E-prescribing has been widely publicized as an effective solution for ensuring patient safety, as well as for containing the ever-increasing medication costs. It has been estimated that medication errors cause nearly 7,000 deaths in the United States every year. These errors mostly result from the illegible handwriting on prescriptions which lead pharmacists to deliver wrong medication. The errors can also lead to incidents of wrong dosage or missing out on important information about allergic reactions from various drugs or their combinations. Furthermore, pharmacists frequently spend a lot of time deciphering illegible handwriting on prescriptions. Time spent this way is completely wasted and if anyone calculates the total amount of time wasted on a daily basis understanding such prescriptions by all pharmacists working in the United States it would surely turn out to be a significantly big figure.

E-Prescribing comes with considerable financial benefits as well. According to recent reports by 2014 it can help a state save up to $16 million in claim expenses and the federal government up to $53.8 million.  Health expenditure would decrease by $164 million with insurance companies and low income residents being the biggest beneficiaries as they stand to save around $45.6 and $41.9 million respectively on healthcare.

E-prescribing has many other benefits as well. For one, it can improve beneficiary health outcomes. Providers that adopt and invest in this technology would be able to improve quality and efficiency. This would not only help reduce costs but also ensure appropriate drug usage. Providers and dispensers would be better informed about formulary-based drug coverage and co-pay information. This would help speed up the renewal process of medications. The problem of drug diversion can also be thwarted by the use of this technology as providers and pharmacists can be readily alerted about duplicated prescriptions in the case of controlled substances.

According to records, number of prescriptions written annually in the United States is nearly 3 billion. This places it among the largest paper based process in the country. The establishment of an e-prescribing system would dramatically streamline the process and make it significantly more efficient. Thus this system can empower both prescribers and pharmacists.

Binary Spectrum is a well-reputed company with an online presence which has been developing software for e-prescribing with highly successful results.

Integrated healthcare services entails broader acceptance by clinicians to foster collaboration among primary and secondary providers to improve the experience of patients. Most integrating systems are evolving towards eliminating intermediary costs and providing a one-stop-shop service. Healthcare authorities need to identify areas of integrated healthcare and develop collaborative ways of working. The following are the main benefits of an integrated healthcare service:
·          Reduce duplication of healthcare interface
·          Improve accessibility and experience of the service provided
·          Enhance quality provided through a persistent manner
·          Availability of data at right time
·          Practical and personalized healthcare model

Real requirements have constantly been ignored in an EMR design. Understanding the fact that physicians are performing their tasks under high time pressure and in a demanding environment, EMR is not just meant to boast about improved efficiency, more time for patient care or long term financial benefits. Instead it should focus on foremost points that are usually missed out like facing process challenges, having lesser customization instead of just providing customization facility, having straightforward tabs wherein minimal entry would populate the entire report or information.

Return on Investment conventionally is based on evaluating the impact of expenses with the revenues gained. When profits exceeded the costs involved, the investment was said to be justified and right. However, this may not necessary be the case with healthcare applications where the value of the investment could be more on intangible details like improved and detailed patient encounter, avoidance of medication errors, better quality care, etc.

The healthcare industry has still a lot to learn and progress on IT investments. It is essential to evaluate the application’s use based on the one using it more than the one providing it. Measuring financial returns is important but not the sole criteria for ROI. There are many qualitative returns too, especially in an industry like healthcare, that proves to be much beneficial than the financial figures. Various intangible benefits that results from adoption of an EMR are reliable quality of care, improved patient security, length of stay that is tremendously reduced and compliance to regulatory requirements. The most essential of all being reduction in medical errors that is the sole purpose of having investments in technology.

Measuring ROI and success of clinical systems like EMR or PM applications can be realized at a clinical and organizational level as well. Access to test results that are otherwise unavailable, quantifying costs per error, improving quality of care in an ambulatory care setting are some of the benefits at a clinical level. The operational efficiency of the organization too improves tremendously.

To evaluate the numerical metrics cash flow analysis, cost effectiveness analysis and total cost of ownership are considered. Main Tangible returns rendered are:

• Improved revenue flows (Real case studies where adoption of EMR has given 300% ROI for the first year and payback period was just 4 months)
• Compensation, grants and tax benefits from the government
• Savings catering to labor, transcription

Ophthalmology framework is specifically designed with the objective to enhance the practice of eye medicine. The framework assists ophthalmologists in better operational management and risk management. Binary Spectrum’s Ophthalmology framework addresses these personalized needs and includes highlights Visual Acuity, Preliminary Examination, Dilatation, Fundus Examination, Refraction and Final Examination.

Considering the entire process to be an ongoing one, there would still be certain issues that may remain unaddressed. It is indeed crucial to handle the networking and security risks that would follow the implementation process of an EMR. Product interfaces, data conversion, documentation and testing issues may crop up once the implementation is done.

Apart from the follow-up training that would be provided, involving an IT representative could help you solve most of the issues that you may face post implementation. Following a systematic approach with regular meetings to deal with the most prioritized one first could prove effective in such a case.

The most important attribute that an EMR vendor should possess and project is that of providing an unbiased source of information. It is advisable to identify and list down the functions that you would expect from EMR depending on your practice requirements. Based on this, few numbers of vendors could be shortlisted for the demo.

Taking guidance from any qualified consultants also helps you to have a broad understanding about the industry. These consultants are knowledgeable and familiar about various EMR vendors and are able to provide credible and unbiased information on the same. One needs to clarify aspects like pricing per physician license, client referrals, post sales support, client /server based and web based distinctions, details of EMR configuration, any negotiations etc.

The focus of the buyer should also be on asking more of open ended questions in order to get detailed information about their system and their process of implementation. This would avoid getting objective answers and have a clearer picture about the whole process. Accordingly, the buyer can consider and decide upon the vendor that meets the practice’s requirements without having to compromise on the needs and desires. Overall, asking the right questions would ensure the most appropriate vendor to be selected.

In order to help oneself in judging the most appropriate EMR for your practice, it is indeed helpful if various aspects relating to EMR are scrutinized. There would be a need to document EMR requirements, conduct hardware requirement analysis, choose between a client-server based model and a web based model, check the affordable cost that could be invested in such an implementation,  certify its CCHIT, HIPAA and HL7 compliance, validate the vendor’s clients list and check the featured modules that  your practice would require.

EMR will usually be supported by certain key features like: Scheduling, Patient Demographics, Clinical Information, Prescriptions, Document Management and Billing. Apart from these, it would be valuable to check any other specific feature that would form a major part of your practice enhancement.

The overview of all the aspects that needs to be evaluated is shown as follows:

There is also a need to know the team involved in such a transformation and the time they would require in implementing an EMR. Most organizations would have a specialized team who would undertake such a responsibility. However, small scaled hospitals and clinics may not have such a facility of a dedicated team. In such cases, they may have to themselves get involved in research work and implementation. Irrespective of the type of practice, the person involved would need to be committed towards accepting such a change.

The doctor, administrator and the office manager need to coordinate and track the implementation issues, deficiencies, decisions made, and tasks assigned. EMR implementation would be driven by the IT team as well, who would be able to connect to such a cause of implementation. The team could develop a comprehensive data which includes details like organizational workflows and processes, hardware installations, software configuration, ways to enter old patient data into the new EMR system, developing a backup system, training to be provided, etc. Aspects like goals, budgets and timelines needs to be taken care of.

Ashok

The need for a high security for Medical Records is very critical given the context of the internet and its abuse, HIPAA provides laws that need to be implemented as part of any EMR or EHR solution. Innovating security of patient record and its interface to the entire eco system of Health Care providers like Labs, insurance, pharmacies, other providers etc is very critical and complex.

Hence it becomes imperative that EMR/EHR solution vendor or technology consultants are chosen based on their technology experience in providing enterprise solutions, their understanding of the HIPAA requirements and domain competence.

Ashok

The pharmacy Industry has entered the “enterprise era” of electronic technologies for clinical development. Virtually all their clinical trials use electronic data capture (EDC). As Electronic medical records (EMR) become more prevalent in offices, Clinics and hospitals; clinical sites and sponsors work towards integrating the collection of Clinical trials and EMR data.

There are two ways in which this can be done:

Via Database Transfer

From each site, the data from an EMR is extracted and transferred to a clinical trial data base. Since this method involves the mapping of database from one system to the other, sites have to first agree to share their data with the central database created for the clinical trial. Privacy issues of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) also create challenges making this a very unlikely approach.

Via Content Labeling

This is the preferred method, the transfer of data through a shared data content labeling standard is used for this method. The Clinical Data Interchange Standards Consortium (CDISC) has developed standards for data interchange and archiving. Using a transactional approach, data would flow from the EMR into an electronic data capture (EDC) system, or vice versa by using either the CDISC or HL7 standards.

The EMR is a highly flexible system designed to accommodate the collection of data from patients with virtually any health problem, at any time. In contrast to this a clinical trial data collection is more highly structured because its intent is to capture specific information, for a specific purpose, at specific times.

Since a clinical trial system may encompass a number of EMR systems but can only be connected to only one clinical trial data system, its more easier, if the data flows from the clinical trial data system (collected by EDC) into the EMR. If the flow of data were in the opposite direction, then each EMR system would require built-in case report forms and the capability to transmit the data to a suitable location in the clinical trial data system.

The Road Ahead

Eventually Electronic submission requirements for clinical trials data will become so pervasive that they will create a competitive threat for companies whoose enterprise technology does not met the challenge.

With years of experience in successfully providing Custom Healthcare Software Development solutions for clients across the globe, we at Binary Spectrum have honed our processes and skills to cater to your specific business needs. Contact us for more information on clinical trial solutions.

Prakash TC. is a Support Manager at Binary spectrum

With hundreds of EMR applications available in the Market, Practices and Medical Practitioners face the unenviable task of selecting a system that will exactly match their requirements. No two practices are identical, so choosing an “off the shelf” EMR application will introduce costly shortcomings in the effectiveness of its use.Almost all practices use some type of EMR application and Practice management Solution. Most Vendors provide complete solutions that are actually well interfaced individual applications. These have their own data bases and data communication is via interfaces. This has been the cause of widespread concern because duplicity of the data entered and the chances of incorrect or forgotten details occurring. Savvy vendors tightly integrate the two there by ensuring that you get the benefit of the seamless work flow.