EHRs and Interoperability
Thomas Alen
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HUM FPX3640
Professor’s Name
21th May, 2025
HIM FPX 3640 Assessment 4 EHRs and Interoperability
| Team 1 | MSU HealthTeam (HT) | Medical Arts Health Care |
| EHR Applications | Praxis EMR | |
| Medfusion | GE Centricity(r) EMR (formerly MedicaLogic’s Logician) | Praxis EMR |
| Allscripts | ||
| PHR Strategies | ||
| Secure messaging feature | Secure messaging, medication renewal requests, and referral requests | Portal access for patients is limited to a few users (not specifically mentioned); however, patients have access to their medical records throughout visits. |
| Send the office an email. Provide a secure registration link through email | Patients can access and update the problem list | Patients are able to review their records and suggest modifications to their records during appointments. |
| Provide lab results | Online pre-visit questionnaires to populate the medical history. | |
| HIE Strategies | ||
| The Delaware Health Information Network’s ability to connect with external providers is limited. | Interoperability is limited to providers outside of the company. | Sending documents to specialists via fax or email (no connection to EHR directly) |
| Shadow clinicians are a great way to gain insight into how clinical procedures work | Problems with hospital information (e.g., discharge summaries and testing outcomes) | Hospitals electronically send laboratory reports (uploaded directly into the patient’s medical records) |
| The hospital-based documents will be used to populate the office records | Secure document exchange is attempted through the portal; however, external services often use documents on paper | The future plans will grant hospitals access to a limited system of healthcare. |
| Optimization | ||
| Team approach representing various needs | The staff was able to spend less time looking for charts (25-30% time reduction). Better documentation aids in making decisions for chronic illness | 90% decrease in chart searching, quicker appointment scheduling, legitimate medications, exact lists of prescriptions, and fewer claims rejected |
| Patient education | Open-access scheduling is due to EHR availability, lower cost of transcription, lower paper chart pulls, remote chart completion, and more effective healthcare coordination within the health system | The reduction in transcription costs, the streamlined prescriptions for labs, and remote access to charts for healthcare providers (e.g., hospital access), Patients are able to review the documents with doctors during visits |
| Challenges | ||
| The inability to submit medical summaries | Highly variable physician buy-in, Network downtime, slow connectivity, Difficulty exchanging data with hospitals/external providers | Reluctance of staff (2 employees quit because of fears), slower documentation than usual. The dictation system, slower recuperation of productivity, and no special charges in accordance with Rural Health Clinic rules |
| While patients and their families can use the portal, | Issues like insufficient security periods, interruptions during usage, and overly complicated features have impeded the early adoption of tablets. Tablets that are aging with no alternative budget | Reliance on a physician Champion (Dr. Dovin) and self-directed learning. No complete data exchange with other suppliers |
| Requirements for Successful Implementation | HIM FPX 3640 Assessment 4 EHRs and Interoperability | |
| It is important to train well prior to going live | Crawl, walk, jog, and run strategies Plus hands-on, medically-guided training |
Dr. Shebuski’s advocate and Dr. Dovin’s training in-house focused first on essential functions (e.g., E-prescribing, electronic prescribing, charting). Practice sessions devoted to the patient (biweekly closings on Thursdays) |
| The system can be customized based on the functions of practice | The department of radiology provides financial support to purchase licenses/tablets and aligns EHR usage with the quality objectives | Support for Vendors: 10 hours of in-person training plus online webcasts at no cost, will move from a hybrid (paper+EMR) to full EMR usage |
| The Organization that Sets Standards for the EHR | ||
| ANSI | Institute of Medicine (IOM) Quality goals (safe, efficient, quick, patient-centered, cost-effective, fair treatment) | Centers for Medicare & Medicaid Services (CMS) |
| ASTM | American Medical Association (AMA) Health IT Advisory Group | Standard Specific to Vendors (Praxis EMR’s safety in the use of medication Documentation workflows |
| Standards for the Electronic Health Record | ||
| HL7 | AMA Health IT Guidelines | CMS Billing Compliance |
| CCR | The Six Quality Goals of IOM: Patient-centered, safe, and effective, prompt, efficient, fair healthcare | Medication Safety Standards, including, for example, Drug interactions alerts, electronic prescribing |
| Case Study Reference | ||
| ONC. (2011). The implementation of the Patient Portal improves healthcare for patients and improves preventive healthcare. HealthIT.gov. Retrieved August 31, 2023, from https://www.healthit.gov/case-study/patient-portal-implementation-improves-quality-patient-care-and-strengthens-preventive | Michigan State Medical Society. (n.d.-b). MSU health team. In A Summary of 14 Case Studies to Guide Michigan (pp. 74-81). Michigan State Medical Society. https://www.msms.org/Portals/0/Documents/MSMS/Resources/For_Practices/HIT/EMR_Case_Studies.pdf | Michigan State Medical Society. (n.d.-a). Medical Arts Health Care. For more details, please consult the Summary of 14 Case Studies to Assist Michigan Physicians (pages 32-36). https://www.msms.org/Portals/0/Documents/MSMS/Resources/For_Practices/HIT/EMR_Case_Studies.pdf |
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