7 Observations on ASC-Based EMR

ASC-based electronic medical records are very different from EMR in the physician's office or hospital, but the goal is to make all EMR systems, regardless of venue, interoperable with each other, so that records can be sent seamlessly.

Joe Macies, CEO of AmkaiSolutions, maker of an ASC-based EMR system, describes how this approach fits into the nationwide EMR trend. In addition to selling its ASC-based EMR system to more than 100 ASCs, AmkaiSolutions also produces EMR systems for physician practices and hospitals.

1. ASC-based EMR is unique. EMR in a surgery center is very different from EMR in a physician's office. Since there are only a limited number of operations performed, the system doesn’t have to be as comprehensive. Steps like diagnosis and treatment, which are necessary for EMRs to track in physicians' offices, are not needed in an ASC-based EMR. An ASC-based EMR follows the process from pre-op through surgery and post-op, making sure safety and compliance requirements are met.

2. No EMR funding for ASCs. Practices that install EMRs are eligible for as much as $44,000 in federal funding per physician, or as much as $67,000 if they have sufficient Medicaid and Medicare volume, and hospitals can get millions of dollars for installing EMRs, depending on their size. But ASCs are not eligible for funds, removing a valuable incentive for installing EMR systems. However, as more hospitals install EMR, ASCs will need to have EMRs to maintain a competitive advantage. EMR systems make ASCs more efficient.

3. True EMR systems still rare in ASCs.
Only about 5-10 percent of ASCs have EMRs. Another 5-10 percent have paperless systems that may be mistaken for EMR but do not have the ability to process information. These non-EMR systems display patient information in a PDF-style page.

4. Little interoperability yet. It is still difficult to send information electronically from one EMR system to another, whether the system is in a hospital, physician's office or ASC. Even when both sender and receiver have an EMR, information often must be faxed. For example, the physicians office faxes the patient's history and physical to the ASC. The document might be scanned into the ASC-based EMR and displayed as a PDF-style page, but the information on the page cannot be integrated into the EMR system. The ASC-based EMR can, however, indicate where this information is located and whether it has been processed yet.

5. Interoperability in the future.
Some EMR systems, including AmkaiSolutions systems, are beginning to establish interoperability with other systems. HHS' new "meaningful use" standards are pushing EMR systems toward compete interoperability by requiring use of common data sets and other features. The federal funding for EMR available to hospitals and physicians' offices is contingent upon meeting those standards.

6. Progress on meaningful use standards.
HHS recently released final "meaningful use" standards for next year. HHS scaled back its original set of proposed requirements, issued in January, which practices and hospitals felt were too stringent. The new requirements will apply to EMR systems in 2011 and 2012 and it is expected that requirements removed from the final rule would be applied to EMRs in 2013 to 2015.

7. Many vendors won’t meet requirements. Since the proposed regulations were released in January, vendors have been working hard to update their systems. AmkaiSolutions and many other vendors will offer an updated product to all existing customers free of charge. While AmkaiSolutions expects to meet the requirements, many software systems will probably not be able meet them.

Learn more about AmkaiSolutions.

Read more coverage of EMR:

- Factors Influencing Health Information Technology Adoption: A Focus on Ambulatory Surgery Centers

- Study Finds More Than 50% of EMRs Non-Users Plan to Implement Use in Next Two Years

- Time, Technology is Right for ASCs to Transition to a Paperless Environment


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