The Impact of HITECH on EHR Implementation

Software Advice, a trusted resource for buyers of software, recently published findings from a three-year study following the changing demand drivers among prospective buyers of eclectronic health record (EHR) software.

The study captured data over two sample periods: Q1 2010 (shortly after the HITECH Act was signed into law) and Q1 2013. In both sample periods, the reasons providers expressed interest in purchasing EHR software broadly fell into the following categories:

• Replacing paper records;
• Replacing existing EHR software;
• Opening a new practice;
• Replacing other software that wasn’t specifically designed for medical records; or
• Some combination of the above.

For both sample periods, replacing paper records was the most-mentioned reason for EHR purchases. However, the percentage of practices replacing paper records fell significantly from 2010 to 2013, while the percentage of respondents replacing existing software grew by almost 50 percent.

These findings seem to validate a hypothesis that the HITECH Act spurred some practices to adopt EHRs too hastily. For providers, this highlights the importance of having a rigorous selection process in place before making a purchase.

Digging deeper into the data allows us to determine why practices are replacing existing EHRs.

Mentions of being “unhappy with current EHR” grew by 11 percent from 2010 to 2013. Additionally, concerns with cost rose significantly, from only one mention in 2010 to being mentioned by one out of every eight participants in 2013. Customer service concerns grew by nearly 50 percent.

Replacing Paper
The percentage of buyers replacing paper charts decreased from 64.9 percent in 2010 to 50.9 percent in 2013.

In both 2010 and 2013, the top reasons practices mentioned for switching from paper to electronic records had to do with the general benefits of a paperless environment – decreasing paperwork, improving efficiency, and becoming more organized. These motivations suggest practices are interested in more than just stimulus dollars; they also seem to recognize the inherent value of electronic records.

Among potential EHR buyers, we observed a decline in the proportion of practices transitioning from paper to electronic records, contrasted with an increase in the proportion of practices replacing existing software. What our data points don’t show, by virtue of only including buyers in the market for an EHR, are the many providers who are not replacing their EHR solutions – those who have successfully implemented electronic records with great benefit to their practices.

With EHR replacements on the rise, we conclude by emphasizing the need for practices to perform due diligence before making a purchase decision. Careful research can be awarded with a system that contributes to improved patient outcomes as well as increased financial health for practices.


David Fried originally contributed this report to Software Advice, where he currently covers medical practice management, the EMR industry, and political and regulatory issues affecting doctors. View the full report, including methodology and limiting factors, here: Four Years Later: The Impact of the HITECH Act on EHR Implementations.

HealthPoint Rehab Chooses Chart Links as its EHR

HealthPoint Rehab (, a service of Southeast Missouri Hospital, comprises two outpatient rehabilitation centers located in Cape Girardeau and Jackson, Missouri. Combined, the centers employ 25 therapists engaged in physical, occupational, speech and specialty therapies including orthopedic, neurological, myofascial and lymphedema. The two centers handle about 33,600 total patient visits annually.

Realizing the inexorable trend toward electronic medical records, the HealthPoint management team decided to abandon its paper-based system and make a comprehensive search for an advanced electronic solution.

“We knew the need for EMR was coming,” said Andrea Marchi, PT, MBA, CSCS, HealthPoint rehab manager. “We wanted to get ahead of the curve and have plenty of time to make the right decision. That’s when we began a search that led us to Chart Links – a choice we couldn’t be happier with.”

Chart Links offered a product customizable to HealthPoint’s suite of multi-discipline therapeutic services. “We needed a system that could effectively address and document our many different specialty areas and Chart Links was the only one that had this capability.”

A Compliant Documentation Process

Chart Links Rehabilitation Software is driven by major accreditation, professional, information technology and security standards. It supports compliance with JCAHO, CARF, AOTA, APTA, HIPAA and other rehabilitation professional standards. The system’s documentation helps ensure compliance with Medicare Correct Coding Initiative (CCI) Edits, modifiers and time tracking.

Marchi feels more at ease with proper documentation compliance. “Our compliance is virtually guaranteed because, in a progress note or evaluation section, Chart Links prompts for JCAHO and Medicare documentation in a way that you cannot miss or ignore.”

Unlike paper forms unable to force standards compliance, Chart Links’ electronic forms do not accept signatures without fulfillment of all required standards.

Better Business Decisions with Analytics

Chart Links Analytics allows managers to make informed business decisions through a simple-to-use ad hoc analysis interface that can analyze practice trends, develop universal metrics, measure long-term changes, and gather operational decision-support data.

“What could be a monumental task, taking weeks to accomplish by having to manually track and assemble mountains of data now is as simple as jumping into the system, defining your parameters and – click – up comes the data,” said Marchi. “It’s easy to read and understand. You don’t need any assistance from IT to make this happen. Chart Links Analytics is simply awesome.”

HealthPoint uses Chart Links Analytics for generating statistics for its annual report and as a basis to make good business decisions. Analytics allows HealthPoint, for example, to analyze visits (by location, by therapist, by time-period, etc.), dissect referrals, or scrutinize cancellation rates. “Chart Links Analytics helps us to stay ahead of the game, so we can make better decisions and not be reactive to what has already happened,” observed Marchi.

Routine Tasks Greatly Improved

Marchi also cites the user-friendly Chart Links scheduler as a key benefit. She notes that you can see all you need to see on one screen. Users can sort information by discipline or selected providers, or take a patient and click and copy for 15 visits instead of making 15 individual appointments. “The front desk has nothing but good things to say about the Chart Links scheduler,” remarked Marchi.

Chart Links Customer Service as Outstanding as its Technology

HealthPoint has found that the Chart Links solution extends into exceptional customer service. “The customer service we have received has been fantastic,” said Marchi. “There was no sense that, once we went live, ‘you’re on your own.’ Chart Links doesn’t operate that way. They don’t put limits on customer service. We feel we can call on them anytime. Chart Links consistently delivers on all counts.”

APTA Submits Comments on EHR Testing and Certification Process

April 21, 2010 · Posted in Documentation, meaningful use, physical therapy · Comment 

The American Physical Therapy Association (APTA) recently submitted comments to the Office of the National Coordinator for Health Information Technology in response to a proposed rule that would establish a temporary program for the testing and certification of electronic health records (EHRs).

The proposed rule, released March 10, is the third and final step in the rulemaking process to establish the incentive payments program for the meaningful use of certified EHRs. While physical therapists are not currently eligible for incentive payments under the program, APTA’s comments were designed to ensure that the testing and certification processes established under the temporary program meet the needs of health care providers including physical therapists.

Comments on the permanent testing and certification programs are due May 10.


CMS & ONC Issue Regs Proposing Definition of Meaningful Use and Setting Standards for EHR

The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations issued on December 30, 2009 that lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record (EHR) technology. The regulations will help implement the EHR incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act).

A proposed rule issued by CMS outlines proposed provisions governing the EHR incentive programs, including defining the central concept of “meaningful use” of EHR technology.

An interim final regulation (IFR) issued by ONC sets initial standards, implementation specifications, and certification criteria for EHR technology.  Both regulations are open to public comment.

The Recovery Act established programs to provide incentive payments to eligible professionals and eligible hospitals participating in Medicare and Medicaid that adopt and make “meaningful use” of certified EHR technology.  Incentive payments may begin as soon as October 2010 to eligible hospitals.  Incentive payments to other eligible providers may begin in January 2011.

CCHIT to Seek EHR Vendor Input on Town Call Meeting

The Certification Commission for Health Information Technology (CCHIT®), a nonprofit organization with the public mission of accelerating the adoption of health IT, will host a Town Call tomorrow for the vendor and developer community tomorrow.  Chart Links Chief Operating Officer, Jim Hammer, will participate.  On the call, CCHIT will gather input on the details and timing of its planned new paths to certification of electronic health record (EHR) technologies, with the goal of supporting more rapid, widespread adoption and meaningful use under the American Recovery and Reinvestment Act of 2009 (ARRA).

“We are concerned that providers could not achieve meaningful EHR use in 2011 if they wait until Spring 2010 – the expected date of HHS final approval of requirements – to begin adopting this technology,” said Mark Leavitt, M.D., Ph.D., Commission chair.  “CCHIT has analyzed the recommendations of the Federal HIT Advisory Committees and is preparing to offer new paths to certification beginning this October.”

Besides updating and enhancing its current certification program for comprehensive EHRs in Ambulatory, Inpatient, and Emergency Department settings, the Commission plans to launch a more limited, modular inspection program for EHR technology, focusing only on compliance with ARRA-required standards.

During the event, planned for September 3 at 12:00 PM Central time, concepts and some details of these two programs will be discussed.  Participants will be invited to submit questions and comments online, and respond to polling regarding their interest and readiness for participation in the process.

Information about the free Town Call is available at

More information on CCHIT and CCHIT Certified® products is available at and

No Final Definition of EHR Meaningful Use until Spring of 2010

We’ve been anxiously awaiting a final definition for “meaningful use” of electronic health records (EHR) to determine which hospitals and providers will be eligible for Medicare and Medicaid incentive payments under the American Recovery and Reinvestment Act of 2009.  However, in a press conference on August 20th, Dr. David Blumenthal, the national coordinator for health information technology, predicted that the final definition will not be available until the middle or end of spring in 2010.  A preliminary definition of “meaningful use” is scheduled to be issued by the end of 2009 with a 60-day comment period.