A Smooth Transition to an Effective Electronic Medical Records System
March 1, 2011
With the passage of the American Recovery and Reinvestment Act of 2009, President Obama has earmarked $19 billion in stimulus funds for healthcare IT to assist healthcare providers to purchase and implement Electronic Medical Record (EMR) systems by 2015.
Financial incentives have been set aside as reimbursement funds once an EMR system is in place. So, while implementing an EMR system is now on the “to do” list, most healthcare providers and their IT teams are still sorting out the best way to initiate or progress their move from paper to electronic medical records.
This article will provide recommendations for a smooth and speedy transition to an EMR system. This includes handling new paper documents, getting existing records into the system, and managing process decisions for an efficient workflow.
In addition to financial incentives for installing an EMR system, there are also financial penalties for non-compliance in the form of decreased Medicare reimbursement of anywhere from 1% in 2015 to a full 5% by 2019.1
Although there has been a great deal of discussion and media attention about the movement to electronic records, the reality is that most providers are dealing with complex hybrid records environments consisting of both paper and electronic records, and few have actually completed the transition to the EMR to date. A 2009 survey by The New England Journal of Medicine found that just 1.5 percent of U.S. hospitals have a comprehensive electronic records system and only 7.6 percent have a basic system, with EMR present in at least one clinical unit.2 Therefore, the pressure is on to complete the move.
The Promise of EMR
It is generally agreed that instituting electronic medical records will have benefits for patients in terms of increased safety, reduced medical errors, and coordination of healthcare services from different providers. The long-term plan is that the EMR will also save money for the healthcare industry, since the electronic entry, transfer, and storage of electronic records is more efficient than handling paper.
The benefit of EMR technology is that doctors will have the latest patient information at their fingertips. With the ability to retrieve past medical records electronically, they can quickly gain a snapshot of a patient’s medical history for more efficient and accurate diagnoses. On the operations side, EMR systems can consolidate processes and improve organization, eliminate paperwork, increase efficiency, free-up staff time, and expedite the billing procedure.
Interoperability between different EMR systems would facilitate the coordination of healthcare delivery in non-affiliated healthcare facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance.3
As a result of the anticipated safety and cost-savings benefits coupled with government mandates, hospitals, doctors’ offices, and health centers across the U.S. are moving forward with EMR implementation. It is expected that most hospitals will adopt EMR over the next three to five years.
Beyond Implementing your EMR System
Once you’ve made the decision to implement an EMR system—and that is a major first step—you need to figure out the workflows and processes to make that system meet its potential, and maximize its adoption. Most EMR systems provide the hardware and software to automate clinical functions, with the goal of a single, secure online patient record. But, that is just the beginning.
The EMR system needs to be populated with data. Some new data will be entered electronically by the physician and other healthcare workers via the EMR system, but other data will continue to be generated in paper format that will need to be converted. In addition, existing patient records may need to be entered into the system to further realize the benefits of a single electronic medical record.
After the go-live date, hospitals must operate in a hybrid environment that manages both existing paper and new electronic records. You need to manage patient information, no matter what form it is in. The Iron Mountain EMR Enablement Solution ensures that hospitals are able to work efficiently within this environment, while helping them rapidly make the transition over to a fully digital workflow.
Transitioning to EMR is Not a Do-it-Yourself Project
As a high-level concept, transitioning from paper to electronic records may sound fairly straightforward. However, there are many specific challenges faced by healthcare providers. For example, existing paper-based systems are often full of redundancy and inconsistency. In addition, patient records are highly regulated and subject to both federal requirements (such as HIPAA) and state regulations.
Therefore, partnering with a trusted expert in document management with deep healthcare experience is a solid strategy for a smooth transition. A combination of Iron Mountain solutions and capabilities has proven successful in helping healthcare providers address their most pressing document management challenges. Iron Mountain has bundled these services to specifically help with EMR enablement.
Here are some specific issues to consider during your transition to the EMR:
- Handling new paper documents — Even as the world moves to electronic information, there are still going to be some documents that are “born on paper.” The Iron Mountain EMR Enablement Solution provides Day Forward Conversion to quickly convert paper records into electronic format for integration into your EMR system. Iron Mountain experts can help you establish a conversion workflow that integrates smoothly with your existing business processes.
- Intelligent conversion of important records — Implementing electronic records will not eliminate the challenge of managing paper documents overnight. As part of the Iron Mountain EMR Enablement Solution, our Image on Demand™ (IOD) service can help healthcare providers bridge the worlds of paper and digital records. As an alternative to scanning all records, Iron Mountain converts just the files you need, when you need them, and quickly delivers the images to your EMR system. Iron Mountain can intelligently and selectively image charts, reducing conversions costs, while allowing hospitals to realize all of the advantages of their EMR system.
- Bulk conversion of paper records — While you wind down your paper processes, you simultaneously need a cost-effective and efficient option to jumpstart your move to electronic records. Backfile Conversion delivers bulk conversion of paper documents into your EMR system. Our recommended best practice approach is to limit the volume of your records converted to the prior year, allowing you to populate your system with an eye on controlling costs.
- Workflow and process decisions — As EMR systems are incorporated into a hospital’s workflow, there will naturally be questions around digital conversion and archiving. For example: How much historical data should be included? Should certain types of historical patient information be digitized? What is the process and plan for the transition? How do you correct existing poor processes so that they are solved, rather than transitioned into the new system? With Iron Mountain, you will receive guidance and recommendations on workflow and processes every step of the way.
Trust Iron Mountain to Simplify the Transition
Iron Mountain can help make your transition to electronic records faster, easier and less expensive. At the same time, we can share best practices and compliance strategies for helping you make the switch to the EMR.
“Businesses have a tendency to bring too many functions in-house when they might be better served by an outsourcing partner that could offer better service at a lower cost,” says Jarad Carleton, principal consultant at Frost & Sullivan. “A Frost & Sullivan survey confirmed this problem when organizations surveyed rated their own hybrid information management efforts as ‘average.’ Since it takes more than being average to grow in a competitive business environment, taking a closer look at the cost savings and hybrid information management improvements associated with an outsourcing partner is warranted.”
More than Just a Scanning Service
Much more than just a scanning service, the Iron Mountain EMR Enablement Solution will help you wind down your paper processes as you migrate to electronic records and manage the archived information. Iron Mountain works with healthcare providers to speed the adoption of their EMR by:
- Accelerating the transition to a fully digital workflow
- Bridging the worlds of paper and digital records by applying intelligence to help manage a hybrid system
- Speeding chart completion and coding, compressing the revenue cycle
- Maintaining a secure workflow of patient records
- Partnering with you to redesign workflows
- Helping you to understand and comply with changing HIPAA regulations for reduced compliance risks
- Meeting all of your information needs within your budget
Hospitals turn to Iron Mountain for our unmatched reputation for information management, together with our expertise in bringing cost-effective solutions to our healthcare customers. With a smooth transition to the EMR, hospital employees can dedicate more time to patient care.
As you plan your transition to electronic medical records, consider doing so with the help and support of a trusted partner. Refer to the following resources for more information:
1. Papillion, Anthony, “Purchasing electronic medical records software with economic stimulus funds,” Helium, April 1, 2009.
2. Jha, M.D., M.P.H., Ashish K., et al., “Use of Electronic Health Records in U.S. Hospitals,” The New England Journal of Medicine, April 16, 2009.
3. Electronic Health Record. Wikipedia. Retrieved June 24, 2010 from: http://en.wikipedia.org/wiki/Electronic_Health_Record