Are You EHR Ready?
Resources for Electronic Health Records
The use of Electronic Health Record (EHR) systems in the United States has been growing dramatically in the last few years, primarily due to the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Centers for Medicare & Medicaid Services (CMS) incentive programs.
Under the HITECH Act, eligible health care professionals and hospitals can qualify for CMS incentive payments when they adopt certified EHR technology and use it in a meaningful way. What is considered “meaningful use” is evolving in three stages:
- Stage 1 (which began in 2011 and remains the starting point for all providers): “meaningful use” consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients.
- Stage 2 (to be implemented in 2014): “meaningful use” includes new standards such as online access for patients to their health information, and electronic health information exchange between providers.
- Stage 3 (expected to be implemented in 2016): “meaningful use” includes demonstrating that the quality of health care has been improved.
A new study, reporting on recent data from the National Electronic Health Records Survey (affiliated with the National Ambulatory Medical Care Survey) illustrates the high rate of growth in EHR usage. According to the National Center for Health Statistics (NCHS) Data Brief, 72% of office-based physicians used EHR systems, up from 48% in 2009. 39.6% of office-based physicians reported having a system that met the criteria for a basic system, up from 22% in 2009.1
A basic EHR allows for the collection of patient demographic data, problem lists, physician clinical notes, medication and allergy lists, computerized prescription orders, and the ability to view lab results and radiography images. Only basic EHR systems have the potential to be certified by the Office of the National Coordinator (ONC), a requirement if providers wish to apply for CMS meaningful use incentives.
Regarding meaningful use, the study showed that 66% of physicians intended to participate in the CMS incentive program. Of that group, 27% had computerized systems with capabilities to support 13 of the Stage 1 Core Set objectives for meaningful use.
Another study, a 2012 reader poll by EHRIntelligence.com, also found EHR use high among inpatient care organizations.2 More than 86% of hospital respondents indicated they were using an EHR system. And those not currently using a system have planned to implement one shortly, with a majority (66.6%) indicating that their hospital would be up and running within the next year. Of all the hospitals surveyed, 72.4% specified that their EHR systems were certified for meaningful use.
CMS recently released the final rule for meaningful use Stage 2 which intends to increase health information exchange between providers and promote patient engagement by giving patients secure online access to their health information. Stage 2 also replaces the previous Stage 1 objectives to provide electronic copies of health information or discharge instructions to objectives that allow patients to access their health information online. Patients often require assistance in interpreting lab results or finding additional information about a diagnosis. This provides a unique opportunity for the medical librarian to become actively involved in the implementation of evidence based medicine into the EHR and to promote MedlinePlus Connect to link patient portals and electronic health record systems to MedlinePlus.
Medical librarians have the skills and knowledge to address issues impacting meaningful use and can be valuable partners as institutions continue to strive to meet the next stage’s requirements. We have expertise in the support of clinical decisions procedures, evidence based practices, and standardizations, including data exchange and authority controlled vocabulary, all necessary elements for the interoperability of the EHR.
Funded by the ONC, the HealthIT Workforce Development Program was created to train a new workforce of skilled health IT professionals who will be able to help providers implement electronic health records and achieve meaningful use. One of the components of the program provided grants to community colleges to rapidly create health IT academic programs or expand existing health IT training programs that can be completed in six months or less. One of our regional goals is to support the appropriate personnel at community college HIT institutions to integrate evidence based medicine and consumer health information into their program offerings by promoting MedlinePlus and MedlinePlus Connect.
As EHRs are becoming an integral part of providing quality health care, it is essential for medical librarians to be knowledgeable about various aspects of the EHR and be able to provide resources and information to both medical professionals and health consumers. Further information on the HITECH Act and EHRs may be found on our MCR web site.
Free Online Resources for Electronic Health Records
Office of the National Coordinator for Health Information Technology (ONC)
HealthIt.gov provides in-depth information on EHRs with separate sections for medical professionals, patients, and policy makers. The site is easy to navigate to find the desired information and is presented in an understandable and interesting manner. The section for Patients & Families is an excellent consumer resource, providing a basic introduction to both Health IT and EHRs.
The Official Web Site for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs
HealthIT Buzz – The Latest on Health Information Technology from the ONC
Information Week Healthcare
NLM Tools for EHR Certification and Meaningful Use
Value Set Authority Center (VSAC)
SNOMED CT® – Systematized Nomenclature of Medicine – Clinical Terminology ®
LOINC® – Logical Observation Identifiers Names and Codes
1Hsiao CJ, Hing E. Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001–2012. NCHS Data Brief, no 111. Hyattsville, MD: National Center for Health Statistics. 2012. Available from: http://www.cdc.gov/nchs/data/databriefs/db111.htm.
2Murphy, K. Inpatient EHR Use Among Hospitals, Providers. (2012) Retrieved December 3, 2012 from http://ehrintelligence.com/2012/11/06/inpatient-ehr-use-among-hospitals-providers/.