Considering the entire process to be an ongoing one, there would still be certain issues that may remain unaddressed. It is indeed crucial to handle the networking and security risks that would follow the implementation process of an EMR. Product interfaces, data conversion, documentation and testing issues may crop up once the implementation is done.

Apart from the follow-up training that would be provided, involving an IT representative could help you solve most of the issues that you may face post implementation. Following a systematic approach with regular meetings to deal with the most prioritized one first could prove effective in such a case.

The most important attribute that an EMR vendor should possess and project is that of providing an unbiased source of information. It is advisable to identify and list down the functions that you would expect from EMR depending on your practice requirements. Based on this, few numbers of vendors could be shortlisted for the demo.

Taking guidance from any qualified consultants also helps you to have a broad understanding about the industry. These consultants are knowledgeable and familiar about various EMR vendors and are able to provide credible and unbiased information on the same. One needs to clarify aspects like pricing per physician license, client referrals, post sales support, client /server based and web based distinctions, details of EMR configuration, any negotiations etc.

The focus of the buyer should also be on asking more of open ended questions in order to get detailed information about their system and their process of implementation. This would avoid getting objective answers and have a clearer picture about the whole process. Accordingly, the buyer can consider and decide upon the vendor that meets the practice’s requirements without having to compromise on the needs and desires. Overall, asking the right questions would ensure the most appropriate vendor to be selected.

In order to help oneself in judging the most appropriate EMR for your practice, it is indeed helpful if various aspects relating to EMR are scrutinized. There would be a need to document EMR requirements, conduct hardware requirement analysis, choose between a client-server based model and a web based model, check the affordable cost that could be invested in such an implementation,  certify its CCHIT, HIPAA and HL7 compliance, validate the vendor’s clients list and check the featured modules that  your practice would require.

EMR will usually be supported by certain key features like: Scheduling, Patient Demographics, Clinical Information, Prescriptions, Document Management and Billing. Apart from these, it would be valuable to check any other specific feature that would form a major part of your practice enhancement.

The overview of all the aspects that needs to be evaluated is shown as follows:

There is also a need to know the team involved in such a transformation and the time they would require in implementing an EMR. Most organizations would have a specialized team who would undertake such a responsibility. However, small scaled hospitals and clinics may not have such a facility of a dedicated team. In such cases, they may have to themselves get involved in research work and implementation. Irrespective of the type of practice, the person involved would need to be committed towards accepting such a change.

The doctor, administrator and the office manager need to coordinate and track the implementation issues, deficiencies, decisions made, and tasks assigned. EMR implementation would be driven by the IT team as well, who would be able to connect to such a cause of implementation. The team could develop a comprehensive data which includes details like organizational workflows and processes, hardware installations, software configuration, ways to enter old patient data into the new EMR system, developing a backup system, training to be provided, etc. Aspects like goals, budgets and timelines needs to be taken care of.

Ashok

The need for a high security for Medical Records is very critical given the context of the internet and its abuse, HIPAA provides laws that need to be implemented as part of any EMR or EHR solution. Innovating security of patient record and its interface to the entire eco system of Health Care providers like Labs, insurance, pharmacies, other providers etc is very critical and complex.

Hence it becomes imperative that EMR/EHR solution vendor or technology consultants are chosen based on their technology experience in providing enterprise solutions, their understanding of the HIPAA requirements and domain competence.

Ashok

The pharmacy Industry has entered the “enterprise era” of electronic technologies for clinical development. Virtually all their clinical trials use electronic data capture (EDC). As Electronic medical records (EMR) become more prevalent in offices, Clinics and hospitals; clinical sites and sponsors work towards integrating the collection of Clinical trials and EMR data.

There are two ways in which this can be done:

Via Database Transfer

From each site, the data from an EMR is extracted and transferred to a clinical trial data base. Since this method involves the mapping of database from one system to the other, sites have to first agree to share their data with the central database created for the clinical trial. Privacy issues of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) also create challenges making this a very unlikely approach.

Via Content Labeling

This is the preferred method, the transfer of data through a shared data content labeling standard is used for this method. The Clinical Data Interchange Standards Consortium (CDISC) has developed standards for data interchange and archiving. Using a transactional approach, data would flow from the EMR into an electronic data capture (EDC) system, or vice versa by using either the CDISC or HL7 standards.

The EMR is a highly flexible system designed to accommodate the collection of data from patients with virtually any health problem, at any time. In contrast to this a clinical trial data collection is more highly structured because its intent is to capture specific information, for a specific purpose, at specific times.

Since a clinical trial system may encompass a number of EMR systems but can only be connected to only one clinical trial data system, its more easier, if the data flows from the clinical trial data system (collected by EDC) into the EMR. If the flow of data were in the opposite direction, then each EMR system would require built-in case report forms and the capability to transmit the data to a suitable location in the clinical trial data system.

The Road Ahead

Eventually Electronic submission requirements for clinical trials data will become so pervasive that they will create a competitive threat for companies whoose enterprise technology does not met the challenge.

With years of experience in successfully providing Custom Healthcare Software Development solutions for clients across the globe, we at Binary Spectrum have honed our processes and skills to cater to your specific business needs. Contact us for more information on clinical trial solutions.

Prakash TC. is a Support Manager at Binary spectrum

With hundreds of EMR applications available in the Market, Practices and Medical Practitioners face the unenviable task of selecting a system that will exactly match their requirements. No two practices are identical, so choosing an “off the shelf” EMR application will introduce costly shortcomings in the effectiveness of its use.Almost all practices use some type of EMR application and Practice management Solution. Most Vendors provide complete solutions that are actually well interfaced individual applications. These have their own data bases and data communication is via interfaces. This has been the cause of widespread concern because duplicity of the data entered and the chances of incorrect or forgotten details occurring. Savvy vendors tightly integrate the two there by ensuring that you get the benefit of the seamless work flow.

Preventive Health Care is the key given the drive to bring down the raising health care, Insurance payers are more focused than ever towards paying incentives to providers and plan holders to pay more attention towards direction.

Given this it is important for Health Care vendors or technology providers to provide workflows and alerts in the software to enhance and innovate ways through which preventive health care is driving the care.

To make this happen the EMR or to be precise the charting process needs to see how it could tie the family and social history of the medical record of a patient to alert the physician potentially about the possible preventive measures like diet, tests that the patient must go through to well ahead of time to avoid potential risks.

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• Improved patient safety and overall quality of care
• Reduces or eliminates phone calls and call-backs to pharmacies
• Eliminates faxes to pharmacies
• Streamlines the refill’s requests and authorization processesIncreases patient compliance
• Improves Formulary adherence
• Increases patient convenience by reducing patient trips to the pharmacy and reducing wait times
• Offers true Provider Mobility
• Improves reporting ability

These HIPAA transactions are a set of EDI standards defined to support transactions like verification or elligibility of  patient health plans, process pre authorizations, claim submissions, claim remittance.

These transactions are organized in a sequence of activities that need to be undertaken right from the moment  the patient requests an appointment to the patient checking-in through check-out. 

The HIPAA transactions and the standards to be followed is listed in the following chart in same sequence as discussed above

For more information on either implementing these transaction or buying these components refer to HIPPA Transactions.