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Blog2022-05-06T22:47:18-04:00

Articles on Topics You Need

All Patient Notes in ONE Place – You Don’t Have to Go Looking

Recently, a top journal in the field of Electronic Health Record (EHR) development posted this quote from an anonymous doctor who was dissatisfied with his EHR:

“I firmly believe this EHR makes important information difficult to find and interpret, and it is very inefficient.” He went on to say, “It creates superfluous and difficult-to-navigate notes and information that are not centralized. That makes it easy for care providers to disregard notes, and they often do. That affects patient safety. . . . It is difficult and arduous to document in the EHR, and providers’ efforts to do so still yield subpar results with erroneous, irrelevant information.”

This doctor is pointing out a very real problem inherent in some EHRs. However, he was referring to one of the "ONC Certified" EHRs which we've discussed previously. Those types of EHRS are inherently much more difficult to use than most EHRs that have been specifically created for the mental health professions, such as PSYBooks.

April 29th, 2021|

Does the Open Notes Rule Apply to Me?

The term "Open Notes Rule" is a popular term coined to depict the legislation enacted by the 21st Century Cures Act that is more accurately referred to as the ONC's final program rule on Interoperability, Information Blocking, and ONC Health IT Certification (OpenNotes, 2020). It is a continuation of the legislation originally enacted as part of the HITECH act of 2009 to promote EHR interoperability (with the ultimate goal being a national database for healthcare information on all U.S. Citizens) and open access to records. The Open Notes Rule does NOT apply to PSYBooks users but there are some important things to understand about the current iteration of this legislation, partly in an attempt to help prepare us for what might be coming in the future.

February 18th, 2021|

Why Do People Hate Electronic Health Records (EHRs)?

Actually, most patients don't. A recent study conducted by Catalyst Healthcare Research found that 93% of adults would prefer to go to a doctor that offers email communication, even if there was a $25 fee (Pai, 2014). Encrypted email is incorporated into most, if not all present-day EHRs that also have patient portals. By being integrated with the entire medical record, it's relatively easy for doctors to correspond with patients right from their electronic chart. Leaders in prominent health care groups in Houston, encouraged patient enrollment in their EHR system and have found similar results. Dr. Robert Dickinson, Kelsey-Seybold's medical director for executive health and wellness says, "They think it's the coolest thing they've ever seen. It's like online banking. People love this kind of access. Before, it was kind of mysterious" (Hines, 2014).

However, when you ask doctors if they like EHRs, you often get an entirely different story. You mostly hear dislike, frustration and irritability. There are actually excellent reasons for this.

February 17th, 2021|

More Than a Three-Room House

Imagine a two-room house whose occupants have outgrown it. They decide to solve the dilemma by tacking another room on the back. Great! The siding doesn't quite match - nor does the roof. Some of the existing old-growth trees had to be felled to make the new room fit, and when you're inside, you have to remember to step down and duck a bit as you enter the new room. But hey! The owners still have that extra room! If they decide to put their home on the market, they can advertise it as having three rooms.

Unfortunately, some EHRs are built like this.

April 9th, 2020|

Why Get an Integrated Product?

As a therapist, you can amass your digital tools one at a time or you can invest in a well-integrated bundled product. For example, let's say right now you're mostly looking for a video platform so you can do telehealth. There are companies that ONLY offer subscriptions to video platforms. But is that the best choice?

Depends.

For example, what happens if, after you sign up for your standalone video product, you realize that you also need a way to collect your fees from your telehealth clients. And maybe you need encrypted email so you can contact people in a way that's secure. Or maybe now you need HIPAA-compliant file storage, as your clients begin to send you documents via their new encrypted email. Or perhaps a way to schedule clients online. Or maybe a way to efile and also to send statements and receipts digitally. That's a LOT of tools and we're just getting started!

March 22nd, 2020|

Do I Have to use HIPAA-Compliant Video? 

Right now is a stressful time as COVID-19, more commonly known as coronavirus, continues to spread. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have both emphasized how now it’s more important than ever for us to maintain “social distancing.” How do we do that and maintain our ethical and legal obligations to our clients – not to mention keeping our income relatively intact?

March 15th, 2020|

Encrypted Email – Just How Safe Is It?

PSYBooks’ email not only meets but actually surpasses the HIPAA specifications for encrypted email. HIPAA’s rules for email encryption are broad, giving developers the maximum amount of freedom. This is as it should be. Those who are responsible for writing and maintaining HIPAA/HITECH laws cannot also be expected to keep up with rapid changes in the world of technology the way developers do. Therefore, although HIPAA wisely states that email containing client PHI (Protected Health Information) should be encrypted, it doesn’t specify exactly how that should be done.

October 16th, 2016|

Are Digital Records Better Than Paper?

At it’s simplest, digital record-keeping could simply mean a Word doc, Excel sheet or PDF that you’ve saved on your computer, tablet, phone, thumb drive or other type of digital storage device. There are advantages to digital record-keeping even at this elementary level. For example, with digital records, you no longer have to contend with bulging filing cabinets, finding adequate long-term storage, or shredding – all of which are factors with paper health records. Additionally, it’s relatively easy to make backup copies of digital files to guard against some type of disaster, whereas making copies of paper records is costly, both in terms of time and money and also, effectively doubles the number of filing cabinets or other physical storage space you need.

October 28th, 2015|

Types of EHRs: The Shared Chart Model

At it’s simplest, digital record-keeping could simply mean a Word doc, Excel sheet or PDF that you’ve saved on your computer, tablet, phone, thumb drive or other type of digital storage device. There are advantages to digital record-keeping even at this elementary level. For example, with digital records, you no longer have to contend with bulging filing cabinets, finding adequate long-term storage, or shredding – all of which are factors with paper health records. Additionally, it’s relatively easy to make backup copies of digital files to guard against some type of disaster, whereas making copies of paper records is costly, both in terms of time and money and also, effectively doubles the number of filing cabinets or other physical storage space you need.

October 28th, 2015|

Are Web-Based EHRs Safe?

The most common reason people give for being reluctant to switch to a web-based EHR is safety. When we’re charged with protecting something – in this case, our clients’ records – most of us intuitively feel safer with something we can see and touch; something physical within our own office where we can maintain control of security ourselves. However, despite this subjective sense of safety, Hurricane Katrina taught us all a valuable lesson about the danger of keeping client records on paper. Floods, tornadoes, fires and other types of disasters can destroy paper records in a heartbeat. If you do maintain paper records, at the very least, you should have backup copies of everything – and those copies should be stored at a completely different location – preferably far away from where your paper records are stored.

October 23rd, 2015|

Your Personal File Storage

In addition to being able to store files for each client, you can also upload and store your own digital records in an area set aside just for you. It’s important to note that files are maintained separately. Client files are stored in their charts – separate from all other clients and also separate from your personal files. This is one of the ways PSYBooks adheres to HIPAA/HITECH guidelines.

June 29th, 2014|

File Storage for Each Client

Each of your charts in PSYBooks has a Files tab where you can upload files specifically to that client’s chart. For example, initially you might want to upload scanned copies of their intake forms, insurance cards and/or driver’s license. Later on, you may want to upload copies of releases and consents, EOBs, reports or testing results. If you want, you can also keep copies of routine things you generate such as statements, insurance claims or receipts. Should your client request a PHI report, you can also upload that to their chart so you’ll have a record of what you gave them. There are several advantage to storing these kinds of documents in PSYBooks:

June 29th, 2014|

Your Personal File Storage

In addition to being able to store files for each client, you can also upload and store your own digital records in an area set aside just for you. It’s important to note that files are maintained separately. Client files are stored in their charts – separate from all other clients and also separate from your personal files. This is one of the ways PSYBooks adheres to HIPAA/HITECH guidelines.

June 29th, 2014|

File Storage for Each Client

Each of your charts in PSYBooks has a Files tab where you can upload files specifically to that client’s chart. For example, initially you might want to upload scanned copies of their intake forms, insurance cards and/or driver’s license. Later on, you may want to upload copies of releases and consents, EOBs, reports or testing results. If you want, you can also keep copies of routine things you generate such as statements, insurance claims or receipts. Should your client request a PHI report, you can also upload that to their chart so you’ll have a record of what you gave them. There are several advantage to storing these kinds of documents in PSYBooks:

June 29th, 2014|

User Accounts

User Accounts can be established for anyone you need to grant access to some or all of your PSYBooks records. For example, you might want to create User Accounts for billing personnel, scheduling personnel, supervisees or a colleague who is covering for you. You can allow the user to access the records of all of your clients or just certain ones.

June 22nd, 2014|

When You Have to Produce a Medical Record

Before I started using practice management systems, being required to produce a client’s medical record was a bit scary for two reasons:

  1. First, I typically only received those requests when something important was going on, i.e., a legal proceeding of some sort, a disability or worker’s comp situation, or maybe something having to do with insurance. They were the kinds of things where I felt that a lot might be at stake for my client (and/or for me) so I wanted to make sure I “did it right”.
  2. Second, although I had my own system for organizing client files, the reality is that my records were scattered everywhere. I kept files on current clients in one filing cabinet – unless a certain file got too big, in which case I moved older portions of it to another filing cabinet, unless there was also large artwork in the file, in which case it had to go in the lateral filing cabinet. When a client terminated, files got moved to a storage area in my basement at home. If the client later returned and their file had been especially large, part of it would be brought back to my office, but older parts remained in my basement at home. Then, of course, some documents were on my computer – a smattering of various Word docs and Excel sheets I had pieced together for special notes I had written on clients, letters I had written on their behalf, and various attempts at coming up with THE perfect method for determining how much a client owed me when insurance was involved. I had also tried efiling for awhile at various insurance company’s websites, so some of my records were on various sites on the Internet, too. Somehow, when I was asked to produce a medical record, even though I knew I had everything I needed, finding it all and pulling it all together into some type of meaningful report was a daunting task.
June 15th, 2014|

Types of EHRs: Introduction

Let’s face it. There are LOTS of EHRs on the market and most of us simply don’t have the time, energy, or frankly – interest – to put a lot of effort into researching them. Some therapists have told me that although they’d sort of like to explore EHRs, they begin looking at all the options, get overwhelmed, and decide to put the whole thing off. Although it doesn’t have to be overwhelming, it IS an important decision. An EHR that’s designed well, with attention paid to usability issues so it’s easy to use, can simplify your life enormously and save you a lot of time and money. On the other hand, an EHR that’s poorly designed will have you pulling your hair out and cursing EHRs in general – possibly not realizing that not all EHRs are the same and that there might be better options.

November 1st, 2015|

What is an EHR Anyway?

The acronym EHR stands for Electronic Health Record. Originally the term EHR was supposed to mean a very specific thing. It was to be a type of digital (i.e., computerized) practice management system for health care professionals that could “talk to” (i.e., share data with) EHRs of other health care providers and organizations, such as laboratories, specialists, school and workplace clinics, medical imaging facilities, pharmacies, emergency facilities – essentially anyone that might be involved in a patient’s care. Similar products that did NOT automatically have the “talk to everyone” feature were to be referred to by other names, such as EMR (Electronic Medical Record) or simply, practice management system.

October 31st, 2015|

Types of EHRs: Scope

To begin this series of posts, let’s look at a concept I’m calling “scope”. In reference to EHRs, scope doesn’t refer to the number of users a particular EHR has, but rather, to the number of different roles for which it’s designed. For example, a large scale medical EHR needs different roles or tracks for each of the various personnel that might need to add something to a patient’s chart. That could mean, for example, different tracks for scheduling, billing, intake, nurses and other mid-levels, doctors, lab technicians, social workers, etc. Additionally, such EHRs are designed primarily for hospital settings. Doctors who are affiliated with the hospital can typically access the EHR from their office, but the EHR itself was developed with hospitals in mind.

October 29th, 2015|

Types of EHRs: The Shared Chart Model

At it’s simplest, digital record-keeping could simply mean a Word doc, Excel sheet or PDF that you’ve saved on your computer, tablet, phone, thumb drive or other type of digital storage device. There are advantages to digital record-keeping even at this elementary level. For example, with digital records, you no longer have to contend with bulging filing cabinets, finding adequate long-term storage, or shredding – all of which are factors with paper health records. Additionally, it’s relatively easy to make backup copies of digital files to guard against some type of disaster, whereas making copies of paper records is costly, both in terms of time and money and also, effectively doubles the number of filing cabinets or other physical storage space you need.

October 28th, 2015|

Types of EHRs: Desktop vs Web

Previous posts have discussed advantages of EHRs made specifically for behavioral health vs generic EHRs made for the entire medical profession and also, the differences between EHRs with a shared chart model vs those without. This post addresses another important issue to consider when choosing an EHR: whether to choose a desktop app or a web app.

October 25th, 2015|

Are Web-Based EHRs Safe?

The most common reason people give for being reluctant to switch to a web-based EHR is safety. When we’re charged with protecting something – in this case, our clients’ records – most of us intuitively feel safer with something we can see and touch; something physical within our own office where we can maintain control of security ourselves. However, despite this subjective sense of safety, Hurricane Katrina taught us all a valuable lesson about the danger of keeping client records on paper. Floods, tornadoes, fires and other types of disasters can destroy paper records in a heartbeat. If you do maintain paper records, at the very least, you should have backup copies of everything – and those copies should be stored at a completely different location – preferably far away from where your paper records are stored.

October 23rd, 2015|

Medical Record Notes

Almost all forms in PSYBooks have a section where you can enter notes. Most of these notes automatically become part of the client’s medical record, although a few allow you to designate the note as a personal psychotherapy note (i.e., not part of the medical record). PSYBooks breaks medical record notes into two categories: clinical medical record notes and admin medical record notes. This is done to allow you to give permission for a User to see one type of note but not others. For example, you might want your front office staff to be able to see your admin medical record notes (e.g., a note you might have attached to a client payment), but not your clinical medical record notes or your personal psychotherapy notes.

June 15th, 2014|

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