrals
More accurate and/or higher codes to be billed
(and documented)
• Code coaching - a 2-edged sword

• How it’s purchased and installed…
• Training - Don't skimp
What will the EMR look like in the future
• Device
• Voice to text/commands - how far behind
is thought to text?

• Existing systems deficiencies
• Systems compatibility with future
development
• Preparing staff and management for shift
of technology
• Status of EMR/EHR implementation in the
region
• Investigate the existing disparities
• Latest Development in public & private
sector
• Innovation
• Future trends & objectives

Tests
Certificate distribution