NEW YORK – Electronic health records are here to stay, and that’s a good thing for psychiatrists and their patients, experts said at the American Psychiatric Association’s Institute on Psychiatric Services.
Dr. Daniel J. Balog said the benefits of using EHRs are numerous. They are convenient, encourage patient participation in their care, help improve diagnostics and health outcomes, facilitate care coordination, and help large and small practices achieve greater efficiencies and cost savings, said Dr. Balog, a psychiatrist at Andrews Air Force Base in Maryland.
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A number of psychiatrists are singing the praises of electronic health records and say the benefits are numerous once implemented.
He noted that in a 2008 EHR survey from the Office of the National Coordinator for Health Information Technology, 90% of respondents said that they were satisfied with their systems and that they found it easier to attract and retain staff. In addition, patients seem to buy in to participation in their care.
"Patients equate new technology with quality," Dr. Balog commented.
For providers, EHRs offer quick access to records either on site or remotely, and many systems are equipped with decision-support and performance-improvement tools. EHRs also offer safer prescribing, and eliminate the need for callbacks to clarify an order.
Dr. Daniel J. Balog
Patients can use their EHRs to collaborate in informed decision making, and the electronic records are essential for two-way communication for managing chronic conditions, he said. EHRs give patients access to full information on their medical evaluation, follow-up information, self-care advice, and reminders, and allow patients and their providers to follow medication levels.
Another advantage to using EHRs is that they can support clinical diagnosis and treatment by giving clinicians complete, accurate, and up-to-date information.
"It makes it easier to identify operational problems within a clinic. Back when there was a paper record, it was more difficult in a systemized way to see what was happening in your own clinics. But here, you can look at different records and see if certain actions are being taken for your patients – an example might be measurements of metabolic status of patients on atypical antipsychotics," Dr. Balog suggested.
Computerized records also can reduce medication errors, and make it easier to check for patient allergies and potential medical cross reactions.
Dr. Robert Plovnick
To take some of the economic sting out of converting a records system from paper to pixels, the federal government offers economic incentives that will likely benefit psychiatrists who treat a large number of patients insured by Medicare or Medicaid, said Dr. Robert Plovnick, director of quality and improvement and psychiatric services at the American Psychiatric Association.
Full incentives of up to $18,000 structured as a rebate are available only to those physicians who started participation by Oct. 1, 2012. However, incentives of up to $15,000 are available to those who demonstrate at least 90 consecutive days of meaningful use in 2013, and up to $12,000 for those who get the ball rolling in 2014.
On the other hand, what the feds give they can take away: Starting in 2015, physicians who have not demonstrated implementation and "meaningful use" of a certified EHR system by October 2014 will have Medicare and Medicaid reimbursements reduced by 1%, and the penalties could increase to as much as 5% over time.
Meaningful use of an EHR system would include prescribing electronically, recording patient demographics, documenting smoking status, and providing patients with copies of their records on request, Dr. Plovnick said.
Dr. Lori Simon, a psychiatrist in solo practice in New York City, spent 18 years in software development and implementation in the health industry before becoming a physician.
She advised clinicians to think carefully about what they want an EHR system to do, such as scheduling appointments, billing, clinical charting, order entry, and patient access. Other considerations include how and what data to move into an electronic form. For example, is it better to move all patient records to an electronic form or only those of current patients? Similarly, is it better to move entire charts or subsets of critical data?
Dr. Lori Simon
Questions that clinicians need to ask include whether the system is certified and qualifies for meaningful use; whether files can be accessed remotely, and if so, how easily; and where the data will be stored, whether on a local or central server or in "the cloud" (that is, a remote server).
In addition, the buyer will need to consider the computer platform (PC or Mac) and whether the software is compatible or can interface with other systems within or outside the institution.