New York-based Hammond Hanlon Camp (H2C), an advisory and investment-banking firm, released the second-edition research report, “Merger and Acquisition Trends in Healthcare Services.” The report found that the M&A activity was driven by nearly 1,300 transactions. Among the industry’s service sectors, long-term care and hospitals were leaders in terms of number of transactions and value over the past two years. Continued impact of the Affordable Care Act (ACA), cost pressures and access to capital and patient sources were key drivers of hospital merger and acquisition activity.

The report found several prominent trends, including larger hospital systems, as well as other sector players, expanded their scale, geographic reach or concentration through acquisition activity. Additionally, the majority of transactions (70 percent) within the hospital sector during 2014 involved transactions in which nonprofit institutions were both the target and acquirer.

The report also found affiliations and vertical integration to access new revenue streams, expertise or new services was evident. There was also a growing trend of strategic partnerships that was evident over full asset mergers, including creative and non-traditional relationships. Furthermore, the report found both long-term care and medical office building sales activity reached historically high levels in 2014.

“Mergers and acquisitions remain a key avenue by which many organizations are responding to trends and pursuing growth. Many organizations are hiring mergers and acquisitions hong kong lawyers to help with the process and this allows things to run more smoothly.” said Michael Hammond, H2C principal, in a statement. “Furthermore, creative partnerships are becoming a vehicle in regional markets that have reached saturated consolidation and concentration.”

According to the report, the outlook for health care M&A activity in 2015 and beyond remains strong, with the impacts of reimbursement changes, price transparency, technology costs, competitive pressures of ACOs/ health exchanges and need for efficiencies continuing to fuel transactions.

Increased investment in the health care industry is likely to be seen among private equity and venture capital firms, especially within technology and specialty sectors that can be aggregated for future sale. Those companies that demonstrate capabilities that improve quality, patient satisfaction, cost efficiency and utilization of “big data” to drive performance will be in high demand.

“The rising use of technology and ‘big data’ in all aspects of delivering care will have a transformative effect on health care cost, quality and convenience factors, influencing future M&A trends,” said Bill Hanlon, H2C principal, in a statement.

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The Next Generation Healthcare Facilities Summit will take place Feb. 23 – 25. This is the second year for the event.

The built environment of a health care facility directly impacts the safety, operation, clinical outcomes, and financial success of health care organizations now and well into the future, according to the event’s website. By documenting deficiencies in logistical design and addressing potential improvements in the operation or condition of the facility’s mechanical equipment, lighting and related controls, facilities can work towards operating more effectively.

Additionally, regulatory requirements are pushing hospital owners to demand designs that promote well-being and convenience through strategic site design, according to event planners. Experts will gather to assess the impact of future trends in medical technology and information on clinical practices and health care facility design. Event speakers will also evaluate the regulatory environment (addressing the Affordable Care Act, Americans with Disabilities Act and HIPPA) to comply with state, federal and local requirements, avoiding halts in construction and cost overruns.

Attendees will also be able to learn how to optimize cost effectiveness to make the most out of viable resources, enhancing functional space and utilizing a practical logistics system. Other topics of interest at the event include Building Information Modeling (BIM), Energy Audits (EAs), and Life-Cycle Assessments (LCAs) to increase energy efficiency, assess LEED certification and lower utility costs.

Additionally, ideas will be shared on how regenerative design and aspects of a facility’s interior can promote patient wellness. More specifically how it can attract and retain the best doctors and HMOs.

Experts will also assess the importance and value of using Integrated Project Delivery (IPD) to achieve efficiency during construction.

Event planners are offering a discount code before the start of the summit. Use the code NGHF_HCO to receive 20 percent off standard pricing.

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Research from a September 2014 Columbia Business School study titled, “Should Hospitals Keep Their Patients Longer? The Role of Inpatient and Outpatient Care in Reducing Readmissions,” compared the impact of a longer length of stay in the hospital to the effects of outpatient care for Medicare patients.

The study showed that one additional day in the hospital can reduce mortality risk by 22 percent for patients treated for pneumonia and by 7 percent for heart attack patients. It can also result in five to six times more lives being saved when compared with outpatient care and decrease readmission rates by 7 percent for severe heart-failure patients.

What’s more, the study showed that one extra day in the hospital would, in many cases, cost less overall than the associated outpatient care required with early discharge. The vast number of Medicare patients being readmitted to the hospital within 30 days of discharge is costing taxpayers at least $17 billion annually.

“Currently, about one in every five Medicare patients is readmitted to the hospital,” said Carri Chan, associate professor of decision, risk, and operations at Columbia Business School, in a statement. “Our findings show that one extra day in the hospital could reduce these readmission rates, ensure healthier patients and save money.”

As part of the 2010 Affordable Care Act, the Hospital Readmissions Reduction Program financially penalizes hospitals with higher than expected readmissions. Researchers looked at data on more than 6.6 million Medicare patients treated between 2008 and 2011, and estimated the reductions in readmission and mortality rates of an inpatient intervention (keeping patients in the hospital for an extra day) versus providing outpatient interventions.

Since the focus of the Affordable Care Act’s Hospital Readmissions Reduction Program has been to reduce readmissions of only those patients with heart failure, myocardial infarction or pneumonia, the study focused on these three distinct patient populations.

“Given the stiff penalties imposed under the Affordable Care Act, hospitals are implementing a variety of approaches to aggressively reduce readmission rates, most commonly involving outpatient care,” said Ann P. Bartel, professor of finance and economics at Columbia Business School, in a statement. “While some types of outpatient interventions can be effective, our study shows that hospitals should consider keeping some of their patients in the hospital longer to better control patient care, reduce readmissions and ensure fewer deaths.”

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“Today’s awards will support 21 new construction projects and 126 alteration and renovation projects at health centers across the United States as they work to improve their design and expand existing structures to better support team-based care,” said Mary Wakefield, administrator of health resources and services administration for the Health and Human Services Department, in a statement.

Nearly 1,300 health centers operate more than 9,200 service delivery sites that provide care to more than 21.7 million patients in every state, as well as Puerto Rico, the U.S. Virgin Islands and the Pacific Basin. The health centers that were awarded have been promoting coverage opportunities under the Affordable Care Act by conducting outreach and enrollment activities that link individuals to coverage options available through a health insurance marketplace.

The patient-centered medical home delivery model is designed to improve quality of care through team-based coordination of care, treating the many needs of the patient at once, increasing access to care and empowering the patient to be a partner in their own care, according to HHS.

“Health centers provide access to quality health care for millions of Americans regardless of their ability to pay,” said HHS Secretary Sylvia M. Burwell. “We’re making these investments so that health centers will be able to provide even higher quality services to the patients that rely upon them.”

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Designing an Implementation and Process Map
Integrating a new, comprehensive EHR system starts with designing a well-planned implementation and process map. To begin, the map should be mutually agreed upon by the facility owner, architects, engineers, contractors and other stakeholders, as it helps everyone involved successfully schedule the implementation process, from planning through design, construction, and system activation.
The process map includes comprehensive documentation of all required project steps. It starts with a building analysis, which can help minimize cost escalation and surprises as a project progresses. Next steps include code compliance; the selection of general contractors; costs of design, construction and technologies; detailed EHR construction documentation; safety-permit construction documents; clear identification of locations for new or renovated IT rooms; and comprehensive schedules incorporating work processes managed by owners, architects, contractors, and design/build trade partners.
Another element to consider is a campus-wide analysis of existing architectural and engineering systems and their mechanical, electrical, wireless, and data conditions. Facilities may also identify flexible spaces for use during phased construction, so that neither the patient experience nor caregiver workflow is disrupted. Flexibility is key, in order to accommodate unforeseen complications or surprises.
Staff training to ensure buy-in with the new EHR system, and to enhance work processes and decision-making, is also suggested. The implementation and process map also needs an attainable go-live date for the EHR system.

Instigating Infrastructure Upgrades
Developing an integrated, facility-wide EHR system includes infrastructure upgrades. These upgrades usually begin with routing new cabling and wiring, installing power and data outlets, and enabling Wi-Fi access. IT rack rooms or closets, located and identified in the implementation and process map, are moved and/or renovated.
Most health care facilities are already complex, multichannel organizations incrementally built over the years. Thus, existing systems should be leveraged wherever possible. Still, some existing infrastructure can create renovation challenges, even to simple cable updates. For instance, state and Federal codes often stipulate that if a new system touches an older system, then the older system (or room) and path of travel must be upgraded to meet current codes.
Also, as the architect identifies appropriate locations for new or renovated IT rooms-whether in offices, utility closets, or storage spaces-careful consideration must be given to other systems currently in use or nearby. For instance, is computer modeling reveals a potential increase in heating or cooling loads, HVAC upgrades may be necessary.

Measuring Success
A well-integrated EHR system is based on common-enterprise computer architecture, data standards, and privacy and security guidelines. Included in the system are such features as information model, standards and configurations; secure data exchanges; user identification and authentication; access management; clinician-access channels and event notification; and business intelligence enablement.
Thus a health care facility’s EHR implementation and process plan shouldn’t end with go-live activation. The new EHR system, in complement with additional technological infrastructure upgrades, should include a program for measuring the EHR system’s success with regard to health care quality, safety and security, and productivity.
As the evolution of tablets and smart phones ensures technology becomes more mobile, the patient and physician benefits of EHR systems will grow. In large health care facilities, for instance, patients may already be accessing their personal health information from their smart phone. At home, using a laptop, they will literally tap into the organization’s EHR system in order to easily communicate with their doctor, specialist, or pharmacist from a remote location.
Conversely, physicians and other medical personnel can share patient statistics across locations to ensure proper diagnosis and care. Outside of urban hubs, in more suburban or rural locations, EHR systems virtually bridge distances between locations, so that patients can remain safely in their homes while receiving consultations and care. For these reasons, new protocol for measuring the success of EHR systems is critical.

Conclusion
Such sharing of information resources is generally accepted as the key to substantial improvements in productivity and better quality of care. In addition, also the U.S. population becomes more mobile, national health care networks are increasingly used to facilitate the sharing of health care-related information among various stakeholders and participants.
EHRs add another level of complexity to systems integration. But the benefits of EHRs to health care organizations and their patients – secure access that eases communication between caregivers, specialists, and patients – will grow as mobile technologies continue to drive advances in communications within the health care industry.

About the Authors
Joey Kragelund, AIA, is associate vice president and health care principal with HGA Architects and Engineers in Los Angeles.

Beth Young, AIA, LEED-AP, is project manager with HGA Architects and Engineers in Sacramento.

About HGA
HGA is an integrated architecture, engineering and planning firm. With offices in Los Angeles, San Francisco and Sacramento, California; Minneapolis and Rochester, Minnesota; Milwaukee, Wisconsin; and Washington DC, the nationally recognized firm has developed expertise in the health care, corporate, government, arts, community, education, and science/technology industries since 1953. Our culture for interdisciplinary collaboration, knowledge sharing and design investiga¬tion helps prepare our clients for the future with responsive, innovative and sustainable design. Visit www.HGA.com or follow the firm on Facebook or Twitter.

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Yet this design paradigm is beginning to change as more Americans gain access to health care insurance through the Affordable Care Act, the aging population continues to grow (from 35 million today to 72 million by 2030) and the nursing workforce begins to shrink (50% of nurses are nearing retirement). With caregivers working longer hours and caring for more patients due to these demographic changes, workflow inefficiencies have become more evident in the traditional centralized care model, which often encourages caregivers — nurses in particular — to hunt and gather for medical supplies.

The increasing demand and expectations of nurses has forced health care designers and administrators alike to redesign environments that decrease time spent traveling and increase time spent providing direct patient care. A design solution has been to decentralize caregivers’ tasks and work areas to support a patient-centered care model. Decentralization involves separating highly utilized items that were once found in the central hub (such as charting stations, medications and supplies) and locating them closer to the point-of-care.

Description of the Three Units
To understand if decentralized environments are performing the way they were designed to, HGA Architects and Engineers conducted post-occupancy evaluations at three recently designed inpatient units. Each unit supports a decentralized care delivery model with private patient rooms, yet each varies in configuration and deployment of medication and supplies.

For example, SSM St. Clare Health Center replacement hospital in Fenton, Mo., blends lean design principles with cutting-edge technology to streamline work processes. The 16,200-square-foot single-loaded corridor telemetry unit studied was designed with a decentralized core area where supply rooms and other support areas are located. In addition, there are individual charting stations outside each of the 24 private patient rooms. The patient rooms are also equipped with bedside charting along with medication and supply storage.

At Owatonna Hospital in Owatonna, Minn., the new 10,970-square-foot medical-surgical unit studied supports 18 private patient rooms along a double-loaded corridor design. The unit is configured among two pods. Each pod incorporates a nurses’ station with a charting, medication and nourishment area, a clean holding room, a soiled utility room and nine patient rooms. In addition, the patient rooms have bedside charting and a mobile server to store common medication and medical supplies.

At Butler Memorial Hospital in Butler, Pa., the design team took into account adjacency of medical supplies when designing the seven-floor bed tower addition. The new 21,800-square-foot telemetry unit has a racetrack single-loaded corridor configuration with 26 private patient rooms. In support of a decentralized environment, there are charting stations positioned between a pair of patient rooms and bedside charting and a pass-through server within each patient room.

Research Method
To understand the impact of these decentralized design models on nurses work process and efficiency, HGA Architects and Engineers shadowed day-shift nurses in 30-minute segments. In all, 140 shadows occurred for 70 hours of direct shadowing. During the shadow, researchers kept a log to track the nurses’ path traveled, tasks performed and amount of time spent in areas. The data collected was then analyzed to uncover average time spent in patient rooms, distance traveled and work processes.

The study results demonstrate that nurses on average spent half their day in patient rooms (52 percent). This is a significant increase from the 30.8 percent reported in a previous study that investigated various inpatient unit designs entitled “A 36-Hospital Time and Motion Study” published in The Permanente Journal. Furthermore, nurses spent an average of 6 percent of their day traveling, which equates to roughly 1.43 miles of traveling during an eight-hour shift. This value is notably lower than 2.8 miles reported in an article entitled “How Far Do Nurses Walk?” published in Medsurg Nursing that examined four inpatient units with centralized designs.

These results indicate that adopting a decentralized environment has reduced the need to travel as frequently and as far since commonly used items are positioned closer to the point-of-care. The time saved by traveling less has translated into more time spent in patient rooms.

All three units studied came from a centralized work environment. A concern among caregivers transitioning from a centralized to decentralized work environment is the inability to have spontaneous collaboration and to locate other caregivers quickly for assistance. They feared that separating activities, such as charting, could present a feeling of isolation and that camaraderie would be lost. However, nurses were observed engaging in face-to-face interaction with other caregivers during half of their visits to charting stations. In addition, caregivers on all three units also utilized a wireless phone system, such as Vocera, to help them locate and communicate with others. The findings demonstrate that decentralized environments can still support a collaborative environment and provide opportunities of direct and indirect interaction among caregivers.

The observations revealed that a nurse’s primary path of travel was between charting stations and patient rooms. Therefore, dispersing multiple charting stations among the unit creates for a more efficient workflow environment. However, designers often question how many charting stations are actually required to maintain an efficient workflow and space utilization. As demonstrated with the three units studied, each varying in quantity of charting stations, there are endless possibilities in which a decentralized model can be configured. However, a correlational analysis showed no relationship between the amount of time spent in patient rooms and the number of charting stations on the unit. Therefore, designers should concentrate on customizing charting station decisions based on specific care delivery needs of a particular unit.

Conclusion
Multiple compounding factors, including health care reform, nursing shortage and an aging population has forced the need to create more efficient, patient-centered care environments for caregivers. Designers are responding to these demands by transitioning from a centralized to a decentralized care model. By doing so, nurses are able to spend more time in patient rooms because less time is spent at charting stations and traveling for supplies. Further research needs to be conducted to understand other possible benefits associated to decentralized care, such as reduction in patient falls and lower noise levels.

Kara Freihoefer, PhD, is a design researcher specializing in evidenced-based design, user experience, and human interaction with the built environment with HGA Architects and Engineers.
 

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Medical Office Buildings & Community Health Centers Are the Future

In this economy, everyone is looking for ways to become more efficient. One of the trends we’re hearing more and more about — particularly in the health care industry — is “lean operations.” The goal is to eliminate waste and create a productive and safe environment to provide better care for patients. In the past, outpatient care facilities were multi-tenant buildings that housed isolated providers with different specialties and no link to each other at all; so one office building might have a few primary care physicians, a dentist and dermatologists. They would each have their own separate suites with their own infrastructure. This may have worked just fine for the doctors, but it certainly wasn’t convenient for the patients traveling to multiple locations to receive care.

Investing more capital in multi-specialty doctors’ groups was a logical first step to becoming lean and more efficient. Putting all services (exam rooms, lab work, treatments that don’t require a hospital operating room, radiology, etc.) under one roof is more convenient for patients and helps to keep them out of the hospital. Moving forward, facility designs are changing to reflect this new model, resulting in more new construction and renovations of existing facilities. At Burlington, Mass.-based Erland Construction, we have seen this investment in construction take place first hand. Over the past year, we have managed the new construction of a medical office building and the rehab of a community health center. We continue to receive requests for proposals for similar facilities on a regular basis.

Making the Vision a Reality

One example of this revolution in the health care industry is the new Concord Hillside Medical Associates facility (a Harvard Vanguard practice) in Concord, Mass. Located on a six-acre parcel along busy Route 2, this 50,000-square-foot, two-story structure features patient waiting rooms, examination rooms, a laboratory area, a pharmacy, behavioral health services, an ultrasound room, X-ray facilities and a call center. An exterior MRI pad allows shared equipment to be used at this location — all in an effort to maximize both operational efficiency and a positive patient experience.

In a recent interview, Dr. Ron Kwon, medical director for the new Concord Hillside facility said of this space, “If you look at today’s health care environment, it’s clear that things are changing. It isn’t about just building a new building and adding more space to enable more services; it’s about changing the paradigm of care and how you deliver it in a physical environment. We really wanted the building to be patient-centric, enabling as much one-stop shopping as possible, but to do it in a therapeutic, healing environment. We wanted to make something that was truly innovative.”

During preconstruction, the project team — spearheaded by Dr. Kwon — worked with an outside consultant to ensure the final design would yield an efficient operation. Because this new building houses several services under one roof, it was critical to examine the layout in order to eliminate any waste and maximize productivity.

For example, traditionally a doctor’s office would have all of the exam rooms in one area, a nurse’s station, and doctors’ offices bunched together in the back. At Concord Hillside, they opted for modular “pods,” giving each group a dedicated workstation with its own medical assistant right next to each physician’s office. With this configuration, the physician actually has to cross this “pod” to go between the exam room and his office, enhancing communication between staff and reducing wait times for patients. This improved design also addresses other things that could potentially frustrate patients, such as receiving timely lab results or prescription refills. This lean design really reinforces the benefit of working as a team, while keeping patient needs at the forefront of the process.

The implementation of these modular pods freed up a lot of extraneous space, allowing for the reduction of the clinic from 43,000 square feet to 38,000 square feet. This, in turn, freed up funds to add a pharmacy, imaging services with MRI and complete visual services with an optical shop. With an improved design geared towards patient convenience and 100 percent buy in from the clinical staff, Concord Hillside is embracing the future of the health care industry ensuring that the operations are well-organized and the patients are happy.

Efficiency is the Name of the Game

Health care today isn’t just about treating illness; it’s about preventing illness by promoting and maintaining health. The health care industry is certainly in flux, but change isn’t always a bad thing. In this instance, the change is about becoming better by focusing on the patient experience, rather than just falling back on doing things the way they’ve always been done. The future is bright as health care organizations look to better serve their patients, reduce mistakes and, ultimately, become more profitable.
 

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Led by Matthew McHugh, PhD, assistant professor at the University of Pennsylvania School of Nursing, the study found that increased nursing-to-patient staffing ratios and a good work environment for nurses could help reduce 30-day readmission rates for Medicare patients with heart failure, myocardial infarction and pneumonia.

The research team analyzed data from a cross-sectional survey of 20,000 registered nurses working at 210 hospitals in California, New Jersey and Pennsylvania, which questioned them about hospital work environment, nurse staffing levels and educational attainment. It also used data about hospitals’ structural characteristics, ownership, teaching status and size from the American Hospital Association Annual Survey and data on admissions and readmissions of patients between the age of 65 and 89 years old from state discharge abstract databases.

In compliance with the ACA, the Centers for Medicare and Medicaid Services will reduce payments to hospitals that have higher than normal readmission rates for patients with heart failure, acute myocardial infarction and pneumonia, which is why the team decided to focus on these three diseases.

After factoring in patient and hospital characteristics, the research revealed that nurse staffing levels and nurses’ work environment had a significant impact on readmission numbers for patients being treated for one of the three diseases. Plus, the percentage of nurses with baccalaureate degrees in nursing also had a significant effect on readmissions for patients with pneumonia specifically.

“Our findings indicate that improving nurses’ work environments and reducing their workloads can reduce readmissions for Medicare patients with common conditions,” McHugh said in a statement. “It is certainly worthwhile for hospital administrators to examine these two factors and explore whether they can be optimized to improve patient outcomes and reduce admissions.”

Each additional patient per nurse added to an average nurse’s workload had 7 percent higher odds of readmission for heart failure patients, 6 percent higher for pneumonia patients and 9 percent higher for myocardial infarction patients within 30 days of being discharged. Care in hospitals with good versus poor work environments for nurses had 7 percent lower odds of 30-day readmission for heart failure patients, 6 percent lower for myocardial infarction patients and 10 percent lower for pneumonia patients.

For those nurses that worked in hospitals with good work environments, 59 percent said they were confident that their patients could manage on their own when discharged, versus 48 percent.

The Princeton, N.J.-based Robert Wood Johnson Foundation Nurse Faculty Scholars program provided funding for the study.

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The Affordable Care Act’s expansion of health insurance coverage, coupled with the aging of baby boomers is creating an interesting situation. The amount of patients is predicted to rise sharply because of these two factors, while the number of clinicians to serve these patients is expected to decrease, because baby boomers are retiring and the following generations simply have less people in them.

This means trends involving the amount of people to care for and the amount of people capable of caring for them are going in opposite directions. This convergence of events may create a fertile market for young health care professionals coming out of college, but it also creates heartburn for experts who wonder how this will all play out.

“The Affordable Care Act will expand coverage to over 30 million uninsured individuals, and there are not nearly enough primary care providers to care for them,” said Lynn Babington, Ph.D., RN, professor and dean of Fairfield’s School of Nursing. “This endeavor will address that problem, while funneling health care professionals to medically underserved and economically disadvantaged communities.”

Dr. Barbington explained the hope was that the nurse practitioners aided by this money would help stem the tide of provider shortages in areas throughout the state, like Bridgeport, New Haven and Norwalk.

Associate Dean and Professor Meredith Kazer, Ph.D., APRN, FAAN, added that, “The effort to graduate more nurse practitioners is a national one, and it is truly a credit to the reputation of Fairfield’s School of Nursing that we were funded to the highest grant amount allowed.”

Regulations for nurse practitioners vary from one state to another, but officials in Connecticut have good reason to believe their students will stay. Nurse practitioners in the state have a lot of freedom. They can practice independently, in a clinic or in a physician’s practice. The university encourages students to start their own businesses upon graduation and patient satisfaction levels are particularly high for interactions with nurse practitioners.

“The majority of our family nurse practitioner and psychiatric nurse practitioner students are working, raising families and going to school at night,” explained Dr. Kazer, “Getting financial help could mean the difference between taking one course or two, or might release them from the obligation to work full time, so they can dive into our programs and finish faster.”

The funding also comes with some assurances that recipients will give back to the community. Students who accept the funding are required to work with a disadvantaged population for a prescribed period of time. Priority for the funding is given to fulltime students. The funding will be released over a two-year period.

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Despite all of the uproar, Zeline Howard, an instructor with the medical office program at Coyne College in Chicago, believes EMRs will be accepted and appreciated by the medical community and patients in the long run.

The Coyne College Medical Billing and Coding diploma program provides students with hands-on training in medical billing and collection, records management, medical insurance claims processing, and CPT and ICD9 Diagnostic codes. Medical billing is essential to any healthcare system, whether that be medical coding and billing in NY, NY, or the medical coding and billing on our doorsteps, so ensuring that it’s done correctly is vital. Most medical centers don’t directly handle billing themselves. Instead, they will outsource to a medical billing service, like Precision Medical Billing, to collect the bills for them.

Coyne College also offers diplomas and associate’s degrees for other healthcare programs, including Medical Assisting and Pharmacy Technician. Like any other profession in the healthcare industry, these roles are just as important as the rest, meaning that extensive study must be carried out in order to employ the best people for the job. Luckily, trainee Pharmacy Technicians can prepare for your PTCB exam with this practice test on sites like Medical Hero to give you a head start in this exciting and invaluable career.

Howard has worked in the medical record field long enough to remember a time when there wasn’t a single computer in your average hospital room. She explained that those days are long gone now. On a recent visit to an emergency room, Howard was struck by how much her profession had changed.

“All the doctors and nurses were sitting behind computers,” she explained, “Then when I went into the emergency room, it was all computers in there and while I’m talking they’re typing. No one carries around charts anymore, everything is computerized.”

Even for someone who teaches classes about EMRs, it was a surreal experience and symbolic of the changes in the industry.

Howard felt that most of the resistance to EMRs came from two areas, the fact that the change is mandatory and fears that medical information will be easier to steal if stored on a computer.

The instructor explained many hospitals were already making the change to EMRs; the pushback came from having a mandate with a specific deadline. Medical care providers are required to use EMRs for at least one 90-day contiguous period during 2013 and fully adopt the system by 2014.

An additional requirement, known as “meaningful use” creates a strict structure of rules an organization must follow to prove that it is actually using the EMRs and didn’t just set up a system to meet the mandate, with no plans to use it. The meaningful use requirement is specifically applied to organizations that accept government funding to help make the transition to EMRs. Groups can apply for either $44,000 in federal funding if they accept Medicare or $63,375 if they accept Medicaid, but they can only choose one.

Concerns about computer hackers or employees using the new system to steal information about patients is the other main issue lowering public opinion of EMRs, according to Howard. The instructor added that there had already been documented cases of organizations being sued for fraudulently accepting federal funds and of hackers stealing information, which isn’t helping matters.

Despite these challenges, Howard predicted the changes would be accepted in the long run and the trend towards more high-tech solutions in health care would continue, “as far as man can take technology.”

She said one of the main benefits of the law would be the increased ability for law enforcement, pharmacists and doctors to share information on prescription trends for patients or employees who appear to have a problem with prescription medication abuse. Some states have attempted to set up different levels of information sharing, but Howard felt the increased standardization of EMRs would make a large impact.

The instructor added that part of the problem was that the current generation of medical professionals were raised into a more hands-on approach of dealing with patients and were dubious about the effects of putting more technology in between them and the people they serve.

“It’s my understanding that RNs really do not like sitting behind computers. You know they were trained to be a registered nurse and to care for patients and that’s true for doctors too,” Howard explained.

The instructor said this was changing a little for the younger generation of students in her classes, who have a different view of technology.

“They love my class,” she added with pride.

Howard concluded that the general trend in the medical field, and elsewhere, was that the hunger for new technology would win out in the long run over some of the fears associated with the changes it will bring. At every step of technological advancement, people voice concerns and fears, but the trend towards the cloud, the tablet and the smart phone appears to march forward nonetheless.

Located on two campuses in downtown Chicago, Coyne College offers individualized instruction, flexible class schedules and large, furnished labs. Coyne offers diploma and associate degree programs in a variety of fields including Heating, Air Conditioning and Refrigeration, Electrical/Electronics and HealthCare. To learn more, visit www.coynecollege.edu or call (800)707-1922.

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