Research Paper On The New Software For The Ehr Changeover

Introduction

Rapid technological advancements in electronic health records (EHR) have revolutionized the way the contemporary health industry operates. These health information systems have enabled the automation of essential clinical services, hence improving the efficiency and quality of care delivery. Numerous EHR software abounds in the market. Among them, is the eClinicalWorks (eCW) Complete EHR. The popularity of eCW among individual and institutional consumers stems from its integration of EHR with a practice management (PM) system on one database. This integration eliminates the need for duplicate data entry and streamlines clinical workflow throughout a healthcare institution. More than 34,000 providers use eCW in the U.S (Clinicalinstall.com, n.d.). As a result, the company earns enormous annual revenues exceeding $100 million while maintaining a profit margin of about 30% (Clinicalinstall.com, n.d.). The large profit base enables the company invest in continuous software upgrades and customizations that appeal to the techno-savvy generation. eCW EMR/PM has won several accolades and awards such as the HIMSS Davies Awards and the TEPR Awards, for offering the best information technology solutions in the market. This paper, therefore, recommends eCW for adoption by the ABC Medical Centers.

HIPAA compliance

The HIPAA regulation prescribes the privacy and security rules that providers must implement in order to safeguard the confidentiality and integrity of patient data. Security standards include administrative, physical and technical specifications. The technical safeguards incorporated by the eCW EHR include access controls, audit controls, and transmission security. The patient portal requires patients to enter a unique username and a secure password in order to access their accounts. Without these details, patients cannot log into their accounts and must seek the assistance of the technical staff in the practice or healthcare institution to prove their identification details. Furthermore, the portal logs off automatically if left dormant for a specified period. Details of a patient or physician’s activity on the patient accounts are tracked by the practice management system and reports generated for analysis. Any data transmitted through the eClinicalMobile and eClinicalMessenger applications are encrypted in order to maintain confidentiality. Data encryption ensures that the confidential medical information cannot be read by unauthorized persons in the case of a security breach.
Administrative safeguards employed by eCW EHR include risk management, activity reviews, ePHI access controls, and security reminders among others. The software incorporates a CCMR tool that assists in conducting the risk assessment of the clinical processes and identifying gaps in care delivery that might act as loopholes for unauthorized access. Frequent activity reviews by the practice management system allow providers to track the alterations and updates made on electronic patient records for accountability purposes. The restricted ePHI controls ensure that only the authorized personnel view the protected health information (PHI) of patients. For instance, the eClinicalMobile application is customized for physician use only because they are the ones responsible for making crucial assessments of patients’ medical records. Other staff members can only access PHI remotely, where they must satisfy the required administrative controls set by organizations.
The type and scope of physical safeguards are left at the discretion of the provider or institution that installs the eCW EHR software. Different organizations employ various physical security guidelines depending on their sizes and scale of operations. The conventional safeguards include facility access controls such as security personnel and workstation authorization codes or identity cards. eClinicalWorks company has partnered with several business associates to assist in ensuring compliance with HIPAA rules, data security, risk mitigation and meaningful use requirements. These partners include Compliancy Group, DataFile Technologies, GSG Compliance and MedTech USA LLC (eClinicalWorks.com, 2015a).

Meaningful use requirements

Meaningful use refers to the use of EHR technology to improve the quality of care of both individuals and communities (HealthIT.gov, 2015). The American Recovery and Reinvestment Act (ARRA) permits the reimbursement or funding of providers and hospitals, whose EHR systems meet the meaningful use requirements (Health Resources and Services Administration [HRSA], n.d.). Such funding is provided by the Center for Medicare and Medicaid through regional offices to eligible providers who have met the threshold for the prescribed stage I and II meaningful use objectives. The eCW V10 complies with the “ONC 2014 Edition Criteria” (eClinicalWorks.com, 2015b). As a result, the Certification Commission for Health Information Technology (CCHIT) certified the software as a Complete EHR in 2013. Part of the conditions for certification is the mandatory compliance with meaningful use requirements. In this regard, the accomplishments of the eCW EHR are unrivaled. Furthermore, the compliance status of the software is further strengthened by its legal incorporation and its inclusion of the Healthwise Patient Education EMR Module 9.7. This component allows the software to offer patient education of general health guidelines in order to promote community health. Being a cloud-based module, V10 incurs additional stage two meaningful use requirements such as hosting and implementation fees, stage two monthly compliance fees, and one-time costs incurred while transmitting QRDA files necessary to secure participation slots in the annual payer quality initiatives (eClinicalWorks.com, 2015b). With the aforementioned legal observance in the place, providers using the software are eligible for ARRA funding.

Cost-effectiveness

Cost is one of the pertinent determining factors of the applicability of any software. The magnitude of the weight placed on cost by healthcare organizations and practices stems from the rapidly changing economic landscape that impose additional expenditure items. Providers assess the costs incurred in automating their clinical activities against the long-term benefits that such automation will accrue to them. In this respect, the eClinicalWorks EHR is affordable compared to competing software options. Firstly, it offers several monthly subscription options, which enhance providers’ choice and preferences. The lowest subscription fee is $ 449 per month for each provider to as high as 2.9% of the aggregate collections within a practice (eClinicalWorks.com, 2015c). The EHR functionalities differ with the type of subscription regarding supplemental services such as revenue cycle management and billing management. The subscriptions carry no start-up costs. Secondly, the eCW EHR package provides multiple complimentary applications at no costs. These services include clinical decision support system tools, faxing software, clinical templates, scanning software, role-based securities, and ICD-9 and IDC-10 coding. Moreover, a medical practice consisting of between one and nine providers receives a free initial on-site software training. Thirdly, the EHR software uses a common database, web and client user interface server. This integration eliminates third-party costs and terminal services costs associated with separate database licenses, fax bills, and additional per computer expenses (GroupOne Health Source, 2015a). Fourthly, the automation of clinical services creates a paperless environment that saves on stationery costs associated with manual patient registration. Besides, the messenger application saves on phone bills and paper that would otherwise be incurred through arduous reminder phone calls and letters. Lastly, the software meets the prescribed meaningful use requirements, making it eligible for funding under the Stimulus Act. This funding caters for some of the costs incurred while running the system. Ultimately, the aforementioned expenditure cutbacks culminate in substantial cost savings that make eCW EHR software appealing to consumers.

Superior functionalities

The eCW EHR hosts multiple applications that contribute to its robust utilization. Its essential features include the EMR, practice management, patient portal, eClinicalMobile, messaging, interoperability, and the eClinicalTouch (GroupOne Health Source, 2015b). The EMR platform facilitates the input, storage and quick access to the medical records of patients. The automation of patient registration significantly reduces the incidence of medical errors that were prevalent in the past as a result of poor penmanship. It provides both remote and online access to patient data such as demographics, medical history, medication, lab reports, and scheduled visits among others. The EMR can either be server-based or cloud-based (V10) depending on the needs of the practice. The advantages of the eCW EMR include streamlined workflow from patient admissions to discharge, prompt access to medical content, customization of user interfaces, and swift provider-patient communication.
The Practice Management (PM) system coordinates all the clinical systems within a practice such as patient registration, laboratory services, radiology services, billing, and other auxiliary medical services offered within or outside the practice. By borrowing patient data from the EMR, the PM streamlines workflow by eliminating data duplication. The four principal activities of the PM include scheduling, billing, claims scrubbing and patient demographics. Scheduling involves managing patient appointments across several medical departments or office locations of a practice through the issuance of alerts and reminders. The PM also tracks the progress and status of a patient’s records through the different departments for purposes of bill consolidation upon discharge. Claims Scrubbing entails screening claims before submission using the E&M Coding Advice engine to ensure they are error-free.
The patient portal gives patients the platform to access their personal health records by logging into their personal accounts over the internet. The platform also allows them to request prescription refills, make doctor or medical test appointments and access their lab or x-ray imaging results. Furthermore, patients can securely communicate with their physicians on any issues arising from their respective treatment interventions. The findings of a recent online survey found that 84% of individual agreed to the use of patient portals in their doctors’ offices (WBJournal.com, 2015). This statistic attests to the popularity of eCW HER.
The eClinicalMobile permits authorized physicians or clinical staff members to access pertinent patient data from their smart phones, regardless of their locations. Consequently, they can check and update their schedules, send messages to patients, write prescription refills, and assess lab or imaging results. The importance of this application cannot be negated because physicians work across multiple health institutions and may not be physically available to attend to a patient in a given location.
The eCW messaging application uses the Voice-Over-Internet Protocol (VOIP) to send automated messages or reminders from the practice to individual patients. Physicians can personalize the messages by recording their voices to create a rapport that is hampered by indirect communication mediums. Messaging eliminates the cost incurred by mailing confidential reminder letters or making arduous telephone calls. Moreover, physicians can customize the messenger to suit the preferences of patients in terms of language. Interoperability enables communication and sharing of patient information in a secure and private manner.
The eCW HER offers two interoperability platforms: electronic health exchange (eEHX) and the P2POpen network. eEHX facilitates data sharing and transmission between clinical systems within a community integration platform for population health management. These community-wide clinical systems include ancillary services, immunization registries, ambulatory services, and health information exchanges (HIEs). Conversely, P2POpen permits provider-to-provider or practice-to-practice communication and data transmission. This network is crucial during patient referrals that necessitate data transfer from the previous to the new provider for diagnosis and treatment decision-making purposes.Finally, the eClinicalTouch application maximizes the benefits of the iPad technology. By installing the application on an iPad, patients and physicians can gain cloud-based access to records and navigate through the essential.

Conclusion

Despite the existence of multiple software choices in the market, the versatility of the eCW EHR/PM Software cannot be overlooked. Its principal benefits include its ease of use and flexibility, integrated operations, swift communication, affordability, meaningful use advantages and legal compliance. Its most essential attribute is the possibility of customization to suit the preferences of patients, physicians and the practice as a whole. Given the preoccupation of the current generation with smartphone technology and social media interactions, services such as eClinicalMessaging and eClinicalmobile have assisted the company in exploiting this unique market niche. Furthermore, the credibility of the software has been boosted by its rigorous compliance with HIPAA regulations regarding the patient data security and privacy. This compliance alleviates the fears and anxiety of individuals concerning the potential harm posed by the surge in cyber crime. Being a new institution, ABC Medical Center will benefit from the simplicity, user-friendliness and cost-effectiveness that eCW has to offer.

References

Clinicalinstall.com. eClinicalWorks. Retrieved April 24, 2015, from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CB4QFjAA&url=http%3A%2F%2Fcicorp.com%2FEHR%2FeCW%2FeClinicalWorksOverview201003800.pdf&ei=pZM6Vd-PLMvnaMOQgKAF&usg=AFQjCNHTHarw0iHxBqbbzgm7ahbSApA9wA&sig2=np1X6JaYETnT_6_2pMFIWw
eClinicalWorks.com. (2015b). Meaningful use. Retrieved April 24, 2015, from https://www.eclinicalworks.com/resources/meaningful-use/
eClinicalWorks.com. (2015a). Partners - Compliancy & Security Risk Assessment. Retrieved April 24, 2015, from https://www.eclinicalworks.com/about-us/partners/compliancy-security-risk/
eClinicalWorks.com. (2015c). Our pricing. Retrieved April 24, 2015, from https://www.eclinicalworks.com/products-services/pricing/
GroupOne Health Source. (2015b). eClinicalWorks EHR Product Overview. Retrieved April 24, 2015, from http://www.grouponehealthsource.com/eclinicalworks/key-features/
GroupOne Health Source. (2015a). eClinicalWorks Key Benefits. Retrieved April 24, 2015, from http://www.grouponehealthsource.com/Key-Benefits/Health
Health Resources and Services Administration (HRSA). (n.d.). Health Information Technology. Retrieved April 24, 2015, from http://www.hrsa.gov/ruralhealth/resources/healthit/
HealthIT.gov. (2015, March 20). Meaningful Use Regulations | Policy Researchers & Implementers | HealthIT.gov. Retrieved April 24, 2015, from http://www.healthit.gov/policy-researchers-implementers/meaningful-use-regulations
WBJournal.com. (2015). Study finds strong use of online health tools. Worcester Business Journal. Retrieved from http://www.wbjournal.com/article/20150406/NEWS01/150409968