How to leverage Clinical Decision Support at the point of care

How can Clinical Decision Support help you? By leveraging Elation’s Clinical Decision Support reminders, Elation users can more easily identify patient needs at the point-of-care. Clinical quality measures are also embedded within Elation’s CDS reminders, meaning physicians can more efficiently provide care for their patients and spend less time looking for information on a patient’s chart to satisfy requirements. Why CDS? Clinical Decision Support has several benefits for independent primary care physicians, including: Meet and exceed required clinical quality measurement goals with ease Increase care quality and enhance patient care outcomes Improve efficiency, financial savings, and provider-patient satisfaction How exactly does CDS work in Elation? During clinical encounters, Elation’s Clinical Decision Support reminders appear at the top of every visit note. This functionality automatically prompts users at the point of care so that problems can quickly and easily be addressed by a MA or physician. Information is automatically pulled in based on information from a patient’s chart, problem lists, demographics, and historical items so that information is accurate, relevant, and specific to a patient’s needs. Overall, Elation’s Clinical Decision Support reminders are a sophisticated set of features that can help you create a clinical workflow that is geared toward improving documentation and clinical efficiency. Having a system that supports CDS can enable your independent practice to stay on top of patient care.

Manisha Goud
December 30, 2017

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Avoid 2019 MIPS Penalties by reporting on 1 patient for 1 measure

As the first year of the Merit-based Incentive Payment System (MIPS) track for MACRA comes to a close, many physicians participating in the program might be wondering what action they need to take to avoid costly penalties. With Elation’s built-in dashboards and health policy support, you can put your stresses at ease and avoid penalties in 2019, as a result of performance in 2017. How do you report for MIPS in 2017? The Centers for Medicare & Medicaid Services (CMS) recently loosened some of the requirements of the program. These requirements mean 2017 is a transition year for MIPS and the minimum practices need to do is report some data to test the program and avoid penalties. To avoid 2019 penalties, all you need to do is report on 1 patient for 1 measure. How to do you know which measure to select? Check your CQM dashboard to see which measure you can report on! If you have 1 patient who meets the numerator and denominator for any measure, as long as you report that data point, you will avoid penalties. To access the dashboard, go to the “Reports” section in Elation. Identify which measure is best for your practice by reviewing our CQM webinars below: https://vimeo.com/245775062 https://vimeo.com/245775432

Manisha Goud
December 29, 2017

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Using Elation's CQM Dashboards to keep up Quality Measure performance

Clinical quality measures (CQMs) play an important role in fulfilling the requirements for both MIPS and CPC+. Even more importantly, however, providers participating in quality programs need a easy and efficient way to track progress on their CQMs to ensure program success. Thankfully, Elation users can leverage CQM Dashboards to simplify quality program participation. What is Elation’s CQM Dashboard? A CQM dashboard is a built feature that gives users a real time snapshot into current performance. Both CPC+ and MIPS participants can utilize this dashboard to stay on top of these programs. How can you leverage the CQM Dashboard for Quality Measures? First, go to the “Reports” section in Elation. Then click on the respective quality program you want to track. You will then receive access to a dashboard with relevant CQMs and how a practice is performing against 30% and 70% benchmarks for CPC+. For more background on a CQM, click on the CQM name and you will be redirected to a help center article. Elation’s dashboard also gives users a more detailed overview of patients that either meets criteria or does not meet criteria within the patient list by displaying details such as the patient’s last visit. From here you can click the patient’s name to document completion of a screening,  schedule the patient for a follow up visit, or take any other necessary actions. Overall, these powerful dashboards allow you to see which measures you want to boost performance for during this final stretch of reporting in 2017. For more guidance on MIPS or CPC+ contact a health policy specialist here at Elation.

Lucy Li
December 6, 2017

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Use Elation’s document tags to better keep track of patient care for quality programs

Earlier this year, we published a post on how to leverage document tags for CPC+. Here is an update on the benefits of Elation’s document tag feature for all users whether or not your practice is participating in CPC+. What are document tags? Document tags make logging the completion of eCQMs for programs like Meaningful Use and CPC+ more effortless in Elation’s Clinical First EHR . You can tag reports, visit notes, and non-visit notes to not only categorize these items for better organization but also use them to track completion of screening and measure requirements and to make them easier to find via chart search and Patient List search. Document tags for quality programs like CPC+ are flagged gold making them easier to distinguish from those used for internal tracking purposes. How can you use Elation’s document tags for quality programs? Document tags can be added to a visit note by scrolling to the bottom and clicking on the +Tag link. Once the appropriate flagged tag is identified and added, the patient will then show as meeting the measure or qualifying for a measure exclusion. You can also add document tags and flag completion of measures through the Health Maintenance section, or by adding document tags to reports. A list of all of Elation’s document tags can be viewed here.

Manisha Goud
December 1, 2017

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Improving clinical efficiency with Elation’s new Point-of-Care Labs feature

The Elation user community now has access to our Point-of-Care (POC) Labs feature! This new feature will allow Elation practices to significantly cut down the amount of time it takes to record Point-of-Care Labs to just a matter of seconds to put time back into your day and help you focus on your patients. Why use Elation’s Point-of-Care Labs? POC Labs is easy-to-use, quick, and enables users to capture POC lab results at the point of care. With just a few clicks, providers and staff can enter lab results performed at the office. Staff have the option to file results on their own, or flag abnormal results for the provider to review and sign off. The results entered can trend alongside existing interfaces and external documents manually entered. Results entered on POC Labs can help your practice satisfy clinical quality measures. For example, entering A1c results through the POC lab form will count towards the Diabetes A1c CQM. How does this feature work? Elation’s Point-of-Care Labs features works by enabling practices to enter their most frequent Point-of-Care lab tests in a matter of seconds by simply clicking on the “Notes” tab. This easy-to-use lab form allows users to input structured lab results that can trend against previous results. The results entered from the POC Lab Form are filed as Lab Reports. We’re excited to see how much time this new feature can save you and your practice! For more details on how you can leverage the POC Labs feature, please check out this article in our Help Center or RSVP for our POC Labs webinar on December 6th.

Erin Rieck
November 27, 2017

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How Elation ensures that MIPS providers avoid penalty

As the first year of the Merit-based Incentive Payment System (MIPS) track for MACRA comes to a close, many physicians participating in the program might be wondering what action they need to take to avoid costly penalties. With Elation’s built-in dashboards and health policy support, you can put your stresses at ease and avoid penalties in 2019, as a result of performance in 2017. How do you report for MIPS in 2017? The Centers for Medicare & Medicaid Services (CMS) recently loosened some of the requirements of the program. These requirements mean 2017 is a transition year for MIPS and the minimum practices need to do is report some data to test the program and avoid penalties. MIPS providers can choose to report either: 1 Quality Measure OR 4 Advancing Care Information Base Measures OR 1 Improvement Activity How can you keep track of your performance through Elation? Within Elation’s “Reports” section, practices can access the ACl and CQM dashboards. In the ACI dashboard, you can view progress on the four base measures. The CQM dashboard shows clinical performance on quality measures and provides access to a patient list where you can address some of these measures. With these useful features, providers can spend less time worrying about quality programs and spend more time providing quality care to their patients. Elation is here for you and your practice during the transition to value-based care. For a more detailed overview on MIPS, watch this webinar below: [embed]https://vimeo.com/241571596[/embed]

Sam Peirce
November 16, 2017

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How to perform patient recall to close care gaps and achieve CPC+ performance goals

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. As a program with a plethora of requirements, it can be challenging to stay on top of monitoring the patients that have not met CPC+ performance measures. As a result, performing patient recall was made easy in Elation so that users can both boost their performance and close patient care gaps. Performing patient recall within Elation Elation’s CQM dashboard is a great way to easily surface patients and their progress - click on the "View List" function to find a list of patients who your practice may have seen this year, but have not yet satisfied measure requirements. Patients may not have satisfied measure requirements for a number of reasons: Missing documentation or result of screening within Elation Patient results out of range (this specifically impacts the outcome measures Diabetes hbA1c Poor Control and Controlling High Blood Pressure) Screening was not performed during initial visit Another helpful reason why your practice should utilize the "view list" functionality is that practices can identify if that patient is due to be seen next by viewing the "upcoming appt” field "does not meet" criteria view. To remind yourself of screenings needed, you can make a post-dated note in the patient's chart to remind providers or staff to either complete the screening or test. or to follow-up with a member of the patient’s care team for results of screening (i.e. breast cancer or colorectal screenings). The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Nick Dealtry
November 10, 2017

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How do you track deceased patients in Elation?

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. One of the most common questions many CPC+ participants often ask our health policy specialists is how do deceased patients who were seen at least once during the measurement period but subsequently pass away count toward CPC+ measures? In other words - Do deceased patients count toward CPC+? Yes. If the patient was seen at least once at a CPC+ practice site, they will still count towards the measurement period. However, next year, these patients will not count towards your CPC performance. Despite this, it’s still important to track “deceased” patients for the following reasons: To make patient recall a more streamlined process (i.e. don't need to call in this patient again if they passed) To be able to run a list of deceased patients to keep track of active vs inactive patient panels Within Elation, patient tags are the easiest way to track and find patients within patient lists. How do you add patient tags for deceased patients? To Add a Patient Tag for deceased patients: Click on the "+ Tags" to the right of the patient's name Add in as many tags are you like, separated by commas Tags will appear beneath the patient name The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Sam Peirce
November 1, 2017

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How to get credit for assessments within Elation

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. Primary care practices participating in CPC+ are most likely familiar with the clinical quality measures (CQMs) addressing the two assessments the program focuses on to encourage preventative care. Despite this, many might not be aware that these assessments can be most easily documented within Elation’s EHR. What are the two assessment measures? The two assessment measures that are tracked for CPC+ are: Dementia: Cognitive Assessment Falls Screening for Future Fall Risk How does documenting assessments help with your CPC+ performance? Documenting these assessments within an EHR will help you make sure you get credit for these CQMs. At the same time, Elation has tools like Clinical Decision Support that can help you screen patients and provide preventative care. More specifically, these tools helps you keep track, identify and tailor treatment plans compared to paper documentation. Ultimately, all of these benefits will help you provide better quality care for your patients - a core focus of the CPC+ program. How to document completion of Falls and Cognitive Assessments First, add a diagnosis to the patient’s problem list: Patients with dementia or at risk for falls will also receive a Clinical Decision Support alert if an assessment is due. This will appear at the top of the chart, and allow you to address the issue directly. Alternatively, you can create any document that allows for document tags (Visit Note, Non-Visit Note, or Report) complete the assessment, and click the “+Tag” item at the bottom of the note, after clicking “+Tag,” search for the appropriate assessment and add it to the note. To document an exclusion, Click +Tag at the bottom of a visit note, or other area where document tags can be added, and select one of the valid tags: For Dementia: Severe Dementia, Palliative Care, or Hospice. For Falls: Unable to Walk The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Lucy Li
October 25, 2017

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Two ways to effortlessly document exclusions for CPC+

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. In response to feedback from our users, CPC+ participants can now take advantage of exclusions in Elation's Clinical Decision Support and Health Maintenance workflows. Now users have the two ways document exclusions for greater efficiency and ease of documentation. What are some examples of exclusions? Cervical Cancer Screening for Hysterectomy patients Colorectal Cancer Screening for Total Colectomy patients Breast Cancer Screening for Bilateral mastectomy patients Cognitive Assessment for Dementia for patients who have severe dementia, have had palliative care this year, or have had hospice care this year How do you document exclusions within Elation? Clinical Decision Support (CDS) Within a visit note, simply find the CDS portal and when addressing your chosen screening or assessment click “Document Exclusion.” Health Maintenance You can also enter these exclusions in the Health Maintenance section by selecting the appropriate exclusion from the drop-down. How does documenting exclusions help with your CPC+ performance? Besides simplifying documentation, documenting exclusions are important because these exclusions help your practices report numbers that are more accurate for the CPC+ program. The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Kimmy Hu
October 18, 2017

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How to get CPC+ credit for hbA1c improvement with Elation

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. As we mentioned last week, CPC+ has two reverse clinical quality measures (CQMs) and reporting for these measures can be tricky without the help of a simple and easy to follow workflow. Elation has designed a workflow for the hbA1c measure, in particular, to make meeting program requirements less stressful for your practice. What is the hbA1c measure? The Diabetes HbA1c Poor Control CQM is designed to track the percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c less than 9.0% during the measurement period. As we discussed, this is a reverse measure meaning the goal of this measure is to ensure patients keep their A1c below 9% and practices should aim to lower their percentage for this CQM. How do you satisfy this measure within Elation? To ensure successful completion of this measure for CPC+ follow the steps for the workflow below: 1. Locate the patient with a Diabetes diagnosis (E11.9, etc): 2. Receive HbA1c Labs from a Lab Vendor electronically through Elation, or manually document a patient’s HbA1c Results: 3. The HbA1c can be recorded in a structured format by clicking "Actions" then selecting "Add Lab Values for Trending." You can also refer to this video for a more detailed walkthrough: [embed]https://vimeo.com/234893720[/embed] As with many more complicated CPC+ measures, information can be incorrectly entered or transferred from lab interfaces not compliant with the program. In order to back enter results for this measure to ensure you receive credit, follow the workflow below: Go to Reports > Clinical Quality Measures For the measure "Diabetes HbA1c Poor Control" click on View List From the pop-up window, click on "Meets Criteria". This list are the patients who need data entered as structured data (as there is no data entered via structured entry OR hbA1c value is >9.0%" How does Elation’s workflow help your practice succeed in CPC+? Satisfying a reverse measure like this one which relies heavily on interfaced lab results can be tricky; however, Elation limits wasted time by making documentation straight-forward so that your practice’s progress in the CPC+ program moves forward without a hitch. The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Lucy Li
October 12, 2017

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Elation makes it easy for you to meet the Use of High Risk Medication in the Elderly measure for CPC+

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. Patient safety makes up an important component of fulfilling CPC+ requirements. One of the quality measures that aims to improve patient safety is the Use of High Risk Medication in the Elderly measure. What do you need to know about the Use of High Risk Medication in the Elderly measure? CPC+ designed this measure to track the percentage of patients 66 years of age and older who were ordered high-risk medications. Reporting on the measure counts both the percentage of patients who were ordered at least one high-risk medication and the percentage of patients who were ordered at least two different high-risk medications. To succeed at this measure, providers should try to avoid prescribing high risk medications to elderly patients as often as possible. Since this is a reverse measure, the lower number the number you report, the better your performance. How does Elation simplify meeting this measure within its EHR? For CPC+ practices using Elation, we have added a new clinical decision reminder to allow you to inform your decision-making while prescribing a medication. This CDS will be on for all practice starting Friday, October 6th, but CPC+ practices have the ability to turn it on sooner through their Settings section: With the CDS on, whenever you open a prescription form for patients 66 years and above and enter in a medication, an alert will appear. This clinical decision support reminder includes an overview of the measure and how it’s calculated. You will also have access to the medication list to see examples of prescriptions for high-risk medications through this alert. To view your progress on this measure, the CPC+ CQM dashboard will have a full and complete look at how your practice is doing and which patients are affected by this measure. How can you leverage this Elation CDS reminder for CPC+? Meeting this measure requires no extra work from CPC+ physicians and staff within Elation. The measure’s information is available at the point of care meaning CPC+ participants can easily address the measure and save time they could be spending with their patients. The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Manisha Goud
October 4, 2017

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Using Elation’s updated CQM dashboard to monitor new PBIP performance thresholds

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. Clinical quality measures (CQMs) are at the heart of meeting CPC+ requirements and staying on track with the program. But while CPC+ physicians might be familiar with CQMs themselves, how can physicians keep track of their progress toward fulfilling these measures? Having a CQM dashboard can help! What is a CQM dashboard? A CQM dashboard is a built feature that gives users a real time snapshot into current performance. CPC+ participants can utilize this dashboard to stay on top of the program. In response to CPC+ lowering benchmarks for CQM requirements, Elation has updated our CQM dashboard to reflect the new 30% and 70% benchmarks. How can you use Elation’s Updated CQM dashboard? Within the reports section in Elation, users can select the CPC+ button to access the CPC+ CQM dashboard. This dashboard displays relevant CQMs and how a practice is performing against 30% and 70% benchmarks. Each CQM corresponds to a help center article that is accessible by just clicking on the CQM name. The dashboard highlights completion once you hit a benchmark by displaying the CQM in orange (for the 30% benchmarks) or green (for the 70% benchmarks). Elation’s dashboard also gives users a more detailed overview of patients that either meets criteria or does not meet criteria within the patient list by displaying details such as the patient’s last visit. From here you can click the patient’s name to document completion of a screening,  schedule the patient for a follow up visit, or take any other necessary actions. How can you leverage a CQM dashboard for CPC+? CPC+ requires its participants to meet 9 measures within the 30% benchmark and 6 measures within the 70% benchmark. By using Elation’s CQM dashboard, users can have greater visibility and check their CPC+ progress quickly and easily and zero in on areas to focus on when it comes to patient care. The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.  

Sam Peirce
October 2, 2017

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Staying on top of CPC+ screening measures within Elation

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. As part of CPC+, practices commonly chose to focus their quality improvement efforts toward the three Health Maintenance measures that CPC+ physicians can choose to report on. Elation gives you options on how to address and report these measures to make participating in CPC+ and caring for your patients a breeze. Why are Health Maintenance measures important for CPC+? To ensure physicians are providing the highest-quality preventative care the three following measures comprise one-third of the 9 total quality measures that practices should report on in the 2017 performance year. Breast Cancer Screening Cervical Cancer Screening Colorectal Cancer Screening How can I address these screening measures within Elation? Elation gives physicians and staff multiple options to quickly reference patient screenings and address any outstanding tasks either within the visit note or outside the visit note as well. This gives users the flexibility to document whenever they want, however they want. Within the visit note: 1. At the top of the visit note, users can address a screening by using the Clinical Decision Support (CDS) feature. When a patient is due for a screening, an alert will appear at the top of the visit note. 2. After finding the appropriate screening under CDS, users can document existing results or refer the patient to a specialist if needed. Outside the visit note: 1. Within the Health Maintenance section at the bottom of a patient’s clinical profile, click on the name of the incomplete screening and add in information relevant to the screening to complete the measure. 2. You can also tag a report in the patient’s record with the appropriate document tag to meet the measure’s requirements. What are the advantages of using Elation’s screening options for CPC+? Independent practices participating in CPC+ have the opportunity to save time without sacrificing their flexibility by using Elation’s screening features to participate in CPC+. Whether they want to document at the point of care or after the point of care, Elation is designed to meet the needs of physicians. Ultimately, documenting completion of these screenings are critical for your practice to succeed in CPC+.   The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Nick Dealtry
September 20, 2017

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Quickly identify and manage CPC+ clinical quality measures with Elation’s document tags

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. As many CPC+ physicians know, part of participating in CPC+ includes being able to balance meeting the measurements and providing exceptional care. Document tags within Elation’s Clinical First EHR make participating and caring for your patients more effortless What are document tags? Document tags are critical for logging the completion of eCQMs within Elation. You can tag reports and visit notes to not only categorize these items for future reference but also use them to track completion of screening and measure requirements. We now make it easier for you to know which document tags qualify for measure completion by flagging the document tags with a gold “CPC+” flag! You’ll be able to distinguish which document tags are being used for quality programs from those used for internal tracking purposes. How can you use Elation’s new CPC+ document tags? Document tags can be added to a visit note by scrolling to the bottom and clicking on the +Tag link. Once the appropriate CPC+ - flagged tag is identified and added, the patient will then show as meeting the measure or qualifying for a measure exclusion. You can also add document tags and flag completion of measures through the Health Maintenance section, or by adding document tags to reports. A list of all of Elation’s document tags can be viewed here. How can document tags help you succeed in CPC+? Now that clinical quality measures are appropriately labeled within Elation, CPC+ physicians know exactly which tags count for meeting the program’s requirements. With greater visibility, physicians can address CPC+ measurements more readily and ultimately improve their performance! The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Lucy Li
September 13, 2017

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Using Elation’s CQM dashboard to monitor CPC+ performance

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. Clinical quality measures (CQMs) are at the heart of meeting CPC+ requirements and staying on track with the program. But while CPC+ physicians might be familiar with CQMs themselves, how can physicians keep track of their progress toward fulfilling these measures? Having a CQM dashboard can help! What is a CQM dashboard? A CQM dashboard is a built feature that gives users a real time snapshot into current performance. CPC+ participants can utilize this dashboard to stay on top of the program. How can you use Elation’s CQM dashboard? Within the reports section in Elation, users can select the CPC+ button to access the CPC+ CQM dashboard. This dashboard displays relevant CQMs and how a practice is performing against 50% and 80% benchmarks. Each CQM corresponds to a help center article that is accessible by just clicking on the CQM name. The dashboard highlights completion once you hit a benchmark by displaying the CQM in orange (for the 50% benchmarks) or green (for the 80% benchmarks). Elation’s dashboard also gives users a more detailed overview of patients that either meets criteria or does not meet criteria within the patient list by displaying details such as the patient’s last visit. From here you can click the patient’s name to document completion of a screening,  schedule the patient for a follow up visit, or take any other necessary actions. How can you leverage a CQM dashboard for CPC+? CPC+ requires its participants to meet 9 measures within the 50% benchmark and 6 measures within the 80% benchmark. By using Elation’s CQM dashboard, users can check their CPC+ progress quickly and easily and zero in on areas to focus on when it comes to patient care. The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Sam Peirce
September 6, 2017

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How CPC+ physicians can leverage Clinical Decision Support at the point of care within Elation

With the first CPC+ performance period now well underway, Elation is excited to bring our users weekly updates to help you save time, get the most out of using Elation for CPC+, provide better care for your patients and ultimately succeed in this program. Learn more about Elation and CPC+ here. Primary care physicians and especially those participating in CPC+ understand the importance of having the most up-to-date information at their fingertips at any given moment when they deliver care. Clinical electronic health records (EHRs) like Elation fulfill this need in part with Clinical Decision Support (CDS) tools that can enhance decision-making throughout the clinical workflow. Why CDS? Clinical Decision Support has several benefits for independent primary care physicians, including: Meet and exceed required clinical quality measurement goals with ease Increase care quality and enhance patient care outcomes Improve efficiency, financial savings, and provider-patient satisfaction How exactly does CDS work in Elation? During clinical encounters, Elation’s Clinical Decision Support reminders appear at the top of every visit note. This functionality automatically prompts users at the point of care so that problems can quickly and easily be addressed by a MA or physician. Information is automatically pulled in based on information from a patient’s chart, problem lists, demographics, and historical items so that information is accurate, relevant, and specific to a patient’s needs. How can CDS help you during CPC+? By leveraging Elation’s Clinical Decision Support reminders, Elation users participating in CPC+ can satisfy program requirements at the point of care. CPC+ clinical quality measures are embedded within Elation’s CDS reminders, meaning physicians can more efficiently provide care for their patients and spend less time looking for information on a patient’s chart. Overall, Elation’s Clinical Decision Support reminders are a sophisticated set of features that can help you create a clinical workflow that is geared toward improving documentation and clinical efficiency. Having a system that supports CDS can enable your independent practice to stay on top of patient care throughout CPC+. The statements contained on this website are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained on this website.

Manisha Goud
August 30, 2017

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Using EHRs in clinical research and trials

The Federal Drug Administration (FDA) issued guidance in May 2016 on the use of electronic health records (EHRs) in clinical trials and research. In its “Guidance for Industry,” Use of Electronic Health Record Data in Clinical Investigations, the FDA recognizes the widespread use of EHRs as well as the benefits of optimizing the technology tool in clinical research. The introduction to the guidance documentation states that “in an effort to modernize and streamline clinical investigations, the goals of this guidance are as follows: Facilitate the use of EHR data in clinical investigations Promote the interoperability of EHRs and electronic systems supporting the clinical investigation” The FDA recognizes that “there are opportunities to improve patient safety, data accuracy, and clinical trial efficiency when data from these systems are used in clinical investigations” while also providing guidance and recommendations on the use of EHRs in research and trials. Interoperability between systems is seen as being a helpful tool in transmitting vital information and “may simplify data collection for a clinical investigation by enabling clinical investigators and study personnel to capture source data at the time of a subject’s point-of-care visit.” The FDA guidance adds that the “interoperability and automated electronic exchange of information between the EHR and the sponsor’s electronic system supporting the clinical investigation, such as an electronic data capture (EDC) system, may benefit the clinical investigation and patients and other health care providers.” The security of patient data is a concern when EHRs are used in clinical investigation. Researchers and trial sponsors must adhere to HIPAA requirements for patient privacy and safety when accessing and transferring data. They must also conform to any regulations and requirements for data integrity that may be put in place by their own institutions. The FDA guidelines advise that, when used properly, “EHRs may enable clinical investigators and study personnel to more easily combine, aggregate, and analyze data from many different sources.”

Tyler Comstock
August 22, 2017

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How the states rank on EHR usage

The use of health information technology has increased over the past several years, in some states more than others. One of the tools seeing such an increase is the electronic health record (EHR). The Center for Data Innovation recently conducted a study that included the measure of the EHR adoption rate by physicians and healthcare facilities in the US. The result, The Best States for Data Innovation, published in July 2017, provides some interesting insight into the state-by-state rankings. The top-ranked state for EHR usage in 2015 was Massachusetts, followed by Wyoming, Washington, Minnesota, and Indiana. Many factors contributed to these states being ranked in the top five for data innovation and EHR use. The report explains that Massachusetts, as well as a number of other states that ranked near the top, “participated in a multistate working group on EHR interoperability, which promoted interoperability among state vendors.” In addition, in Wyoming “the Department of Health began offering a fully certified EHR platform to Medicaid providers at no cost in May 2012.” At the bottom of the list are Vermont, Hawaii, Louisiana, Rhode Island, and finally, New Jersey. Only 75% of hospitals and 62% of physicians in New Jersey adopted EHRs. Why do these rankings matter? What benefits do EHRs provide to physicians and healthcare facilities? The report ranks states by their innovation efforts, particularly by their adoption of EHRs, because “these technologies help ensure that a patient’s medical information is available at the point of care, and allow physicians to use decision-support systems to help reduce mistakes and improve quality of care.” The Center for Data Innovation explains that their scoring “indicator is a composite score of two variables: the percent of all office-based physicians who have adopted a certified EHR and the percent of nonfederal acute care hospitals that have adopted basic electronic health record systems. The values for this variable are extracted directly from the source and then standardized. The standardized scores are weighted equally, then summed for a final score.”

Tyler Comstock
August 21, 2017

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First steps after you've gotten a new EHR system

Congratulations! You’ve made the decision to purchase an electronic health record (EHR) system for your independent practice. Now what? Getting the most of your new EHR system means that you will need to set it up and use it as quickly as possible. Writing in Physicians Practice, Alex Tate recommends several steps to take to make that happen. The first step is to contact your vendor to get assistance and training. Elation works with our clients to make sure their EHR solution works for them. We migrate patient data for our clients for free and we offer training and 24/7 support. Elation’s cloud-based EHR is intuitive and generally takes less an hour to learn, so you can start using it for your practice right away. Additionally, Tate recommends: Use shortcuts when you can. Setting up templates and triggers can help reduce the amount of repetitive information that you will enter into the EHR, based on the typical types of illnesses and procedures your practice manages for patients. Integrate a portal. Patient engagement is critical for the quality of patients’ healthcare as well as for meeting certain Medicare requirements. The patient portal enables communication to flow more seamlessly between patient and providers as well as between providers. Investigate all of your EHR’s features. Explore the many opportunities to improve your practice and to provide quality healthcare to your patients using the EHR’s features. Set up practice management tasks for handling administrative tasks to help your practice run smoother. Consider other add-ons. Coordinating additional technology tools with your EHR system can further improve your practice’s efficiency. Stay current. Review the vendor’s information for updates and additional guidance on using your EHR to its fullest. Elation’s blog posts and resource center are designed to provide you with up-to-date news and assistance. Get the entire team involved. Engage your staff in learning and using the EHR system for patient and practice management tasks.

Parker Nieves
August 18, 2017

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Clinical First EHR features: Cockpit View

Managing a patient’s records during a visit can be cumbersome. Particularly if those records are kept on paper in a file folder, the physician may spend a great deal of time simply trying to find the right visit note or lab result. Even with the use of some electronic health records (EHRs), physicians find that they have to flip between screens to access the information they need. That can be time-consuming and frustrating for the provider as well as the patient. An article on physician’s concerns in HealthAffairs summarized the challenges: “Patients, providers, payers, and vendors all have an interest in improving the usability of EHRs and integrating them into clinical workflows that produce better, more efficient care.” Wasted time and records that are difficult to access can actually impact the quality of care the physician is able to provide the patient. Elation’s Clinical First EHR resolves all of those issues with its Cockpit View. While most EHRs rely on a linear workflow which forces back-and-forth screen toggling and extra clicks, Elation’s Cockpit View surfaces everything the independent physician needs in a unique three-pane console, providing more flexibility. Having immediate access to the patient’s information significantly reduces the amount of time the physician spends looking up records and can increase the amount of time actually spent with the patient. The Cockpit View is built with the busy physician in mind. There are only two screens to become familiar with, providing all the information needed. The windows can be ordered and reorganized based on the provider’s preference regarding specific practice workflow. We recognize that each physician’s workstyle is different, whether working online or organizing papers on a desk. With a Clinical First EHR, the provider can document visit notes, order lab tests, e-prescribe, and write referrals in any order, making the process efficient as well as effective.

Tyler Comstock
August 15, 2017

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What are the clinical tools independent physicians need for value-based care?

The transition from fee-for-service to value-based care requires physicians to be prepared with the right tools. A survey conducted in mid-2016 showed that “only 29 percent of polled physicians stated that they have the tools necessary to function effectively in the world of value-based care payments.” Primarily, these tools consist of the right technology needed to manage patient information and to coordinate care with other providers. Primary care physicians need information at their fingertips, to gauge the quality of their patient care and to be able to report results. The electronic health record (EHR) is an important tool for physicians to have and to use correctly. To be truly effective, EHR systems must be interoperable. They must talk to each other for true coordination of care to occur. Patients with chronic or complex conditions, in particular, may see multiple physicians, so the primary care provider must have immediate and accurate access to those patients’ medical information to provide quality, value-based care. A tool such as Elation’s Collaborative Health Records (CHR) is designed to provide physicians with on-demand access to patient information from any provider in their network. CHR gives providers visibility into their patient’s complete care record for more accurate reporting on clinical quality measures and compliance for value-based reimbursement. Physicians do not necessarily need more data; rather, they need access to the data that will impact them and their patients. They need tools that will help them communicate with their patients and with other providers. And, they need to see the patient’s medical information, including visit notes, diagnoses, and medications, in one click, rather than spending time combing through paperwork or waiting on requested information. Current and accurate data can make all the difference in a patient’s care and in a physician’s ability to provide value-based care.

David Burke
August 8, 2017

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The history of electronic health records (EHRs)

Prior to the 1960s, all medical records were kept on paper and in manual filing systems. Diagnoses, lab reports, visit notes, and medication directions were all written and maintained using sheets of paper bound together in a patient’s medical record. Those records were labeled using the patient’s last name, last few numbers of the patient’s social security number, or some other chart numbering system. The records were then filed and retrieved from specially made shelves designed to hold vertical file folders. In the mid-1960s, Lockheed developed an electronic system known then as a clinical information system. The rest, as they say, is history. Other technology and engineering companies started to develop electronic medical records systems for hospitals and universities. In the 1970s, the federal government “began using EHR … with the Department of Veteran Affairs’ implementation of VistA, originally known as Decentralized Hospital Computer Program (DHCP),” according to an article in the AMA Journal of Ethics. By the 1980s, more focused efforts were made to increase the use of EHR among medical practices. The Institute of Medicine (IoM) implemented a study of paper record usage in the mid-1980s and published the results in 1991. The report argued the case for using EHR, “as one of seven key recommendations for improving patient records, and to propose a means of converting paper to electronic records.” By 2004, the need to convert medical records to EHRs was recognized nationally with the creation of the Office of the National Coordinator (ONC) of Health Information Technology (IT). Shortly after, EHRs were incorporated into the Health Information Technology for Economic and Clinical Health Act (HITECH), providing “higher payments to health care providers that meet ‘meaningful use’ criteria, which involve using EHR for relevant purposes and meeting certain technological requirements.” HIPAA regulations were adjusted to account for electronic protected health information (ePHI) that was being maintained by these EHRs. Today, the EHR is a secure and effective tool for maintaining a patient’s healthcare data, for communicating with patients and other providers, and for supporting the patient-physician relationship. No more shuffling through paper files, waiting for faxes, or searching for paperwork to be able to provide quality care for patients.

Gabby Marquez
August 4, 2017

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What is a Clinical First EHR?

Patient records have traditionally been maintained on paper, in files, in rows and rows of specially tabbed folders in a physician’s office. When the patient came in for an appointment, an assistant would retrieve the paper file, make some notes on it, and place it in a file holder outside the exam room for the physician to pick up before seeing the patient. Notes from other providers, lab results, and information from healthcare facilities would have to be sent to the physician’s office via fax or regular mail. When that information did not arrive in a timely manner, a staff member had to make additional calls or send more faxes to request the records again. When received, those notes were inserted into the patient’s file for the physician to flip through and read while the patient waited. Electronic health records (EHRs) have changed the entire process, for the better. EHRs are electronic versions of those paper files, with the added touch of being shared seamlessly and securely between all providers involved in the patient’s healthcare. The physician has all the information needed to treat the patient effectively with one click and, as a result, also has more time to spend talking to and listening to the patient during the visit. The Office of Health Information Technology (IT) details the advantages of EHRs over paper files in that they “are built to share information with other healthcare providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” Elation’s Clinical First EHR is more than just an electronic record. It is a commitment to building a provider-centric Clinical EHR that exists at the nexus of the clinical workflow, supports the physician-patient relationship, and drives outstanding patient outcomes. The Clinical First EHR also enables the physician to quickly identify patients who aren’t meeting goals based on custom care management protocols, Meaningful Use objectives, or specific document tags, and easily schedule a follow-up appointment to address any potential gaps in care.

Parker Nieves
July 31, 2017

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The relationship between EHR design and patient safety

Electronic health records (EHR) are designed to improve the quality of care a physician is able to provide for a patient. EHRs help reduce the issues that arise with paper medical records, including missing or incorrect information and delays caused by waiting for information to be transferred from one provider to another. As with any tool, however, care must be taken to use the EHR system properly in order to ensure it is a helpful tool and is not causing further issues for the patient’s safety. The Electronic Health Record Association (EHRA) recently published Electronic Health Record Design Patterns for Patient Safety, which outlines potential areas of the EHR that might impact patient safety, including: Medications Alert Fatigue Lab Results Numeric Display Displaying Text The EHRA warns that confusion regarding medication information may result from the use of abbreviations or non-standard naming conventions. The association advises that “medications should be displayed in accordance to the FDA-approved list of ‘Generic Drug Names with Tall Man Letters’ and the Institute for Safe Medication Practices’ (ISMP's) list of ‘Additional Drug Names with Tall Man Letters.’" Alert fatigue occurs when providers and healthcare workers become desensitized to the volumes of alerts they receive every day. Prioritizing alerts within the EHR, based on the potential for patient harm, can help overcome alert fatigue. The highest priority, or critical, alerts should be interruptive, not allowing the healthcare worker to bypass them until they are read and acknowledged. The EHRA advises that lab results must have a consistent display, regardless of where the results originate. In addition, they must be clearly separated according to previous and current results, and clearly flagged for abnormal results that require action. Lab results and diagnostic tests often show up in numerical format. These can be hard to read and interpret correctly. The recommendation is to add a zero at the thousands level and in front of fractional numbers, for example, 1,000 and 0.25, instead of 1000 and .25. Likewise, text needs to be easily read on-screen, to ensure accurate interpretation and to ensure appropriate instructions are provided to the patient. Shortcuts, such as abbreviations, can lead to errors in patient communications and to issues with patient safety. The provider who follows these guidelines and uses care when inputting visit notes and other patient-related information can have a significant positive impact on the level of patient safety involved in reading and interpreting patient data in an EHR.

Tyler Comstock
July 28, 2017

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Using EHR documentation to improve clinical data integrity

Technology has improved both the speed and the convenience of medical record documentation. Electronic health records (EHR) that keep a patient’s data organized and accessible have virtually eliminated the need for traditional paperwork in an independent physician’s office. However, an unbalanced emphasis on speed and efficiency can also lead to input errors. When optimizing the use of EHR documentation, care must also be taken to maintain the integrity of the data. Data integrity is crucial to ensuring that patient records are accurate, so patients receive the appropriate care. Otherwise, decisions might be made based on erroneous information, leading to potentially disastrous results. Data integrity is also crucial for meeting reimbursement requirements. The American Health Information Management Association (AHIMA) published a 2013 update to its EHR Documentation Guidelines, Integrity of the Healthcare Record: Best Practices for EHR Documentation. Their update includes the guidance for providers completing patient records that they “must recognize each encounter as a standalone record, and ensure the documentation within that encounter reflects the level of service actually provided and meets payer requirements for appropriate reimbursement.” Relying too heavily on tools of convenience within the electronic record platform, such as “copy and paste” and automatic fill-ins can lead to compromised data. Providers and their staff must understand the necessity of reviewing and confirming that information in the patient chart is accurate, before relying on it for the patient’s healthcare plan or submitting for reimbursement. Maintaining accurate documentation within the EHR is essential for the health of the patient as well as for the health of the independent provider’s practice. Data that contains errors, such as another patient’s information, can not only endanger those patients but also can become an HIPAA issue if not handled appropriately. A few minutes spent on verifying data can help ensure that the patient is being treated accurately and that the practice is on solid ground for reimbursement and records integrity.

David Burke
July 28, 2017

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What is a cloud-based EHR?

An electronic health record (EHR) contains a patient’s medical information, including provider visit notes, lab results, medication lists, and communications with the patient and other providers treating that patient. Many independent physicians are now taking advantage of EHRs that help them track their patient’s medical progress and help them remain compliant with the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program. EHRs are maintained on a server, making them accessible by multiple providers and clinical staff members. They can be kept on a local server in the physician’s office or they can be cloud-based. What does it mean for an independent physician to operate with a cloud-based EHR? With cloud-based EHR systems, data is stored on external servers and can be accessed with any device that has an internet connection, while server-based EHR systems store data within the practice on a personal server. The EHR system is maintained by a Software as a Service (SAAS) provider, so the independent physician does not have to spend time or money on server installation or upkeep. Updates are handled by the SAAS provider as well, which eliminates a significant headache for the medical practice. Common benefits of a cloud-based EHR system, as described by The Office of the National Coordinator (ONC) for Health Information Technology (IT), include: Reduced upfront hardware and software costs Reduced ongoing maintenance costs Higher levels of IT-service availability than in-house IT services Reduced run-time failures In addition, rather than having to purchase, install, and maintain an entire server system, the independent physician using a cloud-based EHR system can start small and increase the IT allocations as needed. Security for patient data on a cloud-based EHR is a responsibility shared between the SAAS provider and the independent physician. Information contained in an EHR is considered electronic protected health information (ePHI) and is covered under HIPAA regulations. The ePHI is heavily safeguarded by the cloud-based EHR, ensuring that patient information is both safe and easily accessible by the independent physician.

Parker Nieves
July 28, 2017

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Debunking common EHR myths

Electronic health records (EHR) are designed to streamline patient records, provide easy access to patient data, and encourage communication between physicians and patients. As with most new technology, there are some misconceptions and myths still prevalent in the healthcare world about EHR. A recent blog post in exscribe, published by Orthopaedic Healthcare Solutions, helps to debunk some of those EHR myths. Myth: Spending too much time on the computer takes away from the physician’s face-to-face interactions with patients. In fact, quite the opposite is true. When independent physicians have immediate access to a patient’s medical data with the touch of a finger, the physician can actually spend more time talking with - and listening to - the patient and less time sorting through paperwork. EHRs also provide a portal for patient engagement after the visit, further developing that crucial physician-patient relationship. Myth: EHRs pose a security risk. In fact, patient records are more secure on a cloud-based EHR system. A patient’s electronic protected health information (ePHI) is covered under the current HIPAA laws. When using a cloud-based system, security is actually more heavily safeguarded. Cloud-based servers are initiating careful and tactical efforts (such as conducting risk analyses, encrypting data, etc.) in order to assure that a patient’s ePHI is kept safe and private. Myth: EHR systems are all the same. In fact, there are major differences between EHR systems. The choice of an EHR solution for an independent physician’s practice can make the difference between a smooth implementation and the time spent training and acclimating to the new system. In addition, an EHR system should be selected that provides the physician with the ability to coordinate care with other providers and communicate seamlessly and securely with patients. Elation’s EHR solution is designed to provide independent physicians with the advanced technology they need to improve the quality of healthcare they provide to their patients. Learn more about how a Clinical First EHR is different than other EHRs.

Tyler Comstock
July 28, 2017

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Tackling rising health IT costs

Health IT costs have ballooned to an annual $32k a year per physician according to one study. The 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) promoted and provided funding for adoption of health information technology, but also imposed new requirements for independent physicians that resulted in increased costs. Stimulating the use of electronic records and electronic health information exchange was intended to “establish programs to improve health care quality, safety, and efficiency through the promotion of health IT.” Being able to share health information is particularly important for independent primary care physicians with patients who see multiple providers. However, it is just those independent physicians who are challenged by the increased health IT costs. In addition, the move toward value-based payments and away from the fee-for-service structure “requires more patient outreach and technology to pull off successful management of populations of patients,” according to a recent Forbes article. Independent physicians who are faced with complying with the HITECH Act and with adjusting to value-based payments, while also focusing on patient quality, need a solution. Elation's EHR system offers an affordable response to the changes in the Health IT environment. Electronic records and the interoperability between EHR systems give independent physicians the immediate access they need to patient information, enabling them to provide the coordinated care that will ultimately save on healthcare costs and provide higher quality patient care. At Elation, our philosophy is ingrained in the solutions we provide to independent physicians. We offer a system that saves physicians money and helps them earn more. Our EHR system streamlines communication with patients and with other providers, saving time and money, as well as reducing duplication and errors caused by traditional communication methods. Practice management enables physicians to reduce waste, reduce the time spent on administrative tasks, and improve their practice by better understanding and using their data for improved patient results. At Elation, we understand the issue of rising costs and wasted time and money. Our solutions are designed to make Health IT more affordable and more effective for the independent primary care physician.

Gabby Marquez
July 28, 2017

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What is a certified EHR?

The Centers for Medicare & Medicaid Services (CMS) has established standards for independent physicians to qualify for the Medicare and Medicaid EHR Incentive Programs. To be eligible for the incentive payments, providers “must use an EHR that is certified specifically for the EHR Incentive Programs.” Additionally, CMS states, EHR certification “helps providers and patients be confident that the electronic health IT products and systems they use are secure, can maintain data confidentially, and can work with other systems to share information.” What does it mean for an EHR to be certified? An electronic health record (EHR) system must meet certain standards in order to be certified. Specifically, the EHR must meet the functional and security requirements as well as meaningful use criteria as established by CMS. Certification is achieved when a company such as the Drummond Group assesses the capability of the tested product and determines that it meets all the established criteria.  Drummond Group began testing their first EHR solutions in September 2010, and since then has tested hundreds of EHR systems. A Drummond Certified™ seal serves as an important resource for independent providers and healthcare organizations who are looking to invest in EHR software and who need to meet the meaningful use criteria. When Drummond applies its seal, it guarantees that the EHR meets industry standards and that it is interoperable, a very important function for primary care physicians and specialty providers. An EHR system cannot receive the Drummond seal without undergoing rigorous testing. The Drummond Group tests the EHR throughout its lifecycle including auditing, quality assurance, conformance testing, customer software test lab services, software certification, web service tests, and consulting. A certified EHR system comes with a guarantee of operability and assures the independent physician of compliance, reliability, and adherence to industry standards. With meaningful use requirements and incentive payments becoming more significant challenges as CMS moves toward value-based reimbursements, choosing a certified EHR for an independent physician’s practice is imperative.

David Burke
July 27, 2017

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Emerging from EHR purgatory through value-based reimbursement

As an independent physician using an EHR system, do you find that you are spending more time on the computer than with your patients? EHR systems are theoretically designed to enable you to spend less time on charting and billing so you will have more face-to-face time with patients. However, a reimbursement structure that rewards quantity over quality may be challenging that EHR design theory. Writing in the New England Journal of Medicine, Allan H. Goroll, MD, an internist at Boston-based Massachusetts General Hospital, posits that the “underlying mode of physician payment” is the driving force toward “EHR purgatory.” Dr. Goroll goes on to explain that “delivery from EHR purgatory may require a fundamental change in the way we pay clinicians: moving from rewarding processes to rewarding outcomes.” Value-based reimbursement shifts the focus back to the quality of patient care and shifts the EHR focus back to managing data on patient visits, lab results, and the patient’s healthcare plan. The EHR must also promote communication between patient and physician as well as between a patient’s multiple providers. Elation’s Clinical First EHR enables independent physicians to spend their time focusing on patient care rather than on tedious and often repetitious data input. At Elation, we recognize that entering and re-entering information has remained a time-intensive and cumbersome part of adopting electronic health records. Elation reduces this need by prioritizing automation throughout the workflow. Clinical First is a commitment to building a provider-centric Clinical EHR that exists at the nexus of the clinical workflow, supports the physician-patient relationship, and drives outstanding patient outcomes. Independent physicians should be able to spend more time engaging with their patients during visits and during follow-up communication and less time in EHR purgatory. We understand that, as an independent physician, you are concerned about your patients’ care quality. You need to spend less time on the paperwork and on the computer and more time doing what you do best, providing value-based patient care.

Parker Nieves
July 20, 2017

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Using EHRs to reduce stroke risk

The American Heart Association states that 800,000 people experience a stroke in the United States each year. Of those, approximately 130,000 people die. Preventing or reducing the risk of stroke is crucial for independent physicians who are concerned with the quality of their patients’ healthcare. How can electronic health records (EHRs) help these physicians as they focus on helping their patients? Researchers in California are studying the impact EHRs can have for physicians who are able to review a patient’s medical records for signs of a second stroke. Patients who have had one stroke may have an irregular heart beat called atrial fibrillation, which has been identified as a risk factor for a second stroke. The researchers have found that if physicians using EHRs can “identify the stroke patients who are most likely to experience atrial fibrillation, they could start treatments that would help prevent a second stroke.” Stroke patients are monitored while they are in the hospital and, often, after their discharge. Not all patients require or receive such monitoring. Reviewing a patient’s medical records in an EHR can provide the independent physician the information needed to determine whether a stroke patient is in danger of experiencing additional strokes, without the need for 24/7 monitoring. Understanding the clinical data contained in the EHR can actually help the physician determine which patients need that constant monitoring and which can be assessed based on their medical records. The study assigned risk factors and then categorized patients into risk groups based on those categories. Risk factors for stroke that are known to be “age, obesity, congestive heart failure, hypertension, coronary artery disease, peripheral vascular disease and disease of the heart valves — are the basis of a scoring system that assigns patients to one of three risk groups.” Elation’s Clinical First EHR enables independent physicians to input and review the data that can be so crucial in predicting and reducing stroke. Our EHR tool also provides the communication tool that can play a critical role in patient-physician communication, which can also help with awareness and prevention.

Parker Nieves
July 20, 2017

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The importance of usability in our healthcare system

Electronic health record (EHR) systems offer helpful functions for independent physicians, including the ability to manage patient visit notes and coordinate with other providers. However, the tool has to be usable if it is to serve its intended purpose and be valuable to those physicians. The International Organization for Standardization (ISO) has developed a standard definition of usability as “the effectiveness, efficiency and satisfaction with which specified users achieve specified goals in particular environments.” In other words, the tool must be effective in achieving the physician’s goals in using it, be an efficient way to achieve those goals, and provide the physician with the satisfaction that it has served its function in reaching those specific goals. Why is usability important? At the recent Electronic Health Records Association (EHRA) Usability Summit, it was pointed out that usability does not just affect the physician in an independent practice. Often, a medical assistant or billing staff member will also use the EHR to add or manage patient information. Patient and physician use of the communication feature also requires usability on the patient’s end. All of these individuals must be able to use the system effectively for the process to flow seamlessly. Usability is also an issue where the security of patient data is concerned. When data is shared among multiple physicians, laboratories, and healthcare facilities, each of those providers must be able to use the tool appropriately to prevent a breach of confidentiality. The need for increased security levels becomes a greater concern as the use of technology increases. The importance of usability is reflected in the need to provide quality care efficiently and effectively using such advanced tools as EHRs. Elation’s philosophy is focused on building a technology platform that doctors and patients use because they want to use it. The usability of the Elation EHR system builds trust, improves the quality of care, and enables the independent physician to be more productive and effective.

David Burke
July 18, 2017

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Technology driven value-based care

The shift to value-based payments from fee-for-service payments is essentially a shift to quality from quantity. No longer will physicians be paid for each service or each visit. The trending emphasis is on providing value-based primary care that is focused on the quality of patient outcomes rather than the number of patient visits. How can technology help physicians deliver on the promise of value-based care? Financially, the independent physician will need to be prepared for the new fee structure, according to a recent article in Revenue Cycle eLearning. With a “true outcomes-driven model, the bundled payment model will require the payer to look ahead and pay providers a single, pre-determined price for an entire encounter at the time of service delivery.” The single payment will include all related services and follow-up visits. Adopting an EHR system will become essential to managing value-based primary care for optimum patient and financial outcomes. Effective technology will be an essential tool for the independent physician in driving not only financial solvency but also patient health. As the article notes, “an EHR will serve as the underlying system for everything moving forward.” An EHR system enables the independent physician to manage patient care as well as the practice itself, more efficiently and effectively. Having access to a patient’s complete medical record, including information from other providers, labs, and healthcare facilities, enables the independent physician to develop and implement a more complete overall picture of the patient’s care plan. Redundancies - and the associated costs - are reduced or eliminated. Elation’s philosophy from the start has been to help independent physicians provide value-based primary care that benefits the patient and the practice. We recognize the enormous chasm between the world of policy and payers and the world of the front-line physician. We have built our solutions with a mission to strengthen the relationship between patients and physicians, and enable phenomenal care for everyone. Elation’s EHR system can help transform value-based primary care.

Parker Nieves
July 17, 2017

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EHR use expected to increase regardless of whether the ACA is repealed

The Affordable Care Act (ACA) continues to be threatened with repeal and replacement. Even as the new bills are debated and delayed, however, many aspects of healthcare will continue to move forward. Advances in technology, particularly in the use of electronic health records (EHR), are actually predicted to increase as they positively impact improvements in patient diagnosis and treatment. The Harvard Business Review (HBR) has identified three aspects of healthcare that are not affected by the deliberations over the ACA: The population will continue to age, the article points out, and aging patients will need expanded health care delivery. The research and discoveries that impact the life sciences will continue in healthcare laboratories. The use of technology that has “become a pervasive element across the health care system, with a major impact on diagnosis, treatment, and communications,” will continue to increase. The HBR article points out that the use of EHR has grown tremendously over the past few years, from one in five practicing physicians using an EHR in 2004, to the nearly nine in ten who use the tool today. EHRs are important instruments in the independent physician’s practice, used to “guide treatment, assess outcomes, and measure quality of care.” In addition, coordinated care driven by EHR interoperability will become increasingly important to the treatment of the aging population. Life sciences research also continues to be impacted by electronic patient data. The increase in discoveries in the laboratory is “being driven by two major trends: the availability of personal health data, and the plummeting cost of integrating massive health data sets in the cloud.” Technology will play a significant role in healthcare delivery now and in the future, regardless of political debates over healthcare insurance and payment options. Advances in EHR systems, particularly in interoperability between the systems, will continue to fuel advances in improving patient outcomes and in the overall quality of healthcare.

David Burke
July 13, 2017

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Prominent CIO predicts EHRs are headed in a more patient-centric direction

Healthcare is all about the patients. Electronic health records (EHRs) are designed to maintain those patients’ medical data in a seamless, secure environment. EHRs are also intended to provide a platform through which providers can communicate with each other and with their patients about their patients’ care. In a recent blog post, John D. Halamka, MD, MS, Chief Information Officer of Beth Israel Deaconess Medical Center, describes what he envisions as a “transition from EHR 1.0 to EHR 2.0” as EHRs move toward being more patient-centric. Dr. Halamka, who is also Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician predicts that certain trends will impact the future of EHRs: Fewer government mandates. EHRs will be able to focus more on results rather than simply recording activity. Team-based care. Independent physicians will rely on staff and other physicians to assist with inputting data and prioritize patient messaging. Value-based purchasing. The use of the EHR is moving away from fee-for-service payments and toward patient satisfaction. The next generation of EHRs “should include the functionality necessary to document care plans, variation from those plans, and outcomes reported from patient-generated healthcare data.” Usability. Patients as well as physicians should have access to improved EHR usability, to more properly and actively manage their care. Consumer driven. The patient needs to be included as an active participant in the care management process. Patient portals within the EHR should enable the patient to schedule appointments electronically, interact with physicians, and become “an equal member of the care team, providing them with care navigation tools.” EHRs are headed in a more patient-centric direction, in a move toward supporting “teams of caregivers focused on value while treating patients as customers.”

Tyler Comstock
July 7, 2017

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Can electronic health records predict a patient’s future health?

Researchers at the University of Chicago are examining whether electronic health records (EHRs) can be used to make healthcare predictions. The researchers at UC Medicine believe that, by extracting information from a patient’s electronic health records, they can “create predictive models that could help prevent unplanned hospital readmissions, avoid costly complications and save lives.” The research project is a collaborative effort of UChicago Medicine, Stanford, and the University of California, San Francisco, with Google’s machine-learning research team. An important aspect of this research is the ability to extract information from health records that are electronically maintained. When a patient’s data is stored and managed using a tool such as Elation’s Clinical First EHR, the data is accessible not only for patient care, but also to be used to improve a patient’s future health. A Clinical First EHR enables the independent primary care physician to holistically evaluate patient population with a longitudinal record that trends vitals and lab values over time. Understanding a patient’s current situation and gathering information that helps in predicting future trends can make a significant difference in the patient’s care management plan. Communicating this information to the patient and to specialty providers caring for the patient is also a vital piece in the overall collaborative care picture. The UC Medicine study is critical to the future of healthcare in general, given the startling statistics described in a recent Science Life article on the research project. Specifically, each year in the United States: Unplanned hospital readmissions cost as much as $17 billion The CDC estimates that health care-associated infections lead to 99,000 deaths Problems with medications cause more than 770,000 injuries and deaths Globally, 43 million people a year worldwide are affected by medical error. Elation’s philosophy has always been focused on our mission of enabling phenomenal care for everyone. Our Clinical First EHR can help manage patient care more effectively now and contribute to healthcare predictions that will save lives.

Gabby Marquez
June 21, 2017

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Elements of an ideal EHR

An electronic health record (EHR) system that is poorly designed may actually require more of an independent physician’s time and focus than was intended by the advance in technology. What do independent physicians really want to see in their EHR system, to ensure it contributes to the efficiency and effectiveness of their practice? What are some of the elements of a perfect EHR for physicians? The American Medical Association (AMA) conducted a study of physicians using EHR in 2016 and came up with a list of features that they believe should be part of an effective EHR system, based on the feedback of those providers. The EHR system should: Enhance physicians’ ability to provide high-quality patient care Support team-based care Promote care coordination Elations’ clinical EHR for independent physicians addresses all of these concerns. In fact, our focus has always been on developing the right tools that will enable independent physicians to provide the highest quality patient care, without being bogged down in administrative paperwork. At Elation, we are also focused on care coordination and have developed the Collaborative Health Record with the goal of enabling the independent physician to automatically collaborate with a patient’s other providers. Additionally, the AMA recommends that EHR systems should “expedite user input into product design and post-implementation feedback.” At Elation, one of the key features of our clinical EHR for independent physicians is that we encourage users to provide their input so we can make improvement based on their feedback. Jesse M. Ehrenfeld, MD, MPH, an associate professor of anesthesiology, surgery, biomedical informatics and health policy at Vanderbilt University School of Medicine and a member of the AMA board, stated that physicians “want tools that help us provide high-quality care and make the process of care easier and more efficient.” That’s exactly what we want at Elation as well. We designed our clinical EHR for independent physicians to enable physicians to focus more fully on their patient outcomes, through the coordination of the highest quality care. Want to learn more about why Elation is truly the ideal EHR for independent physicians?

Parker Nieves
June 15, 2017

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