EMRs at work at Detroit marathon

DETROIT – Henry Ford Hospital researchers took electronic medical records onto the marathon route last year to show that the technology could make it easier to care for runners. The researchers presented the results recently at the American Medical Society for Sports Medicine's annual meeting in Mexico.

The study is believed to be the first time researchers have evaluated the viability of using electronic medical records for injury management and surveillance during a marathon, according to Christopher Guyer, MD, athletic medicine physician at Henry Ford Hospital and lead author of the study. Volunteer medical providers at the 2009 Detroit Free Press Marathon coordinated care for the 19,372 participants via laptops and a Web site.

Among the benefits of using an electronic medical record system were:

All medical team members were able to coordinate patient care in real time with other medical providers and hospitals.
Race organizers and staff could quickly assist families in locating injured marathon participants or spectators along the route.
Researchers will have data available to them that should improve the ability to identify trends in injury patterns and as such, improve the preparation for future mass participation events.
"Our study showed implementing an electronic medical record method in a mass participation setting is quite feasible and could eventually provide a wealth of data for study of injury trends," Guyer said. "It could also help medical providers better prepare for future large sporting events."

According to Running USA, a non-profit organization for the running industry, approximately 467,000 Americans complete a marathon each year, and with rising interest in the sport, has come the increased need for coordinated event coverage by qualified medical providers.

Guyer said that in preparation for the Detroit Free Press Marathon, an information technologist with the state's Medical Biodefense Network created a secure patient intake form and event log, accessible on the Internet. The form included basic demographic data for marathon participants and spectators, as well as fields for complaint, exam, treatment and disposition data. All patient information was stored on a secure server and patient confidentiality was maintained as records reflected race bib numbers or unique identifiers generated by the application.

Medical providers from Henry Ford Hospital and the Detroit Medical Center were able to access the Web site by using a unique username and password, and with one training session were able to use the system easily, Guyer said.

During the marathon, military-grade mobile laptop computers equipped with cellular data cards were issued to medical providers. One laptop was located at each remote first aid station and one was at the main medical coordination center. An electronic event board was also available in the coordination center, viewable by medical command staff. The equipment was provided by the U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response Hospital Preparedness Program.

"Data from the 216 runners and spectators who sought medical attention was entered in real time by medical providers and was immediately viewable by other providers on the network of aid stations," Guyer said.

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Sunny Outlook for Small Practice EMR Adoption, Meaningful Use Cloudy

CAMBRIDGE, MA – The percentage of small physician practices that are planning to implement an EMR has grown in the last six months, according to a new vendor survey. But while the percentage of respondents who said the American Recovery and Reinvestment Act (ARRA) was driving technology adoption more than doubled during this period, most are still unaware of requirements and nearly half say it will not impact their buying decision.

Cambridge, Mass.-based NaviNet, America's largest real-time healthcare communications network, conducted the survey via email earlier this month, targeting physician practices with 10 or fewer physicians. The survey generated 269 responses.

NaviNet compared its March 2010 survey with one conducted in August 2009 and found that EMR implementation was higher than expected among this segment. In 2009, only nine percent of respondents from provider practices with 10 or fewer physicians reported that they planned to implement EMRs within the next six months. Six months later in 2010, 12 percent are currently implementing.

EMR PLANS UP
The survey found that 17 percent of respondents say their offices will implement a new EMR by end of 2011. Of those, 68 percent will do so within the next 12 months. If EMR adoption follows previous growth rates, the industry can expect an even higher percentage of practices implementing EMRs than predicted, NaviNet projects.

The percentage of respondents with no plans to implement an EMR has decreased significantly, the survey found. In 2009, 31 percent reported they had no plans to implement EMR. In 2010, only 21 percent say the same.

ADOPTION DRIVERS
The NaviNet survey indicates that nearly twice as many provider offices' IT buying decisions are driven by concern about not being reimbursed versus the potential to earn incentives.

In 2010, when respondents were asked what external factors were influencing their offices' decisions about changes to technology, 53 percent said CMS mandates––a 14 percent spike over 2009.

Administrative concerns continue to be a pressing issue for providers, more so than clinical concerns or potential financial incentives. Nearly the same percentage of respondents in 2009 and 2010 cited the need to manage their practices' administrative overhead more effectively as a driver behind IT adoption––44 percent in 2009, 45 percent in 2010.

The survey results show that the opportunity to receive incentives from ARRA after meeting the CMS criteria for "meaningful use" of technology is becoming more important; in just six months the percentage of respondents that said ARRA was driving technology adoption more than doubled––12 percent in 2009 to 27 percent in 2010.

MEANINGFUL USE
That said, the survey found that in 2010 most practices are still unsure or unaware of meaningful use reporting requirements and nearly half of practices say ARRA will not impact their technology buying decisions:

* Only about one quarter (26 percent) of respondents said that they plan on following CMS' guidelines for meaningful use to qualify for incentive payments provided by ARRA;
* More than 60 percent (63 percent) said they were unaware or unsure of what the meaningful use reporting requirements are; and
* Nearly half of respondents (48 percent) said that meaningful use requirements will not impact their EMR buying decisions.

"The NaviNet survey results are encouraging, as they suggest that small physician practices are getting more serious about HIT adoption," said Brad Waugh, president and CEO of NaviNet. " Furthermore, it is also encouraging to see federal incentive programs having more of an impact on IT adoption. However, it is clear that opportunities remain for education about how to meet Federal requirements. Providers would benefit from knowing that a wide variety of IT solutions, in addition to EMRs, will satisfy their office's business requirements and also the clinical criteria for Meaningful Use. Many physicians already have these solutions in their offices—so additional investment could be minimal or unnecessary."

ADOPTION BARRIERS
In 2010, nearly 50 percent of NaviNet survey respondents said that cost remains the biggest barrier to EMR adoption. Other barriers cited by respondents were:

* Forty-six percent of physicians said they are not ready to pursue adoption;
* Twenty-seven percent of practices say they do not need an EMR; and
* Twenty-six percent of practices do not how they will achieve return on investment.

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Cerner News Cheers Investors

KANSAS CITY – Analysts are bullish after the investors meeting held Thursday by Cerner, the Kansas City maker of EMR and CPOE systems.

"Overall we walked away with a greater level of conviction that Cerner 'gets it,' and will continue to gain marketshare in a rapidly evolving industry," wrote Piper Jaffray research analysts Sean W. Wieland and Mohan A. Naidu, who reiterated their "overweight rating" and $98 price target for the health IT giant.

The pair were encouraged by the growth that could be afforded by ARRA funding – monies disbursed both to Cerner itself and its provider clients – noting that the company "still expects to see a lot of opportunities from the stimulus. Specifically, their base of customers should receive about $8 billion in stimulus funds, and the company expects to see about $2 billion of this."

Cerner expects that "there will be about 2,200 CPOE decisions," the analysts continued, "and about 1,250 of those are greenfield with no existing clinical system. Most of those are critical access hospitals with [fewer than] 100 beds. During the CIO panel, we learned that there is very little chance of the timeline getting pushed out (in contrast to recent reports)."

Moreover, Wieland and Naidu were pleased that Cerner execs offered "a glimpse of growth opportunities beyond the stimulus, and numerous opportunities that could drive upside to numbers." Management expressed intent to "grow operating margin by at least 100 basis points per year on double digit revenue growth," they wrote. "We interpret that as a worst case scenario, not guidance."

Finally, the analysts expressed optimism about the company's plans for global growth, writing that president Trace Devanny's recent relocation to London "tells us that Cerner's commitment to international expansion is real," and noting Devanny's indication that the company feels "global opportunity eclipses domestic opportunity."

Specifically, the pair mentioned some Cerner projects in France due to be completed later this year, "which we believe will be a catalyst for international revenue growth in 2010. In our view, if the company can get international revenue to return to 2008 levels, it would likely drive upside to numbers."

Cerner (CERN) stock closed at $85.15 on Thursday, up from $41.48 on the same date last year.

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Gingrey: HIT Stimulus Bill 'Right Thing to Do'

ATLANTA – In the HIE Symposium’s opening keynote, Congressman Phil Gingrey, MD (R-Ga.), said using the stimulus bill to drive adoption of integrated EMRs is “absolutely the right thing to do.” Gingrey called the bipartisan health IT efforts “the single most important thing we can do” to bring down the cost of healthcare.

In order to have a fully integrated healthcare system, physicians need to be able to buy certified technology and have access to a health information exchange infrastructure. The industry also requires having a qualified workforce to facilitate these endeavors, he said. The American Recovery and Reinvestment Act’s HITECH Act covers those areas through incentives to healthcare providers and funding for health information exchange and regional extension centers, he said.

Gingrey said he is in favor of the incentives and penalties structure of the HITECH Act.
Co-keynote presenter Rhonda Medows, MD, commissioner and state health officer for the Georgia Dept. of Community Health, pointed out five success factors for state-level HIEs. True leadership is required. With leadership often changing, it’s critical to plan for those successions in order to have sustainability and continuity, she said.

True collaboration involves not just collaboration among public and private entities, including the business community, but also across the continuum of care, she said. Medows emphasized that clinical care should go beyond individual encounter to impact such areas as population health and emergency preparedness.

While funding is being dispersed for EMR implementations and HIEs, sustainability once those funds are gone is critical, she said. Stakeholders need to come up with financial strategies that involve concerted efforts to invest multiple resources. States need to review their current laws and administrative policies to determine their impact on HIEs, Medows said.

Finally, communication is key. Health IT enables communication. At the end of the day, the industry needs to be able to say these efforts improved care of the patient and delivery of healthcare, enabled the measurement of the effectiveness of care, enabled the use of data for such things as population health and emergency preparedness, and prompted innovation in healthcare, Medows said.

The ultimate customer is the patient and consumer, she said. “We intend to deliver with your health,” she said. “HIT is a wonderful thing. It’s a great opportunity.”

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MEDITECH

An EMR implementation can be one of the most significant investments in terms of both time and money hospitals and clinics face. Profero Solutions consulting services provides experienced consultants to support your MEDITECH EMR implementation. Profero Solutions can augment your current staff in these critical areas:

* System Selection & Strategies
* Project Planning & Management
* Creating Training Curriculum & Materials
* Proven Ambulatory & In-Patient Implementation Models
* Workflow Assessment, Development & Validation
* Advanced Clinical Documentation Tools

A critical factor in a successful EMR implementation is an effective, efficient Go-Live strategy. The Go-Live stage of an EMR implementation is critical to the adoption by your staff and getting you to your expected ROI. Profero Solutions has the ability to provide local licensed clinical staff professionals to augment your existing staff in the following areas:

* Training & Training Support
* Unit and Integrated Testing
* Hot Line Staffing during Go-Live
* End User “Elbow Support” during Go-Live
* Super User Development
* Clinical Documentation Tools Development
* System Optimization

For more information visit: www.proferosolutions.com

McKesson

Profero Solutions provides consultants with proven experience in McKesson software modules and in many cases they are cross-trained between multiple software disciplines. This cross-training can bring a level of expertise to the project that will result in time and cost savings. Whether your project involves a multi-clinic install or upgrading a McKesson release, Profero's consulting services group is ready to support your EMR implementation.

Are you ready to meet the economic stimulus meaningful use criteria? This effort requires allocating the extra resources to get it done. Augment your staff with Profero Solutions consultants to expedite the process. Our McKesson consulting team can assist you with the following:

* System Selection & Strategies
* Project Planning & Management
* Creating Training Curriculum & Materials
* Proven Ambulatory & In-Patient Implementation Models
* Workflow Assessment, Development & Validation
* Advanced Clinical Documentation Tools

The Go-Live stage of an EMR implementation is critical to the success of the project. In addition to consulting, Profero Solutions has the ability to provide local licensed clinical staff professionals to augment your existing staff in the following areas:

* Training & Training Support
* Unit and Integrated Testing
* Hot Line Staffing during Go-Live
* End User “Elbow Support” during Go-Live
* Super User Development
* Clinical Documentation Tools Development
* System Optimization