EHR implementation consultants and specialists

This is republished from NonClinicalJobs.com Electronic health record (EHR) vendors are looking for implementation consultants and specialists. The nice thing is that most of these EHR companies will train you, but you should expect to travel quite a bit for this type of job. The majority of these clinical informatics positions are being filled by nurses, but physicians can play a unique role when it comes to interacting with other physicians. You see, physicians generally like to learn from other physicians. They want a colleague to provide them with pointers and tips on how a system can improve the clinical workflow. Many hospitals are cultivating physician "champions." These champions are influential advocates and have a unique way of communicating with other physicians in the hospital system. We need more champions, don't we? So, if you're thinking about a career in health IT, consider how you can play a role in the EHR implementation process. Implementation is just the first step. Maybe you could be instrumental in helping physicians and hospitals reach "meaningful use" so they can receive financial incentives from the government through the HITECH Act (Health Information Technology for Economic and Clinical Health Act) within ARRA. Who are some EHR vendors? Here are a few (in no particular order or preference): Allscripts, GE, Epic, McKesson, NextGen, eClinicalWorks, Practice Fusion, athenahealth, Cerner, ChartLogic, Eclipsys, Greenway, Ingenix, MedConnect, and many others.

Inpatient "lessons learned" from health IT implementations (#HIMSS10)

I attended a great education session this morning where presenters shared their "failures and lessons learned" as they implemented health IT in their hospitals. The room was very crowded and quite a few people were standing in the back. The presenters represented the following hospitals and health systems:

• MultiCare
• Children's Hospital Boston 
• Kaiser Permanente in Southern CA

They shared their successes and also emphasized some of the key failures and lessons learned as they implemented CPOE and other health IT inpatient solutions, including:

• Conduct regular interdisciplinary workflow meetings
• Medication reconciliation remains a challenge
• Who owns the MAR when you transition from a paper MAR to an e-MAR? (Medication Administration Record)
• Train, re-train, and then train again
• Physician champions are key
• Involve the nurses!
• Account for variations in clinical workflow in different settings
• Be prepared for verbal orders
• Physicians want to learn from other clinicians
• Re-evaluate and continue to make improvements and refinements

Special thanks to HP for sponsoring me to attend and blog here at HIMSS10.   

Integrating PACS with EHR

PACS = picture archiving and communications system (used in radiology)
EHR = electronic health record

So, it should be simple to integrate digital radiology images into an existing EHR, right? Well, it can be more complex than that because you have different PACS and EHR systems out there. The systems may not "talk to each other" very effectively.

One recent project demonstrates a successful link between Merge’s Fusion PACS with an EHR system from Epic. Where did this occur? Minneapolis-based HealthPartners and Merge Healthcare. Epic is widely used in many hospital systems. This Epic/Merge integration certainly won't be the last. However, I wonder which PACS solution will emerge as the leading option for hospitals running EHRs such as Epic.

Here are some interesting tidbits about PACS according to Wikipedia:

Most PACSs handle images from various medical imaging instruments, including ultrasound (US), magnetic resonance (MR), positron emission tomography (PET), computed tomography (CT), endoscopy (ENDO), mammograms (MG), digital radiography (DR), computed radiography (CR) etc.

In August of 2004, DR Systems was the first to announce that it had received FDA clearance for diagnostic reading of digital mammography images on a PACS. Since that time, other PACS vendors including CareStream Health, GE Healthcare, Cedara, FUJIFILM, Philips Healthcare, Sectra, Emageon, and Siemens Medical Solutions have also obtained FDA clearance for full field digital mammography (FFDM).

Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. There are several Digital Imaging and Communications in Medicine (DICOM) Viewers available both free and proprietary. Some of the DICOM Viewers include: Medstrat, eFilm, K-Pacs, DICOM Works, OsiriX, SureVistaVision , UniPACS, Syngo Imaging, VRRender, ImageJ and MicroDicom. Various viewers can connect directly to a PACS server or retrieve images from local storage. Of note, OsiriX is an open-source DICOM viewer.

So, did you catch all those acronyms? Welcome to the world of Health IT!

Epic MyChart

Epic Systems Corporation is probably the 700 pound gorilla when it comes to electronic health record (EHR) companies. They provide inpatient and outpatient EHR applications to many large hospitals in the U.S. This company makes the daily work of those who attended medical billing and coding schools a lot easier. They also provide a personal health record (PHR) service for patients through something called "MyChart." You'll see this at the Cleveland Clinic, UT Southwestern, Medical College of Wisconsin, University of Texas Medical Branch, University of Chicago, Metro Health, Dreyer Medical Clinic, Buffalo Medical Group, and many other places.

Want to see MyChart in action? Then let me refer you to a story in the Buffalo News. The Buffalo Medical Group is the largest physician group practice in the area and they have been using MyChart to provide patients with an integrated PHR service. Here are a few snippets from this interesting article: "Using MyChart, patients can see their medical records over the Internet, immediately get lab results, seek prescription refills, make appointments and quickly get questions answered... It cost the Buffalo Medical Group about $50,000 to digitize records for each physician, and providing the MyChart feature on top of that costs 20 cents per patient per month, said Dr. John C. Notaro, the group’s associate medical director...There’s a gain in efficiency, doctors said, because patients can do more with less phone contact with the office and with less time spent waiting for help...Patients who use MyChart say they had little trouble processing lab results and other records, and doctors responded quickly to inquiries."

So, does it sound too good to be true? If more people are becoming tech savvy, then solutions like MyChart and other integrated PHRs may become very popular. If you'd like to read the full article at the Buffalo news, click here.

Health IT and Political Generosity

There's an interesting article in BusinessWeek about Health IT (or HITECH if you prefer). There's a diagram that show the political generosity associated with some of the major companies that develop EHRs (electronic health records) and e-prescribing solutions. Specifically:

• Allscripts: 100% support to democrats
• Cerner: 35% support to democrats
• Epic: 98% support to democrats
• GE: 61% support to democrats
• McKesson: 44% support to democrats
• Siemens: 60% support to democrats

I don't like to get into politics in my blog, so I won't. However, I find this data to be fascinating. I was reading about how Glen Tullman, the CEO fo Allscripts, used to exercise and play basketball with Obama at the same gym.

The economic stimulus plan includes $19.6 billion towards health IT. How do you think hospitals and physicians will leverage this opportunity?

What's the Best Electronic Health Record (EHR) for My Practice?

What is the best electronic health record (EHR) or electronic medical record (EMR) for your clinical practice? Can you confidently answer that question? Which vendor will you choose? Nextgen? GE Centricity? Allscripts? Epic? Cerner? eClinicalWorks? e-MDs? MedPlexus? McKesson? Hopefully you're only considering EHRs that are Certification Commission for Healthcare Information Technology or CCHIT certified. ASP of server-based?

Maybe you're even considering some free EMR options like Practice Fusion. How do you plan to make your decision? Do you feel like you could make an informed, educated decision about EHR selection? When you start adding billing and other practice management capabilites. Have you considered e-Prescribing? What if you're a cardiology or oncology practice? Do you know what type of subspecialty solutions are available? I feel like there are so many questions that need to be answered for hospitals and clinicians who are looking for an EHR solution.

Jobs in Health IT

There are a growing number of jobs in health IT. If you have an interest in that industry, then start getting familiar with companies like:

• GE Centricity
• Nextgen
• Kronos
• Cerner
• McKesson
• Lawson
• Meditech
• Epic
• Eclipsys