Showing posts with label EMR Medical. Show all posts
Showing posts with label EMR Medical. Show all posts

Thursday, June 9, 2011

EMR Market Expected To Increase Growth

While the sales growth in electronic medical record (EMR) systems has been slower than anticipated due to confusion over vendor qualifications and federal guidelines, the EMR market did grow in 2010 and it should see much better years ahead, according to a report from Kalorama Information.

The value of the market for EMRs was about $15.7 billion in 2010, according to the New York-based healthcare market research company in its latest report, “EMR 2011: The Market for Electronic Medical Record Systems.”

The EMR growth rate in 2010 was 13.6 percent–just above the rate in 2009 (10 percent). These rates were less, though, than predicted by Kalorama researchers (it had predicted about a 15 percent growth for both years). However, the rates may be improving as physician adoption improves and more incentive checks for EMR adoption under meaningful use guidelines are sent out.

Kalorama is predicting that adoption and upgrading activities will be “brisk” in coming years. As new systems are sold, companies will earn revenues from existing clients in servicing and consulting–resulting in a market growth rate of 18 to 20 percent for the next two years.

“We think that while progress was made in physician adoption and in vendor sales, there is still a lot more potential,” said Bruce Carlson, publisher of Kalorama Information, in a statement. “There are still a considerable number of physicians who need to be fully functional and hospitals that have to improve their stage ranking.”

Source : http://www.emrspecialists.com/2011/03/emr-market-expected-to-increase-growth/

Thursday, March 17, 2011

EMR Spending Expected to Double in 4 years

Government incentives for using electronic medical records will result in spending on systems doubling by 2015, according to a report by IDC Health Insights. However, the study notes that much of that growth will come closer to end of that projected period, because vendors are having trouble keeping up with the orders.

Total EMR spending, which is expected to grow from $1.9 billion in 2009 to $3.8 billion by 2015, is about twice the growth rate analysts are seeing over the health information technology market and the general IT market, said Judy Hanover, research director of provider IT strategies for the Framingham, Mass.-based market research company and co-author of the report.

The report notes that a separate IDC survey in August 2010 found that 44% of health care organizations plan to accelerate or aggressively accelerate their plans to deploy EMRs because of financial incentives in the 2009 economic stimulus package. The stimulus provided incentives of up to $44,000 under Medicare and nearly $64,000 under Medicaid for meaningful use of an EMR.

But this rapid deployment is causing a vendor backlog that has resulted in unanticipated delays of up to six months for some practices and hospitals. Hanover said this has been a bigger issue for inpatient system deployments, but analysts are starting to see it on the ambulatory side as well.

The authors of the report predicted that the largest chunk of EMR investments will come in 2015. Not only is the backlog expected to cause delays, but some physicians will put off purchasing until it gets closer to 2015, when incentives turn to penalties.

The forecast shows clinics and physician practices will spend $335 million on EMRs in 2011 and $490 million in 2015. Ambulatory EMR spending overall was $633 million in 2009 and is expected to reach $1.4 billion in 2015.

Making an early decision on an EMR will help ensure that staff members are available for its installation, Hanover said. Practices might want to consider looking at third-party vendors if their primary vendors are experiencing a backlog, she said. Many third parties can provide installation and training services with the help of the vendor, she said.

After 2015, vendors are expected to enter a “maintenance cycle” in which revenue will come mostly from replacement systems or upgrades. Not only could the government require EMRs to perform more functions than they do today to qualify for incentives, health system reform may have an impact.

“We do expect to see, as health care reform goes into effect, a massive consolidation in the provider community in terms of acquisitions and reductions in the total number of providers,” Hanover said. “And that will drive some replacements and upgrading and reinvestment in EMRs.”

Source : http://www.emrspecialists.com/2011/02/emr-spending-expected-to-double-in-4-years/

Wednesday, March 9, 2011

Medicare EMR Incentive Program Begins Registration

Washington — Starting Jan. 3, eligible physicians and hospitals will be able to register for the Medicare electronic medical record incentive program, a prerequisite for obtaining billions in available federal bonuses, the Centers for Medicare & Medicaid Services announced Dec. 22, 2010.

Also starting Jan. 3, registration for the Medicaid EMR incentive program will launch for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. In February, registration will open in California, Missouri and North Dakota. The remaining states probably will launch their Medicaid EMR incentive program sign-ups in the spring and summer, CMS said.

Officials with CMS and the National Coordinator for Health Information Technology said they hope for broad registration by doctors and hospitals. To prepare for the process, health professionals are encouraged to visit the CMS website (www.cms.gov/ehrincentiveprograms/).

“With the start of registration, these landmark programs get under way, and patients, providers and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” said CMS Administrator Donald M. Berwick, MD.

David Blumenthal, MD, the national health IT coordinator, said, “It’s time to get connected.”

He added that his office and CMS have numerous resources to help physicians and hospitals enroll in the program. They include a website that lists more than 130 certified EMR systems (onc-chpl.force.com/ehrcert/).

Another site lists the 62 regional extension centers that can assist physicians in obtaining the bonuses (healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495/).

Physicians who want to participate must register in either the Medicare or Medicaid EMR incentive programs. Participants must choose only one program — they cannot receive payments from both. However, after receiving a bonus for a given year, they may change their program selection once before 2015.

In 2010, CMS finalized standards that doctors and hospitals must meet to demonstrate meaningful use of their EMR systems. Physicians can receive as much as $44,000 over a five-year period through Medicare, and up to $63,750 over six years through Medicaid.

CMS on Dec. 22, 2010, announced several additional key 2011 dates for the EMR physician incentive program:
  • January — Some state agencies begin issuing Medicaid EMR incentive payments.
  • April — Participants begin to attest eligibility for Medicare bonuses.
  • May — CMS begins issuing Medicare bonuses.
  • Oct. 3 — Physicians have a final chance to begin their 90-day reporting period to demonstrate meaningful use in 2011.
  • Dec. 31 — 2011 bonus payment year ends for eligible professionals.
Source : http://www.emrspecialists.com/2011/01/medicare-emr-incentive-program-begins-registration/

Wednesday, February 2, 2011

Healthcare iPad Deployment To Approach 70% In 2011

Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicates that iPad deployments are accelerating in large part due to the mobile device’s compelling point-of-care applications and uses.

Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey’s results were released earlier this month.

Data showed that nearly 70% of the attendees were from hospitals or healthcare organizations with more than 1,500 employees, and 15% of attendees were executive-level staff or physicians.

More than 25% of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70% plan to deploy the devices within the next year.

One-third of respondents identified point-of-care applications — including lab order visualization and results, clinical decision support, and medical image viewing applications — as top priorities, while 18% identified general administration, including billing, coding, and claims applications, as top priorities.

Nearly 75% identified secure configuration and deployment as the number one iPad IT management challenge, and 53% identified mobile application deployment as a key issue.

Lynne Dunbrack, analyst with IDC Health Insights, said security will remain a top concern for healthcare CIOs, especially if clinicians bring in their own devices to access the hospital’s healthcare information systems, such as electronic medical records (EMRs) and computerized physician order entry (CPOE) systems.

“As more patient information is moved into EMRs and made accessible both inside and outside the organization via a range of devices, including mobile devices and tablets, the risk of a privacy breach rises. Organized deployment and virtualized clients will help to mitigate this concern,” Dunbrack said.

Dunbrack also noted that the iPad, which has a sleek design, an intuitive user interface, and a large screen (relative to a smartphone), is becoming increasingly popular among clinicians. As the iPad gains traction among healthcare providers, EMR vendors will develop bidirectional integration between their EMR applications and clinicians’ mobile point-of-care devices such as smartphones and tablets.

Vendors are also developing EMR applications specifically for the iPad, Dunbrack observed. One example is St. Louis-based ClearPractice, a company that develops Web-based ambulatory EMR and revenue cycle management applications. ClearPractice recently launched Nimble, a comprehensive EMR application designed and developed specifically for the iPad.

Alan Snyder, BoxTone’s CEO, said in a statement that the iPad is redefining how organizations leverage mobile technology in the enterprise and the healthcare community is leading this paradigm shift.

“As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity,” Snyder said.

Source : http://www.emrspecialists.com/2010/12/healthcare-ipad-deployment-to-approach-70-in-2011/

Monday, January 17, 2011

Officials Preparing Adjustments to Meaningful Use Final Rule

CMS soon will release modifications for certain provisions in the final rule for Stage 1 of the meaningful use ehr incentive program, Government Health IT reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for incentive payments through Medicaid and Medicare.

Tony Trenkle — director of the Office of e-Health Standards and Services at CMS — said the adjustments to the meaningful use criteria currently are undergoing a federal clearance process, which is the final step before publication. Trenkle spoke on Wednesday during a Health IT Policy Committee meeting.

Trenkle added that CMS also will release guidance for health care providers on how to meet quality measures in the incentive program.

Discussion of Stages 2, 3

During the meeting, the Policy Committee also considered what incentive requirements to include in the next stages of the meaningful use program.

Committee members discussed whether Stage 2 meaningful use requirements — which are expected to go into effect in 2013 — should be incrementally built on requirements from Stage 1, or if there should be a set of larger steps framed around measuring and improving patient outcomes.

Paul Tang — chair of the meaningful use work group and chief medical information officer at the Palo Alto Medical Foundation — said the committee would prefer to establish the Stage 3 goals for 2015 first and then backtrack to form Stage 2 requirements.

Committee member Latanya Sweeney — director of the data privacy lab at Carnegie Mellon University — said future meaningful use criteria should incorporate privacy regulations (Mosquera, Government Health IT, 10/20).

National Coordinator for Health IT David Blumenthal said that the rollout of Stage 1 of the meaningful use criteria “was very rushed” (Conn, Modern Healthcare, 10/21). He added that the next stages should focus on infrastructure and interoperability.

Time Frame

Tang said that the meaningful use work group aims to have draft requirements for Stages 2 and 3 by Nov. 19, adding that it will revise the draft after taking comments from the full Policy Committee.

He said final recommendations could be submitted to the Office of the National Coordinator for Health IT by the third quarter of 2011, while CMS could release a notice of proposed rulemaking on the next stages by the fourth quarter of next year (Manos, Healthcare IT News, 10/21).

Source : http://www.myemrstimulus.com/officials-preparing-adjustments-to-meaningful-use-final-rule/

Friday, December 31, 2010

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/

Tuesday, December 28, 2010

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/

Friday, November 26, 2010

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/

Thursday, November 11, 2010

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/

Monday, October 11, 2010

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/

Wednesday, September 8, 2010

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/

Friday, August 27, 2010

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/

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/