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/
Friday, August 27, 2010
Wednesday, August 25, 2010
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/
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/
Wednesday, August 18, 2010
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/
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/
Friday, August 6, 2010
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
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
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