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EHR and EMR management – getting data and making sense of it all

by Lisa Chamoff , Contributing Reporter
From the April 2015 issue of DOTmed HealthCare Business News magazine

The use of electronic health records has long been touted as a major way to improve patient care by preventing drug reactions and heading off costly diseases like diabetes and cancer. The reality has not been quite so positive, with the American Medical Association saying the expensive programs disrupt workflow, interfere with patient care, and impose an administrative burden.

Last year, the Centers for Medicare and Medicaid Services announced that 257,000 doctors, or about one third, had failed to achieve Meaningful Use of electronic health records, and would see Medicare payments cut by 1 percent in 2015. While CMS announced earlier this year that it intends to modify requirements for Meaningful Use in 2015, hospitals and physician practices are still being required to move down the path to recording and exchanging information in a meaningful way.

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Health information technology companies are responding with new products that promise easier image sharing and workflows, time savings, and the holy grail of interoperability. Big health care networks and smaller physician practices are also getting some good results with technology that is helping to save them time and make the electronic records more useful.

The big picture
Storing and sharing images is a big part of interoperability and there are still challenges to overcome in image sharing between specialties. While there are many image sharing products on the market, Cleveland Clinic has been using Agfa HealthCare’s Enterprise Imaging solution in a years-long project to enable sharing of images among its many hospitals, emergency departments, and specialty centers.

Dr. Cheryl Petersilge, a clinical professor of Radiology at Cleveland Clinic, who also works in clinical informatics, has been working on the effort to add images from a wide range of departments, including radiology and cardiology, as well as ophthalmology, endoscopy, and dermatology, into a library that is integrated into the Epic Systems EMR.

Aside from radiology images, the focus is also on wound care photography, endoscopy and laparoscopy images, ultrasound for anesthesia, the emergency department, and women’s health. “There are just so many images,” Petersilge says. “We continue to actively enroll new service lines, but we’re just beginning to fully comprehend the full breadth of medical images that need to be archived.”

At the moment, there are no Meaningful Use requirements for viewing images in the electronic health record, but there are for sharing images electronically with the patient. “That’s not the main focus of our project,” Petersilge says. “We believe that having images incorporated into the electronic medical records should be considered a critical component of EMR evolution and should be recognized by some of the EMR certification and recognition of advanced deployment.”
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