It’s rare to find a group of physicians, administrators and the government in agreement. However, in the case of electronic health records and oncology practices, all players seem to be on the same page. Now is the time for oncology practices to adopt an EMR, opines Robert S. Miller, MD, medical oncologist and physician advisor for medical informatics at Sidney Kimmel Comprehensive Cancer Center at The Johns Hopkins Hospital in Baltimore. Teresa McKay, CEO of West Michigan Cancer Center in Kalamazoo, Mich., ups the ante. “We are long past the time for dialogue about EMRs; it’s time for action. If practices don’t embrace the EMR quickly, they will be left woefully behind and will be acquired by other practices or have to seek refuge in hospitals.”
Current market penetration is low, but interest is high, largely due to Health Information Technology for Economic and Clinical Health (HITECH) Act incentives that offer EMR users up to $44,000 in carrots to demonstrate meaningful use. While money talks and has certainly spurred interest in adoption, there are other compelling reasons for oncology practices to consider investing in EMR technology. For starters, an EMR improves patient care in an entire host of ways, increasing access to information, improving safety and more. Plus, even in the pre-HITECH era, a well-deployed system delivered ROI by slashing labor and supplies budgets.
Despite documented benefits among early adopters, implementation can be tricky. Experienced users also agree on another issue—no oncology EMR is perfect. As oncology practices set their sights on EMR nirvana, Health Imaging & IT provides a guide to help users optimize the gains.
West Michigan Cancer Center has documented hard ROI from its EMR deployment; the 12-physician practice calculated more than $300,000 in cost savings during each of the first two years of deployment and nearly $600,000 in savings annually in the third, fourth and fifth years. “We didn’t anticipate significant financial gains with the project,” confesses McKay. Instead, the practice used patient care as the justification for early adoption of an EMR in 2004. “We felt very strongly that if we did not deploy an EMR we could not continue to provide high-quality patient care. Efficiency and ROI happened as by-products after the fact.”
The paper chart business impacted service to both referring physicians and patients. If a referring physician requested an update in the pre-EMR days, one of the practice’s eight medical records staff had to physically locate the chart and send it via dumbwaiter before anyone could respond to the physician. Today, all data including images can be accessed in exam rooms. “Our doctors look brilliant,” claims McKay.
|A Field Guide to EMR Acronyms|
|CCHIT: Certification Commission for Health Information Technology (CCHIT), a non-profit organization dedicated to accelerating the adoption of robust, interoperable health information technology. The organization expanded its EHR certification program into oncology last spring and appointed a volunteer work group to develop criteria for EHRs in oncology this summer. CCHIT was named an authorized testing and certification body with the Office of the National Coordinator (ONC, see below) at the end of August.
EHR & EMR: Although the acronyms are used interchangeably, an electronic medical record refers to the electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care, according to the now-disbanded National Alliance for Health Information Technology (NAHIT). NAHIT defines an electronic health record as the aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one healthcare organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care. Interoperability is the cornerstone of an EHR.
ONC: The Office of the National Coordinator for Health Information Technology (ONC) is the principal federal entity charged with coordination of nationwide efforts to implement and use advanced health information technology and the electronic exchange of health information. ONC establishes standards and certification criteria for EHR certification while the Centers for Medicare and Medicaid Services