Meaningful use may have different interpretation for patients.

Even though I am a health care consultant concerned with health information management and the transition to the Electronic Health Record. I am also a consumer of health care. I was born with a cleft palate. I have since found out that I probably have a condition called Sticklers syndrome. Once this diagnosis was tossed around and landed in my medical record it has caused some concern with obtaining life insurance at a reasonable rate. Now as of today, I have one physician that has uses this term repeatedly and none of my other physicians that I go to even know what it is. This is very frustrating for me especially since I have a career in health information technology. I checked with some of the agencies out there that capture rare disease information and they report that there are 4 cases in the United States that have Sticklers syndrome. I know this is not accurate because since my diagnosis of this condition my own daughter of 23 has been diagnosed with it. I have already myself found numerous cases with the Stickler foundation where I reviewed some of their cases. What a discrepancy with our reporting system? We have some real issues with how things are recorded and reported in the US and so I am excited to see that this issue might finally be addressed and corrected with utilizing an Electronic Health Record EHR) and thus by reporting to patient registries for quality improvement, public reporting, etc.

The second category of engaging patients and families is long overdue. I think if I have read correctly that the committee is wanting to:

• Provide patients with an electronic copy of or electronic access to clinical information per patient preference
• Provide access to patient specific educational resources
• Provide clinical summaries for patients for each encounter

I think that education is the key here. The American Health Information Management Association (AHIMA) has taken an active role in trying to educate consumers and empower them to take more responsibility for their health care information. More needs to be done in this area. Here again I go back to my own personal experience. I have to track my health information so that I can ensure that I receive good quality care. I believe everyone should have access to their personal health information at all times. I really feel that each physician should give the patient a summary of his/her condition after each encounter. This doesn’t have to be in paper format. It could be sent to a flash drive and every patient would have one with their personal health information on it. Of course training would need to be done on how to use a flash drive. (Believe me there are a lot of people who do not even know about them or how they work) The flash drives today are becoming more sophisticated and technically secure. A person can purchase one with password protections, or biometrics. I feel very secure using a flash drive to carry my information to and from my doctor’s appointments. As a consultant, I am also very involved with training the health care providers about the importance of sharing information with their patients. I am also involved with training different health support groups on how to approach their providers when they need information. Training is the key here.

I hope this gave some insight to my thoughts on the term meaningful use. When you look at the term meaningful use one really has to ask themselves who is the end user. Who is the consumer of this information? To me the answer is -we all are.

To find out more on how I am involved please go to my website. www.healthcaretracker.org

The Story behind the Health Care Tracker

My name is Deresa Claybrook and I was born with a birth defect (cleft palate and deformed lip) and as a result of that birth defect I have spent many hours in and out of physician’s offices and clinics as a child. I had a difficult time learning to speak clearly and correctly. As a result of my condition I also have poor vision which required me to wear thick glasses as a child. I also have dental and sinus issues as a result of a small airway and the repair. I can remember being very self conscious of all these facts when I was younger.

At each new doctor’s visit, I can remember my mother telling each physician that I saw all about my medical history. Sharing my medical history over and over again with each new physician and also sharing my current concerns with my physicians is still something that I do today. In fact, we probably all have shared our health care information with a health care provider or two or three at some point. You can probably relate with me because I am sure you know the drill when you go to a new physician and you sit in the waiting room and complete that health care questionnaire. We all know that it is a must needed step but what a time consuming process.

Sharing complete accurate health care information with our health care provider is a very important first step. In fact it is the first step in the health care process. It is very time consuming and a hassle to recall all our health care services and medications while we are waiting in a waiting room but it is one that is essential for quality care.

As I grew older, I realized that I wanted to do something in the medical field but I really did know what exactly. I went down the career path to be a registered nurse but soon found that it was not the right path for me. I later heard about a career whereby I would be responsible for all of the medical records and making sure that what each health care provider did each day along with their staff would be documented and available for years to come. Yes, that is right I became what use to be known as a medical records librarian, today we are called Health Information Management Specialist.

On a personal note, I have been trying to keep track of my own health care information along with my family’s information for years. I am also a mother of two grown children. I also enjoy writing as a past time but that experience in itself really hasn’t prepared me for tracking health care information. For example, in order for me to track my own health care information I have since found out that the hospital where I was born is no longer in existence. Most records were destroyed in a fire. Most of my physicians from my childhood are no longer around. Even as an adult some of my physicians that I have built a good report with are no longer on my insurance plan. This fact in itself has forced me to choose different physicians for my health care. Let’s face it, health care information is a challenge to capture and store.

I decided since I have both the professional and the personal experience of tracking health care information that I would develop a company called Positive Resource Health Care Industry Consultants. (Positive Resource for short) In 2007, I decided to develop a product that is easy to use by both the health care provider and the health care patient/consumer. I decided to call the product the Health Care Tracker. The health care tracker comes with forms and these forms are easy to use and the health care tracker allows you a portable way to use information when you need it most. The health care tracker was developed in 2007 and has been used by thousands and by assisting others with tracking their health care information.

I don’t want to stop there; I want to find out what products really work to track or monitor health care information and make them available to health care organizations and to the public. Health Care organization’s need guidance on selecting and implementing the EHR from an expert, someone who understands records, I want to help with the training and the transition. We all need a good thermometer, blood pressure device in our house but which of these is the right tool for tracking your health care information when you are sick? Do you know? Today, we have the ability to track many different aspects about our healthcare.

I am taking my disability and using it to the best of my ability and helping others. The term for meaningful use has a whole new point. I think everyone should track their health care informmation and have a personal health record. Thank you for allowing me to share with you!

Electronic Health Record and the back side

I am so excited to see so many hospitals, clinics and physicians offices transitioning to the electronic health record (EHR). As a consultant, I definitely see the advantages for the practices on a daily basis. The goal of the electronic health record is to place comprehensive health information at the fingertips of any medical provider who treats that person. Rather than chasing paper records, physicians, nurses and other staff members or even consultants like myself can access the EHR from any department or facility where the patients receive care. The EHR allows physicians and staff members to:
• Document interactions with patients.
• View medical histories and insurance information
• Make referrals
• Order laboratory tests and view test results
• Send electronic prescription requests to pharmacies (reducing the risk that hard-to-read handwriting will lead to medical errors)
• Flag potentially harmful drug interactions

It also provides physicians with “decision support” tools, such as clinical guidelines and checks for drug interactions; and generates printed post-visit summaries for patients, among other benefits.
While these are the advantages to the electronic health record on the front side, there are areas of concern on the back side. As a consultant, who conducts record reviews, I see a lot of waste. Physicians are documenting in a handwritten format and also electronically. I am not sure why they are doing that. Are the physicians still not comfortable with their systems? Is it just that hold habits are hard to break. This is a challenge for me as an auditor I have to scan that information into a data base for review. The problem comes with trying to get from one system to another. Most of the time, I am printing progress notes and other forms from one system out on paper and then scanning to another system for review. At times it feels like I am reinventing the record. This can all better served with a flash drive. The flash drive can really be a great tool. The flash drive can cut down on the re-printing of a record and make it to where two systems can talk to each other.

Just the other day, I was reviewing some past articles on the electronic health record and I come across one that was referencing the original content of what President Bush had envisioned for the Electronic Health Record. This article that I was reading was dated, April 26, 2004. We are now in 2009 five years later. The article read something like this according to a White House document released Monday, the president “believes that innovations in electronic health records and the secure exchange of medical information will help transform healthcare in America.” The briefing memo says Bush envisions “a dramatically changed system” in which patients carry their healthcare information on a keychain and can authorize any physician or clinician to access their full records electronically. Finally the system would serve as a sentinel to alert public health authorities of a possible disease outbreak or bio terror attack. The ultimate goal is to allow medical information to be stored and shared electronically while assuring privacy and security.

I think President Bush was right on target with envisioning a way to carry health care information on a keychain. Even though he was referencing the patients, this concept is great fro a auditor or consultant. I guess I just didn’t think that I would be using the flash drive like that as a health care information management specialist. I am already using a flash drive for my own health care information called the health care tracker but now when I look in my purse or brief case I have several flash drives. The flash drives are encrypted and password protected. The flash drive is definitely the tool for the back side. How do you feel about the fact that the flash drive can be used this way?

PHR growing pains can be fixed.

The personal health record (PHR) is really facing some challenges now as the awareness of the value of the personal health record becomes known to the American public. What good does it do to sit in front of a computer and input medical information about yourself and your family and then have it coupled with data from a billing record when it is not accurate? People are starting to value their health information and billing information more and more. With the awareness of the Google Health products and their involvement, consumers are now more aware of the overall benefits of keeping a personal health record. But don’t be fooled, Google health products has had its share of headaches up to this point. It seems that we have so many choices with these products yet there are no standardizations measures of where the data comes from among any of them, on the clinical side or the administrative (billing) side.

As a consultant, I have seen some of the same issues with the electronic health record (EHR). I have seen where errors in the record constitute errors on the billing record or claim. One thing about the electronic health record (EHR) that is different from the personal health record (PHR) is that during the transitioning process, most consultants recommend that the health care facility or the providers fix their issues before they implement a large EHR system. Most consultants recommend that the issue of duplicate records be eliminated or at least be under control before implementing an EHR. Electronic Health Record systems typically only look at health information when they transition they do not necessarily couple this with billing information. Although most health centers do not review every record that is handed out, there is a formal record process for a hospitalized patient record. The hospital record has several built in steps to ensure that meets quality standards, assembled correctly, coded, billed and maintained properly. The same cleaning process needs to take place with the administrative data if it is going to be incorporated in to the personal health record side. Patients do not know to ask if there billing information is clean or not and they shouldn’t have to. The patient has the right to clean and accurate information on their clinical information and their administrative billing information.

When workflow processes are computerized this does not mean they are automatically accurate. This is the part of the puzzle that needs to be fixed just because we spend millions of dollars to implement the electronic health record or we ask that every patient be responsible for their own health care information by completing a personal health record, does not mean that we will NOT have problems. Garbage in is always equal to garbage out. If this data is not cleaned up in the paper medical record and on the claim or billing side with the insurance carrier, we will be wasting money if it is not standardized in some format. If everyone is not held accountable for their entries into the electronic health record or personal health record then we will be wasting money as well.

How do we fix the growing pains of the PHR? We start with educating the vendors so they are not selling products that are programmed to do more than they should be doing with valuable health care information. There are so many programmers being hired to just make the system work, that the people doing the actual work do not understand that health care information is different in one, how it is used and secondly how it is interpreted. Vendors should work closely with groups such as CCHIT to ensure standardization among personal health records. Vendors should work collaborately with other health care professionals on building a standardization format for the medical record so that it can be used easily with a personal health record. Another important step is to train medical personnel on what to down load on to a thumb drive/CD and what to give to a patient. It begins with education. We now need to switch roles and to train others to take more of an analyst approach to the record. We all need to become quality documentation experts in our own practice. Is there anyone auditing the final process or overseeing the results of the record? This needs to be built in. We cannot afford to sit and wait and become another Mr. DeBronkart who eventually discovered a problem: He found out that some of the information in his Google Health record was drawn from his billing record. His story really could have been a disaster. In the end, he had some good advice for others using a personal health record. He recommends that you check it, to see if it is accurate.

As a consultant, I feel that we are allowing too many hands in the pot. I am very concerned that there are too many people building EHR/PHR systems and they do not have the health information management background needed. I am not only scared for the patients but for the health care practitioners who practice.

Training your Staff on the Electronic Health Record (EHR)

It is a typical busy morning at the clinic. You notice that your staff is busy with their usual duties and functions. You decide to take a minute and instead of going into your office right away you decide to sit in the front waiting room and look around. It is amazing what you see. It is only 9:30 am on a Monday morning and the front waiting room is packed with very ill patients. You watch as your staff pulls their records, greet patients and takes down their information. You also notice there are three receptionists on the phone taking calls and making appointments for future dates. The patients are very restless and fumbling through magazines and tossing and turning in their seats. You think to yourself, how are we going to be able to implement the electronic health record in this type of a busy practice? You know that behind the scenes it is probably more hectic. You have two new medical assistants and you are still one short. The nurses are on the phone making referrals. The coding and billing section is busy dealing with insurance companies that are slow to pay and that won’t return phone calls. You take a big deep breath and decide to go in and face the challenges of the day. Two days ago first thing in the morning after taking off your coat the owner, the main physician informs you that the practice will soon be implementing the electronic health record. The physician also mentions for you not to worry that the vendor would be conducting all the training. You know in your head that the training is not the real issue at hand. You think to yourself, how are we going to stop the train or this case the practice to allow for the training? The physicians want to continue to see their patients. Does this sound like a typical day for you as an office manager at your clinic or practice? Here are some things to think about before implementing the training of electronic health record.

Planning is a very important element. Determine what records will be converted to the electronic format first. Look at what forms you have that you could train on first. Do you have any forms that are standardized? Secondly, look at your staff and their down time? It might not be the best time for training on Monday at 9:30 in the morning. You might want to pick the right time and target group. Look at your overall practice and determine if you want to go live on a certain date with a lighter load. Maybe you know that on Wednesdays your practice only deals with preventive medicine visits. Well women or well child etc. That load might be lighter and easier to implement a electronic record on. You also might want to consider hiring temporary help since you are already short handed and your clinic is busy. Also make the vendor work for you. Ask them what they have done in the past at similar large clinics. How can they streamline the process and make it work effectively?

As an office manager your role is a full one. Communication is a key. Your staff needs to be informed. Find out all the information about who the vendor is and what they will be doing. Yes, it is sad that you didn’t have any input on the selection of the electronic health record but no sense crying over spilt milk, take the bull by the horn and run with it. You have a clinic to run and now an EHR implementation project. Educate or train yourself first. Train yourself on the product, the cost, the implementation time, the training etc. Make yourself an expert. Find out what others are doing in your area. Some large clinics actually hire a project manger so that the office manager can stay focused on running the practice. I wish you the best of luck. For more information please visit www.healthcaretracker.org

Six ways to Recession Proof your Career

I listened to the news again today and I heard more information then I wanted to know about the recession and job cuts. Times are challenging and where do we begin to look for answers on how to recession proof ourselves and our jobs. Some people chose to listen to the media such as radio, television or the internet for information on the economy while others look to a higher power for their answer. Before anyone can really understand how to recession proof themselves they must understand what is going on inside and outside their organization. They need to look outside at the whole world to really understand the recession. Most organizations today are transparent with their finances and with their employees. It is your right to find out as much as you can about your job and its financial position. If you have done your homework on ways to recession proof your job, you can find that the internet gives a whole host of ideas to how to do this. As a Human Resource professional that specializes in training I would like to give you the six steps that really work.

I guess I have to put this comment in here. There is an old saying by Benjamin Franklin that states there is nothing in this world that is really certain except for death and taxes but with that being said we have to think positive. First off to really retain your position you must hold multiple skill sets. If you do not hold multiple skills, at least keep your current skills up to date, be a life long learner and make yourself an expert. What this means is that the employer is looking for who holds the most value to the organization. Those are the ones they generally keep. Ask yourself, Can you cross-train someone? Are you a leader or the go to person on the project if not maybe re- position yourself that way. Some other thoughts are to take a course, go to a seminar, and attend meetings to make sure that you are gaining information and knowledge. The key here is to be valuable.

Second, perform your best and talk up your contributions. This is the time to take on extra duties. Become indispensable. Think of ways to generate revenue. This is not the time to bury your head in your work but work hard and make it count. The key here is to be visible. Most people that are laid off always wished they had done more for their company that they had worked for. So make sure you are taking this time seriously and doing the best and most that you can for your company.

The third thing that is important to recession proofing your job is your attitude. This means no whining allowed. At all times be positive. It is more important than ever to be involved in teams and team activity. Stay away from the gossip and complaint centers in your organizations. Show up at work on time and maybe even delay your vacation or personal time off unless the company requests that you take it. Show the organization that your attitude states that you are for the company first.

The fourth thing is communication. This is a soft skill also known as an interpersonal ability but for the most part it is an important one. Soft skills are personal attributes that enhance an individual’s interactions, job performance and career prospects. Can you communicate effectively with your boss, your peers and your customers? Do you get along with others? Written and verbal communication skills are sought after on almost all job descriptions. It is a must to be proficient in this area.

The fifth way to recession proof your job is to treat everyone like customers. So many of our jobs are being outsourced and it is very important to treat our co-workers, bosses and everyone inside and outside the organization like a customer. Customer service is very important and can mean the difference in success and failure which can mean hiring or lay offs.

The last thing that is important to recession proofing is networking. Do you know what is going on inside the company? Keep a broad perspective. It is very important to always keep your resume up to date. Keep your ears tuned in. If a personnel company calls it is a good idea to return calls from headhunters. Here again the key is to be seen inside and outside the organization, just in case.

Electronic Health Record (EHR) can wait! Recession proof my job!

Let’s get real. Times are challenging and even tuff for some hospitals and clinics. They are considering lay offs if they haven’t done so already. How do you stay a float in these uncertain times? I came across some simple steps for those of us that are employed to keep in mind while we are working through this stressful situation. I am not by any meanings saying that the electronic health record is not an important endeavor but first things first. New projects or even old projects that were set to roll out have been placed on hold for most facilities. For administrators and managers they realize the work still has to get done and when times are lean they have to decide who can get it done best and whom they might have to lay off.
If you want to make sure that you are one of the best, consider honing these skills.

As a human resource specialist, I have seen those that possess multiple skill sets are the ones that employers like to keep. The best you can do for yourself is to get or keep your skills up to date, be a life long learner or even make yourself an expert. Let’s face it there are things that are out of our control such as the date a person is hired. If you were one of the last ones on board having multiple skill sets might be the determining factor of having a job or not.

Another area that managers and the human resource look at before considering someone for a pink slip is their performance and or their productivity. One thing that you can do during this time is talk up your contribution, take on more work, and become indispensable. You can also think of ways to generate revenue or even be the go to person. Making yourself valuable or more valuable is a key element. This is not a time to stay in your cubicle and keep your nose to the ground. Those are normally good traits but being seen is vital at this time because out of sight out of mind.

I have also seen companies have a difficult time letting people go because of their attitudes. Yes attitude can make a difference. Are you a team player? Do you get along with others? I know these seem like such simple traits that most of us learned in kindergarten but they really can make it or break it. Your attitude is very important in challenging times. This is the real case where your attitude could determine your altitude. So keep in mind no whining allowed. Be positive and get involved with teams. On almost every job post or job advertisement they will request that you to be able to communicate effectively. Communication be it verbal communication or written communication is essential and must be done correctly. Knowing how to address customers and others is a key element to customer satisfaction.

So many individuals forget this step; treat your manager and coworkers as your customers. Always remember good customer service without it jobs are cut or being outsourced.

One of the most important things a person can do for themselves is network with others. Networking (internal & external) means keeping a broad perspective. Always have an updated resume close by just in case. Be seen and stay in contact with staffing agencies. This is the time to take their phone calls and see what they have available. I have always advised others to always go on at least one interview a year. This will keep you up to date with the current trends and it will also help your self confidence.

Yes it is true the EHR can wait. People should always come first before purchasing new products or starting new projects. The time for electronic health record implementation is right around the corner and the planning must begin but for some hospitals they are in survival mode. It is sad but it is true. For more information please visit.

Presidents Obama Speech leaves Excitement in the Air on Health Care Reform and the Electronic Health Record

On February 24, 2009, President Obama sent a clear message that he wants to work on three areas, Energy, Health Care and Education. He stated that these issues are the pressing issues for his four year term. Whether you agree or disagree with his position on these major issues I am sure that you would agree if you watched him address congress last night that he knows how to move a group. President Obama addressed the area of energy first. President Obama made the statement that his budget begins with energy. Here is what he said about energy.

We know the country that harnesses the power of clean, renewable energy will lead the 21st century. And yet, it is China that has launched the largest effort in history to make their economy energy efficient. We invented solar technology, but we’ve fallen behind countries like Germany and Japan in producing it. New plug-in hybrids roll off our assembly lines, but they will run on batteries made in Korea. Well I do not accept a future where the jobs and industries of tomorrow take root beyond our borders – and I know you don’t either. It is time for America to lead again. Thanks to our recovery plan, we will double this nation’s supply of renewable energy in the next three years. We have also made the largest investment in basic research funding in American history – an investment that will spur not only new discoveries in energy, but breakthroughs in medicine, science, and technology.
We will soon lay down thousands of miles of power lines that can carry new energy to cities and towns across this country. And we will put Americans to work making our homes and buildings more efficient so that we can save billions of dollars on our energy bills. But to truly transform our economy, protect our security, and save our planet from the ravages of climate change, we need to ultimately make clean, renewable energy the profitable kind of energy. So I ask this Congress to send me legislation that places a market-based cap on carbon pollution and drives the production of more renewable energy in America. And to support that innovation, we will invest fifteen billion dollars a year to develop technologies like wind power and solar power; advanced biofuels, clean coal, and more fuel-efficient cars and trucks built right here in America.
As for our auto industry, everyone recognizes that years of bad decision-making and a global recession have pushed our automakers to the brink. We should not, and will not, protect them from their own bad practices. But we are committed to the goal of a re-tooled, re-imagined auto industry that can compete and win. Millions of jobs depend on it. Scores of communities depend on it. And I believe the nation that invented the automobile cannot walk away from it.
None of this will come without cost, nor will it be easy. But this is America. We don’t do what’s easy. We do what is necessary to move this country forward.

Secondly, he moved into the area of health care. And he stated that for that same reason, we must also address the crushing cost of health care. He went on to say. This is a cost that now causes a bankruptcy in America every thirty seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. In the last eight years, premiums have grown four times faster than wages. And in each of these years, one million more Americans have lost their health insurance. It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas. And it’s one of the largest and fastest-growing parts of our budget. Given these facts, we can no longer afford to put health care reform on hold.
Already, we have done more to advance the cause of health care reform in the last thirty days than we have in the last decade. When it was days old, this Congress passed a law to provide and protect health insurance for eleven million American children whose parents work full-time. Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives. It will launch a new effort to conquer a disease that has touched the life of nearly every American by seeking a cure for cancer in our time. And it makes the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control.
This budget builds on these reforms. It includes an historic commitment to comprehensive health care reform – a down-payment on the principle that we must have quality, affordable health care for every American. It’s a commitment that’s paid for in part by efficiencies in our system that is long overdue. And it’s a step we must take if we hope to bring down our deficit in the years to come. Now, there will be many different opinions and ideas about how to achieve reform, and that is why I’m bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.
I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.

The president then addressed the third challenge. He stated that the third challenge we must address is the urgent need to expand the promise of education in America. In a global economy where the most valuable skill you can sell is your knowledge, a good education is no longer just a pathway to opportunity – it is a pre-requisite. Right now, three-quarters of the fastest-growing occupations require more than a high school diploma. And yet, just over half of our citizens have that level of education. We have one of the highest high school dropout rates of any industrialized nation. And half of the students who begin college never finish. This is a prescription for economic decline, because we know the countries that out-teach us today will out-compete us tomorrow. That is why it will be the goal of this administration to ensure that every child has access to a complete and competitive education – from the day they are born to the day they begin a career. Already, we have made an historic investment in education through the economic recovery plan. We have dramatically expanded early childhood education and will continue to improve its quality, because we know that the most formative learning comes in those first years of life. We have made college affordable for nearly seven million more students. And we have provided the resources necessary to prevent painful cuts and teacher layoffs that would set back our children’s progress. But we know that our schools don’t just need more resources. They need more reform. That is why this budget creates new incentives for teacher performance; pathways for advancement, and rewards for success. We’ll invest in innovative programs that are already helping schools meet high standards and close achievement gaps. And we will expand our commitment to charter schools. It is our responsibility as lawmakers and educators to make this system work. But it is the responsibility of every citizen to participate in it. And so tonight, I ask every American to commit to at least one year or more of higher education or career training. This can be community college or a four-year school; vocational training or an apprenticeship. But whatever the training may be, every American will need to get more than a high school diploma. And dropping out of high school is no longer an option. It’s not just quitting on yourself, it’s quitting on your country – and this country needs and values the talents of every American. That is why we will provide the support necessary for you to complete college and meet a new goal: by 2020, America will once again have the highest proportion of college graduates in the world. I know that the price of tuition is higher than ever, which is why if you are willing to volunteer in your neighborhood or give back to your community or serve your country, we will make sure that you can afford a higher education. And to encourage a renewed spirit of national service for this and future generations, I ask this Congress to send me the bipartisan legislation that bears the name of Senator Orrin Hatch as well as an American who has never stopped asking what he can do for his country – Senator Edward Kennedy. These education policies will open the doors of opportunity for our children. But it is up to us to ensure they walk through them. In the end, there is no program or policy that can substitute for a mother or father who will attend those parent/teacher conferences, or help with homework after dinner, or turn off the TV, put away the video games, and read to their child. I speak to you not just as a President, but as a father when I say that responsibility for our children’s education must begin at home.

Not to make light of his speech but I can see as a health care consultant that we are going to need some positive energy in the health care realm as well. Maybe not the type of energy he mentioned but energy just the same. Government officials that oversee health care issues and administrators cannot afford to manage out of anger. They must all govern with a sense of responsibility or they will be like the banking industry. They must work together with each other. They need to move towards each other. There needs to be more education done on health care reform and the electronic health record to get everyone to agree with how we are going to move on these health care issues. While most are optimistic about our future, I am already hearing of those that are rejecting the budget and the direction our president wants to take us. In order for our health care system to change, we really must look at things differently. We need more than just excitement or energy in the air.

Standardization is a Major Barrier for the Electronic Health Record (EHR) for the Front end user as well as the Back end

Health care information is still very fragmented. The majority of our health care providers still use the paper record and for those that have implemented the electronic health record they are finding that more standardization needs to take place for the process to be successful. The standardization barriers are present on the front end and carry over to all facilities. One of the major barriers is how we capture health information from the beginning. We capture health care information with a pen/pencil, clipboard and a history form. The process usually takes place in a hospital waiting room or health care provider’s waiting room. The forms are all different from provider to provider. There is no standardization of the history form and every healthcare entity can make their form(s) fit their particular need. We are just now starting to see those that have implemented the electronic health record do away with this manual form completion process but still among those that have implemented the electronic health record there is no standardization to the forms process as of yet. The problem of standardization continues inside the health care organization when information is being used for e-prescribing, not all the processes are standardized and not everyone is on board. Anyone that works with health care information on a daily basis is probably familiar with the issues at hand in this area. The good thing is that we are working on the process to fine tune it.

As a consultant, I see some real challenges or barriers that so many people have not begun to deal with of even think about. I am speaking of reviewing records retrospectively for information and quality. If you are a field reviewer or anyone for that matter that needs to look at health information after the fact such as an attorney or an insurance company, there are many barriers to reviewing and retrieving health information health care information. We are all still in a transitional mode and some information is in an electronic format and other information is not but for the most part there is not any standardization to this information. This creates several headaches for field reviewers. Field reviewers are finding that with some electronic medical record software they are not able to electronically send a set of progress notes specifically related to a date of service because the software requires for them to send electronically the entire section of progress notes which is a HIPAA violation. There are instances where electronic health record software system information has to be placed on a compact disk (CD) or printed out to meet the guidelines of the reviewer. There are other times where information has to be printed out before it can even be scanned. This is defeating the purpose of having an electronic health record. With so many different systems it is hard to adequately train reviewers on all the different types of electronic health record software that are available today. Here again no real standardization. In come cases the field reviewer has to sit with an employee at the site so that the employee can navigate the electronic health record system to retrieve the necessary information for the reviewer. This takes away from the advantage of health care information being easier to use in an electronic format.

Standardization is huge barrier. The problem is bigger than just what the health care organization deals with internally and with their scope. Health care information is utilized in the larger playing field. We need health care information to go across city and state lines even nationally. This is a real barrier when there is no real standardization to this health care information. We really don’t want to have socialized medicine structure but we do need some standardization with health information. Even our automobiles that we drive today have some standardization to them. Yes it is true that not every car or truck is alike but for the most part we can get in one and drive it. Sure the windshield wiper switch might be on the left side in one automobile and on the right side in another but we can still drive the automobile. The same needs to be true of health care information. We need to be able to have some set of standards and yet still be able to get behind the software program and navigate it. I believe we are working on this process but my real concern is that there will be money allocated in the near future and everyone will go out and purchase the electronic health record. This will be great when it happens but I still have some reservations. Problems will arise because there is not any real standardization to the health care information that we will be sending across the wire and this will lead to a bigger issue. The bigger issue is the fact that we will not have any real control of health care information. We need to be looking at quality control today. If you would like more information on this topic please view the website.<img src=”http://healthcaretracker.files.wordpress.com/2009/02/ekg.jpg?w=64″ alt=”CB051776″

Stimulus package links Personal Health Records (PHR) & Electronic Health Records (EHR)

Yes it is true the economic stimulus bill, which President Obama signed yesterday has some provisions for the electronic health record and the personal health record. According to a Washington post article that came out yesterday there is a break down of the stimulus package and it states that $20.2 billion has been allocated to health information technology. I have also noted some provisions for the PHR and I am sure they will be included for the EHR. There are some provisions that go along with it the stimulus package. The stimulus package imposed some new consumer protection requirements on vendors of personal health records. The vendors of the personal health records along with the electronic health record must notify affected individuals following the discovery of a breach of unsecured identifiable health information in PHRs. Vendors also must notify the Federal Trade Commission.
There are rules for those that offer third party provisions. If a third-party service provider provides services to a PHR vendor or covered entities that offer PHRs they must notify affected vendors or entities of a beach. The notification shall include the identification of each individual whose unsecured PHR identifiable health information has been, or is reasonably believed to have been, accessed, acquired or disclosed during such breach,” according to the legislation. The Federal Trade Commission (FTC) shall treat violations as unfair and deceptive acts or practices under the Federal Trade Commission Act. The legislation requires the FTC to publish interim final regulations within 180 days of enactment. The requirements will remain in effect unless Congress enacts new legislation governing PHR breach notifications. The provisions for including security breeches is coming at an optimal time and really the needs for such provisions should have been here yesterday because of information being stolen outright or on computers that house personal information. We have all seen the headlines in the past about personal information being lost or stolen.
In a recent article that I read there was a laptop stolen from a hospital in Texas. The article tried to make light of the fact that there was no patient information involved only employee information. Employee information that was lost or stolen included names, dates of birth and social security numbers. As a consultant, I can see how this can happen. So many health care organizations are not really training their employees in this area. How much training does a health care organization really offer an employee(s) on confidentiality and release of information? I know some hospitals that offer a once year approach about confidentiality via an in service with a short video. Most companies panic after the security breach or after the fact and they do not really take it seriously when they purchase computers and hand them out to employees. It is easy for health care managers to think that since most individuals that work with confidential information are trained initially and are professionals that more training isn’t really needed in this area. This type of thinking is wrong. For those of us that deal with confidentiality and with protected health information this issue needs to be on the front burner at all times in the health care setting.
Even though the stimulus package includes provisions for breeches it really needs to include training on protected health information and security. If you would like more information about health information security, please feel free to contact us.