HIMSS Analytics Names First Korean Stage 7 Hospital

SEOUL, South Korea – Seoul National University Bundang Hospital (SNUBH) has reached Stage 7 on the HIMSS Analytics Electronic Medical Records Adoption Model (EMRAM) scale. It is the first hospital outside of the United States to achieve the Stage 7 designation, and the only hospital in Asia to do so.

The EMR Adoption Model provides a leadership guide for IT adoption in healthcare. The higher the stage, the more advanced the IT application coverts to. Stage 7 represents a totally paperless environment.

Only 1 percent of US hospitals rank at the Stage 7 achievement level on the EMRAM. At this stage, care coordination across the hospital is improved using EMR, developing better health information exchanges, and data warehousing for population health improvement.

The Seoul National University Bundang Hospital reached Stage 7 with:

• Almost all medical orders entered by physicians.
• Ninety percent of physicians enter patient health information into the EHR, using structured templates that generate data, allowing clinical decision support for clinical guidance.
• Efficiency gained through automation, such as relying on only four transcriptionists to support 910 inpatient beds and over 4,000 outpatient visits per day.
• The Medical Imaging department is fully digitized producing 1.2 terabytes of data per month for 70,000 radiologic exams per month.
• The Closed-Loop Medication Administration (CLMA) process has the highest level of patient safety for bar-coded medications through RFID technology
• The hospital uses clinical data warehousing for developing over 250 quality clinical indicators and 98 critical pathways.
• A Health Information Exchange exists between the hospital and 36 private clinics in its region.
  

“The Seoul National University Bundang Hospital is an excellent example of healthcare IT adoption to improve the quality and efficiency of care while improving patient and employee satisfaction,” said John P. Hoyt, executive vice president of Organizational Services at HIMSS. “We congratulate the hospital and its information technology team for creating this environment for its patients, employees and medical staff.”

HIMSS Analytics is beginning to collect data on electronic health record implementation from all hospitals in Korea. More information on Stage 7 recognition is available on the HIMSS Analytics website.

Source : http://www.emrspecialists.com/2010/12/himss-analytics-names-first-korean-stage-7-hospital/

The ‘Three-Legged Stool’ Model For EMR Transition

PORTLAND, MAINE – “What do you really hold dear to you that you want to preserve into the future as you transition to an electronic medical record?” That’s the question consulting firm Innovation Partners International posed to Maine providers attending a regional extension center (REC) educational forum this week.

Bernard Mohr, a partner at the firm, said he grew up next to a farm with milking cows. The stools the farmers used to milk the cows were three-legged. He explained that they found that a stool with three legs was actually “much more stable on uneven ground than a four-legged stool.”

The stool, Mohr said, is a metaphor for a different model for managing the transition to an EMR.

According to Mohr and Robert (Bob) Laliberte, who teaches the UNE Project Management Program and is also a partner at Innovation Partners International, the three legs of the “stool” of an EMR implementation are: life-giving properties, hopes and aspirations and first steps. If you can identify those three components then you’ll have a better chance at having a successful transition to your EMR, they said.

Mohr and Laliberte asked the 30 providers in attendance to pair up in groups and identify the life-giving properties or the core values that give their practices vitality and that, “if not retained during the transition to their EMR, would irreparably worsen the situation.”

“Autonomy is important for me,” said one doctor. “And feeling like I am doing something that matters – helping people. If I end up just playing with medical records that would be the pits for me.” I don’t want to spend more time with a machine than the people I am trying to help.”

Laliberte told attendees they had to think of an EMR as a possibility rather than a burden. He asked providers to think about “exciting possibilities” that the technology could bring to their practices.

Providers agreed that improved quality of care and patient satisfaction were at the top of the list. They also said it was important that providers have improved satisfaction as well.

“In the end, the most important thing is that you are making a difference for your patients, that is what it is all about,” said one attendee.

The last question attendees had to answer was, “what is the smallest step you could take in the next week to start moving toward your desired future?”

Attendees said identifying their goals and visions for the technology as well as talking to other providers about their experience could be possible action items for them.

Remember, said Laliberte in closing: “the EMR is at the service of the patient.”

The session was part of regional forum series being held by The Maine Regional Extension Center (MEREC), overseen by HealthInfoNet, and Quality Counts, a regional healthcare collaborative committed to improving health and healthcare for the people of Maine.

Source : http://www.emrspecialists.com/2010/11/the-three-legged-stool-model-for-emr-transition/

Meaningful use final rule to see minor revisions

BALTIMORE – The Centers for Medicare and Medicaid Services plans to correct a few inconsistencies in the meaningful use final rule it published in July and will post on its web site more detailed guidance for providers on how to meet quality measures required by the health IT incentive program.

The minor revisions, including more detailed descriptions of each of the meaningful use objectives and measures, “should help clarify issues and help the (Health IT Policy Committee) plan for recommendations for future stages,” said Tony Trenkle, director of CMS’s Office of e-Health Standards and Services.

Trenkle, who spoke at a Sept. 22 meeting of the policy committee’s meaningful use workgroup, did not offer further information on the clarifications. They would be released “shortly,” he said.

The panel met to propose preliminary requirements for the second stage of meaningful use in 2013, such as raising the level of performance required for computerized physician orders, electronic prescribing and other measures that were begun in the first stage.

In doing so, Paul Tang, chairman of the meaningful use work group, reminded the panel of its main goal: to move clinical practices operating without EHRs into the digital age.

“We want to pay particular attention to smaller practices and hospitals,” said Tang, who is also chief medical information officer of the Palo Alto Medical Foundation. “We want to raise the tides but not sink the boats.”

To set preliminary requirements for stage 2 in 2013, the panel is taking a ‘backfilling’ approach by splitting the difference between existing stage 1 requirements and where it wants to end up by 2015 for stage 3 of meaningful use of ehr.

For example, to set the stage 2 requirement that physicians should use e-prescribing for 60 percent of their prescriptions in 2013, it picked the midpoint between the current stage 1 requirement of 30 percent and the stage 3 goal that 90 percent of prescriptions should be ordered electronically.

Compared with the first set of meaningful use requirements, stage 2 should also incorporate more standard and coded data from EHRs, which should reduce the reporting burden on providers. “We hope that they are capturing the information as part of patient care and not a separate activity,” Tang said.

Staking out new ground, the group introduced objectives for a glide path to care coordination, starting with a measure that calls for providers to link members of their care teams electronically with at least 20 percent of their patients.

The work group will present its preliminary recommendations on stage 2 meaningful use measure in October. In December, the panel will put out a request for comments on the proposals.

In April, the panel will be able to get indications of the number of providers reporting stage one measures and a sense of the market, Tang said. The policy committee wants to make final recommendations by April to give vendors sufficient time to add functionality to EHRs.

Source : http://www.myemrstimulus.com/meaningful-use-final-rule-to-see-minor-revisions/

New York EMR Network Set To Be The Largest In The Country

NEW YORK – The New York Department of Health (DOH) and the public-private partnership New York eHealth Collaborative (NYeC) on Tuesday submitted a plan to ONC outlining a proposal to spend $129 million in state and federal funds to build and implement a statewide medical records network.

The network is being touted by officials as the country’s largest – connecting hundreds of hospitals, thousands of medical practitioners and up to 20 million patients a year. Once completed, New York doctors anywhere in the state will have instant access to critical Electronic Medical Records (EMR) of every patient.

“Better information helps doctors do a better job,” said David Whitlinger, executive director of NYeC. “This statewide network will empower healthcare providers by giving them access to a wealth of patient data that they didn’t always have at their fingertips. While cutting edge technology plays a tremendous role in modern medicine, in many respects medical records are still stuck in the past. We look forward to helping create a system that will greatly improve the quality of medical care and therefore people’s lives.”

The proposed statewide network will link together several existing regional electronic medical records networks with new infrastructure and programming, and state agencies will set policies to govern the system’s implementation and maintenance. Currently, healthcare providers can share some electronic records with certain neighboring medical institutions.

The Statewide Health Information Network for NY (SHIN-NY) will allow patients and healthcare providers to have immediate access to histories, prescriptions, test results, medical analysis and diagnoses, and more, anywhere in the state.

“Having this information can mean the difference between life and death,” said Eugene Heslin, a practicing New York physician who serves on the Board of NYeC. Heslin says having quick access to patients’ information such, as their medication history, can be life-saving in an emergency.

While several other states and the Veterans Administration have set up large networks for medical records, officials say New York’s system will ultimately dwarf them when completed given the scope of the state’s medical facilities. The proposal establishes a preliminary timeline for the implementation of many of the core services the network can provide – ranking them in priority – and foresees new services being added every several months between mid-2011 and 2014.

“New York is once again leading the nation in healthcare initiatives that will provide better treatment to the millions of patients treated in the state every year,” said New York State Department of Health Deputy Commissioner of Health Information Technology Transformation Rachel Block. “We feel it is our responsibility to help all patients and healthcare providers across the state have access to the same vital information that can help save lives. We look forward to working with NYeC and other state programs to create this network and establish rules that will make electronic medical records secure, accessible and helpful to the many stakeholders all around the state.”

Source : http://www.emrspecialists.com/2010/11/new-york-emr-network-set-to-be-the-largest-in-the-country/

EMR-Driven Disease Management Reduces Mortality, Costs

EMRs keep on proving their mettle in the area of care coordination.

The latest evidence comes from Kaiser Permanente Colorado, which improved outcomes by mining its EMR and electronic disease registries to match patients with heart disease to clinical pharmacy specialists and “personalized” nurses. In a study published in the November edition of the journal Pharmacotherapy, Kaiser researchers reported an 89 percent reduction in mortality, as well as cost reductions of $60 per day for cardiac patients enrolled in a disease management program, as compared to a control group.

The program, called the Kaiser Permanente Collaborative Cardiac Care Service, can notify pharmacy specialists if a patient doesn’t pick up a prescription or if a cholesterol test reveals a need to change medications, for example. The pharmacists or nurses then can contact individual patients to help them make the necessary adjustments to their treatment.

Rather than seeing costs increase due to the extra service, healthcare expenditures declined significantly for patients in the program. Hospitalization costs averaged $19 per day for participants, vs. $69 per day for those receiving standard treatment. Kaiser also reported small cost savings on physician office visits and medications due to the better coordination.

“This program works because it is a team approach,” study co-author Dr. John Merenich, medical director of the Clinical Pharmacy Cardiac Risk Service at KP Colorado, tells Healthcare IT News. “Our teams of nurses and clinical pharmacists, as well as our health information technology, require significant investment. We always knew it was the right investment because it saved lives. Now we know it’s also the right investment because it provides the highest quality care at a lower cost. This is the value people have been looking for in health care.”

Source : http://www.emrspecialists.com/2010/11/emr-driven-disease-management-reduces-mortality-costs/

Wound EMR Could Reduce Amputation Rates For Diabetics

EMR (Electronic medical records) specifically for wounds could substantially cut amputation rates for diabetes patients with foot ulcers, a study recently presented at the American College of Surgeons 96th Annual Clinical Congress determined.

Records pulled from an online wound EMR (OWEMR) system set up at by Dr. Jason Maggi at New York University Langone Medical Center’s Department of Surgery over a six-month span showed that there were up to 137 variables for each record, reports Medscape Medical News. Automated alerts sent out to all doctors involved with a particular patient’s care help doctors to sort through that information and integrate quantitative measures like healing rates in real time, according to Maggi, the study’s senior author.

“Effective management of this information and analysis of data in a timely fashion can mean the difference between limb salvage and amputation,” Maggi said, according to Medscape.

The OWEMR combined information like medications, medical history and lab results with digital photos of patient progress to help doctors “centralize information” onto a single page.

Dr. Danielle Katz, an associate professor of orthopedic surgery at SUNY Upstate Medical University who moderated Maggi’s presentation, hailed the study as potentially being “the future of medicine.”

Said Katz, “I think more and more there will be a push to have applicable practice guidelines [and] methods for tracking outcomes, and I think this really demonstrates a very potentially useful tool.”

Source : http://www.emrspecialists.com/2010/10/wound-emr-could-reduce-amputation-rates-for-diabetics/

EMR Development Debate Focuses On Standards, Competition

Lest anyone think the issue has been settled, national health IT coordinator Dr. David Blumenthal says there is a “raging debate” in scientific and policy circles about whether standards or competition should drive EMR development, MassDevice reports.

“There is a raging debate in the computer science world, which I have only lifted the lid on because I’m not a computer scientist, but it goes basically like this: Do we want a world where somebody sets very detailed standards for what computers have to do in order to create interoperability? Or do we want a world that’s a little bit more like the Internet, where a minimal set of standards was created and an enormous, vibrant competition and spontaneous growth occurred?” Blumenthal reportedly said at a gala for the Lucian Leape Institute of the National Patient Safety Foundation.

“I hear both sides of that argument, constantly, and even those people who believe in the minimal set of standards aren’t really sure what that minimal set is, but we’re working on precisely that,” Blumenthal added.

He was responding to a question from former U.S. Treasury Secretary Paul O’Neill about EMR standardization.

“Why is it that we’re reluctant to declare that we are going to design the best prototype that we can with an idea that we will have [iterative versions] as we learn more and we identify more needs?” wondered O’Neill, himself now a patient-safety advocate. “Why is it that we can’t call to question and get on with what’s a clear and apparent need for a national standard that’s a work in progress?”

“It’s not that it has to be perfect from day one, but your office basically says, ‘We’re going to do this now’?” O’Neill asked. O’Neill noted that he had seen the “travesty” of a $500 million investment in a proprietary EMR that was not interoperable with competitive systems, something that’s “not worth a damn” when a patient travels outside the local service area, and he does not want to see others waste money like that.

Blumenthal also addressed the recent news that medical licensing boards may require health IT competency for physicians to keep up their licensure. “Information is the lifeblood of medicine, and unless physicians and other healthcare professionals are capable of using the most modern technology available for managing information, I think they will have trouble claiming, in the 21st century, the unique competence that entitles them to being licensed and board certified,” Blumenthal reportedly said at the NPSF event. “I think they’ll have trouble holding up their heads as professionals and claiming that they are at the top of their game and capable of providing the best care that technology allows.”

Source : http://www.emrspecialists.com/2010/10/emr-development-debate-focuses-on-standards-competition/

Making Meaningful Transition To EMR

With the publication of the meaningful use guidelines on July 13, it is now clear what hospitals and doctors must demonstrate in their adoption of electronic medical records to grab a share of the billions of dollars available in federal incentives. Not as obvious, however, are the steps to take in negotiating this transition.
More than just the right technology, there must be a plan for preparing paper records and workflow processes for a “new normal,” where doctors will utilize both paper and electronic records to treat patients. The need for this “EMR enablement” work has been mostly lost amid the discussion of what technology milestones hospitals must hit and by when.

Hospitals that correctly complete this preparatory stage will realize three benefits: a more efficient records management program that returns cost savings to apply toward EMR; a better-organized records system that makes EMR implementation easier; and improved workflows for treating patients with hardcopy and digital records. Below are key EMR-enablement steps:

Centralize paper records for better access and lower costs
Today, most hospitals have patient records and films bottled up in specific departments, with no ability to share this information across the entire organization. In many cases, this produces unnecessary duplication of records and inconsistent management processes. Consolidating hardcopy patient records and films and then re-engineering how the organization stores and uses them can save time, cut costs and improve the quality of care through faster access to patient data. These new workflows need to account for how organizations archive, use and protect patient records in paper and electronic form. 
Stop saving – and paying for – outdated and duplicate records

Going digital does not mean digitizing every patient record. A thoughtful approach – what to digitize versus what can remain paper-based or securely destroyed – is required to reduce costs and improve care. A study from the American Health Information Management Association found that more than half of U.S. hospitals keep medical records forever, a behavior driven by the twin forces of industry regulations like HIPPA and state retention laws. Hospitals should comb through their records and destroy duplicates as well as those records past state-mandated retention periods. Destroying these outdated files and redundant copies cuts storage costs and makes digitization more cost-effective.
Begin your EMR journey with the right records

Make no mistake: paper records are not going to disappear any time soon. A portion of the physical patient record will continue to exist and grow at least in the near term. Information technology will certainly change how records are accessed and stored, but paper will continue to coexist with electronic information in a so-called “hybrid” record environment for many years to come. An intelligent approach to digitizing records will control costs and change how documents are shared and protected, improving workflow-based functions like billing, coding, and chart completion. Records can be shared simultaneously by many different departments instead of being handed off piece-by-piece to complete these functions. Scanning only what is needed as it is needed – and not just scanning every record, or even the entire record – ensures that the investment in an EMR is on par with treatment requirements, using patient history and clinical needs as criteria for conversion.

The opportunities of moving to the EMR are great. By addressing the core issues of what (and how) information needs to be stored, accessed and protected, healthcare providers can develop a more efficient pathway to the EMR and, in the process, deliver the patient care and cost savings benefits promised by this transition.

Source : http://www.emrspecialists.com/2010/10/making-meaningful-transition-to-emr/

Mayo Clinic Using EMRs To Reveal Genetic Predisposition To Disease

EMRs are moving into genomics, at least at the Mayo Clinic.

In a study published in the Journal of the American Medical Informatics Association, Mayo physicians showed how EMRs were able to help them determine the genetic variants that make certain people more likely to develop peripheral artery disease.

With consent of patients, researchers tapped the Mayo database of more than 8 million Electronic Medical Records to pinpoint clinical variables that could indicate a predisposition to PAD, a task that would be difficult if not impossible with paper records, Healthcare IT News reports. The physicians were able to confirm several cases of the disease and to identify phenocopies–traits found in confirmed cases–of atherosclerotic PAD.

“Although manual abstraction of medical records can provide high-quality data, for large studies such as genetic association studies, manual review of medical records can be prohibitively expensive and time-consuming,” the study says. “Our study demonstrates … several significant advantages over traditional approaches to genomic medicine research by simplifying logistics, reducing timelines and overall costs through efficient data acquisition.”

The team, from Mayo’s Divisions of Cardiovascular Diseases and Biomedical Informatics and Statistics, said that structured EMR data from large institutions “offer great potential for diverse research studies, including those related to understanding the genetic bases of common diseases.”

Source : http://www.emrspecialists.com/2010/09/mayo-clinic-using-emrs-to-reveal-genetic-predisposition-to-disease/

HIMSS Analytics Europe to award wired hospitals

BRUSSELS – HIMSS Analytics Europe will introduce awards for European Hospitals that have achieved the highest scores on the EMR Adoption Model (EMRAM). They’ll be unveiled at the upcoming HIMSS Europe Health IT Leadership Summit in Rome from September 29 to October 1.

HIMSS Analytics Europe recently launched the European EMR Adoption Model and is currently surveying hospitals across 12 European countries. Initial findings will be presented at the upcoming Leadership Summit, alongside the announcement of the criteria needed to achieve the highest level of EMR adoption.

HIMSS officials explained that the European EMR Adoption Model has been adapted to meet the unique needs of European Healthcare Institutions and draws on the HIMSS Analytics US EMR Adoption Model which was developed in 2005 as a methodology for evaluating the progress and impact of electronic medical record systems for hospitals in the HIMSS Analytics Database. Tracking their progress in completing eight stages (0-7), hospitals can review the implementation and utilization of information technology applications with the intent of reaching Stage 7, which represents an advanced electronic patient record environment.

Stage 7 hospitals:

* Deliver patient care without the use of paper charts
* Are able to share patient information by sending secure standardized summary record transactions to other care providers
* Use their vast database of clinical information to drive improved care delivery performance, patient safety clinical decision support, and outcomes using business intelligence solutions
* Are best practice examples of how to implement sophisticated EMR environments that fully engage their clinicians.

The validation process that confirms a hospital has reached Stage 7 includes a site visit conducted by an executive from HIMSS Analytics Europe and two current chief information officers to ensure an unbiased evaluation of the Stage 7 environments.

“Stage 7 hospitals provide best practices that other healthcare organizations can study and emulate as they strive to use EMR applications to improve patient safety, clinical outcomes and patient care delivery efficiency,” said Uwe Buddrus, General Manager, HIMSS Analytics Europe. “The accomplishments of Stage 7 hospitals serve as important indicators of high quality patient care with the interoperable electronic medical record in place.”

Source : http://www.emrspecialists.com/2010/09/himss-analytics-europe-to-award-wired-hospitals/

Should physicians nearing retirement deploy EHRs?

One of the lesser discussed factors determining whether to adopt EHRs or not is the number of years that a physician who owns his or her practice has left before retirement.

This is a complicated issue, and the advice will vary from physician to physician, given his or her specific circumstances. There are, however, a few common facts that need to be taken into consideration.

As one healthcare consultant noted, putting in an EHR system in the office doesn’t instantly deliver value. It’s – rightly – what you do with the system. And that will require time, likely years, to reap the benefits of improved clinical outcomes of patients and perhaps derive new sources of revenues (such as charging agencies to send out data, etc.). The question is whether the physician has the time to develop value or meaningful use out of the EHRs.

There will be immediate benefits, such as data retrieval automation, which can cut down on office staff time doing low-priority tasks. Intangible benefits may surface in the form of increased patient satisfaction when appointments can be scheduled via e-mail or test results received electronically without staff intervention and time.

Another benefit is the elimination of duplicative tests, but until the fee-for-service model is replaced, this particular benefit is lost revenue for physicians. Although the industry is beginning to embrace such models as bundled payments and payments tied in with medical homes, the timeline for when we are completely rid of fee for service is fuzzy at best. Will the physician retire before that happens? If retirement is less than five years away, I’d say it’s unlikely we’ll see payment reform.

Choosing the most cost-efficient system and a vendor that guarantees achieving meaningful use criteria may remove some of the discomfort and uncertainty over the major changes. Certainly physicians should reach out to their local regional extension centers (RECs) to help with implementation and workflow and office reengineering.

The healthcare consultant made a number of good points. It’s not the end of the world if the physician’s practice does not have an EHR since many larger organizations have their own and simply have that acquired practice implement the system that they use. That’s what happened to my physician’s office, although the acquisition occurred more than five years ago, which was at a time when EHRs weren’t a hot issue, as they are now.

At any rate, David Blumenthal, MD, said that in the near future adopting health IT will be part of the cost of doing business and part of the profession. Who knows when that will be? But when that time does arrive, it may just matter who is fully using EHRs and who is not.

Source : http://www.ehrexperts.us/should-physicians-nearing-retirement-deploy-ehrs/

Detroit Medical Center pegs EMR savings at $5M a year

DETROIT – Detroit Medical Center executives say they have achieved improved patient safety and saved $5 million to boot, thanks to DMC’s system-wide electronic medical system.

It is the second year in a row in which computer-based healthcare information processing created major improvements in quality of care and cost-savings for DMC’s eight hospitals, officials said.

The windfall in savings - triggered by highly effective electronic monitoring of critical tasks such as treating pressure ulcers and preventing medication errors - resulted in a healthy return on investment, they said.

The $50 million system powered by Kansas City, Mo-based Cerner Corp, has gone online throughout the DMC in gradual stages over a 12-year period, starting in 1998.

“The latest numbers are in, and we continue to see great strides in improving quality, treating patients more quickly and preventing error, which translates to dollar savings as well,” said Chief Nursing Officer Patricia Natale. “This work with these results is very exciting.”

“The savings are only part of the story,” she added, “because EMR is also a major step forward on the road to better quality of patient care. Thanks to EMR, we’re now seeing a dramatic reduction in the length of hospital stays due to pressure sores, along with a dramatic reduction of drug errors through EMR-enabled medication scanning.”

“The latest surveys show that EMR has helped to reduce medication errors by up to 75 percent,” said DMC Chief Medical Information Officer Leland Babitch, MD. “Obviously, that’s a major gain for patients - especially given the fact that medication errors account for the majority of accidental deaths and injuries at U.S. hospitals.”

The U.S. Institute of Medicine has estimated that up to 100,000 patients die as a result of hospital errors annually.

Treating pressure ulcers

The impact of the electronic medical record system on the treatment of pressure ulcers was especially noticeable, said DMC quality-of-care administrators.

They noted that the chronic sores often require extended hospital stays and thus drive up costs. But the most recent DMC Patient Care Services study of severe pressure ulcer cases showed that close EMR monitoring of bedsores reduced the average length of stay required to treat them by nearly three full days last year, compared with the average length of ulcer-triggered stays before EMR monitoring began in 2008.

The DMC study concluded that the reduction in the length of pressure ulcer-related hospital stays - in a system that admits more than 75,000 patients each year - was now helping to generate more than $4.5 million in yearly cost savings.

“The data on electronic medical records and patient safety and quality of care are clear and convincing by now,” said DMC Vice President for Quality and Safety Michelle Schreiber, MD. “Those data demonstrate beyond a reasonable doubt that EMR is an extremely powerful tool when it comes to protecting patients from hospital errors.

“But EMR is also proving to be an effective method for promoting quality of care - and the new numbers on bedsores and length of stays show how computer-based recordkeeping helps caregivers to take better care of patients day in and day out.”

In spite of the savings to be had from hospital-based EMR, however, recent studies show that the majority of U.S. hospitals have either failed to implement top-to-bottom EMR systems - or are cutting back on information technology (IT) programs already in place.

As of August 2010, fewer than 4 percent of U.S. hospitals had implemented the level of system-wide electronic patient recordkeeping that is now in place at the DMC. In addition, a recent study at the University of Michigan School of Medicine showed that more than one-fourth of the nation’s recession-affected hospitals have been cutting back on their already existing IT programs.

The cash-strapped hospitals were slashing IT budgets, reported the study in the Journal of Hospital Medicine, in spite of the fact that the Obama administration has recently made available more than $2.73 billion in Medicare/Medicaid bonuses for clinicians and hospitals that spend to improve their electronic medical records systems.

“The DMC has spent $50 million on building a powerful EMR system over the past five or six years, said Michael Duggan, president and CEO of the Detroit Medical Center, “and we did it because we like to think of ourselves as the ‘hospital of the future’ - as a state-of-the-art healing center where patients know they can get the best healthcare available anywhere today. ”

“At the same time, the ability to greatly reduce healthcare costs via electronic medical records is an added bonus - which makes implementing EMR a win-win situation for everyone involved.”

Source : http://www.emrspecialists.com/2010/09/detroit-medical-center-pegs-emr-savings-at-5m-a-year/

EMR Challenge: Tough Road To Reach Meaningful Use

Electronic medical record (EMR) systems have the true potential to transform the practice of medicine in ways that will improve patient care. But physicians must be secure in knowing that they will have the necessary support when they make the leap into the paperless world.

Congress and the White House have recognized the need for that support by getting behind Medicare and Medicaid incentives for physicians who undertake the daunting and costly process of adopting EMR systems. A final rule issued in July outlines how doctors can become “meaningful users” and receive the bonuses needed to help offset such a major investment.

Fortunately, federal officials are listening to some physician concerns about the government setting the bar too high for doctors to clear. Based in large part on advice from the American Medical Association and others in organized medicine, the final meaningful use rule has some greater flexibility for physicians. For instance, it allows them to defer some EMR requirements in the first two years and makes others easier to fulfill.

But despite the improvements, the bonus requirements are still going to make adoption a tough sell for many practices, especially the smallest ones. Obtaining a Medicare or Medicaid bonus in 2011 or 2012 still will require physicians to meet 20 EMR objectives, each with its own measure to determine whether doctors are compliant. Miss just one of them, and a physician who has spent tens of thousands of dollars on an EMR system might lose out on as much as $18,000 in a Medicare bonus for the year.

The margin of error is not wide enough for physicians. A requirement for doctors to maintain up-to-date diagnosis lists on their EMRs, for instance, mandates that such lists cover more than eight out of every 10 patients — a tall order. And if the government determines that a practice did not qualify for a bonus, no appeals process exists for those physicians to argue that they made the grade.

Physicians also are dealing with a tight deadline for EMR adoption. Because the federal government’s meaningful use rule on EMR systems is so recent, not a single vendor so far has been able to offer a product that will meet the requirements.

Officials expect such products to start reaching the market this fall, but that doesn’t leave physicians much time to research, purchase, implement and test such systems before the incentive program launches in 2011. Getting on board with a paperless system involves much more than simply plugging in the box and booting it up.

And as for those dedicated physicians who are ahead of the curve on EMRs? Some of them might not find out until fall that their costly systems are not going to be deemed government-certified for meaningful use.

The AMA is calling on the federal government both to establish a bonus appeals process and to deem early adopters’ systems as certified if they meet the meaningful use requirements. Heeding that advice would help allay some physician concerns.

But with all the uncertainty in the air, too many physicians — especially those in smaller practices — might conclude that the risks of failure are not worth the potentially outside chance of reward when it comes to EMR adoption. That would serve only to widen the gulf between those who have entered the paperless world and those who are still struggling to do so.

That gap will have consequences. The EMR incentives are voluntary — but not for long. Unless Congress changes the plans, in a few years Medicare bonuses will be replaced by penalties for vulnerable physicians who have not been able to overcome the barriers to EMR adoption. Those cuts will be on top of any deep reductions that might be required under the broken Medicare sustainable growth rate payment formula.

Physicians are ready to be teammates with the federal government in the shift to a better way of handling patient records. But federal officials must realize that if they are too strict in setting the rules of the game, they risk shutting out too many valued players.

Source : http://www.emrspecialists.com/2010/08/emr-challenge-tough-road-to-reach-meaningful-use/

EMR Purchase Poses Dilemma For Doctors Near Retirement

Investing in an electronic medical records system was not something many physicians late in their careers were probably thinking about a few years ago. But the introduction of incentive pay for adopting an EMR — and the penalties for not adopting — have older physicians wondering if such an investment is worthwhile.

Starting in 2011, physicians will have the opportunity to earn up to $44,000 over five years in Medicare incentives, or $64,000 in Medicaid incentives, for “meaningful use” of an EMR as defined by the federal government. But if a physician plans to stay in practice more than five years and does not adopt an EMR, he or she can expect Medicare reimbursement to start declining in 2015, leading to a 5% total cut by 2019.

Todd Sherman, lead partner of the Sherman Sobin Group, a Mount Laurel, N.J.-based financial consulting group that specializes in physician retirement planning, said meaningful use is a hot topic for those deciding whether to invest in technology this late in a career.

Sherman, who works mostly with physicians five to eight years away from retirement, believes the choices for physicians in one- or two-physician practices is especially hard. Not only must they consider shouldering an investment in a new system they might not use for long, they also must try to reflect on how that system might affect the sale of the practice.

Experts say many vendors would like doctors to believe an EMR would be a great selling point for potential buyers of a practice. In some cases, that’s true; in others, it could become a major expense with no return.

The answer depends on the true value of the EMR, said Joseph Mack, a health care consultant from Dana Point, Calif. Several factors play into that equation, including the cost of the investment, its financial return and the time it takes to arrive at that return. But don’t think the system alone will add value to your practice, Mack warned. The value comes from what is accomplished with the EMR.

An EMR can help reduce costs and improve care in many ways, including better documentation, improved efficiency and better care coordination. But a physician generally must invest money and time to reach a break-even point.

The system’s price is usually the biggest factor. However, some systems can be implemented with little capital investment, especially Web-based models that are hosted remotely and do not need a big infrastructure investment.

For most practices, there will probably still be periods of several-months of reduced patient volume while the practice adjusts to new workflows, which means practices also should plan on reduced revenue as staff members get up to speed with the new procedures, experts say.

“There’s a lot of manpower costs that are not articulated in vendor information, because they [the vendors] don’t have to deal with it,” Mack said.

It could take 18 months to several years before practices reach the break-even point. For a physician on a tight time schedule, underestimating break-even by as little as six months could throw a wrench in long-held retirement plans. Therefore, practices need to quantify benefits so they can be weighed against the costs, and a realistic time frame can be predicted, Mack said.

Exactly when break-even occurs could depend on the technical savvy of the practice staff, who will need to know how to operate the EMR, Mack said. It also could depend on choosing the right system.

Sherman said once a realistic expectation of break-even is set, physicians can determine their succession plans. Those less than three years away from retirement may have a hard time justifying the investment, Mack said. But those eight to 10 years away probably should find a way to make the investment, Sherman said. Not only could they earn incentive pay and avoid penalties, they also could provide a higher level of service in those last years of practice.

That higher level of service also can help build the practice’s profitability, which is especially important if the physician plans to sell, Mack said. Data collected from an EMR could help physicians earn other pay-for-performance bonuses in addition to those from meaningful use. If the EMR helps improve efficiencies, it could lead to a larger patient load and, at the very least, cleaner claims for better billing.

Everything that adds to the cash flow in a practice matters to a potential buyer, not how much was spent on technology, Mack said. But if you buy an ineffective EMR, it actually could increase your costs, thus reducing the value of your practice, he said.

If it doesn’t make financial sense to make the purchase, the lack of technology won’t necessarily hinder selling, Sherman said. Many small practices are being bought by larger groups that already have an EMR. They will want that same EMR installed at any practice they buy.

“I am a big proponent of an EMR, but doctors have to examine the cost benefit of it,” Mack said. “Unless the EMR helps increase their profitability … then it can’t really be said the EMR will increase the value of the practice when you sell it in one, two or three years.”

Source : http://www.emrspecialists.com/2010/08/emr-purchase-poses-dilemma-for-doctors-near-retirement/

EMR retrieval tool full of potential

BOSTON – Radiologists’ use of an advanced search tool that aims at improving the way they retrieve and sort data from an electronic medical record has the potential to benefit many other departments, according to one of the authors of a new study.

The Queriable Patient Inference Dossier (QPID) search engine was initially developed in 2005 in response to the need for radiologists at Massachusetts General Hospital in Boston to quickly have access to information about their patients.

Michael Zalis, MD, lead author of the study, which was published in the August issue of the Journal of the American College of Radiology, says the system serves as an adjunct to the hospital’s EMR system.

“Even in its simplest implementation, the presence of an EMR system presents considerable challenges to the radiologist,” he explains. “For example, radiologists commonly encounter each patient with little prior familiarity with the patient’s clinical situation. As a result, the time and effort required to retrieve, review, and assimilate EMR data relevant for the case at hand becomes an important consideration for use of EMR in busy clinical practice.”

The QPID system currently serves 500 registered users at Massachusetts General Hospital and posts 7,000 to 10,000 thousand pages of medical record data daily, according to hospital officials.

“[QPID] It was developed separately from the EMR and operates in a read-only fashion in relation to it,” Zalis says. “Thus QPID is not a source of new EMR data, but serves as a method to extract useful patterns of EMR data from the separately curated clinical data repositories at our institution,”

He says this tool has the ability to extend the radiologist’s awareness of a patient’s clinical history and care record, which he says can lead to better value, quality, and safety of practice.

“The potential impact of advanced EMR search tools is by no means limited to radiology and in fact many departments in the hospital and outpatient clinic may benefit from these capabilities,” Zalis says. “In our own institution, with the QPID search system, we have catalyzed a growing base of enthusiastic users, many of whom have contributed their own insights and content to the system’s catalogue of search modules, each of which is potentially applicable at more than one site. The future for advanced search of the EMR looks to be exciting and full of potential.”

Source : http://www.emrspecialists.com/2010/08/emr-retrieval-tool-full-of-potential/

Four Ways To Jump-Start E-Health Record Adoption

Most of the 1,500 largest U.S. hospitals have already deployed electronic health record systems. Not so for the nation’s 700,000 practicing doctors. Less than 20% of them use EHR, and many aren’t using fully functional systems. So what’s at stake if all these doctors don’t get on board with deploying these systems? A lot.

Digitized records provide a timely, cost-effective way to share patient information. If physicians aren’t using them in their private practices, they lose those benefits, as do the hospitals they work with. Paper records continue to be shuffled, putting patients at risk for medical mistakes, ill-informed treatment decisions, and unnecessary tests because hospitals and doctors don’t have easy access to information about recent tests, health histories, and other important data.

There are looming financial implications as well. The Health Information Technology for Economic and Clinical Health Act, part of last year’s stimulus legislation, provides more than $20 billion in incentives to doctor practices, hospitals, and other healthcare organizations that show they’re making meaningful use of EHR. A first round of rules defining what constitutes meaningful use was released last month and includes some requirements that providers be able to electronically exchange patient data; later stages of rulemaking are likely to include more stringent requirements.

At risk are incentive payments of as much as $64,000 for a physician practice. For hospitals with fewer than 50 beds, incentives could run as high as $2.5 million, and for ones with 500 or more beds, as much as $5.2 million, according to the American Hospital Association. Penalties for non-compliance start in 2015, when physicians and hospitals that treat Medicare patients would see a reduction in fee reimbursements.

Source : http://www.ehrexperts.us/four-ways-to-jump-start-e-health-record-adoption/

Physician champions speak out

As we head into the next stage of EHR adoption, now that the meaningful use criteria have been finalized, it’s time for health IT advocates to start rallying their physician colleagues to get serious about implementing and deriving value from EHRs.

Eugene Heslin, MD, lead physician at Bridge Street Medical Group in the New York Hudson Valley, is one such physician champion. There’s an interesting element about Heslin’s story. His six-physician practice has been using EHRs since 2006. In 2009, it joined 10 other practices totaling 237 primary care physicians across 51 sites in the Hudson Valley region in adopting the patient-centered medical home model. Here’s the thing: Health IT was used to support the PCMH’s approach to care, which required physician office redesign.

The PCMH model is all about coordination of care and communication among a patient’s multiple healthcare providers, which could include inpatient, PCP, specialist, skilled nursing facility, and home healthcare. Try getting all the visits and results updated in real time for each provider by paper. If you succeed, no doubt you’ve expended a lot of time and resources.

There will be other new models of care that will require a more efficient means of communication and sharing of information. Health IT will be the infrastructure that enables that sharing and communication.

Heslin said that the federal incentives can help drive critical mass among his colleagues and create widespread adoption at the community level. Many say that health information exchange is what will make EHRs valuable. Once there’s widespread adoption, connectivity is the next step. So it’s important to get to critical mass.

Heslin was spot on when he said that we need “to develop efficiencies and logic systems that allow us to rationalize care – to care for our patients using more intelligent tools, more efficiently – and not ration care. Meaningful use moves us in that direction.” At a time when demand will far outstrip demand, the industry needs to be more efficient – not at the expense of the patient. Any time you can deliver clinical decision support, a comprehensive view of the patient, just to name a few, you are indeed rationalizing care. Important difference.

The industry needs more advocates such as Heslin to speak concisely and eloquently of the value of EHRs.

Source : http://www.healthcareitnews.com/blog/physician-champions-speak-out

EHR developed for long-term care holds promise

By Molly Merrill

COLUMBIA, MO – Researchers from the University of Missouri are developing an electronic health record system aimed at meeting the needs of a population of older adults that’s expected to almost double in the next 20 years.

According to the U.S. Administration on Aging, there will be about 72 million older adults living in the U.S. who will require care from a workforce that is already projected to be lacking.

Researchers from MU are currently working on a solution they say may help alleviate some of the burden. They’re developing an EHR system that encompasses standard health assessments and those obtained through new technologies. The goal, they say, is to increase efficiency and accuracy, improve patient outcomes and reduce costs for long-term care.

“As the use of emerging technologies increases along with the older population, maintaining complete and accurate patient information can be overwhelming,” said Marilyn Rantz, professor in the MU Sinclair School of Nursing. “A comprehensive system that encompasses all measures, old and new, is the key to enhance and efficient clinical decision making.”

The EHR is being tested at TigerPlace, an independent senior-living facility in Columbia, Mo. According to the researchers’ initial findings, use of the EHR system can enhance nursing care coordination and advance technology use and clinical research.

“New technologies to passively monitor older adults’ health are being developed and are increasingly commercially available,” Rantz said. “The challenge remains to integrate clinical information systems with passive monitoring data, especially in long-term care and home health settings, in order to improve clinical decision making and ensure patient records are complete.”

Effective EHR systems display data in ways that are meaningful and quickly assessable for clinicians, Rantz said. With access to comprehensive data, clinicians can make more informed clinical decisions, better perform risk assessments and provide risk-reducing interventions.

Source :- http://www.ehrexperts.us/ehr-developed-for-long-term-care-holds-promise/

Knowledge Networks says half of docs now use EMRs

By Neil Versel

Hard to believe, but 52 percent of specialists and 50 percent of primary-care physicians claim to be using EMRs, up from 42 percent and 38 percent, respectively, two years earlier, a new survey indicates. The survey does not specify what EMR usage means.

“While use of this technology will soon be mandated, these ‘early adopter’ levels suggest a desire for digital convenience at a time when patient record keeping promises to become exponentially more complex,” reports New York-based survey firm Knowledge Networks. The company conducted the study of nearly 11,000 healthcare professionals through the Physicians Consulting Network, which maintains a research panel of physicians and other caregivers.

(We quibble with whether 50 percent is “early adopter” level–or even accurate–and that technology will “soon be mandated.” CMS will penalize those that haven’t gotten to “meaningful use” by 2015, but won’t exclude non-compliant providers. For that matter, participation in Medicare and Medicaid is voluntary.)

One possible explanation for the increased EMR use is the fact that physicians continue to be crunched for time, a situation that will only get worse as 32 million newly insured patients enter the healthcare system in coming years, thanks to the Patient Protection and Affordable Care Act. Supporting this theory is the finding in the survey that 14 percent of primary-care docs and 12 percent of specialists expect to spend less time with pharmaceutical sales representatives in the next six months. Those numbers compare with 9 percent (PCP) and 8 percent (specialists) in the 2008 survey.

Meanwhile, physicians seem to be embracing smartphones to improve their efficiency. The survey found that 62 percent of specialists and 55 percent of primary-care physicians have such devices, and that at least 17 percent of these smartphone owners are using their phones for e-detailing from pharma reps.

“Healthcare professionals are embracing new technologies that promise more control and convenience; we cannot help but see a connection between the use of smartphones for e-detailing and an anticipated drop in time spent with sales reps,” Knowledge Networks Senior VP Jim Vielee tells Healthcare IT News. “These trends seem destined to magnify as healthcare reform takes effect, creating dramatic upswings in doctors’ case loads.”

Source :- http://www.emrspecialists.com/2010/07/knowledge-networks-says-half-of-docs-now-use-emrs/

Doctors Increase EMR Use

By Nicole Lewis

A growing number of primary care physicians (PCPs) and specialist doctors are using electronic medical records and other technologies as they adopt health information technology to streamline their workflow processes, a new study shows.

The survey, conducted by Knowledge Networks in conjunction with the Physicians Consulting Network (PCN) and its panel of specialists and other health care professionals, shows that 52 percent of specialists and 50 percent of PCPs said they are already keeping their patient records in an electronic format — up 10 percentage points for specialists and 12 points for PCPs since 2008.

Published last week, the study of nearly 11,000 health care professionals also shows that more than half of PCPs and specialists already have smartphones, and that many are using them for email, shopping, e-detailing and to participate in surveys.

The report reveals that smartphones, such as iPhones and BlackBerries, are quickly becoming a way of life for medical professionals. Sixty two percent of specialists and 55 percent of PCPs report having one, and roughly 85 percent to 90 percent of those who have them are using them for Internet and for email.

Other findings were that 17 percent of PCPs and 18 percent of specialists who have smartphones are using them for e-detailing, which refers to the use of technology to bypass sales calls from pharmaceutical representative. Higher proportions — 29 percent of PCPs and 24 percent of specialists — use smartphones to participate in on-line surveys.

Executives at Knowledge Networks say the research reflects the way digital technology and other factors are transforming doctors’ attitudes and habits.

“Marketers must adjust to the needs of plugged-in, increasingly busy doctors in everything they do - from the platforms they use for messaging to the time they expect to have with prescribers,” Jim Vielee, senior vice president at Knowledge Networks, said in a statement. “Health care professionals are embracing new technologies that promise more control and convenience; we cannot help but see a connection between the use of smartphones for e-detailing and an anticipated drop in time spent with sales reps. These trends seem destined to magnify as health care reform takes effect, creating dramatic upswings in doctors’ case loads.”

Knowledge Networks is a company that works closely with clients to create, effective marketing, advertising, public policies, and social science research.

Source :- http://www.emrspecialists.com/2010/07/doctors-increase-emr-use/

Flexibility built into final rule on meaningful use EHR

WASHINGTON – Federal officials released the final rule on meaningful use Tuesday, which will allow physicians and hospitals to qualify for thousands of dollars in stimulus funding incentives for the adoption of electronic health records.

The 864-page final rule, several weeks late from its anticipated delivery before June 21, outlines the specific qualifications providers must meet to achieve the meaningful use of electronic health records.

At a news conference Tuesday morning, federal healthcare officials praised the advance of electronic health records, while acknowledging the difficulties providers face at the onset of adoption.

According to David Blumenthal, MD, national coordinator for health information technology, the final rule differs from the proposed rule issued last January: It allows providers more flexibility in choosing which measures to use for qualifications.

According to Blumenthal, the proposed rule required doctors to comply with 23 measures, and hospitals 25 measures. The government received more than 2,000 comments on the rule, many of them asking for more flexibility in allowing clinicians to qualify.

Blumenthal said the final rule took those comments into account. The final rule requires doctors to comply with a set of 15 core objectives during the first year - or Stage 1- of adoption. Hospitals are required to comply with 14 core objectives. In addition to the core objectives, both hospitals and doctors will have to choose five more objectives from a “menu” of 10, he said. The remaining objectives will be deferred to Stage 2 of adoption.

The final rule also reduced the number of electronic prescriptions a doctor is required to make from 75 percent to 40 percent, Blumenthal said.

Kathleen Sebelius, Department of Health and Human Services Secretary, said the Federation of American Hospitals is an “enthusiastic supporter” of the new rule. The federal government hopes other groups will join them, she said.

Blumenthal, a physician, said he is confident the use of electronic health records will become a core professional competency among physicians, who will eventually lead the way in adoption. Until then, the government will encourage healthcare IT adoption through financial incentives, such as these set up under the meaningful use rule. The government will also supply “shoulder-to-shoulder” support for providers through the regional extension centers.

Key changes in the final CMS rule include:

• Greater flexibility with respect to eligible professionals and hospitals in meeting and reporting certain objectives for demonstrating meaningful use. The final rule divides the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer in 2011-2012. This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.
• An objective of providing condition-specific patient education resources for both EPs (eligible providers) and eligible hospitals and the objective of recording advance directives for eligible hospitals, in line with recommendations from the Health Information Technology Policy Committee.
• A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, which conforms to the Continuing Extension Act of 2010
• CAHs (critical access hospitals) within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.

A CMS/ONC fact sheet on the rules is available on the CMS Web site.

Source : http://www.myemrstimulus.com/flexibility-built-into-final-rule-on-meaningful-use/

EMR use inches up in physician offices

By Neil Versel

The first anniversary of the enactment of the American Recovery and Reinvestment Act–Irvine, Calif.-based research firm SK&A published a report saying that 36.1 percent of physician offices have some form of electronic medical record. That’s 3.2 percentage points greater than the 32.9 percent adoption rate reported in February 2009.

Those numbers may seem high, based on studies in esteemed academic publications such as the New England Journal of Medicine, but they are in line with the findings from recent Centers for Disease Control and Prevention report. It’s also worth noting that SK&A had a huge sample size of 180,000 physician offices in the U.S.

It’s no surprise that adoption rates seem to be related to number of physicians, number of exam rooms in the office and daily patient volume, with larger practices more likely to have EMRs. Practices owned by integrated health systems tend to have greater EMR usage as well, slightly above 50 percent. Given that primary care is increasingly burdened with high patient loads and starved for cash, general practice was near the bottom in terms of EMR adoption, SK&A reports. Dialysis, critical care and radiology reported the highest EMR usage rates.

Source: http://www.emrspecialists.com/2010/07/emr-use-inches-up-in-physician-offices/

Federal panel wants national reporting on EMR software, data errors

By Neil Versel

The Adoption/Certification Workgroup of the federal Health IT Policy Committee wants to require hospitals and physicians to report “hazards and near-misses” as a result of software malfunctions, beginning in 2013. Reporting would become part of demonstrating “meaningful use” of EMRs and thus a condition for receiving Medicare and Medicaid bonus payments.

While some would like to see a database on EMR and data glitches up and running sooner than that, some patient-safety advocates believe 2013 is unrealistic. “I think it will take a while to do this right,” UCSF physician Dr. Robert M. Wachter tells the Huffington Post Investigative Fund. “The problem here is that there are potentially dangerous systems and we have no mechanism to figure out what they are or to force them to improve,” he adds.

The database could help pull together an uncoordinated group of existing public and private data repositories, such as the voluntary reporting system the FDA runs to track issues with devices it regulates. However, that system, like many others, has limited public access and redacts any fields that could identify the reporting organization.

The workgroup envisions a reporting system in which patients are encouraged to report errors and omissions in their own medical records and recommends that vendors include “feedback” buttons so they can report problems with a single click.

To learn more:
- see this Huffington Post Investigative Fund story
- check out this take from Federal Computer Week

Source:http://www.emrspecialists.com/2010/07/federal-panel-wants-national-reporting-on-emr-software-data-errors/

NCPDP Script Standard Adopted as Core Requirement for ePrescribing in Meaningful Use

The National Council for Prescription Drug Programs (NCPDP) today acknowledges and applauds the U.S. Health and Human Services Department (HHS) on its Final Rules announcement on “meaningful use” of an Electronic Health Record (EHR), including the adoption of NCPDP SCRIPT Standard for the secure, electronic transmission of prescriptions and prescription-related information.

The Final Rule on Standards to meet Meaningful Use announced the NCPDP SCRIPT Standard Implementation Guide Version 8, Release 1 (Version 8.1) October 2005 or NCPDP SCRIPT Standard, Implementation Guide, Version 10.6 can be used. This allows flexibility for those prescribers – eligible practitioners, hospitals, provider associations, state and federal governments, software vendors and more – that already are using the SCRIPT Standard as well as flexibility for implementers.

“The Final Rules will help clinicians achieve better and more effective patient care,” stated Lee Ann Stember, President of NCPDP. “We are very pleased with the Final Rule as it relates to ePrescribing and using the NCPDP SCRIPT Standard to achieve Meaningful Use.”

The NCPDP SCRIPT Standard was first published in 1997 and has been updated annually based on the business needs identified by the industry. SCRIPT is a standard created to facilitate the transfer of prescription data between pharmacies, prescribers, intermediaries and payers. This standard allows for quick and accurate communication between the prescriber, pharmacist and payer to provide information for the prescriber and pharmacist to make informed decisions with the patient while reducing the potential for medication error.

Source: http://www.eprescriptionservices.com/ncpdp-script-standard-adopted-as-core-requirement-for-eprescribing-in-meaningful-use/

CMS Recognizes Updated E-Prescribing Standard for Medicare Part D

In an interim final rule released Tuesday, CMS “recognized” the use of version 10.6 of the National Council for Prescription Drug Programs SCRIPT Standard for electronic prescribing under the Medicare Part D drug benefit, Health Data Management reports.

According to CMS, “recognition” means the agency approves the use of the updated standard for e-prescribing; however, it is not yet formally adopted as the new standard.

New features in the version 10.6 standard will allow users to provide:

• Prescriber order numbers;
• Drug NDC source data;
• Pharmacy prescription fill numbers; and
• Date of prescription sale.

According to CMS, the new functions will “facilitate better record matching, the identification and elimination of duplicate records, and the provision of richer information to the prescriber between willing trading partners.”

CMS plans to publish the final version of the interim final rule on July 1 (Goedert, Health Data Management, 6/29).

Source: http://www.eprescriptionservices.com/cms-recognizes-updated-e-prescribing-standard-for-medicare-part-d/

HHS sends final meaningful-use rules to OMB for review

By Joseph Conn

HHS has sent its final meaningful-use rules and certification criteria for electronic health-record system testing to the Office of Management and Budget—typically one of the last bureaucratic hurdles before rules are released. The criteria are called for under the EHR subsidy program established by the American Recovery and Reinvestment Act of 2009.

OMB received a copy of the final rule of the “meaningful use” criteria from the CMS Monday, according to the posting on the website of its Office of Information and Regulatory Affairs.

The White House budget authority also received a copy of the final rule on an initial set of standards, implementation specifications and certification criteria from HHS on July 2.

Under the Medicare provisions of the stimulus law, to receive an estimated $14 billion to $27 billion in federal subsidies for EHR purchases, hospitals and qualifying office-based physicians must use certified EHRs in a “meaningful manner.”

Robert Tennant, the Washington, D.C.-based senior policy adviser to the Medical Group Management Association, Englewood, Colo., said he expects a quick turnaround on both rules.

“By law, they have 90 days in which to review, but I think in all practicality, OMB has been involved in the drafting of the final rules, so it’s no surprise when they get them,” Tennant said.

OMB has had HHS’ controversial final rule on the federal requirement on public and patient notification in the event of a breach of personally identifiable health information since May 15. Tennant said he expects both recently submitted rules to be released in a week or so, possibly even later this week.

Tennant also said a proposed healthcare IT privacy rule just left the OMB review list, so “it should be published in the next couple of days.”

Source:http://www.myemrstimulus.com/hhs-sends-final-meaningful-use-rules-to-omb-for-review/

5 Tips to Stay on Top of Your Hospital Bill

The Commonwealth Fund states that in 2007, 72 million Americans either experienced problems paying medical bills or accrued medical debt. Billing errors are often at the root of this problem, creating medical bills that patients can’t afford. Interpreting a hospital bill can be complicated and reviewing it line-by-line can be time-consuming and overwhelming.

It pays off to be informed. There are medical billers, medical coders, doctors and other health care professionals involved in each hospital stay. Miscommunication on any part can lead to mistakes. What can you do? Start by following these tips:

1. Plan ahead if possible – If your hospital stay is planned, make sure you double check your coverage before your hospital stay. This will enable you to verify the cost of any procedures and the amounts that will be covered.

2. Don’t leave the hospital without an itemized bill – Once you’re discharged, it is harder to obtain, so make sure you have it in your hand before you leave.

3. Keep track of everything – It is important for you to know who is treating you and exactly what they are doing. Make sure you ask questions and take names. Note: if you are unable to keep track of this information, have a spouse, family member or friends do it for you.

4. Don’t immediately pay the bill – Make sure you take the time to carefully go over the bill and understand what the charges are for. Once you pay the bill, it will be harder to re-coup your money if there are mistakes.

5. Make the hospital accountable – Don’t let the hospital ignore the erroneous charges and assure you that your insurance company will pay for it. Mistakes are mistakes and the hospital needs to correct errors.

Source: http://www.mymedicalbillingoutsourcing.com/5-tips-to-stay-on-top-of-your-hospital-bill/

Pharmacy Groups Call for DEA To Clarify New Rule on E-Prescribing

Four pharmacy organizations say they support the Drug Enforcement Administration’s efforts to allow electronic prescribing of controlled substances but called for further clarification on the new e-prescribing rule, Modern Healthcare reports.

On March 31, DEA published in the Federal Register its interim final rule on e-prescribing of controlled substances. According to DEA public affairs officer Barbara Carreno, the rule took effect June 1.

NCPA Letter

On Tuesday, the National Community Pharmacists Association sent a letter to DEA offering to provide guidance on a requirement for digital signatures on e-prescriptions.

NCPA also asked the agency to allow nurses to act as liaisons between long-term care facilities and pharmacies because most long-term care centers do not employ full-time physicians.

Letter From Four Groups

In another letter, four pharmacy groups asked DEA to clarify:

• The steps that prescribers must take to account for changes in e-prescriptions;
• The responsibilities associated with digital signatures;
• Work flow procedures in long-term care facilities; and
• E-prescribing options for emergency situations.

The groups also requested that third-party audits occur less frequently and that pharmacies be allowed more time to respond to security concerns identified in internal audits.

The letter’s signatories were the:

• American Pharmacists Association;
• American Society of Consultant Pharmacists;
• American Society of Health-System Pharmacists; and
• NCPA (Robeznieks, Modern Healthcare, 6/3).
• Emdeon Makes Recommendations

In a comment letter on the interim final rule, software and service vendor Emdeon Business Services noted that it will take time to add a new field to e-prescribing transactions to indicate that a prescription has been digitally signed.

As an interim solution, Emdeon recommends placing the signature indicator inside an XML “envelope” or “wrapper” in the header of the prescription.

Emdeon also offered recommendations about archiving, altering content and verifying eligibility (Goedert, Health Data Management, 6/1).

Source: http://www.eprescriptionservices.com/pharmacy-groups-call-for-dea-to-clarify-new-rule-on-e-prescribing/

ONC Starts Accepting Applications for EHR Certification Groups

The Office of the National Coordinator for Health IT has started accepting applications from organizations seeking to be named as testing and certification bodies for electronic health record systems, Modern Healthcare reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate “meaningful use” of certified EHR systems will qualify for federal incentive payments.

ONC issued the final rule on the temporary testing and certification program on June 18, and the rule appeared in the Federal Register on June 24.

The stimulus package gave ONC the option of retaining the Certification Commission for Health IT as the sole EHR certification group or recognizing a new organization, according to Modern Healthcare. ONC opted to expand its search for a new group, and CCHIT has joined a pool of applicants for the distinction.

Carol Bean, a standards harmonization analyst for ONC, said HHS to date has received about 40 application inquiries and 14 requests for applications. She said ONC has 30 days after receiving an application to decide whether the organization qualifies as an “authorized testing and certification body” under the temporary certification program.

The final rules for the permanent authorization program have not yet been released, although a proposed rule was issued in March (Conn, Modern Healthcare, 7/1).

Source:http://www.myemrstimulus.com/onc-starts-accepting-applications-for-ehr-certification-groups/

Los Angeles County approves $17M for EMR in juvenile detention facilities

By Neil Versel

Plenty has been said about the potential for EMRs and telemedicine to improve the woeful state of care in America’s prisons, but juvenile detention facilities often get left out of the discussion.

On Tuesday, Los Angeles County supervisors approved $17 million in funding for an EMR system to manage the medical records of the more than 1,500 youngsters being held in county juvenile camps and halls. The EMR is intended to improve record keeping in the county’s Probation Department, which federal authorities have cited multiple times in recent years for keeping inadequate medical records on youths in custody.

The Los Angeles Times reports that the U.S. Department of Justice has said the poor record-keeping has resulted in “inconsistent or inappropriate treatment and medication.” Los Angeles County currently faces the threat of a civil-rights lawsuit that could strip county officials of some of their control over the Probation Department, the newspaper says.

Though juvenile detainees often get moved between facilities in Los Angeles County, paper records don’t always follow them. The EMR is intended to rectify that problem. The Probation Department’s CIO says the unspecified system should be in place in 15 to 18 months.

Source:http://www.emrspecialists.com/2010/06/los-angeles-county-approves-17m-for-emr-in-juvenile-detention-facilities/

Report Tracks Demand for Consultants To Help With Health IT Adoption

Nearly 70% of health care providers expect to hire a professional services firm to help them achieve “meaningful use” of electronic health records, according to a new report from research firm KLAS, Healthcare IT News reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of EHRs will qualify for Medicaid and Medicare incentive payments.

Report Findings

For the report, KLAS researchers interviewed 118 health care providers (Monegain, Healthcare IT News, 5/18). They found that integrated delivery networks had the highest need for external expertise, with 90% reporting plans to collaborate with consulting firms (Guerra, InformationWeek, 5/20).

Trend Toward Specific Tasks

Researchers noted that many health care providers already have achieved some level of health IT adoption and now are seeking to hire smaller groups to complete specific tasks.

Mike Smith — report author and KLAS general manager of financial and services research — said many health care organizations hire consultants to help bolster physician adoption of clinical information systems (InformationWeek, 5/20).

Above article publish on http://www.ehrexperts.us/report-tracks-demand-for-consultants-to-help-with-health-it-adoption/

HHS to study patient perceptions of EHRs

The Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health IT is seeking patient perceptions of the delivery of healthcare through the use of an EHR.

“Health IT experts agree that HITECH stimulus funds are likely to improve how physicians practice medicine for Medicare and Medicaid beneficiaries and, ultimately, for advancing patient-centered medical care for all Americans. However, there is an evidence gap about patients’ preferences and perceptions of delivery of health care services by providers who have adopted EHR systems in their practices,” the HHS’ May 14 notice in the Federal Register stated.

According to the notice, the goal of the proposed Patient Perceptions of EHR study is to help policymakers understand how primary care practices’ use of EHRs affects consumers’ satisfaction with:

* Their medical care,
* Communication with their doctor
* Coordination of care.

“The research questions for the proposed study are motivated by a concern that patients may have negative experiences as practices begin to use EHRs,” the agency wrote.

HHS plans to survey 840 patients about their opinion of their medical care when their primary care physicians use EHRs, according to the notice, which can be read here.

Above article publish on http://www.ehrexperts.us/hhs-to-study-patient-perceptions-of-ehrs/

The Right Medical Billing Software Can Make All of the Difference

When it comes to the practice of medical billing, precision is absolutely paramount to ensuring that payment from claims submitted to insurance companies, or respective administration entities, is received by the doctor or other licensed health care provider who provided the service. Most medical billing professionals are required to perform a myriad of duties that include managing healthcare billing as well as processing, altering and resubmitting claims while adhering to the most current regulations and policies in the industry. Even the most experienced and well-trained in the field are prone to the possibility of human error, which can end up being extremely costly to the healthcare provider. This is why the use of electronic medical billing has been rapidly gaining in popularity throughout the medical field.

By incorporating the use of software, those who work in medical billing can increase their precision in tracking a range of functions – from keeping tabs on patient demographics, appointments and diagnoses, to gathering and keeping track of billing information and insurance payments, scheduling, and generating reports. In addition to significantly reducing the chance for human error, the use of an electronic medical billing system generally offers substantial savings in time and money, as it makes sure that every patient bill is paid and all accounts received are kept up to date.

The majority of electronic billing systems for the medical industry require that the user sticks with the sections detailed in the Health Insurance Portability and Accountability Act (HIPAA), which emphasize improved security standards, ANSI billing formats, etc. It has been found that the use of the correct electronic medical billing software within a company assists in and facilitates a smooth work flow. And, since the software gives employees better access to personal details and time schedules, it’s likely that customers and patients will be satisfied as well. Insurers also benefit, since they are able to receive payments at a faster rate – often in less than half the time it used to take.

When looking for electronic medical billing software, be sure to select the system that will work best for your particular organization. And don’t hesitate to ask for assistance from the vendor regarding features and which one will be best suited for the company. Also, you might want to inquire as to whether a sample account could be provided on a trial basis, and they may have a sample CD available for you to take. Once all of the questions have been answered to your satisfaction, you will be able to make an informed decision as to which one to choose.

Above article publish on http://www.mymedicalbillingoutsourcing.com/medical-billing-software-difference/