Electronic Health Records Software Analysis - Research Paper Example

EHR SOFTWARE RESEARCH PAPER (MEDI TOUCH) Table of Contents Table of Contents 2 List of Tables 3 Introduction 4 MediTouch EHR 6 Product uses 7 Unique features of Medi Touch 8 Integration with other information systems 9 Usability 11 Benefits of Medi Touch EHR 13 Comparison of Medi Touch and AllegianceMD EHR 15 Implementing Medi Touch EHR 16 Advantages of Medi Touch 17 Disadvantages 18 Interoperability 18 Conclusion 19 References 20 List of Tables Table 1: Primary and Secondary Uses of Electronic Health Record Systems……………………4 Table 2: Four healthcare interoperability levels and Related Issues……………………………..21 List of Figures Figure 1.1: Paper-based Practice…………………………………………………………………5 Figure 1.2: Electronic-Based Practice…………………………………………………………….5 Figure 2: Medi Touch EHR on iPad being used to upload patient image to a patient chart directly…………………………………………………………………………………………….7 Figure 3: Levels of E-Prescription…………………………………………………………...…..11 Introduction Electronic health records (EHR) are being implemented in many healthcare facilities worldwide in order to improve the quality and effectiveness of global healthcare (Borycki & Kushniruk, 2008; World Health Organization, 2005; Shortliffe & Cimino, 2008). EHRs make possible the well-organized management and efficient preservation of health records to improve patient care (Taylor, 2006). A good EHR should be convenient to use remotely and to anyone with authorized access to the system. Given that the healthcare field is very complex and calls for numerous important decisions to be made, sometimes in difficult scenarios, it is crucial that information is correct, dependable and well-timed. The information held in the EHR can be used to find and assess clinical evidence for treatment (Taylor, 2006) and this may help discover new treatment methods. Thus EHRs allow for a number of primary and secondary uses (See Table 1). Table 1: Primary and Secondary Uses of Electronic Health Record Systems Primary Uses: Direct Patient Care Patient Care Management Patient Care Support Processes Financial and Other Administrative Processes Patient Self-Management Secondary Uses: Education Regulation Quality Assurance and Surveillance Research Public Health Policy Support Source: Adapted from IOM (2003) EHRs are an improvement from paper-based records of patient information in terms of flexibility and leverage as illustrated by Figures 1.1 and 1.2. As the extent of information in the medical field is constantly increasing (Chen, Fuller, Friedman & Hersh, 2005) a good EHR should be well structured to meet the extra demands on the organizing and representation of patient healthcare information. Figure 1.1: Paper-based Practice Here, only one person has access to the system at any one time. Figure 1.2: Electronic-Based Practice In this system, multiple users may access the system simultaneously, as long as appropriate privacy and security measures are put in place. In this discourse, the author will examine EHR software, Medi Touch and depict its qualities, how it functions and usability. This discourse will critically evaluate the suitability of Medi Touch as EHR software against other EHR software and explore how efficient and effective it is. MediTouch EHR Medi Touch EHR is a software used in the electronic management of health records designed by HealthFusion. Medi Touch is essentially web-based but incorporates a touch screen user interface (See Figure 2). This aspect makes Medi Touch a distinctive EHR and user-friendly. As such, its users do not have to install any software in-house or conduct training to learn how to use it as it is accessible through a web browser on any Windows or Mac computer. Its dual usability is an appealing factor especially to tech-savvy physicians who own Apple iPads. In fact, Medi Touch from the get go was designed with Apple’s operating system and market influence in mind. This foresight is one of the factors that makes this particular EHR stand out from its competitors. Most of the other EHR products do not offer effective hardware support on the iPad platform and medical practitioners on the go, who may require a mobile computing platform to work with, will not be sufficiently served with these other EHR products. This is because, although these EHR products may be displayed on the iPad, this is facilitated by slow, remote access software as the software cannot run directly on the iPad browser (Flam, 2011). Medi Touch, on the other hand, is built for the latest trend in technology-the mobile tablet- and is thus optimized for iPad use and touch making the experience fast and efficient as one can use the complete set of features on their smartphone that this EHR had to offer, easily and effectively. Figure 2: Medi Touch EHR on iPad being used to upload patient image to a patient chart directly Source: HealthFusion (2012) Product uses Medi Touch is a web based EHR that offers several features which are easy to use. Additionally, it offers benefits such as practical management features, security features, training resources and support. Its basic features allow physicians to make charts, form problem lists, manage medication, do electronic prescriptions, check for allergic reactions and history, manage orders, get lab test results and manage documents effectively (Meditouch, 2011). Medi Touch also offers sophisticated billing, scheduling, claims, eligibility, ERAs, denial defense, iPad-friendly electronic health records, PQRI, reporting, and mobile applications with high-end value and J.D. Power-recognized outstanding customer service. (The EHR Scope, 2012). Further, Medi Touch can also be customized to meet the personal preferences or unique needs of the user. Users can decide to employ this software standalone or integrate it with HealthFusion’s practice management system which is used for automating the administrative tasks of the practice. Depending on an organization’s or physicians’ needs, the EHR system used on its own or along with the practice management system is integral in improving patient care (Shekelle et al., 2006), reducing medical errors, providing links to medical information and clinical assessment support systems, simultaneous access to patient data, superior security, enhanced legibility and more accurate documentation. Medi Touch meets ONC-ATCB certification to become a Meaningful Use Certified EHR and users literally do not have to put in any extra effort when using this software in order to earn their ARRA stimulus funds as it offers simple steps to facilitate the incentive payment. Unique features of Medi Touch HealthFusion Inc. (Briggs, 2011) outlines the following features characteristic of Medi Touch, as unique to this particular EHR. They are:- It is a complete system, fully integrated with EHR, practice management and clearinghouse solutions. It is OS-agnostic, so it runs on all platforms. It has compatibility with Apple or Windows PCs, including tablets, having been designed with the Apple iPad in mind. It has pre-loaded specialty settings, and one can start charting immediately. It is web based, requiring no hardware specifications or software installations so it works anywhere with internet access. E-prescriptions are secure as it is SureScripts Certified. It is a certified Meaningful Use EHR, and provides an easy to understand Meaningful Use Report Card to each provider, enabling the tracking of incentive payments. It requires no start up fees and is easy to use and customize to one’s workflow and style. It allows enhanced imaging functionalities using MediDraw on either the iPad or PC. It allows customization of its technologies to meet the unique needs of its users. Through its patient portal, users have access to all the major labs and can share the results with their patients. It supports automatic updates of all codes, medication and formulae. It has a domestic, full-time customer service support system, acknowledged by J.D. Power and Associates for providing outstanding customer service experience. It has a friendly payment system. MediTouch is priced on a pay-per-provider, monthly platform, which covers all support and training resources. Integration with other information systems Medi Touch is a web based software that integrates with the HealthFusion practice management and Clearinghouse solutions, automating all aspects of the administrative and revenue process including claims submissions. It only integrates with HealthFusion’s practice management system. Being web based, Medi Touch is compatible with both Windows and Mac operating systems. It is built on the native iPad touchscreen platform, thus it is also offers a smartphone user interface, making it accessible for users who need to use mobile computing technologies. Medi Touch as a EHR system performs its functions by integrating with over 50, 000 pharmacies especially when it comes to e-prescriptions which describes various levels (See Figure 3) and many more labs for carrying out tests. Patients can access their medical information, billing and appointments through a patient portal. An organization‘s workflow can be automated and scheduled into the integrated EHR, e.g. appointments can be scheduled into the practice management billing system. A practitioner’s daily schedule is input into the EHR and everyone in the organization can view that information, along with insurance and eligibility details. A physician who completes an order, can process the diagnosis and procedure codes into the EHR and this automatically updates the patient’s information and through the patient portal, the patient is able to view such changes. The integrated clearing house takes care of handling claims and sending them to the payer, without any additional input from the user, such as export of claim batches. Additionally, the integrated system also verifies the eligibility of a member in advance, and lets the physician know if one is eligible or not before a scheduled appointment. Figure 3: Levels of E-Prescription Source: eHealth Initiative (2004) Usability Medi Touch is a web-based EHR built with the needs of the practitioner in mind. Being OS-agnostic, it is designed to think and work like most physicians, who are not often tethered to a desk. Today, practitioners often need to make critical decisions, sometimes from remote places and medical information from a mobile computing platform comes in handy. Medi Touch serves this purpose and remains cost effective, secure and offers outstanding support services. Medi Touch is simple to use and has a friendly interface, compatible with Windows and Mac computers, and also offers a touch screen function. It comes as a complete system, fully pre-loaded with the features that users will need, and one can get started immediately. Physicians may use its charting function, as it is designed to chart in the same manner that medical professionals are trained to chart, and also lets them connect with labs and view results of lab tests. Patient flow and schedules can be monitored and appointments made in well formatted text. Through Medi Touch, users get an interactive experience as it offers directions to medical practices and pharmacies, and allows physicians to monitor a patient’s progress using charts. The staff are able to understand patient complaints and how to use the system data as the EHR includes more than 2000 pre-loaded interviews to facilitate this. Medi Touch has a live customer service support staff that was recognized by J.D. Power & Associates for providing outstanding customer service to its clients. The customer service support staff are available via various communication channels e.g. email, live chat, help desk, phone, forums, among others, to handle complaints, training and questions. To get understanding of Medi Touch EHR, there are instructional videos, recorded demos, FAQs, webinars and pdfs available for such learning and training. To determine how efficient an EHR system is, and determine its user-friendliness, the following questions should be asked:- How easily can the user accomplish the task? Is it easy to find your way around? Does the system appear easy to learn? Are both beginners and experts accommodated? Are unrelated, confusing choices offered? Does the EHR make the work easier? Does it make the work faster? The usability of a technology determines its effectiveness, and poor usability can even endanger patients. The Medi Touch EHR is modeled to work in a manner similar to the average workflow of most physicians. Its set of features are easy to understand and simple to use. Being entirely web-based, users do not have to install any software on-site. All one needs is to access the system and log in using their browser on a Windows or Apple PC. Being a native iPad EHR, it is also easily accessed on tablet and smartphones. Users can also customize this EHR to their own requirements e.g. charting preferences and use custom forms even on the touchscreen platform. Medi Touch is a flexible EHR with a powerful and easy-to-navigate interface. Because users do not have to install any modules, as it comes pre-loaded with commonly used terminology, medical phrases and forms, users can begin using it immediately. Its integrated feature allows users to also manage revenue and claims. Medi Touch EHR is an efficient system that makes work faster and easier. Both experts and beginners are accommodated, as it is designed with practitioners’ workflow in mind, and offers renowned customer support, to assist with training and inquires. Benefits of Medi Touch EHR A successful EHR system is seen to be:-: Patient centered It can be incorporated with multiple information sources Value added information processing Secure Flexible, easy to use user interface Multiprofessional Secondary use of data Medi Touch is essentially patient oriented as its overall purpose is to improve patient care. Its set of features is suitable for a large number of specialty medical fields such as podiatry, neurology, psychiatry, cardiology, among several others. It is a system that is effective for any size practice, from a small practice to a large organization as well. It has a patient portal that allows patients to view and access their medical interactions with clinicians in real time, and automatically updates their information. Also, it is capable of exchanging key patient information e.g. medication list, allergies, test results, etc. with other medical care providers electronically. Medi Touch allows integration with various systems, although on the HealthFusion platform. It integrates with the Practice management and clearinghouse solutions, which allows for interoperability. This means that it allows for efficient management of workflow across the clearinghouse, billing, scheduling, clinical and patient experience. All aspects of the hospital experience are automated and catered to in an efficient and effective manner. This EHR also connects to thousands of pharmacies and labs and credible sources of medical literature to allow it to retrieve accurate and relevant information to assist in making clinical decisions and diagnosis and e-prescribing medication. Patient record information is obtained from several other sources but presented to the user as if emanating from a single source, making the system simple and easy to understand which is because of the integration with other information systems. Medi Touch is an effective EHR that supports physicians in their decision making. This is aided by the additional functionalities that the system employs. For instance, these functionality forms include patient follow up, alerts and reminders, automatic refill requests, dosage calculations, and such. These functionalities assist physicians in providing quality medical attention and support their treatment plans effectively. Medi Touch is a secure system that preserves sensitive information of patients from unauthorized access. Only persons involved in the treatment of a patient are able to access that patient’s health records; this is done through controlled access. Controlled access is maintained by identification through unique user IDs, person authentication, password and recovery protection, secure remote access and encrypted data transfer. For health information exchanges with other medical care practitioners e.g. labs or pharmacies, Medi Touch EHR has adopted government-approved data exchange standards to facilitate secure data exchange. According to HealthFusion (2011), the standards used by the connected EHR system include:- Health Level 7 (HL7) ANSI X12 (HIPAA Standard) Continuity of Care Record (CCR) (read) Continuity of Care Document (CCD) (read and write) NCPDP Script 8.1 XML Secure FTP (File Transfer Protocol) HTTPS and more For many users of an EHR system, their interaction is only through the user interface. As such, how users adapt to the interface determines how well they will accept it and prefer it over other systems. Medi Touch EHR system is easy for a practice of any size to implement. The interface is simple to use yet superior and is made to function similar to how clinicians operate. The system comes already pre-loaded with commonly used terminology, phrases, charts and forms, and users can begin charting soon after the first login. Unlike other EHRs, Medi Touch allows users to customize the system, or its functions according to their preferences. Anyone can do this as it is simple to understand, and even those with few technological skills can use and customize the system after a brief training provided by their customer support, at no extra cost. Medi Touch is among the best EHRs in use as it is able to allow simultaneous access from several users at the same time from various locations, which is a key requirement of a good EHR system (Lundgren, 1997). The unique aspect of Medi Touch system is that it is the first all-in-one web based touch screen EHR. This product differentiation makes the system an excellent choice over other less diverse EHRs. The compatibility with Windows and Apple operating systems, and touch screen user interface is ideal for mobile medical care and the future of healthcare. As it integrates with information from other healthcare faculties, the physician is able to make accurate decisions and diagnosis. With Medi Touch, you can use it anywhere and everywhere as long as there is internet access. Comparison of Medi Touch and AllegianceMD EHR AllegianceMD EHR uses artificial intelligence to provide a system that aims to improve patient care. It is touted as the best in its class and is designed on the premise of being the only EHR of its kind. This system is built to learn a user’s habits with time, and works with that. After continued use, the system adapts to the user’s workflow habits and helps them customize the charts and forms quickly. On the other hand, the user interface of Medi Touch is simple and designed to work in a typical fashion accustomed to most physicians. Medi Touch is doctor-patient oriented and strives to facilitate the bond between the two rather than replace it with technology. Both systems offer training and support for users, though Medi Touch has an award winning customer service staff. Medi Touch comes with pre-loaded features that use common medical terminology and expressions, and codes and forms that are familiar to the ones most practitioners use. Thus, it is easy to get started with from the first instance. Its sensitive touch screen interface allows doctors to chart the way they normally do with pen and paper but using their fingertips, so much training is not required. Both systems are web based, and can be accessed remotely, with no need of purchasing and maintaining servers and complicated VPN networks. In both, they have integrated EHR, billing software, and practice management software. Additionally, the systems connect to e-labs and clinicians can order and view lab results in real time. Medi Touch integrates interactive mapping capabilities that help users find their way or locate their nearest healthcare facilities such as pharmacies. The system will record the information for future use when dealing with that patient. Patient data is saved in an easy format, and can be tabulated for easier reference. The system allows physician to track patient progress via growth charts, allowing comparisons and assist clinicians to make accurate diagnosis. Implementing Medi Touch EHR Medi Touch, being a web based system, can be described in a number of ways, such as ASP (Active Server Pages), SaaS (Software-as-a Service) and Cloud(the web) computing. Such web based EHR systems are straightforward, affordable and feasible. This system requires no start-up or installation charges. Data is stored in HealthFusion’s Pure Cloud where it is secure and protected by HIPPA-certified standards. One of the factors that deter practitioners from implementing EHR in their practices is the costs involved. With Medi Touch, this factor is not a hindrance as the payment plan is done according to a monthly subscription method that is friendly to its users. In effect, it is the most reasonably priced, handy and efficient EHR in the market. It is suitable for any medical office, regardless of its size and users can get started on it with the first login. In order to implement the Medi Touch system from a paper based workflow, it is more prudent to scan first what you will need per patient rather than start with all the records in your system (Flam, 2012). Sometimes this may be less than 10% of the paperwork that may be enough to chart a patient’s history to give information needed to provide excellent patient care. The paper records may then be uploaded into the Medi Touch EHR in bulk, and afterwards sorting them in the appropriate charts is easier. Manual entry and managing of patient medication and allergy lists can be minimized as they are imported from the Surescripts database, which is a component of this EHR. The conversion will demand the practice to devote considerable time to implement the system while dealing with patient visits during the transition before all documents are updated into the system, but with time the EHR will reduce the time taken by staff to complete tasks, enhancing patient care. Advantages of Medi Touch It is congruent with Windows and Mac operating systems It offers cloud computing, ensuring data security and validity It operates well with mobile computing technologies, having been designed on the original iPad platform and allows for mobility The domestic customer support staff are professionally recognized as providing exceptional service It is easy to use and understand, even for non-IT oriented users Implementation is easy and does not call for purchase of servers or other software It comes pre-loaded with a set of features designed in a manner familiar to the workflow of clinicians thus easy to get started with immediately. It is customizable, depending on users’ choices It is integrated with other information systems, and connected to other healthcare facilities e.g. labs thus facilitate accurate information sharing and informed diagnosis making and treatment decisions. It has set secure measures that meet HIPAA standards, and has won the Surescripts White Coat of Quality award for the e-prescribing system it employs. It is affordable, as it does not require purchase of servers and costly training, and payment is on a monthly subscription platform which also caters for support and training. Disadvantages It may be complex to use for users with non-IT skills Training may take time Interoperability With increasing knowledge and information currently involving the medical field, it is imperative to enhance the realization of the benefits that may be garnered from having such knowledge especially with EHR systems. Importantly, the possibility of sharing the knowledge and information among the various stakeholders and systems involved in this field is crucial. This sharing and accessibility is known as interoperability. Technical interoperability ensures that geographic barriers are eliminated, which however, may not be enough to ascertain that the benefits to be got from sharing information with other actors in the healthcare field will be realized. It is also essential to eliminate semantic interoperability. The table below demonstrates the areas in which interoperability is essential to ensure effective healthcare delivery and quality patient care: Table 2: Four healthcare interoperability levels and Related Issues Health policy: cooperation Vision & strategies Processes & measures, incentives Socio-economic (sustainable), legal framework Accreditation and certification Health service providers (Organisational level): collaboration Organisational structures and culture Intra & inter-jurisdictional service processes Change management, behavioural change Systems thinking, business process re-engineering Semantic interoperation Terminologies, classifications Translation Data Structures Technical / functional interoperation Technical / functional interoperation Technical standards Hardware and software connectivity Security User interfaces Source: empirica / i2-Health / SemanticHEALTH (2006) Medi Touch when evaluated against these levels stands out as having met the interoperability standards as it has met necessary functional and security standard measures and standardization of terminology. Conclusion EHR adoption goes a long way to improve patient care. It improves the accuracy of certain tasks such as prescribing medication and calculating dosage requirements. Medi Touch is the earliest EHR to come as a complete package with cloud computing and touch screen functionality that is affordable and secure (HealthFusion, 2011). Designed by HealthFusion Inc, this system operates across various platforms i.e. Windows and Apple computers, giving users a flexibility to work remotely. This EHR system has ONC-ATCB certification (Office of the National Coordinator - Authorized Testing and Certification Bodies) and has won the Surescripts secure standards award plus the J.D. Power & Associates award for outstanding service. Medi Touch helps practices automate their tasks, enhances the workflow of practitioners and improves patient care. The comprehensive and integrated features that this system employs provides for this. By integrating with HealthFusion’s practice management and clearinghouse solutions, this EHR is an inclusive system. This EHR is equipped with various features that are friendly to all its users, from the physician to the patient and does not require elaborate IT skills to utilize. References Borycki, E.M. & Kushniruk, A.W. (2008). “Where do technology-induced errors come from? Towards a model for conceptualizing and diagnosing errors caused by technology” (pp. 148-166). In A. W. Kushniruk and E. M. Borycki (Eds.). Human social and organizational aspects of health information systems. Hershey, Pennsylvania: Idea Group. Chen H., Fuller S.S., Friedman C., Hersh W. (2005). “Knowledge management, data mining and text mining in medical informatics”. In: Chen H., Fuller S.S., Friedman C., Hersh W. (eds.) Medical informatics: Knowledge management and data mining in biomedicine. New York: Springer Science+Business Media Inc. pp. 3-33. eHealth Initiative (2004). Electronic prescribing: Toward maximum value and rapid adoption: Recommendations for optimal design and implementation to improve care, increase efficiency and reduce costs in ambulatory care. Washington, D.C. EHR IMPACT (2008). Study on the economic impact of interoperable electronic health records and ePrescription in Europe. Germany: Empirica,Communication and Technology Research Flam S. (2011). iPad tablet adoption by doctors for EMR use — No really means, not yet. Retrieved from: http://blog.healthfusion.com/index.php/ehr-adoption/ipad-tablet-adoption-by-doctors-for-emr-use/ HealthFusion (2011).Retrived 5th March 2013 from, http://www.healthfusion.com/connected.asp HealthFusion (2012).What do i do with my paper chart? — The middle of the road makes the most sense. Retrieved 5th March 2013, from http://blog.healthfusion.com/index.php/ehr-adoption/what-do-i-do-with-my-paper-chart-the-middle-of-the-road-makes-the-most-sense/ Lundgren P.A & Wisser C. (1997). Functional requirements for IT support for nursing information systems integrated in electronic healthcare record systems (EHCRS). StudHealth Technol Inform.pp.;46:337-42. Meditouch (2011). MediTouch EHR electronic health record software. Retrieved 5th March 2013, from: http://www.softwareadvice.com/medical/healthfusion-meditouch-profile/ Shekelle, P. G., Morton, S. C., & Keeler, E. B. (2006, April). Costs and benefits of health information technology. Evidence Report/Technology Assessment No. 132. Rockville, MD: U. S. Agency for Healthcare Research and Quality. (AHRQ Publication No. 06-E006). Shortliffe, E.H. & Cimino, J.J. (2008). Biomedical informatics: Computer applications in health care and biomedicine. New York: Springer Verlag. Taylor P. 2006). From patient data to medical knowledge: The principles and practice of health informatics. Oxford: Blackwell Publishing Ltd. The EHR Scope( 2012). Compare EHRs. Retrieved 5th March 2013 from, http://www.ehrscope.com/compare-ehrs/ World Health Organization. (2005). eHealth tools and services: Needs of the member states. World Health Organization: Geneva. Read More