2. Scan/convert existing paper charts to electronic format

3. Computer hardware/PC, laptops/tablets

4. Highspeed/Broadband carrier

5. Access to Personal Health Records (PHR)

6. Patient Portal (scheduling, access, PHR)

7. Practice website

8. EMR/EHR system integration, install training and maintenance

9. Wireless/mHealth apps

10. EPrescribing (eRx)

11. Financing options

12. Connection abilities with Regional Extension Centers, Health Information Exchanges

Alabama Regional Extension Center – The University of South Alabama AL

Arkansas – HITArkansas AR

Arizona Health-e Connection, Phoenix, Ariz. AZ

CalHIPSO (North) CA

CalHIPSO (South) CA

California – HITEC-LA – Local Initiative Health Authority for Los Angeles County CA

CalOptima (COREC) CA

Colorado Regional Extension Center (CORHIO) CO

Connecticut- eHealth Connecticut, Inc., Rocky Hill, Connecticut CT

EHealth DC Washington DC DC

National Indian Health Board (NIHB) DC

Delaware – Quality Insights of Delaware, Inc., Wilmington, Delaware DE

Florida – Rural and North Florida Regional Extension Center
Community Health Centers Alliance, Inc. FL

Florida – South Florida Regional Extension Center Collaborative FL

Florida – University of Central Florida, Orlando FL

Florida – University of South Florida, Tampa FL

Georgia GA-HITREC Morehouse School of Medicine GA

Hawaii Pacific Regional Extension Center HI

Iowa (Telligen) Health Information Technology Regional Extension Center IA

Idaho -WIREC (Washington & Idaho Regional Extension Center) ID

Illinois – Chicago Health Information Technology Regional Extension Center (CHITREC) IL

Illinois Health Information Technology Regional Extension Center (IL-HITREC) IL

Indiana Health Information Technology Extension Center IN

Kansas Foundation for Medical Care, Inc. (KFMC) KS

The Kentucky Regional Extension Center (Kentucky REC) KY

Louisiana Health Care Quality Forum LA

Massachusetts e-Health Institute (MeHI) MA

Maryland – Chesapeake Regional Information System for our Patients,Baltimore MD

Maine – HealthInfoNet ME

Michigan Center for Effective IT Adoption (M-CEITA) MI

Minnesota – Regional Extension Assistance Center for Health Information Technology (REACH) MN, ND

Missouri HIT Assistance Center MO

Mississippi- Regional Extension Center for Health Information Technology in Mississippi MS

Montana – Health Technology Services (HTS) Mountain-Pacific Quality Health Foundation MT, WY

North Carolina AHEHC (University of North Carolina) NC

North Dakota – REACH (Key Health Alliance – Stratis Health), Minnesota – North Dakota ND, MN

Nebraska – Wide River Technology Extension Center NE

New Hampshire – Massachusetts eHealth Collaborative, Inc. NH

New Jersey’s Regional Extension Center NJ

New Mexico Health Information Technology Regional Extension Center (NM HITREC) NM

Nevada – Health Insight NV

New York eHealth Collaborative (NYeC) NY
NYC REACH NY

Ohio – HealthBridge Inc. OH

Ohio Health Information Partnership (OHIP) OH

Tri-State Regional Extension Center – Ohio, Kentucky, Indiana OH, KY, IN

Oklahoma Foundation for Medical Quality (OFMQ) OK
O-HITEC OR

Oregon O-Health Information Technology Extension Center OR

PA REACH East – Quality Insights of Pennsylvania, Inc. (Eastern) PA

PA REACH West – Quality Insights of Pennsylvania, Inc. (Western) PA

Ponce School of Medicine, Puerto Rico PR

RI Regional Extension Center (REC) RI

South Carolina Research Foundation, Columbia SC

South Dakota Regional Extension Center (SD-REC) SD

Tennessee REC – Qsource TN

Texas – CentrEast Regional Extension Center – Texas A&M System Health Science Center – Rural and Community
Health Institute TX

Texas – The North Texas Regional Extension Center (NTREC) TX

Texas – University of Texas Health Science Center at
Houston – Gulf Coast Regional Extension Center (GCREC). TX

Texas – West Texas (WT-HITREC) – Texas Tech University Health Science Center TX

Utah – HealthInsight UT

VHQC (Virginia Health Quality Center) VA

Vermont Information Technology Leaders VT

WIREC (Washington & Idaho Regional Extension Center) WA, ID

Wisconsin Health Information Technology Extension Center WI

West Virginia Regional Health Information Technology Extension Center WV

Wyoming – Health Technology Services (HTS) WY

In a few years there will be financial penalties. But as far as patients are concerned electronic records help your doctor to follow up on lab tests, office visits and even hospitalizations. The down side is instead of everyone using one system there are multiple ones out there. In many cases the computers can’t talk to each other which makes a barrier.

Remember it is early. Electronic medical records in hospitals and doctors’ offices are like driving a model T.

There is a long way to go.

2. Do you hold user group meetings? How often? Can users share information online?

3. Do you have an office workflow report to track stuff like phone message turnaround time by nurses and providers?

4. How often should we expect software updates? Will you be on top of MU Stage 2-3 requirements?

5. Have your clients been more successful with an “all at once” implementation approach or a phase-in approach?

6. What happens when my office is hit by a disaster-are the records safe?

7. How many providers, in our specialty, use this system? (Talk to the references, and make sure that the users are not investors in the company!)

8. What is the “signature advantage” of your system over others?

9. How many clients can demonstrate they have achieved their ROI or shown attestation?

10. Can we load our fee schedule and insurance contracts and see performance comparisons?

11. Security: Do you carry cyber and privacy liability insurance coverage?

12. Will an EHR migration absorb all of the patient demographics through a reverse migration from the billing data?

13. How often are coding updates incorporated?

14. Does the vendor have a complete inventory of drug, allergy, food interactions and their respective alerts incorporated into the system and again, how often is the database updated?

15. What is the pricing structure, by practitioner? By location? Are there different prices for varying types of practitioners? Do you recommend a ASP/SaaS model or client-server? Why?

16. Does my local Regional Extension Center (REC) have experience with your company or product? Do they recommend or endorse use of your solutions?

17. Is your system template driven? Customizable?. For my specific specialty, how much time do I need to devote to populate and customize the templates to become functional in my practice? How much time is needed from me to tailor to my needs and style?

18. What reporting capabilities are natively embedded in your system? Is it a separate module? How easy is it to generate my own custom reports (ad hoc)?

19. To achieve meaningful use qualification, do you have dashboards and other tools to allow me to evaluate how our providers are doing in the specific areas needed to qualify for ARRA/HITECH funds?

20. Do you have a money-back guarantee for Stage 2 and Stage 3 of Meaningful Use qualification?

21. Why is your company different from more than 200 other EMR vendors?

22. Are you a reseller or vendor direct? Can some other company sell me the same EMR system you are proposing?

22. Who is going to scan and digitize all of my existing paper charts?

23. How am I going to finance this EMR purchase?

24. How do I get my $44,000 in incentive funding to start using this new EMR system?

25. Vendor stability: Do you anticipate your company being bought out by another EMR vendor?

The HITECH Act (Health Information Technology for Economic and Clinical Health) calls for most US physicians to move from paper based to Electronic Medical Records by 2014. Qualifying physicians that purchase a EMR EHR system that demonstrates “meaningful use” (MU) will qualify for upto $44,000 in incentive payments. The sooner a physician adopts a MU EMR systems, the more that physician will receive from HITECH EMR adoption incentive funding.

Within the next two or three years, the EMR marketplace may reach “PeakEMR”, the point at which physicians purchasing of Electronic Medical Record systems reaches its highest level and begins to slow.

This concept of “Peak EMR” is based on the bell curve theory first introduced in 1956 by M. King Hubbert as related to worldwide oil reserves, called “Peak Oil”. Similarly, the EMR adoption curve will peak when half of the Eligible Provider (EP) physicians have begun using electronic medical and records in a “meaningful” way.

Consider these generally accepted statistics EMR /EHR statistics:

The US has 640,000 physicians. Not all of them are required to adopt EMR systems as required by the HITECH Act, so the number of potential sales is far from the seemingly large pool of 640,000 EMR purchasing prospects. Then, consider that there is more than one physician in a practice, all using the same system. That’s a one unit sale, not one for each provider.

On top of that are estimates that cite approximately 25% of physicians are already are using a EMR system. Estimates for adoption, mind you, range anywhere from 5% to more than 50%. Now, consider claims of many EMR vendors all claiming to have thousands and thousands of users already. If so, this further diminishes EMR sales forecasts.

So are there enough Eligible Providers to go around? Sales of electronic medical records is competitive. Physicians are confused and overwhelmed. EMR vendors are consolidating. Even with claims of a recent report stating that 35% of physicians currently using an EMR system will be replacing that current system, the efforts of EMR vendors is understandably in high gear to gain a piece of the EMR market before the window of opportunity closes.

(CCHIT 2011/2012 certification does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments)

So what kind of test or inspection did the EMR system pass?

Certified EMR systems have demonstrated ability to deliver data such as:
Drug-Drug/Drug-Allergy Checks
Drug-Formulary Checks
Problem List
Medication List
Allergy List
Vital Signs
Body Mass Index
Growth Charts
Smoking Status
Incorporate Lab Results
Patient Lists
Medication Reconciliation
Immunization Registries
Public Health Surveillance
Education Resources
Automate Measure Calculation
Access Control
Emergency Access
Automatic Log-Off
Audit Log
Integrity
Authentication
General Encryption
Encryption when Exchanging Electronic Health Information
CPOE
ePrescribing
Record Demographics
Patient Reminders
Clinical Decision Support
Electronic Copy of Health Information
Timely Access
Clinical Summaries
Exchange Clinical Information and Patient Summary Record
Calculate and Submit Clinical Quality Measures
Adult Weight Screening & Follow-Up
Hypertension: Blood Pressure Measurement
Tobacco Use Assessment and Cessation
Influenza Immunization
Weight Assessment and Counseling
Childhood Immunization Status
Diabetes: LDL Management and Control
Breast Cancer Screening
Colorectal Cancer Screening