Faulkton Area Medical Center (FAMC) a 12-bed critical access hospital in Faulkton, S.D., has met Stage 1 Meaningful Use criteria using a certified electronic health record (EHR). By successfully attesting for Stage 1 Meaningful Use with the Centers for Medicare & Medicaid Services (CMS), Faulkton can receive payments from an EHR incentive payment program recently initiated in South Dakota. The incentive payments would help FAMC partially recover costs already incurred to meet federally mandated program guidelines. FAMC is one of the first facilities in South Dakota to achieve this milestone.

Since implementing their EHR more than 3 1/2 years ago, FAMC has experienced significant adoption among the hospital's staff. The Stage 1 Meaningful Use attestation demonstrates the facility’s ability to satisfy federal standards as they demonstrate adoption of a certified electronic health record.

"After a lot of hard work, dedication and the determination of many people at FAMC, we have achieved Stage 1 Meaningful Use," said Tom Hericks, Director of Nursing at Faulkton Area Medical Center. "We will continue to progress through this sometimes confusing and frustrating process. HealthPOINT has been a great resource for us on this journey and we are fortunate to have them to assist us in achieving Meaningful Use. We are very proud of our accomplishments here at FAMC and continue to work hard to meet and exceed the challenges placed on us. Without a team effort by all, Meaningful Use Attestation would not have been possible."

FAMC is dedicated to the continual improvement of its healthcare services, programs and technologies that benefit patients and the dynamic community served by the hospital in the north central area, 60 miles from Aberdeen. HealthPOINT, South Dakota’s Regional Extension Center based on the Dakota State University campus in Madison, was created to specifically help rural facilities like FAMC.

"Faulkton’s team has achieved what many others are still working towards and their dedication is remarkable. As one of the first critical access hospitals in the state to achieve attestation, this is a milestone for their facility as well as their patients, who will all benefit. Safety and quality of care are just a few benefits their EHR provides. As they continue into the next stages, they will see even more benefits including reduced medical costs, as several studies have shown,” said Kevin Atkins, Engagement Manager for HealthPOINT.

Congratulations Faulkton!

At the ONC Annual Meeting on November 17, 2011, the Office of the National Coordinator for Health Information Technology (ONC) announced that the network of 62 Health IT Regional Extension Centers (RECs) achieved one of its first major milestones – gaining commitments from 100,000 primary care providers (PCPs) to adopt electronic health records in a meaningful way. As part of this network of RECs, HealthPOINT has enrolled 80% of the primary care providers in South Dakota. Representing roughly one-third of all PCPs in the U.S., these 100,000 providers are building the foundation of a fully-electronic healthcare system.

“This is an enormous milestone for America’s healthcare providers,” said Farzad Mostashari, MD, ScM, national coordinator for health information technology at ONC. “EHR-enabled providers are taking the first steps in transforming healthcare in the U.S., enhancing the safety and quality of care for patients. We would not have been able to accomplish this without the hard work of regional extension centers across the country.”

Primary care providers are the foundation of America’s healthcare system as they are often the patient’s first point of contact for healthcare and can be the center of the patient’s care network. EHR-enabled PCPs allow clinicians to share more accurate, complete information and better coordinate patient care across specialists, hospitals and other healthcare providers. As EHR technologies become more widely adopted by providers and reach their full potential, patients will be able to access their own health information and become empowered partners in their medical care.

“I wanted to deliver the best, most technologically advanced healthcare for my patients, but as a small internal medicine practice, it was very tough,” said Dr. Annette Bosworth, who works with HealthPOINT. “By working with HealthPOINT, we have been able to implement an EHR system that has given us the ability to improve how we track a patient’s medical progress and coordinate care with other clinicians.”

Since April of 2010, HealthPOINT has been using its broad, Health IT expertise to help PCPs, who face unique and complex challenges with EHR adoption, make a smooth transition to their EHR goals. Because all practices are different, HealthPOINT gears its support to meet each practice’s specific needs – from identifying financial resources to negotiating with EHR vendors to redesigning office workflow. Over 1,000 healthcare professionals are already working with HealthPOINT, the Health Information Technology Regional Extension Center (REC) based at Dakota State University’s Center for the Advancement in Health IT (CAHIT). In just 19 months, HealthPOINT has built a non-profit and self-sustainable education, outreach, and direct technical assistance partner for rural healthcare in South Dakota. HealthPOINT’s expert Health IT professionals are located throughout the state and have traveled over 20,000 miles from Sisseton to Wall and over 80 communities in between to provide more than 10,000 hours of expertise that small South Dakota clinics and hospitals could not normally find nor afford.

Throughout the country, RECs are working with providers in different practice settings to ensure widespread adoption of electronic health records. While RECs mainly assist primary care providers, they also work with specialists such as cardiologists. The regional extension centers leverage their broad health IT experience to provide assistance to clinicians working in practices of various sizes and in both urban and rural settings.

As part of its EHR Incentives Program, the Centers for Medicare and Medicaid Services defined meaningful use criteria to ensure providers use a certified EHR system to:

• Exchange health information as part of coordinated care,
• Report clinical quality care measures and
• Utilize electronic medical services such as e-prescribing

If you'd like more information on how you can join the 100,000 providers and get your organization started on the road to Meaningful Use, just click HERE.

The 4th Annual eHealth Summit is fast approaching and with great excitement, we announce the offering of Continuing Medical Education units to providers who attend the 2011 eHealth Summit! For only $75 (or free to HealthPOINT members), providers will receive up to 5.5 CME's, based on how many sessions they attend that day. Not only is this a great way to get your physicians engaged in EHR efforts, it's extremely cost efficient when you compare other events offering as many CME's.

Accreditation Statement: The Sanford School of Medicine of The University of South Dakota is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation The Sanford School of Medicine of The University of South Dakota designates this live activity for a maximum of [5.5] AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Don't Forget! If you become a member of HealthPOINT, your registration at the eHealth Summit is included and free of charge! Start here and get a free quote to access HealthPOINT's Member Services. Click below for more information on this state-wide event and how to Register.

I have always considered data to be fun, exciting, and able to tell stories that no words could match. Until recently though, I thought I was on an island in regards to my affinity for data and the wonders it holds. With the mass implementation of electronic health records, practice management systems, laboratory information systems, pharmacy information systems, pharmacy inventory systems, I could go on and on…. The amount of data that is being generated in the health care environment today is dizzying. Data is becoming a major topic of discussion at every meeting, conference, and email blast that hits my inbox.

• Will healthcare utilize this data?
• Will we keep the data to ourselves to ensure no one is able to point a finger at our deficiencies while also keeping our successes to ourselves?
• Will we let our patients make informed decisions about where they would like to have their bypass surgery or where they will deliver their high risk premature baby?
• Will we share this data with others to assist in diagnosis and treatment?
• Will we pick apart the data and render it useless?
• Will we use it only for marketing and bottom line padding?
• Will our data management and governance be centered by the mission of our facilities and our value statements?
• Will safety, quality, efficiencies and reduction of health care disparities be the goal of my stacked bar graph?
• Will regression analysis make us regress or push us to new heights of excellence?
• Will we squander this opportunity?
  
• OR will we set our sights on the principles of the HITECH act and Meaningful Use?

Most of these questions are yet to be answered but I wanted to offer a couple of basic principles that must be employed when establishing a data driven environment:

• Build a data governance framework within which all data management functions will work.
• Establish a strategic data management plan that is guided by integrity, transparency, auditability, security, accountability, stewardship, and standardization.
• Identify data stewards that are responsible to reinforce the message that data is a valuable asset to any organization and to manage the data as such.

We are on the cusp of making some decisions that will affect the future of healthcare. I would rather make those decisions based upon data than anecdotes.

- Holly Arends, RHIT

Clinical IT Manager, HealthPOINT

November 7, 2011 has been announced as this year's date for South Dakota's 4^th Annual e-Health Summit. This will be an exciting opportunity to educate and update attendees on the positive results of electronic health record technology. This event will be held in Sioux Falls at the Holiday Inn Downtown. Registration and Vendor Exhibits will begin at 7:00 AM. Dr. Douglas Knowlton, President of Dakota State University, will welcome attendees and kick-off the event.

The event will contain varied topics surrounding Health Information Technology (HIT), Health Information Exchange (HIE), and Electronic Health Records (EHR). The topic of HIT will involve the supportive elements of electronic health information through management. Breakout sessions will examine HIT aspects. Areas of core HIE factors will be explored and promote dynamic transmission of HIT components. Benefits for healthcare providers regarding EHR’s will also be discussed.

For the main event, an informative testimonial will be given from Ron Fovargue, Vice President of Technology for Mercy Health, who understands directly how EHR’s provide protection in natural disasters. A horrific tornado struck Joplin, Missouri and destroyed one of his hospitals, St. John's Medical Center. Ron will discuss the benefits of EHR in real world disasters. EHR’s were adopted before the devastating disaster and guarded the health records from destruction. The devastating story of St. John’s Medical Center has received national news coverage from ABC News and CNN. Come join us and hear firsthand along with many other great topics related to the electronic health record initiative.

We hope you will join us. This event promises to provide new insights on the advantages of HIT, HIE, and EHR’s.

Click HERE to register.

This week is shaping up to be a big one in the Health IT world. Starting last Monday and continuing through the week, HIMSS (Healthcare Information and Management Systems Society) is hosting the Sixth Annual National Health IT Week. This collaborative forum is a place where public and private healthcare constituents will work in partnership to educate industry and policy stakeholders on the value of health IT for the US healthcare system. It’s a great way for the health IT community to come together under one umbrella to raise national awareness. Comprehensive health care reform is not possible without system-wide adoption of health information technology, which improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers.

With Meaningful Use now paving the way, eligible providers across the country increasingly understand the benefits for themselves and their patients, and are adopting Meaningful Use compliant electronic health records.

For more information and a list of activities, visit www.healthitweek.org.

Also on Monday, the Office of the National Coordinator (ONC) launched a campaign to empower and educate patients, caregivers, and individuals managing their day-to-day health about how they can be partners in their own health care through health IT. On Monday, they held an online presentation called the Consumer Health IT Summit. Secretary Kathleen Sebelius joined Farzad Mostashari, National Coordinator for Health IT, other Department of Health and Human Services senior staff, as well as leaders from across the government, and industry leaders from public, private, and non-profit organizations who are all pledging to help consumers engage in their own care through health IT.

Visit www.hhs.gov/live to access the presentations.

And for anyone who is interested in the growing world of patient engagement, check out this video by Regina Holliday and her compelling story of how EHRs could have saved her husband's life. Click HERE to view it.

Today, consumers have access to an amazing amount of information. We can purchase more goods and services than ever before - largely due to the internet. Even better, we can make INFORMED purchases because of consumer reviews done on products we are most interested in. If you want to buy a blender, Amazon can show you the best rated blenders, you can sort them by price, etc. The information we have is empowering to say the least.

Healthcare has been acknowledging this shift as tools for the consumer have appeared. With sites like WebMD and HealthGrades, consumers are becoming more engaged in their healthcare. They want to know more. They want to help themselves get better more than ever. They want to be involved.

To highlight this point, check out this video from "e-Patient Dave," a speaker at a recent ONC Regional Meeting held in Minneapolis. Dave is a cancer survivor. Given 24 weeks to live, Dave used information from the internet community and his doctors to find a cure. His story and resolution is a hint of what many will see - empowered patients who seek information to help make themselves better.
If you are a provider and seek assistance with an electronic health record - the wealth of information and the speed at which you can access that information will save time, eliminate errors, avoid duplication, improve outcomes and provide your patients the access they desire to their own health. See below if you seek help on how to get started.

“Laura, the doctor will see you now.”

Laura puts down the aged magazine that she has looked through during her last three appointments and she wonders how long this is going to take. She wonders if this appointment will get her any further than previous appointments. When her name is called and Laura is escorted down the hall to step on the scale, she notices that instead of paper used to record that dreaded number, the nurse is using a laptop. What in the world? Where did that come from? When asked, the nurse explains that the doctor is now using an “electronic health record” which will replace her paper chart. She further explains, while finishing taking the remainder of her vital signs, that all of her medical information is now readily available to the doctor without having to rely on flipping through pages and pages of paper.

Laura is a little more comfortable with this idea since they use computers at her office, but there are still hundreds of questions. What information are they recording? Who will see this information, and more importantly what’s the benefit? The doctor enters the room, and Laura notices she has a laptop, also! When questioned, the doctor tells Laura she now has a reliable source for her patients’ information and with less time spent in searching, she has more time to spend with YOU. She also explains how she can securely share information with other physicians’ offices and then make more informed decisions regarding her care.

During the examination, the doctor asks Laura to sit beside her at the small desk in the room so that she can observe the doctor typing the answers to Laura questions; about what brought her to the office today, what were her symptoms, etc. The doctor shows her on the screen a diagram of her condition. Then with just a few keystrokes, the doctor orders lab tests, a radiological test, medications and even sets up an appointment for Laura to see a specialist located in another office. Laura feels she is truly part of this appointment and not just another name or number. She is even offered an electronic copy of her visit, but Laura declines feeling more confident than ever in her care plan.

As she walks to her car, Laura realizes how different this appointment was compared to the last time she was there. Health information was electronically captured and immediately available for review, saving time and effort for all involved. She felt like she was offered personalized care. It occurred to her that the medical staff appeared more concerned with accommodating her needs and worked diligently towards an improved outcome for her because they knew her pharmacy of choice and explained the next steps.

If you are a patient, does this situation reflect your last visit to a medical provider? Were you THE patient or just another name on the list?

- Laura Moller

Clinical IT Specialist

Do you understand all of your fears before taking the "plunge?" The first time one jumps into a pool, anxieties and fears can arise, although we don't always understand why. Is it because it's a leap into the unknown? Or is it just uncertainty at something new?

Taking the plunge into the world of the electronic health record is not too distant from our pool analogy. Large AND small healthcare facilities have legitimate concerns about transitioning from paper-based charts to electronic health records (EHRs). That's fairly commonplace when you talk about change in general. During my travels as a Clinical IT Specialist, I have traveled throughout South Dakota to various clinics to understand their EHR readiness and the challenges that lie within this new pool.

After attending the 2011 Healthcare Information and Management Systems Society (HIMSS) conference my own observations were emphasized by one the of the speaker, Dr. Alice Loveys, MD, FAAP, FHIMSS from CMIO Monroe County Medical Society. Her presentation was focused on EHR implementation in small physician offices. The points below are important items to remember and great information for clinics to consider as it relates to adopting an EHR.

Many small clinics embrace independence or as Dr. Loveys stated are “Independent thinkers.” The great thing about adopting an EHR is that it allows small clinics to be independent while offering their patients the same benefits that patients of larger systems will have through an EHR.

• Adopting an EHR is a great way to continue your services and provide that "hometown feeling." Personalized delivery is enhanced with an EHR through the fast access of information. You can increase patient engagement and showing them what information is put into the system and how it works best and addressing any concerns they may have at the same time.
• Adopting an EHR doesn't have to break the bank. Small clinics tend to have high overhead and low margins so any expense can be a huge consideration for their budget. Medicare or Medicaid incentives are available to help defray expenses.
• Developing a prepared and highly detailed project plan is the key to success. As we all know, EHR implementation and adoption is a huge undertaking that takes time. The challenge is the amount of time and effort it does take and the possibility of production loss. Clinics are busy places with limited staff that do a variety of jobs. The more developed the plan, the faster issues can get resolved.
• Seek to understand your technical capabilities and level of computer experience amongst your clinic staff.  Size, location, and even the age of a practice comes into play when planning for an IT infrastructure. Clinics have limited technology which can place an impact on the timeline of the implementation process.
• Adopting an EHR is more than just an IT project.  It involves processes and is also a people project. “We have always done it this way,” is not the way of the future any longer. People will have to be trained and as the training continues, processes will improve. Identifying a training plan and incorporating different learning styles and different needs of level of detailed information is important.

Maintaining a small physician practice in the age of EHRs is doable.  And, as these tips demonstrate, a little forward thinking today will reap benefits in the years to come. Undoubtedly, there are many steps to be taken during this EHR journey. Through understanding, planning and preparing you too will be ready to do a cannonball into the EHR pool.

What other challenges does your small practice suspect or will face?

- Tara Gill

Clinical IT Specialist

Once as a patient, I sat in the waiting room and watched a timely conversation unfold between three other patients about their medical information.

The third person nodded reluctantly and added, “I just don’t want everyone looking at my information.”

Do you or your patients think like these people? Is the verdict still out as you decide or are you liking the changes you see with an EHR? Or, are you like the third person - not sure what is happening with your electronic record? Security of information, especially medical, is a very real concern for patients, as well as the people gathering and entering that information. If there is one thing that is no secret – people want their healthcare information to be kept secret and accessed only by their provider.

There are security measures you must consider while choosing the right EHR vendor for your organization. Basic questions need to be answered so you can confidently tell patients their medical/personal information is safe and protected. A certified vendor will inform you:

• How will the information be stored and the process for which it will be backed up?
• Who will be the people who will be able to view the medical information?
• How will the information be shared to those people who will be given access to it?
• Just what, specifically, is found in a medical record?
• What other personal information may also be included?
• What will happen if an outside source requests the electronic health information?

A secure system meets the concerns of many patients and staff but will also contribute to a profitable practice. Using an electronic health record which is certified by the Office of the National Coordinator for Health Information Technology and Authorized Testing and Certification Bodies (ATCB), assures that the required privacy and security standards have been tested and verified during the certification process. The ONC’s certified Health IT Product List contains an updated listing of both ambulatory practice or inpatient practice software vendors.

The security measures that the ONC-ATBC certification include will increase data validity, accuracy and integrity; with tools in place to prevent fraud from occurring and reports when it has been attempted as in the recent case of hospitalized football players.

Having security and privacy answers met ahead of time decreases any uncertainty and resistance by both staff members and patients. Plus, it will move the facility that much closer to implementation and adoption of your electronic health record.

If people trust their banks and credit card companies with their financial information, what do you think causes concern with electronic healthcare information?

-Terry Disburg

Clinical IT Specialist