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/