The Continuity of Care Document (CCD) is a health-care standard electronic medical records (EMRs) EHRs will use to exchange data based on requirements outlined in meaningful use—but that’s not all you need to know about it.

What is it? The CCD is based on the Clinical Document Architecture (CDA), a document standard governed by the HL7 organization.

Is it anything like a CCR? A Continuity of Care Record (CCR) was created by the Massachusetts Department of Public Health. It included information necessary for providers to effectively transfer care. The CCD contains all the same information, but places it under the architecture of the CDA.

What does it do? The CCD’s primary purpose is the exchange of information, usually when a patient is transferred from one care setting to another. It includes 17 sections, including family history.

What are its limits? A CCD isn't intended to be a complete medical history; it’s intended to include only the information that is critical to effectively continue care.

Can a provider or patient view it? A CCD must be readable by humans using any standard Web browser, so any clinician, or even the patient, can open the CCD and view the data.

Finally, the U.S. Supreme Court has ruled, and the Patient Protection and Affordable Care Act—also known as Obamacare—is constitutional.

We know what it will provide from a consumer point of view: many uninsured will soon have access to affordable coverage. The plan will keep young adults on their parents' plans, end pre-existing condition restrictions and increase consumer information about health-care choices.

Now, however, health-care providers are on the edge of their seats, asking what it means for them. Here are three expert opinions. Claire Marblestone, attorney at healthcare provider firm Fenton Nelson: the decision will significantly impact all health-care providers. Many providers were waiting to see what would happen. Now, they will have to make changes. For example, there will be mandatory adoption of compliance and ethics programs for certain facilities, incentives to adopt electronic healthcare records and additional funds for rural health-care providers. The changes to Medicare and Medicaid will also impact reimbursement.

Bart Stupak, former Michigan Congressman: the industry focus will be on implementing programs as soon as possible. Demand for health care will explode as baby boomers continue to age. In order to accord expansion, it will be important for providers, insurers and the government to reduce the costs of delivering quality health care.

Bruce Johnson, CEO of supply chain management company GHX: healthcare is still in a state of change. The healthcare business is two-dimensional: It must deliver high-quality care to save lives while running businesses efficiently. So, healthcare reform is driven by the need to reduce costs while delivering high-quality care. To achieve that, businesses still need to change. Health-care providers need to standardize and streamline their processes.

Primary care practices using electronic medical records (EMRs) identify patients who need preventative or follow-up care 30 times faster than practices using paper, according to a recent study.

The study was commissioned by Canada Health Infoway, a not-for-profit organization funded by the Canadian government, and conducted by researchers at St. Mary's Research Centre, MedbASE Research and McGill University.

Essentially, practices were asked to identify their patients who qualified for six interventions - immunization, follow-up care after a heart attack, cancer screening, diabetes management and two medication recalls - by reviewing charts, then report how long it took to do so. Those practices that did not complete the chart review by a cut-off time, recorded the percentage of charts they had reviewed.

Practices using EMRs reviewed the records of all their active patients in an average of 1.4 hours. Paper-based practices, meanwhile, reviewed 10 percent of all active charts in 3.9 hours - meaning they would need 40 hours to conduct a full practice review.

Practices using EMRs were also more confident in their ability to contact patients regarding follow-up care or intervention. On a scale of one to five, with five being very confident and one being not confident, practices using EMRs chose 3.8 vs.1.9 for paper-based practices.

Richard Alvarez, president and CEO of Canada Health Infoway, said, “These results demonstrate the value of EMRs in enabling clinicians to deliver high-quality patient care in a timely fashion.”

There’s a big gap between what physicians thought they could do, and what they were eligible to do, to collect meaningful use incentives last year, according to a new study, which appears in the May issue of Health Affairs.

The study shows that 91 percent of physicians nationwide were eligible for federal electronic medical record (EMR) incentives in 2011. However, only 10 percent intended to apply for the program.

That number was on the low side of what the federal government had anticipated. The Center for Medicare & Medicaid Services had estimated that 10 percent to 36 percent of Medicare-eligible professionals and 15 percent to 47 percent of Medicaid-eligible professionals would demonstrate meaningful use in 2011.

According to the authors, among physicians intending to apply for meaningful use, about 21 percent were ready with the 10 core capabilities. Even in the state with the highest degree of readiness - Wisconsin - only 32 percent of physicians were ready with the 10 core capabilities.

The authors say the low level of readiness illustrates the challenges in meeting the federal schedule for financial incentives. Healthcare practices have support options, however. Your IT provider can help you if you need assistance preparing your meaningful use.

With the adaptation of Stage 2, companies operating in the electronic medical records will shift their focus from the capture to exchange of health information. One industry insider has recommended 10 things your EMR needs to be truly interoperable.

1. Single sign-on (SSO). Applications tend to proliferate, and if you don't allow people to switch between these applications using a common login and password, users will get frustrated and give up.
2. Context transitions. As applications grow, and you need to integrate them into an EMR, SSO won’t be enough, because you’ll still lose the “active patient or task" being performed. You’ll also need to provide for the transition of context between applications.
3. Widget publishing. EHRs often have hundreds of functions, and if some are exportable or publishable as widgets, they become much easier to integrate into new user interfaces in the future.
4. Widget consumption. EMRs will become more like containers of cross-application functionality than innate functionality, so consuming widgets will be a basic requirement.
5. Mash-ups. EMRs should allow access to their content through the content management interoperability services (CMIS) standard, thereby allowing users to unlock content they have in various health records.
6. Customizable dashboards. EMRs should provide dashboards that can be tailored by organization, user role, or even user.
7. Interactive Voice Response (IVR). IVR, which allows an EMR to interact with users through phones and other voice systems, such as Skype, will improve collaboration with patients and other physicians who aren’t at a computer.
8. Voice recognition. This will help users conduct EMR tasks more efficiently.
9. Natural language understanding. Because most EMR data is entered by humans, an EMR must integrate with systems that can convert the spoken word or typed text to structured data.
10. Customizable data import and export. A good EMR must allow customizable importing and exporting of simple lists in common formats, such as Excel, CSV and XML.

Most medical practices that implement Electronic Medical Records (EMRs) see a significant financial return on investment (ROI). Here are five ways that happens: You can see more patients; you'll reduce missed appointments; your claims processing will be more efficient; you'll spend less on hard technology costs; and you'll improve reimbursements. Below we discuss each in more detail.

1. You can see more patients. Once you've implemented an EMR and established good work flows, you'll spend less time documenting, allowing you more time to see more patients.

2. You'll reduce missed appointments. Cancelations and no-shows are key performance indicators. An EMR can reduce them by issuing appointment reminders, and a reduction in missed appointments can improve your bottom line.

3. Your claims processing will be more efficient. Once you've implemented an EMR, you'll spend less time filing, faxing, and retrieving charts and moving documents, which will allow claims to be processed faster.

4. You'll spend less on hard technology costs. Once you've implemented an EMR, your technology will be centralized, so you’ll make fewer ad hoc purchases. Moreover, if your EMR is cloud-based, you'll spend less on equipment overall.

5. You’ll improve reimbursements. Many EMRs have alerts that make sure you're using the correct document to satisfy reimbursement requirements—and improved legibility is a bonus.
   

   Published with permission from TechAdvisory.org. Source.

Wondering what the most-discussed health care IT topics were in 2011—and what they'll likely be in 2012? ID Experts compiled expert opinions and found them to be much the same: mobile devices, patient privacy rights, and data breaches. Below are several of the items from ID Experts’ top 10 list, and additional items and details are available here.

• Mobile devices could create problems due to data breach risks—because while 81 percent of health care providers use mobile devices to collect, store, and transmit secure information, only 49 percent secure the devices.
• Class-action lawsuits will rise as patients sue health care providers for failing to secure their personal information, creating significant risks and increasing costs for organizations affected by these lawsuits.
• As more health care providers use social media, the exposure of personal information will increase, forcing health care providers to develop social media plans to prevent employees exposing patient information through personal social networking sites.
• Economic realities will force health care providers to outsource many functions including billing to third parties and business associates, and that will create weak links in data privacy and security.
• The use of mobile devices—tablets and smartphones—will continue to grow in the industry, meaning health care providers will need to balance usability with security.

An electronic medical record (EMR) implementation isn't just about replacing paper charts with digital technology. EMRs also provide a perfect opportunity to review and improve your workflows. The result can be increased efficiencies—which means decreased costs.

Your medical practice has probably been doing things the same way for a long time. Maybe you think you do things well, and most likely you actually do. Most practices, however, have not recently reviewed and optimized processes to the extent possible. Few have standardized procedures in writing, for example.

Implementing an EMR won't automatically make these improvements. In fact, most people think EMRs solve problems, but they actually amplify problems that already exist in a practice.

Because of this, adopting an EMR presents a good opportunity for you to make your practice more efficient by reviewing processes and optimizing your own workflows. In fact, you may find that with little effort you are able to identify new efficiencies that could save time and money.

Be patient, however. The adoption of technology is an iterative process. In other words, while EMRs are full of functions that will bring efficiency to your practice if implemented correctly, this won't happen overnight. Give it some time. Typically, health care groups are in the learning and adoption phase of their transition for several months. You should see results after that.

Electronic medical record (EMR) implementations aren't always simple—especially for small physician groups, which may lack dedicated information technology resources. However, following a few best practices regarding your constituents can help ensure that the process proceeds smoothly. Here are three.

Personalize for physicians. No two physicians are exactly like, so no two physicians should have to do things the same way. And that applies to functions both large and small. People approach even the simplest of technologies, such as email and word processing, differently. A good EMR will provide several ways to accomplish the same task, so be sure you offer physicians the option to choose which will best fit their practice styles.

Include nurses. With that said, an EMR isn't all about the physician. While physicians may be leaders and key decision-makers, they are not the exclusive users of an EMR. According to some reports, nurses account for almost 75 percent of chart use, and physicians just 25 percent. As a result, one of the greatest mistakes of EMR implementation is forgetting about nurses. When you create an EMR committee, be sure to have nursing representatives on it.

Round on users. Just as physicians and nurses "round" on patients at a hospital, you should round on everyone in the practice to gauge their comfort with the EMR. Thirty days and then again six months after you go live, visit each user to observe how he or she uses the EMR, take suggestions, and offer tips about how to best use the EMR within your workflows.

Electronic medical records (EMRs) are safer than their paper counterparts, according to a new survey of physicians—but a similar survey of patients didn't get the same response. They think paper is still safer, which means some education is in order.

The survey, which was conducted by GfK Roper on behalf of Practice Fusion, asked patients and medical professionals how they view EMR safety versus paper chart safety.

Fifty-four percent of physicians answered that EMRs are safer, with just 18 percent selecting paper as the safer option. Patient views, however, differed: Forty-seven percent of them said paper is safer, with 39 percent selecting EMRs as the safer option.

Also interesting is why physicians and patient responded the way they did when choosing paper records. Of physicians who believe paper is the safer option, 36 percent said paper is more secure because it is less likely to be hacked or lost. Of patients who believe paper is the safer option, 59 percent said paper records are more private than EMRs, allowing for more control over who sees them.

Interestingly, of the patients who said EMRs are safer, 77 percent said the greatest benefit of EMRs over paper records is being able to access records when needed.

What does it mean? The medical community is rejecting paper charts and embracing technology, says Practice Fusion—and that's easy to understand if you're a practicing physician who has any experience with an EMR. But it's also easy to understand patient concerns, which means more education about why EMRs are safer than paper charts is necessary.