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Author Archives: Praxis EMR

New EHR Survey shows users want more than just the basics

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A recent survey by Software Advice, in collaboration with Research Now Healthcare, found that many of the most common concerns for prospective EHR buyers are no longer such overwhelming problems for current users. The ongoing survey has collected responses from over five hundred EHR users to date.

The results show that 58% of users had little or no problem with the costs of supporting the system. 49% believed that learning to use the EHR posed little, if any, challenge. In addition, achieving government Meaningful Use standards was little or no problem for 61% of users. These numbers suggest that several of prospective buyers’ most pressing concerns are not echoed by current users– in other words, EHRs tend to work better in these areas than many non-users expect.

The survey also found that 50% of users thought that reduced productivity was a moderate or major challenge. Another 55% felt the same about integration with other systems. Customization was a major problem for 20% of users and a moderate problem for another 29%.

Interestingly, many of the major challenges presented by the study are Praxis EMR’s major strengths. Among its users Praxis has allowed for a major increase in productivity by decreasing the time needed to document cases. One of the key features of Praxis is its ability to smoothly connect to all users in the Praxis network to one another, as well as to pharmacies, labs, and other administrative services. Praxis was founded on the basis that each doctor practices uniquely and deserves a system they can personalize without the use of a template.

The overall results of the survey suggest that EHR users are more satisfied than they have been in the past with basic EHR functions. They are now beginning to seek more advanced features, such as personalization and better interoperability with other tools. Overall, it is clear that physicians are becoming more comfortable with the EHR basics and beginning to demand more of their technology.

See the survey here.

Survey: The era of the EHR switch is far from over

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Source: The EHR Software BuyerView 2014 Report, Software Advice

Source: The EHR Software BuyerView 2014 Report, Software Advice

According to a recent study on 385 randomly selected medical practices by Software Advice, Inc., 40% of EHR buyers are looking to replace their EHR. The desire for better technical support and more integration between applications ranked among the top reasons for replacement.

From the first quarter of 2013 to the first quarter of 2014, the number of buyers seeking EHR replacements grew by a third. Of the 2014 buyers, more than 50% cited cumbersome software, the desire for integration, or inefficiency of prior EHR systems as the reason for seeking new technology.

In the assessment of concerns for new software, it was found that about 40% of buyers were most concerned with strong mobile support. 89% of buyers wanted software that would integrate with other applications, including billing and patient scheduling.

Of those surveyed, 47% were medical practitioners, while 36% were owners or directors. All expressed a desire for a system with government compliance that could be implemented quickly and efficiently. The trend in growth of EHR buyers is expected to continue in coming years.

The EHR dissatisfaction crisis: looking beneath the surface

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The rise in provider dissatisfaction with EHRs and the second-time buyer boom have been well-documented and much-discussed. However, when analysts look to understand the cause of this dissatisfaction, they identify only superficial reasons: lack of training, workflow issues, price, or poor customer support, to name just a few. They fail to look deeper and miss the underlying structural cause of physician frustration.

When they break down the reasons for the poor reception of today’s EHRs, analysts are missing a crucial point: doctors are dissatisfied with major EHRs because they are all built in the same flawed manner. Templates are the reason for the plummeting survey results and the rapidly increasing second-time buyer contingent. Templates overwhelmingly slow doctors down, create unnecessary and uncomfortable new workflows, expose doctors to the risks of sub-par documentation, and more – yet nearly ever major EHR uses them.

If the EHR industry is to address usability problems, it must look beyond the symptoms and find the underlying cause: the structure and nature of templates.

Template-free Charting At HIMSS13!

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For the first time in our 20-year history, Praxis EMR was a first-time exhibitor at the HIMSS Conference & Exhibition in New Orleans March 3 – 7, 2013.

The Exhibition was an amazing opportunity to share our unique technology with attendees.  We had fascinating conversations about what EHR usability really means, and how to use our template-free system to help doctors practice better medicine.  In addition, we were honored to see Praxis user Dr. Jeremy Bradley receive the HIMSS Davies Award for excellence in the use of electronic medical records.

Overall, an exciting and informative week. Check out these photos of our booth!

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Interfacing and Interoperability: not an EHR selling point

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It may sound counterintuitive, but it’s true: interoperability should no longer be a major selling point when looking for an EHR.  Why?  Because every good EHR should be fully interoperable.  And soon, every EHR will have to be interoperable.

Interoperability is one of the most exciting areas of health IT: it holds incredible potential to change the practice of medicine, and can dramatically increase the quality of treatment patients receive.  As we all know, the federal government has provided increasing support for interoperability initiatives in recent years.

Many of the major EHRs attempt to impress physicians with their size, then boast that their systems can “talk to,” or are compatible with, a range of billing software, other hospitals, and other EHRs.  Uninformed EHR buyers are overly impressed, and move to purchase one of these systems.  It’s true that interoperability is a crucial part of any EHR: so crucial, in fact, that you should never purchase an EHR that is not fully interoperable. For that very reason, though, interoperability is not a special benefit or selling point.

The federal government has stepped in and mandated interoperability.  When these requirements are fully implemented, any certified EHR  will be able to exchange information with any hospital, laboratory, medical equipment, or billing software, as well as with any other EHR.  Software that can not achieve full interoperability is simply not certified.

In other words, don’t let the issues of size and compatibility distract you in the EHR search: purchase your favorite EMR, large or small, as long as it is ONC-certified.  All EHRs and health centers will be required to interface with yours.

Never let any EHR company sell you interoperability as a special or unique feature.  It’s time to go beyond interoperability and talk about what really differentiates today’s EHRs: usability.

 

Choosing the Right EHR is a blog series about the many factors to consider when purchasing an EHR.  It offers important perspectives for doctors looking to purchase their first EHR, as well as those who are switching to a new system.

Is your EHR an automobile or a tricycle? The quick-start myth

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Many doctors say, “I want a no-brainer of an EMR that is easy to learn and is very cheap, free if possible. In fact, I want to try it out without any reading or training whatsoever.”  Be careful what you wish for: you are bound to get it!

No one would argue that it is easier to learn to ride a tricycle than to drive an automobile.  Few, however, would claim that a tricycle is more usable – at least, we don’t see many adults driving tricycles to work these days.  Indeed, tricycles are so simple that three year-olds can use them without training, while many of us spent a semester in high school learning how to drive a car.  Completely free of context, therefore, a tricycle is more “intuitive,” even more “usable,” than a car. However, a tricycle’s quick learning curve is easily overshadowed by the automobile’s superior power and functionality.

For these reasons, when an EHR promises that you can “learn in minutes” or “be up and running instantly,” take a second look.

All of the best EHRs require training – in fact, studies show that the level of EHR satisfaction is directly correlated to the amount of training users have undergone.  The better you know your EHR, the more it will do for you, the more satisfied you will be.  On the other hand, EHR users with the least amount of training are generally the least satisfied. Many of the best EHRs cannot be learned in just five minutes, but they are superior tools that will do more for your practice.  Take time to learn your EHR, and you will be rewarded.

Don’t be distracted by the appeal of the quick (or “instant”) start-up.  Instead, take a look at what the EHR can do for you on a day-to-day basis after suitable training.  If a program were to save you two hours a day for the rest of your professional life, how much time would be reasonable to learn how to use it right? This is the real question to ask yourself and your EHR vendor.

Choosing the Right EHR: the only list you need to read

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We are excited to introduce Choosing the Right EHR, a blog series on the many factors to consider when purchasing EHR software.  The EHR market is changing rapidly: companies are appearing and disappearing, federal requirements are changing, and technology continues to evolve.  Recommendations that were helpful five, three, or even one year ago no longer apply.  This blog series will give you tips that are applicable to today’s EHR market.

This is the first year since the advent of EHR technology that over 50% of doctors shopping for EHRs are second-time buyers. Purchasing an EHR is one of the most important decisions doctors will make in their careers, and yet many doctors still don’t have enough experience or information to make the decision that is right for their practice.

Our blog series will explain the following key points in detail:

When choosing the right EMR:

  • Plan to invest time in your research
  • Ask yourself “Why Now?”
  • Never delegate your EMR selection to someone else
  • Read reputable surveys
  • Be aware of the dangers of templates
  • Look at EMRs that are built for doctors
  • View demos, but don’t stop there
  • Watch a practice in action
  • Focus on the software and the needs of your practice

Don’t be seduced by:

  • Gadgetry: every good EMR is compatible with any device
  • Interfacing and interoperability: every certified EMR is interoperable
  • Dashboards: tracking performance criteria should be a built-in feature
  • The myth of integration: choose software that is built for doctors, not for everyone else
  • Web vs. server hosting: both are viable options
  • Instant startup: the best and most sophisticated EMRs require training

Remember:

  • Your EMR is a medical tool that should:
    -Save you time
    -Improve the quality of medicine you practice
    -Reduce information overload
    -Make your life easier and reduce stress
  • The best EMRs require training
  • The Gold Standard: does this EMR help or hinder my practice of medicine?
  • Federal requirements and Meaningful Use are important, but not the only reason to buy

Stay tuned!

Billing and EHRs: the myth of integration

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Until a few years ago, billing applications took advantage of doctors’ lack of familiarity with EHRs to sell “integrated solutions.” According to this marketing pitch, an EHR is better and more effective when it contains all of the functions needed in a clinic, including billing and other administrative task management. Although it sounds attractive at the outset, this logic is fundamentally flawed: an EHR is an incredibly complex product, and is therefore best designed and developed by and for physicians, not by billing experts.  Studies on usability and satisfaction tell us just that- and have done so for years!

The goal of billing software is to make you the most money at the lowest cost and with the least effort. Companies with good billing platforms are successful because they know how to best maneuver through the insurance system and other red tape. But what does that have to do with medicine? You’ve got it- nothing! Why would anyone assume that great billing companies would also make great EHRs? And why would anyone assume that great EHR companies also make great billing software?

Fortunately, after seeing continuous failure and customer frustration, many billing applications have stopped attempting to develop EMRs and have adopted new strategies. Billing platforms now form strategic alliances with what they perceive to be the best EMRs. The theory behind this approach is solid, and a win-win for all concerned: if your clinic is happy with your billing service, why change simply because you need an EMR? While “integrated solutions” seem to be convenient “one-stop-shops” for all of your clinical needs, they will cost you in the long-term. In contrast, good billing programs contain added value because they earn money by optimizing reimbursements.

Do not be deceived by the integration myth. In today’s technology market, any superior billing application should be easily interfaced with your EMR of choice, and most interfaces should be completed at no charge. The myth of integration has been a major factor in the rise of user dissatisfaction in the EHR market. It is time for doctors to rise above this marketing pitch: demand specialization and interoperability from all of your medical tools!

CMS warns that templates don’t make the cut: Template users face Medicare denials

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EHR templates have long been under scrutiny, but only now are consequences being established for the use and mis-use of templates. In a recently published addition to its instructions for payment review contractors, Centers for Medicare and Medicaid Services (CMS) states that templates do not provide adequate documentation of clinical encounters. In fact, in cases where templates are used without other documentation, progress notes will not qualify for Medicare payments. As stated in CMS instructions:

“Review contractors shall remember that progress notes created with Limited Space Templates in the absence of other acceptable medical record entries do NOT constitute sufficient documentation of a face-to-face visit and medical examination.”

This change in CMS review guidelines follows a string of criticism in recent months regarding the limitations, and even unlawfulness, of EHR templates. While not all templates use or allow for the much-maligned copy-and-paste feature, all templates limit user input in some way, whether it be by pick-lists, checkboxes, or boilerplate fields. Further, some templates are built primarily to maximize revenues, not to document detailed information about the care provided. CMS has come down particularly hard on these templates, stating:

“Physician/LCMPs should be aware that templates designed to gather selected information focused primarily for reimbursement purposes are often insufficient to demonstrate that all coverage and coding requirements are met.”

The risks and limitations presented by templates will be under heavy attack for a long time to come, and prospective EHR buyers must make themselves aware of these risks. If you are shopping for an EHR, make sure to ask template-based EHR vendors lots of tough questions. While all templates are templates in the end (and template-free alternatives, while few, are available), certain templates do put physicians at greater risk than others. As the financial and legal challenges to templates continue to mount, it is critical to implement an EHR system that allows you to capture patient care in your own words, and at a level of detail that properly documents each case.

All practitioners will agree that patients are more than simply lists of symptoms; it seems that CMS is finally beginning to punish EHR users who attempt to reduce patients to lists and checkboxes.

Praxis EMR Training Seminar: Sept 13-16

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From September 13-16, Praxis EMR clients, trainers, and staff gathered in Orlando, Florida for the 2012 Praxis Training Seminar.

After a welcome address from CEO Dr. Richard Low, participants divided into beginner and advanced groups.  Course material covered the new features included in Praxis v5 as well as a detailed walk-through on how to attest to Meaningful Use.  Dr Jeremy Bradley, Praxis EMR user and director of Kentucky’s first NCQA Patient-Centered Medical Home, also gave a presentation on improving medical quality and reimbursement through pay-for-performance initiatives & practice advisories. All participants worked directly with their clinic’s Praxis EMR systems via wireless internet, allowing them to implement their new skills in real-time.

We love spending time with our physician users, receiving their input, and seeing first-hand how they use Praxis EMR in daily practice.  Many thanks to all who participated this year: you help us make Praxis EMR better and better!

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