IntroductionEver since the 2009 Meaningful Use(MU) mandate of electronic healthrecords, the AMA has continuedto give the CMS feedback on thechallenges the MU program posesfor physicians. In 2013, a study by theRAND Corporation reported the extentof unhappiness with EHRs. While few(18%) wanted to return to the old, paperbased systems, many complainedabout EHR usability and the negativeeffects on their productivity.1A year later, the AMA created anexternal advisory committee–theAMA Advisory Committee on EHRPhysician Usability. The physiciansand healthcare information technology(IT) experts on the committee listenedto the complaints and feedback fromThe “Hateful 8” signs of a poorly functioning EHR:1. Interfering with patient care2. Poor team communication3. Lack of care coordination4. Adding to the workload5. No custom options6. Unwieldy data7. Few mobile options8. No product reviews or feedbacktheir members, and in late 2014,published their list of priorities forimproving EHRs.2 The AMA hasconsistently maintained that the costof implementing electronic medicalrecords (EMR) systems shouldn’t be atthe expense of patient care. The 8-itemlist they created was a reflection of theareas where EHRs needed to improve.Let’s call it the “Hateful 8.”

Managing a medical practice is a challenge if your EHR technology isn’t keeping up.Many independent practicesare getting bogged down byEHR systems that don’t providethe functionality they need. Ifany of the items on the “Hateful8” list sound familiar to you, it’stime to consider an upgrade.Medical practices that were earlyadopters of EHR technologyhave outgrown their older, clunkyEHRs. Since EHR systems havebeen around for a few yearsnow, medical practices will bemore savvy when shoppingfor their next EHR vendor. Onehealthcare CIO described thecurrent approach to shoppingfor a new EHR. “Hospitals andhealth systems have becomeexperienced in how to use anEHR. We know more specifics interms of what we need, what wewant and what actually matters.This time around, healthcareentities have the advantage ofhaving lived with an EHR forseveral years, and we knowmore specifically what we wantout of our systems.”3The AMA’s EHR Usability Wishlist 20144 Enhance physicians’ ability to provide high-quality patient care Support team-based care Promote care coordination Offer product modularity & configurability Reduce cognitive workload Promote data liquidity Facilitate digital & mobile patient engagement Expedite user input into product design & implementation feedbackIn December 2015, the AMAexpressed its desire “to maximizethe use of electronic health recordsin place today, while allowingvendors to continue to innovate andcreate new technologies.Flash forward to December, 2015.The AMA sent another letter tothe CMS emphasizing the need for“usable and interoperable toolsthat involve patients and supportcare coordination.” While clearlyfrustrated with Meaningful Userequirements, the AMA expressedits desire “to maximize the use ofelectronic health records in placetoday, while allowing vendors tocontinue to innovate and createnew technologies.”5

Innovations in EHR technologyIt’s time to revisit the AMA’slist and report on the progressEHR vendors have madeon improving EHR usabilityand productivity. The EHRtechnology of today reflectsEHR vendors’ commitmentto continuous improvementand innovation since the AMApublished its list two years ago.AdvancedEHR has tackledthe issues the AMA describedback in 2014 with innovativefeatures and functions tosupport managing your medicalpractice. AdvancedMD iswidely recognized as a leadingprovider of cloud-basedmedical software programs. Ithas earned the #1 ranking from AdvancedBilling medical billing software AdvancedCloud cloud-based data management AdvancedEHR electronic health record software AdvancedExchange health information integration AdvancedInsight financial reporting and analytics AdvancedPM practice management software AdvancedRCM revenue cycle management AdvancedScheduling medical scheduling softwareOur updates to EHR usabilityhave automated and streamlinedadministrative tasks, givingyou more time with patients.Mobile and cloud technologyhas improved communicationbetween members of clinicalKLAS, the leading independentindustry analyst, in a numberof categories including productquality, functionality, andintegration. AdvancedMD isan all-in-one solution for yourpractice with products designedto support your independentpractice:For the AMA, “configurability” wasan issue. That’s why we continuallyupgrade your EHR to fit the uniqueneeds of your practice.teams for greater coordinationand integration of clinicalinformation. Our new, integratedEHR software is reducing thetime spent on charge slips byoffering customizable templatesthat automatically populate withinformation. Another innovationis the advanced, built-in securityfeatures that protect patientinformation and practice datafrom security breaches ordata losses.

Enhance EHR usability by automating workflowsThe robust AdvancedEHRAs we release new productssystem has the functionality and and features, you will continuecustomizable features to helpto enjoy an effortless userstreamline your workflow, notexperience because there is nocomplicate it. Usability is critical software to install or satisfy the AMA’s desire forAll software updates occuran EHR to “enhance physicians’ automatically–for free–whichability to provide high-qualitymeans every time you log in,patient care.”6 For the AMA,you’re running on the latest and“configurability” was also angreatest software.issue. That’s why we continuallyupgrade your EHR to fit theCloud-based EHR systemsunique needs of your practice.include automatic, hourly databackup, which means you don’thave to spend your valuabletime with tedious manualprocesses. Every backup isverified to restore correctly andadditional secure copies arestored every night. EHR systemswith automated processes andsecurity procedures also ensurethat you’re complying withstringent HIPAA regulatory andsecurity requirements.The AMA wants EHRs to “support team-based care”and “improve care coordination.” AdvancedEHRfacilitates the coordination of care with oneapplication, one database, and one login, so everyteam member is included and informed.Team care coordination with one application, one database, one logincostly rework. Your practiceThe AMA wanted EHRsavailable to each member ofteam can manage patientto “support team-basedyour staff wherever they are.demographics, scheduling,care” and “improve careMultiple people can work incharting, billing and denialcoordination.” AdvancedEHRthe same patient record atfollow-up in a single platform.facilitates the coordinationthe same time. Our softwareAnd with single click login, youof care with one application,is tightly integrated to providegain quick and easy access to itone database, and one logina seamless experience as aall. This streamlines consistent,so every team member isunified solution, to ensure thereal-time clinical workflowincluded and informed. Theclinical and business functionsamong providers, clinicians,answer is interoperability.of your medical practice workWhen you update a record,in unison. Having one database billers, and office managers.all information is automaticallyeliminates dual data entry and

Cloud-based mobile solutions for on-demand dataAdvancedEHR clients benefitimportant clinical data: patientfrom our AdvancedMobileDoc charts, histories, and schedulesiOS app that makes yourwherever you are, on most anydocumentation tasks moredevice. Physicians who use ourmanageable and betterEHR can use their notebook,organized. This gives youtablet, or iPad and get theanytime, anywhere access tofreedom to practice on thego. Access to data gives yourpractice actionable insight intoyour financial performance,track compliance, performanceagainst contractual qualitygoals, and published guidelines.The benefits of AdvancedCloud aresignificant: reduced maintenance,automatic and offsite data backup, freesoftware updates, increased security,and multi-site connectivity. Our cloud andmobile solutions are meeting the AMAneed for “data liquidity.”Anytime, anywhere access and securityA cloud data managementprocess data. It’s more agilesystem also protects yourthan on-premises, client-serverpractice from the threat ofsystems. Medical practices cannatural disasters. Paper chartseliminate their dependence onare easily lost in the event ofserver hardware and in-housea fire or flood. AdvancedMDtechnical support, at a tinyallows you to recover yourfraction of the cost. The benefitsimportant data with secureof the cloud are significant:offsite storage that exceedsreduced maintenance,HIPAA requirements by 300%.automatic and offsite dataAdvancedCloud is a network of backup, free software updates,remote servers hosted on theincreased security, and multiinternet to store, manage, andsite connectivity.

Better patient engagement with patient portalsor the management of chronicThe ability to “facilitateillness, a comprehensive healthdigital and mobile patient7engagement” was an important information technology strategymust include interoperabilityEHR function outlined bybetween a patient’s mobilethe AMA. One member oftechnology, telehealththe committee stressed thetechnology, and the electronicimportance of interoperabilityhealth record.”8and using mobile technology todeliver better care.The AdvancedMD patient portal“Given the rapid growth ofis integrated with our EHR anddigital technology in health care, practice management softwarewhether for health and wellness, to deliver a cohesive integratedsystem for managing care in thedigital age. All that is requiredis a link from your practicewebsite, an Internet connection,and authorization to access thepatient portal. AdvancedEHRensures a private and secureonline portal for patients to: Request an appointment Send & receive messages from your office Request prescription refills View account balances & make payments Access their medical informationAdvancedMD has beeninnovating EHR, combining theneeds of the private practicewith the latest advances inmedical software technology.We work everyday to improveEHR functionality and give themembers of the AMA the toolsthey need to help, not hindertheir ability to provide the bestcare possible with maximumpractice efficiency. Our systemcan replace several disparatesystems with an all-in-one EHRand practice managementsolution that allows you tooptimize schedules, simplifycheck-in and checkout,document patient encounters,prescribe and order, captureand pursue revenue, measurefinancial performance, andpractice on the go.AdvancedMD simply makes running your practice easier. Learn more abouthow AdvancedMD can work for you. 800 825-0224 advancedmd.comSchedule live MW, Chen PG, Van Busum KR, et al. Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and HealthPolicy. Santa Monica, Calif: RAND Corporation; -records.html2AMA calls for design overhaul of electronic health records to improve usability. American Medical Association. 9/16/143Miliard M. CIOs target population health, patient engagement in 2016. Healthcare IT News. 12/14/154AMA calls for design overhaul of electronic health records to improve usability. American Medical Association. 9/16/145AMA proposes reforms to Meaningful Use program to benefit patients, physicians. 12/15/156AMA calls for design overhaul of electronic health records to improve usability. American Medical Association. 9/16/147AMA calls for design overhaul of electronic health records to improve usability. American Medical Association. 9/16/148Raj Ratwani, PhD, AMA Advisory Committee on EHR Physician Usability, Washington, D.C.Visit advancedmd.comCall (800) 825-0224 2016 AdvancedMD, Inc. All rights reserved.

list and report on the progress EHR vendors have made on improving EHR usability and productivity. The EHR technology of today reflects EHR vendors' commitment to continuous improvement and innovation since the AMA published its list two years ago. AdvancedEHR has tackled the issues the AMA described back in 2014 with innovative