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Do you feel that Electronic Health records would benefit an Alzheimer's unit being Private Pay only?

While there may not be any obvious financial benefits, if there is a need to coordinate care with other providers, then the answer is yes. Health records that can be shared safely and electronically with providers such as labs, x-ray centers, hospitals, and even the resident's primary doctor, will provide more efficient and hopefully more accurate sharing of information critical to the day-to-day care of any resident who has more than one provider.

Is there a mandated timeline for a skilled nursing facility and/or assisted living facility to have an EHR?

Not at this time. The national goal is for interoperable EHR systems by 2014, but as of today there is no Federal legislation in place that has set a date or incentives for SNF, ALF or other long term care operations. However, some states do have regulations in place, so be sure to check with your licensing authority.

When do you expect that LTC will get funding for electronic stimulus funds?

That is a good question. Long term care is being at least talked about on Capitol Hill. But so far there are no proposed laws.

How do eMARs fit into the EHR?

Like the paper MAR, an eMar is part of the provider's "chart" of care for a given resident. As such, it is a piece of the EMR - the electronic medical record - and is therefore one component of the electronic health record owned by the health care provider. An Electronic Medication Administration Record (eMAR) system electronically presents translation of the actionable medication orders and facilitates real-time documentation of the actions taken to satisfy the orders.

What MDI Achieve products are best designed for expected EHR standards and "meaningful use" requirements?

Keep in mind that "meaningful use" as it relates to Federal incentives have not yet been defined for long term care. However, MDI Achieve's Matrix product does meet nearly all of the criteria that are currently used for doctor's offices and hospitals. Because it is our intent to seek certification of Matrix from CCHIT and/or HHS, it will meet all of the criteria once they have been established.

How much should a provider budget for consideration of an EMR/EHR? (ballpark)

The answer really depends on what a provider wants to implement. In some cases it might only be necessary to add some missing components, especially if a "best of breed" approach is taken. It will also depend on the size of the provider organization, and what kinds of business processes they want to improve. The only way to get a good answer is to speak with your regional sales manager.

Were there incentives given to LTC when MDS was mandated in mid 90's?

We don't recall any. However, it could be said that there was a "dis-incentive" for those that did not comply, because it became a condition of getting paid by Medicare and other payors.

Explain a little more about certification plan that is scheduled to begin next summer. Is this certification of LTC software packages?

The work has already begun by the Long Term and Post Acute Care Workgroup (LTPAC) of the Certification Commission for HIT (CCHIT). You can follow their progress at their web-site: http://www.cchit.org/workgroups/long-term-and-post-acute-care.

CCHIT intends to offer a certification program for Electronic Health Records Systems (EHR-S) for software used in the LTPAC sector. The certification is based on accepted functional use criteria developed by HL7 and other organizations. It will build on the certification criteria already in place for other care settings.

The goal of certification is to give information to the provider community about whether a software package meets certain interoperable functions, for example, secure transmission of data. It is not intended to be an endorsement about ease of use, but rather to advance the goal of national interoperability of health records.

Is there a finalized template for the type / format of data for LTC that allows easy interoperability between providers? Along those lines, wasn't the federal government working on a centralized database/repository for medical information?

There is no final "template" for the type or format of data for LTC. That is the goal of the certification efforts underway - to pick from existing standards such as the HL7 Clinical Document Architecture.

It is unlikely that there will be a central repository of medical information. Rather the vision is for a National Health Information Network using accepted standards so that information can be requested and shared across the network. Secretary Sebelius recently announced funding for advancing NHIN.

I have heard there will be an new XML standard that may supplant the HL7 standard. Can you comment?

There has been some talk about using ebXML - electronic business eXtensible Markup Language - as part of the standards based approach for sharing data. It is doubtful that it would supplant HL7 which uses XML in its version 3.0.

I am an IT person from an LTC organization. Is there an existing EHR system right now that we can use in our facility?

At this point, what are the requirements for long term care organizations and when are the required implementation dates?

There are many EMR systems already in the marketplace and your organization is probably already using one. And there are systems already in the market - we offer one - that are comprehensive health record charting systems. The national goal is for interoperable EHR systems by 2014, but as of today there is no legislation in place that has set a date or incentives for SNF, ALF or other long term care operations. However, some states do have regulations in place, so be sure to check with your licensing authority.

What do you think will be needed to incentivize hospitals to share information with LTC?

Only a Federal or state law will provide the real incentive. There are exceptions - there are some wonderful regional organizations that see the value of sharing the information in all care settings. Being interoperable with other care settings probably needs to be a condition of payment.

So does MDI Achieve have EHR Software?

That depends on your definition of an EHR.

Our flagship product, Matrix, has a variety of EHR capabilities. These include eScribing, Point of Care ADL tracking in real-time, wireless electronic charting, automated physician and provider faxing, electronic documents, lab requests and results associated with the chart. The system provides not only the ability to efficiently capture and process resident information, but also interoperability features to communicate with pharmacies, labs and physicians.

I am a Consultant Pharmacist that performs monthly regimen reviews. What is the best way to make sure that pharmacists get access to EHR and have a way to document their review?

This is an excellent question. Pharmacists can be "users" of the software like any internal employee. This is easier with some systems. Our top of the line product is frequently used this way today because it is easy to access remotely. So, the best way to get started down this path is to have a conversation with your client, the provider, and ask how this can be accomplished.

The latest stimulus funds grant opportunity from DOL names LTC as a recipient. Would you be applying for some funds to assist with EMR implementation?

Software vendors are not providers and therefore cannot actually apply for the funds. The provider needs to talk with the funding source and at the same time enlist their software company to be part of the discussion for how to make it happen.