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Cloud-Based EHR Software for Addiction Treatment Providers
If you are searching for a cloud-based EHR software it is vital to consider your unique workflows. The SMART Solution is scalable, secure, and helps to streamline opioid treatment processes from admissions to discharge. SMART is powered by Amazon Web Services (AWS), to increase efficiency, safely. Learn more about this EHR and cloud benefits in the articles below.
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President/CEO David L. Piccoli, II. (left) pictured with Discovery House founder (and father) David L. Piccoli Sr. (right)
In 1991 David Piccoli, II began working as an Administrative Assistant at Discovery House. Soon after,he was inspired to increase the clinic’s efficiencies. He thought there must be a better way to manage the facility’s endless flow of patient records, billing, and paperwork. “It was very chaotic,” Piccoli recalled. “Nobody had access to information quickly.” However, Piccoli wasn’t satisfied with any of the electronic-records products on the marketat that time. The majority of EHR’s focused on just one piece of the business, such as third-party billing or clinic records. “No one ever really combined everything” henoted.
So, Piccoli decided to create the EHR he wanted. He partnered with a computer programmer and family friend, Paul LeBeau. Together, they built a new clinic management software application for Discovery House. The idea was to digitize and automate a facility’s paperwork, from patient dosing and drug testing to scheduling and third-party billing. It worked so well that they formed SMART Management, Inc., to offer the program to other clinics. This EHR, the SMART Solution, was an integral part of making Discovery House such a successful organization. So,SMART continues to grow into a highly regarded EHR solution for OTP’s.
Simplify patient dosing and reduce risk
Substance abuse treatment clinic dosing window
The medication management and dispensing module in SMART’s EHR Software uses automation and built-in checks and balances to simplify medication management and virtually eliminate medication errors.The software automates dispensing and medication inventory for methadone liquids and solid forms including Suboxone, Subutex, Zubsolv, and generic buprenorphine/naloxone films and tablets. Use of Vivitrol (injectable naloxone) is also supported.Automated medication dispensing, auto patient check-in queue, dose verification signature, ID verification, and automated nursing notifications promotes patient safety and helps to limit the risk to both the patient and the agency.
Additionally, inventory management reports enable quick and accurate information gathering, improving inventory control. Moreover, SMART’s Electronic Health Record Software provides you the tools and automation to be ready for DEA audits at a moment’s notice.
HIPAA compliant hosting to protect patient health information
SMART’s cloud-based EHR is powered by Amazon Web Services (AWS), a world-renowned and trusted hosting solution. AWS is HIPAA compliant, helping covered entities subject to HIPAA regulations process, maintain, and store protected health information securely. Learn more about the impact of HIPAA on end-users and EHRs.
Furthermore, Amazon is known to have some of the best data centers in the world, providing multiple sources of redundancy to keep your servers up and running. In the unlikely event that a database restore is necessary, SMART’s Aurora database platform provides precise data protection with nightly back-ups and point-in-time recovery typically within 7-10 minutes. Learn more in the article, EHR Downtime. Impact, Recovery, Preparedness.
Other Benefits of Electronic Health Records
Features of the SMART Solution help increase admissions, streamline medication administration, promote team collaboration, expedite test results, and maximize revenue. Learn more about SMART’s Cloud-Based EHR Software.
Having electronic health records software means that you can document all your clinic’s tasks digitally and in real-time without the need for paper charts. Beyond being paperless, there are many other electronic health record benefits to consider. Below we discuss specific advantages to individual addiction treatment clinics and enterprise organizations.
Electronic health record benefits to individual clinics
Clinics improve staff collaboration and patient care with easily accessible information and reports automation.
Reduces redundancy of data entry; everything is in the system and is only a few clicks away.
Saves physical space and office supply costs without the need for a chart room.
No more time wasted filing and searching for paper charts.
Expedites and automates the receipt of lab test results.
Organizes information making it easy to find simplifying quality control.
Submits co-signatures on treatment plans, service delivery notes, medical orders, and forms remotely, which reduces unnecessary travel time.
Auto alerts and reminders help to ensure that you meet patient’s treatment needs on time.
Optimizes admissions capacity with auto-scheduling and pre-admission screening.
Maximizes revenue and decreases data entry with an integrated insurance billing module.
Better tools and technology improve communication, staff retention, and employee satisfaction.
“SMART provides real-time information that allows staff to feel confident in their clinical decisions.”
Eileen, Director, Boston Public Health
Benefits of EHRs to enterprise organizations
Managing a network of treatment programs can be challenging, but with SMART’s cloud-based EHR, you can create consistency across all locations while scaling to your growing needs.
Stores all your clinical information safely in one place.
Saves operational costs by decreasing the need for equipment upgrades, IT resources, and EHR updates.
Creates uniformity and consistency across all OTP locations.
Establishes your corporate model of forms, services, and reporting.
Reduces administrative costs by automating processing and reporting.
Simplifies insurance, self-pay account management, and reporting functions with data-entry-free billing.
Scales to your needs allowing you to adjust size and performance with no downtime.
Automatically and seamlessly makes updates and improvements to the system.
Leverages the latest technologies (like SMARTBridge™).
Integrates with billing systems and state reporting eliminating the double-entry of data.
Here are some EHR advantages that clinics often overlook
Once you are operational with paperless health records, ensure that you are using all the features available. This will help you be even more efficient.
Create templates wherever possible
Service type templates save your teams from writing repetitive notes and allows them to see the exact data they need.
Release-of-information templates allow your team to choose a pre-populated template saving time on data entry and disclosure tracking.
Agency referral lists (via SMART’s QSOA feature) allow your team to find referral sources and track expiring agreements quickly.
Leverage our EHR’s secure cloud environment to build your key business rules for:
SMART Management, Inc. serves New Horizons Treatment Services of New Jersey with patient records software for addiction treatment. Recently, this long-time community provider made an essential move from SMART’s legacy on-premise EHR software to SMART’s new cloud-hosted solution. New Horizon provides comprehensive multi-disciplinary outpatient addiction treatment services tailored to individuals’ needs. Services include counseling and medicated-assisted treatment (MAT) such as Vivitrol, Methadone, or Subutex. Following this transition, Billing Coordinator, Neerja L. said that“SMART response time has improved drastically. It seems to be faster, especially while generating reports. Patient activity tracer has two timeframe options, which is really helpful.”
Data security in substance abuse treatment is serious business. Fortunately, SMART’s Cloud-Based EHR complies with HIPAA’s security rule, which requires specific protections to safeguard patient electronic health record information. Our EHR Platform – powered by AWS – builds in these safeguards and AWS adheres to all HIPAA protocols. Moreover, world-class companies like Adobe Systems, Siemens, Expedia, and Netflix rely on AWS. However, this cloud infrastructure is impossible to replicate for on-premises software users. We know there are concerns when considering a move to a cloud-based EHR. But many of these concerns are addressed by the inherent advantages of the platform. Below is a list of security benefits that can add value and give organizations peace of mind.
Top Security Advantages of SMART’s Cloud-Based EHR Platform
Audit Controls – Maintains audit logging for all data assets to detect inappropriate access, tracking unauthorized disclosures, measuring performance problems, detecting intrusion attempts, and for the support of investigations.
Data Integrity Controls – Includes a complete set of HIPAA policies for administrative controls. These include physical protections, staff training, and maintaining a “culture of security.”
Backup & Data Storage – Provides point-in-time recovery for cloud-based customers. In the unlikely event that a database restore is necessary, the latest backup is no older than 7 minutes with the next-oldest full database backup being from the previous night. We maintain one year of daily database backups and migrate older backups to the AWS Glacier for long-term retention. Specific data is retrievable from any of the available backup copies. (A fee applies for this service)
Automatic Logoff – Configurable auto-logoff feature in compliance with this HIPAA rule.
Security Incidents – Comprehensive procedures to detect and respond to security incidents. A HIPAA-compliant detailed breach analysis and reporting process support our systems.
As you can see, SMART’s Cloud provides significant advantages and tremendous value. Clinics gain confidence in data security and accessibility allowing them to focus on operations and patient care. Learn more about SMART’s Cloud-Based EHR Software.
What the difference between having paperless health records and being 100% paperless?
The difference between being paperless and having 100% paperless health records can be game-changing. Being 100% paperless means there are ZERO physical patient charts or paper forms. You process every document in your clinic electronically. However, if your staff documents everything on paper and then scans it into the patient chart, you may be considered “paperless,” but not 100% paperless. Also important to note, scanning hand-written patient information means it’s not searchable and deriving metrics would be a tedious, manual process. The data is “invisible” to a computer if it’s hand-written. Whether you are partially paperless or are considering going paperless, it’s important to understand how to get the most out of your record keeping-system.
What issues are most common amongst clinics that aren’t fully-paperless?
Time and time again, we’ve seen EHR users taking actions (or not taking actions) that hold them back from being truly 100% paperless. The need to continuously file paper patient charts may not seem like a big deal if it’s what you’ve always done but; think about the alternative.
When a 100% paperless clinic switches to a new form, it is automatically utilized across all patient files. In a partially paperless environment, different staff members might be using different versions of the same form.
Managing quality of services can be challenging regardless of how you keep your records. However, this process can improve by doing it all electronically. For example, SMART’s EHR can be set to schedule all regulatory services as soon as the Admit and Discharge buttons are clicked. This feature enables clinical and medical staff to run their Service Due Reports. Management teams also can run quality control reports to ensure patients are receiving the right services.
Auditing paperless health records are also simplified when everything is easy to navigate and available electronically. Since everything is accessible remotely, quality control teams don’t need to travel to the clinic. Moreover, the QC reports in SMART’s EHR make it easy to located and focus on problem areas.
Data collection standards
Creating service type templates can significantly improve data collection. You can build-in the questions you would like your treatment teams to document for each service delivered. Additionally, statistical and patient population data collection is easily usable. These templates make completing grants as well as state and internal reporting much more efficient. No more sorting through and keeping Excel documents up-to-date.
What is holding you back from having 100% paperless health records?
Access and outage concerns
Often there is a fear of not being able to access electronic patient charts when the power is out, or a system is down. Fortunately, you can protect against this and run at optimal efficiency by implementing safeguards, like the ones mentioned below.
Important considerations with paperless health records:
Establish more than one internet network connection. Configure a redundant Internet connection to ensure that there is one connection to the internet at all times.
Have a back-up generator. In nearly all scenarios, your operations will cease in a power outage. For this reason, you should secure a generator for the most critical aspects of your clinic and, especially, with paperless health records operations.
Hardware inevitably fails, seemingly at the worst possible times.SMART’s Cloud-Based EHR, powered by Amazon Web Services (AWS), takes your hardware concerns off the table. SMART operates a fully-redundant AWS cloud environment which leverages layer upon layer of redundant technology. With these measures in place, the odds and impact of a connection failure are minimal.
Prepare for disasters with automatic backups. As a 100% paperless chart, SMART’s EHR software secures all data in the cloud. Backups run every 30 seconds reducing the risk of data loss. Having owned and operated clinics in the past, SMART is intimately familiar with what can happen if a clinic experiences a fire or other disaster. Being paperless, with automatic backups means we avoided losing access to crucial information.
Another deterrent to migrating 100% to paperless health records might be the expense of servers, PCs, signature pads, label printers, pumps, etc. making it is easy to put off the transition. However, the drawbacks of not being 100% paperless far outweigh the costs of transitioning. With SMART’s cloud-based solution, your EHR becomes an operational expenditure instead of a capital expenditure. Monthly billing allows you to subscribe only the number of users you need and we can adjust as your needs change.
“SMART integrates every facet of our clinic from dispensing, to counseling, to administration.”
Paul J., Administrator (former), Addiction Treatment Center of New England
Fear of change
Overcoming staff opposition to change can be a challenge. The first step is shifting your focus to educating staff about the benefits and added productivity of a paperless environment. Leadership can ease the transition by promoting positivity and cultivating user perceptions.
Even so, adjusting to a new system can still be challenging; especially for those accustomed to paper as their primary means of record-keeping. SMART helps to mitigate these fears with our implementation process which is designed to get teams up and running quickly and with confidence. Once you commit to implementing an EHR, it is essential to work with your vendor to ensure that your staff is informed throughout the process helping to avoid resistance and confusion.
Successfully implementing paperless health records
Goals and communication
Successful implementations rely heavily upon continuous and clear communications between the EHR vendor and EHR users. Before the implementation begins, set a solid foundation by providing a clear understanding of the process. Every member of both teams should fully understand all requirements and who owns what responsibilities.
Having a complete procedures checklist goes a long way toward keeping everyone on track with what tasks are due and what is upcoming. Part of the checklist procedure is to identify forms, templates, and systems settings.
“They made us feel completely confident in the system in a week. They are all exceptional.”
Heather, Clinical Director, Acadia Healthcare
Training and support
Another critical step is customizing comprehensive training before and after go-live. For our partners, training is delivered both on-site and remotely by our team of training experts. After implementation and training are complete, our Partner Support and Partner Success Teams take charge of the clinic’s ongoing care.
“I really like the new SMART System. It makes our job that much easier. The trainers were all friendly and helpful. They made our transition to SMART very easy.”
The SMARTBridge™ is an electronic health records processing module available in SMART’s cloud-based EHR for opioid addiction treatment. This module provides a secure and automatic transmission of medical records, lab results, and financial data. Managers can track activities through a dedicated portal directly accessible from SMART.
Benefits of EHR data processing with SMARTBridge™
Electronic health records processing with SMARTBridge helps ensure the safety of private patent information. It collects and posts information directly to electronic charts. This tool eliminates the need to enter results manually, saving your time and money.
This module processes inbound Health Level 7 (HL7) messages from other software applications instantly upon receipt. It also generates outbound HL-7 messages to exchange data securely with other applications. The SMARTBridge is HIPAA compliant and only accessible directly by SMART’s IT team.
Scales to your needs
When opening a new clinic, or a network of clinics, scalability of your current technology should be a primary concern. With the SMARTBridge size and performance of your database can be adjusted with no downtime. This feature keeps all your clinics running at peak performance and financial efficiency.
Makes billing more predictable
The SMARTBridge allows you to process your billing per transaction or as fixed monthly amounts. Consistent, repeating revenue improves predictability, helping to further simplifying your processes.
What You Can Expect from HIPAA Compliant Cloud Storage
Amazon Web Service (AWS) offers a broad set of global services. These include computing, storage, database, analytics, application, and deployment services. This helps organizations move faster, lower IT costs, and scale applications. Moreover, AWS is a trusted and proven solution used by hundreds of thousands of business, operating in 190 countries. Incorporating this technology enables SMART to deliver the most powerful EHR solution yet.
It also improves the speed and performance of dosing and reports by enabling simultaneous read/write processes to occur across multiple replicated endpoints.
“I love the fact that the billing on Monday is incredibly fast. I mean unbelievably! Tasks that usually take 15-20 minutes now take under a minute!”
Deb R., Acadia Billing Manager
Enhances data protection
SMART’s new cloud also leverages Amazon Aurora, a database engine that delivers high-performance and reliability with real-time redundant backups and 99.995% uptime. Moreover, recovery from physical storage failures is transparent, and instant failover typically requires less than 30 seconds. Aurora’s storage is fault-tolerant and self-healing. Amazon continuously backs up six copies of your data and replicates them across three availability zones.
Amazon Aurora also provides SMART’s EHR users multiple levels of database security. The first level is network isolation using Amazon’s virtual private cloud (VPC). Access controls and boundaries from other networks in the AWS Cloud protect Amazon’s VPC. They closely resemble a traditional network that you would operate in your own data center with the benefit of the scalable infrastructure of AWS. Next is encryption-at-rest using keys you create and control through AWS Key Management Services (KMS).
Lastly, the encryption of data in transit using SSL. On an encrypted Amazon Aurora instance, data in the underlying storage is encrypted as are the automated backups, snapshots, and replicas in the same cluster.
SMART’s shift to the highly-scalable, fully-managed AWS cloud database affords partners several advantages. Such as exclusive access to the latest developments like the SMARTBridge™. It also saves on operational costs by decreasing the need for equipment upgrades, IT resources, and EHR updates. Learn more about SMART’s Cloud-Based EHR Software.
The short answer is yes, but the level of security depends on how your EHR is hosted. If it’s cloud-based, there are many failsafe measures in place to protect your clinic and patient data. On-premises solutions, on the other hand, are less advanced and don’t have the capabilities to stay current with security, performance, and reliability.
Whether a substance abuse treatment clinic’s data is hosted on-premises or in a cloud environment, hackers will try to find a way to ruin your day. Recovering from an attack can be significantly more challenging for on-premises users. Let’s discuss two real-life scenarios we’ve encountered.
On-Premises Electronic Health Record Security
Scenario #1 – Clinic’s central server infected during a ransomware attack
In the middle of the night, a ransomware virus infected a clinic’s central server, encrypting any file that was not actively in use. Fortunately, the SMART database was in use at that time and thus impervious to infection or alteration. Had it not been in use, SMART would have also been susceptible to the virus. They were able to copy their SMART data to a secure location and restore their entire server from a snapshot made the night before. If the virus had affected their SMART database or if a server backup wasn’t available, the results would have been very different – the clinic would be forced to pay the ransom for a decryption key or lose an entire day’s worth of data.
Scenario #2 – Clinic’s entire server and workstations infected by a ransomware virus
A different clinic got hit quite a bit harder. A ransomware virus infected their workstations and their entire server. This affected their main SMART folder and database. Next, it spread to their external backup device encrypting all previous backups.
The clinic had two choices – they could either pay the ransom and hope to get a decryption key or start from scratch with a blank database. At this point, they did not have access to SMART for over two days. If they could not decrypt the data, they wanted to be ready to start from scratch. SMART worked with the clinic to help build out a new server. After two days, they finally received the decryption key and access to their files. In total, they were unable to use SMART for four whole business days.
This was a frustrating and time-consuming situation for both organizations. On-premises users are responsible for recovering from these attacks. Not only must they worry about getting SMART back up and running, but they also must repair and restore any infected workstations.
How cloud-based EHR protects patient healthcare data
Security concerns with cloud-based users are much different. Since SMART’s Cloud launched in 2016, there have been zero attacks on cloud partners. It is important to note that if a virus infects a cloud-based user, there is still a chance of unauthorized patient information access. However, the odds of this occurring are far less likely because of the separation between user and data as well as the inherent stringent cloud security measures.
The fact of the matter is that cloud security is far more advanced than traditional on-premise tactics. Choosing a cloud-hosted environment means increased security, period. Security is one of the most significant benefits of moving to the cloud, along with uniformity, operational cost savings, and scalability. Learn more in this article’s top ten benefits list.
The first layer is the Virtual Private Cloud (VPC). Data is stored in an encrypted environment. Only SMART data can pass in and out of this environment. Custom-built firewall rules allow us to prevent unwanted access.
SMART Dedicated Servers
The servers that run SMART in the cloud are “purpose-built”; they run SMART only. This prevents the risk of end-users downloading malicious files from the internet. If a user opens a bad email or web link, only their computer will be affected.
In a shared environment, downloading a corrupt file or opening a malicious email can cause a virus to spread throughout the organization bringing productivity to a halt.
Amazon Aurora provides point-in-time recovery for cloud-based customers. In the unlikely event that a database restore is necessary, the latest backup is no more than 7 minutes old with the next-oldest full database backup being from the previous night.
SMART maintains one year of daily database backups and migrates older backups to the AWS Glacier for long-term retention. Specific data is retrievable from any of the available backup copies. *A fee applies for this service.
Trend Micro is a leader in providing cloud system and application security. This solution equips our servers with antivirus and malware protection, as well as intrusion detection, file integrity monitoring, and vulnerability scanning.
Armor Cloud Security
SMART has teamed up with ARMOR to take our cloud security to the next level. ARMOR provides SMART with Security-as-a-Service.
A team of security engineers continuously monitor the environment responding immediately to potential threats and provide recommendations based on the latest developments in cloud security. Their expertise in the security field helps prevent attacks before they happen. They were able to detect and prevent the WannaCry virus two months before it spread worldwide. Armor allows SMART to focus on delivering the best application experience while also providing an industry-leading security solution.
Best EHR Security Measures
In conclusion, the best EHR security measure that you can take is to choose a cloud-hosted environment. In the event of an attack, cloud-based EHR users are only responsible for their local environment’s security. SMART takes ownership of getting the EHR back up and running. Learn more about SMART’s Cloud-Based EHR Software.
HIPAA affects both EHRs and end-users. There are precise rules and regulations about the sharing and storing of electronically protected health information (ePHI) that, if broken, can result in civil violations, criminal penalties, hefty fines, and even jail time. The following details the best ways to safely store PHI and the responsibilities of treatment programs and EHRs like SMART.
Let’s start by looking at HIPAA’s two primary rules:
The Privacy Rule: This establishes standards for the protection of individuals’ medical records and other personal health information.
The Security Rule: This requires appropriate administrative, physical, and technical safeguards to ensure confidentiality, data integrity, and the security of electronically protected health information (ePHI).
EHRs’ responsibility under HIPAA
As a cloud-based EHR provider, SMART is responsible for addressing many of the Privacy Rule provisions and all the provisions of the Security Rule. These provisions include securing, encrypting, and backing up our Partners’ ePHI to ensure its security and integrity, and by periodically testing our readiness for possible threats.
We accomplish this by performing routine, thorough Security Risk Assessments to ensure we are appropriately safeguarding all ePHI we receive, maintain, transmit, or process on behalf of treatment providers.
Performing Security Risk Assessments
Understanding how to address HIPAA requirements begins with a full Security Risk Assessment, defined by HIPAA as “a thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic health information.” (1)
The following questions are adapted from NIST Special Publication (SP) 800-66. These are examples of what you should consider as part of the analysis:
Have you identified all the e-PHI within your organization, including e-PHI you create, receive, maintain, or transmit?
What are the external sources of e-PHI? In other words, do your vendors or consultants create, receive, maintain, or transmit e-PHI?
What are the human, natural, and environmental threats to information systems that contain e-PHI?
How does HIPAA Affect Addiction Treatment Providers?
Addiction treatment providers are required by law to abide by 42 CFR Part 2 regulations but, as Covered Entities, providers are also responsible for addressing all provisions of both the Privacy Rule and the Security Rule. Many of the Privacy Rule requirements must be addressed outside the realm of the EHR itself, such as having a sound set of HIPAA policies, providing training to all workforce members, posting notices, and supporting the patients’ rights granted by HIPAA.
To ensure compliance, consider the answers to the three questions listed above to ensure that all your e-PHI is protected against any reasonably anticipated threats and vulnerabilities. Doing this will help to protect both your organization and your patients.
Storing Protected Health Information (PHI)
Electronic vs. paper health records
Do you process every document in your clinic electronically, or are you still hanging on to those paper charts? Electronically entering, searching, and storing data makes being audit-ready and HIPAA–compliant much more manageable.
There are three main benefits to being 100% paperless. The first is organizational efficiency; being electronic helps ensure that staff has access to the same up-to-the-minute patient information at the same time. Next, you can implement quality control processes like providing forms standardization and auto-scheduling regulatory services. And finally, improve data collection standards by creating service type templates with required questions built-in.
Cloud vs. on-premises hosting
Beyond just electronic data processing, how you host your data is incredibly vital to data security. Moreover, cloud-hosted solutions, by-far, providebetter security capabilities than traditional on-premises hosting. For example, clinics with PHI hosted on-premise are much more vulnerable to data loss during malicious attacks because of the inability to perform tasks like point-in-time recovery.
The SMART way
SMART’s Cloud-Based EHR – Powered by Amazon Web Services – helps covered entities subject to HIPAA, maintain, and store protected health information. SMART employs several layers of security like our virtual private cloud (VPC), Amazon Aurora, Trend Micro, and Armor Cloud Security that protect data stored in the cloud.
Our EHR platform builds in safeguards, and AWS adheres to all HIPAA protocols. As a result, end users benefit from audit and data integrity controls, malware protection, PHI encryption, backup and storage, automatic logoff, security incident detection and response, and contingency operations processes. Learn more about SMART’s Cloud-Based EHR Software.