Are your customers EMR-ready?

Edition: March 2009 - Vol 17 Number 03
Article#: 3147
Author: Repertoire

No one expects you to be an expert on electronic medical records (EMRs). Nonetheless, as more and more physician customers rely on automated billing and medical records, and demand systems that accommodate their diagnostic equipment, as their trusted consultant, it's in your best interest to steer them to the best choices.

Knowing where to begin

With so many information technology terms tossed about, it's important that your physician customers have a basic understanding of health information systems. For instance, the Obama administration has expressed its commitment to creating a nationwide system of electronic healthcare, which it says will enhance patient safety, save money and create jobs. Obama's plan presumably would focus on electronic healthcare records (EHRs), or longitudinal health records that document a patient's health history across various institutions and medical practices. "The electronic health record represents the ability to easily share medical information among stakeholders and to have a patient's information follow him or her through the various modalities of care engaged by [him or her]," says Michael Paquin, president of MPD Group Inc. (Thousand Oaks, Calif.) and a Fellow with the Health Information Management Systems Society (HIMMS).

Electronic health records rely on electronic medical records (EMRs), which Paquin describes as legal records created in the hospital and ambulatory environments that is the source of data for electronic health records. While it is important for physician practices to distinguish between EMRs and EHRs, their first concern generally is to be EMR-ready in order that, down the road, they will be EHR-ready, he says.

Easier said than done. Often, there is the issue of cost. "One- or two-physician practices are getting hammered on cost," says David Bull, director of marketing, Midmark Diagnostics (Gardena, Calif.). In many cases, electronic medical records can present a major expense unless smaller practices can share resources, he explains.

To minimize costs, some small physician practices rely on outside services, such as application service providers (ASPs) or data farms, which host Internet services for a monthly fee, according to Lathe Bigler, senior business development manager, Midmark Diagnostics. But, such solutions present challenges to physicians. It can be difficult to send large amounts of data, such as EKGs or Holter readings, over the Internet without experiencing interruption or "timing out," he says.

The right solution

Even when physician practices have the resources for adding EMR, they can find the process overwhelming. That's why, when physicians solicit sales reps' advice on EMRs, reps should focus on what is the right solution for each customer, says Bigler. "That's the best service they can offer," he says. Still, that's a lot to ask of distributor reps, who are clinical equipment experts, not computer experts, he adds.



Reps should begin by determining just how EMR-ready their physician customers are. To do so, they should ask the information technology expert at the practice several probing questions, such as the following:

"What is your EMR strategy? If you do not already have an EMR, do you plan to add one (or upgrade your current system)?"

"Do you hope to achieve a paperless office?"

"What EMR system do you currently have?" "What software version are you using?"

"What clinical equipment are you using?"

"How is this equipment arranged?" "Do you have an in-house computer system, or are you relying on an Internet or outside software service?"

"What is your timeline in which to achieve your EMR goals?" (It would be a mistake for a rep to sell a practice an EKG system, for example, that won't support a new EMR, according to Bull.)



If the practice lacks an IT "go-to" person, the distributor rep should bring along a manufacturer rep, who is trained on both the clinical and support side of diagnostic equipment.

"There are 350 EMRs out there," says Bull. Some medical device companies may have several computer platforms, meaning that physicians require some form of connectivity to ensure all of their equipment can work together on the same EMR. "Often, the distributor rep helps the physician get [his or her] equipment set up, and there is no response," says Bull. This can be frustrating to both the rep and the physician, he adds. Calling in a manufacturer rep can save time, as well as wear and tear on one's nerves. Midmark has one computer platform, adds Bull. "If one piece of diagnostic equipment works [on a particular EMR], they all will work."

Maintaining standards

While manufacturer reps do, indeed, provide tech support for distributor reps and their physician customers, physicians can draw on other equally important resources for help. A key group is the Certification Commission for Healthcare Information Technology (CCHIT), an independent certification body for electronic health records and their networks. "For [physicians] who are EMR shopping, CCHIT is a great place to start," says Bigler. "There are so many applications out there, and CCHIT provides a means of maintaining requirements and standards, to ensure greater interoperability." Reps should direct physician customers to the CCHIT Web site, www.cchit.org.

EMRs and EHRs must be organized around some specific objectives, adds Paquin. These include:

Functionality. The ability to create and manage electronic records for all patients at a physician practice and automate the flow of work in the office.

Interoperability. The ability to receive and send electronic data between an EHR and outside information sources, such as labs, pharmacies and other EHRs in physician offices and hospitals.

Security. The ability to keep patient information safe and private.

CCHIT certification ensures that physicians purchase systems that adhere to these standards, he points out. "CCHIT has provided for the advance of software innovations and nationally recognized standards for healthcare data creation, storage and exchange," he says. "CCHIT [has enabled] EHR vendors to incorporate innovations and standards into their development cycles and test their products before releasing them, [as well as] provided a schedule for the criteria needed."



Reps should also make their customers aware of the various associations available to answer their EMR-related questions and guide them in their EMR purchases, notes Bigler. "All major medical associations have resources for helping physician practices select an EMR," he says. This includes the American Academy of Family Physicians (www.aafp.org), the American College of Cardiology (www.acc.org) and all major OB/GYN societies, he adds. In addition, the following groups provide EMR services as well:

Towards the Electronic Patient Record (TERP ™). Provides road shows with EMR presentations, speakers and advice on purchasing and implementing EMRs. www.tepr.com

Healthcare Information Management Systems Society (HIMSS). Provides EMR shows, presentations, speakers and consultation on purchasing and implementing EMRs. www.himss.org.



But, perhaps the most important advice distributor reps can give their physician customers regarding EMRs is to network with other physicians who have added systems to their practice, according to Bigler. "Physicians should find out what other doctors like and don't like about their systems," he says.