OmniMD EHR Earns Surescripts White Coat of Quality for 2012

TARRYTOWN, NY, January 3, 2013--OmniMD™, a division of Integrated Systems Management Inc., announced that its OmniMD electronic health record (EHR) has earned the Surescripts® White Coat of Quality distinction for technology vendors for 2012.

"Earning the Surescripts White Coat of Quality for 2012 for OmniMD EHR is an important recognition that we uphold the highest standards of quality in e-prescribing," said Divan Da've, CEO. "Very few EHRs have achieved this distinction. We are dedicated to continuous improvement of our products, and the White Coat of Quality for 2012 is a tribute to our team's work."

OmniMD serves more than 11,000 users with complete electronic medical record (EMR)/EHR software, cloud-based or enterprise. Surescripts is an important component of OmniMD's complete EHR, Da've said.

OmniMD's EHR previously completed Surescripts Gold certification. The resulting Gold Solution Provider status is granted to vendors with software products that surpass Surescripts' baseline product certification to meet criteria that demonstrate a higher level of commitment to e-prescribing. OmniMD was one of only nine vendors to attain that status in 2010.

The Surescripts White Coat of Quality distinction for technology vendors is a critical part of Surescripts' continuous quality improvement program. The White Coat recognizes technology vendors that uphold the highest standards of clinical quality in e-prescribing. E-prescribing saves lives, improves efficiency and reduces the cost of healthcare for all.

About OmniMD
OmniMD, headquartered in Tarrytown, NY, is a division of Integrated Systems Management, Inc., which is a leader in software development and information technology consulting since 1989. OmniEHR™, OmniPM™ and OmniMD Services offer unparalleled reliability, ease-of-use, efficiency, interoperability, and customizability. OmniMD v.11.2 is ONC-ATCB 2011/2012 certified as a Complete EHR and is also CCHIT Certified® 2011 for Ambulatory EHR with a 5-Star usability rating.

OmniMD offers a comprehensive set of services such as Revenue Cycle Management (RCM), medical transcription, document scanning and indexing, a patient portal, patient reminders, IT and networking, and eligibility verification as part of an integrated solution to help practices effectively address their financial, administrative, clinical, and regulatory needs. For more information, please visit http://www.omnimd.com.

Contact:
Connie Jones
Marketing Manager, OmniMD
914-332-5590 x116
cjones@omnimd.com

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/

Study: Most Americans support EMRs

CHICAGO – Seventy-eight percent of Americans favor the use of electronic medical records, according to a recent study by NORC at the University of Chicago, an independent research organization.

The study was published in the February edition of the journal HSR: Health Services Research.

Researchers say this report is different because most previous studies of EMRs have focused on the attitudes of clinicians or health organizations. Surprisingly few have focused on the attitudes of consumers toward health IT and, of those, none were based on a sample that fully represents the American people.

Key findings of the study are:

* Fifty-nine percent believe EMRs could reduce health costs
* Seventy-two percent support sharing of health care information among providers
* Eighty percent favored use of e-prescribing
* Seventy-nine percent thought that personal health records would help patients to be better informed about their health.
* Despite the fact that 48 percent of Americans are concerned about the privacy of medical records, fully 64 percent said that the benefits of EMRs outweigh privacy concerns
* The study also found that Americans aren’t without their reservations. Forty-four percent said they are not willing to pay to increase the use of health IT, and 57 percent said that use of health IT would make no difference in their choice of a physician.

Individuals with lower income and those who have less familiarity with electronic technology have less favorable attitudes towards health IT, the study found. Researchers say this implies that some of the populations that are most likely to benefit from health IT may be least open-minded about it.

“Our core finding is that a large majority of Americans support use of health IT to improve healthcare and safety, and reduce costs, which suggests that government and industry efforts to increase the effectiveness and use of health IT are generally consistent with the public’s wishes,” said Dan Gaylin, NORC’s executive vice president for Research, and the lead author of the study. “But there is still room for efforts to demonstrate the advantages of health IT among some important demographic groups.”

Source : http://www.emrspecialists.com/2011/02/study-most-americans-support-emrs/

Patient-Centered Medical Home Requires an EMR System

Patient-centered medical homes have become all the rage in the healthcare industry these days. The big push is coming from payers who want to cut costs and provider organizations who want primary care physicians to have a bigger say in the care of their patients. No matter who is driving the financial and clinical model, the train isn’t leaving the station, so to speak, without health IT to power it.

At a primary-care practice in St. Louis, Mo., both patients and their families are seeing firsthand how an electronic medical record (EMR) system documents patient treatment and applies clinical decision support and analytics to tailor a patient’s treatment plan.

PCMHs are not all the same, and the Des Peres Internal Medicine office further personalizes treatment by having a nurse practitioner and social worker as part of the PCMH team. One of the Des Peres Internal Medicine physicians said that one of the goals of the PCMH is to increase patient access to care. That could mean access to the social worker via telephone. It also gives patients the extra channel of communicating or completing tasks such as making an appointment, filling a prescription or entering patient vitals via a patient portal.

One of the best benefits of an EMR in a PCMH is the streamlining of care delivery, which includes the elimination of duplicative tests. Most patients in a PCMH likely have multiple chronic conditions that a care team must manage. If patients see multiple specialists on their own, who is coordinating the care? Even if the coordination is done through a primary-care physician, without an EMR to aggregate data and document what happens in every specialist office, the amount of administrative and clinical paperwork would be overwhelming.

Another benefit is empowering patients, which can often translate into taking better care of themselves, especially when they have their up-to-date patient information available to them via the patient portal and clinical decision support and analytics to support their entire care team.

Source : http://www.emrspecialists.com/2011/02/patient-centered-medical-home-requires-an-emr-system/

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/

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/

Hospitals Integrating Their Medical Devices and EMRs

A third of hospitals have integration between medical devices and electronic medical records, allowing data recorded on the devices to be uploaded automatically into EMR, according to a survey released Dec. 1 by HIMSS Analytics.

Most hospitals that have linked devices and EMRs said they believe it saves staff time by eliminating manual documentation.

HIMSS Analytics, part of the Chicago-based Healthcare Information and Management Systems Society, surveyed 825 U.S. hospitals on their use of medical device utilization. It found the devices most likely to be interfaced are intelligent medical device hubs (networked diagnostic equipment that provide data streams) and physiological monitors.

Recording and charting vital signs is one of the core measurements of stage 1 meaningful use. The Centers for Medicare & Medicaid Services meaningful use incentives offer hospitals a base payment of $2 million each from Medicare and Medicaid. Although the stage 1 meaningful use criteria do not require the charting to be done automatically, many believe integration between medical devices and EMRs will be required later.

“The transfer of data directly from a medical device to the EMR can reduce potential medical errors and improve patient care, because no manual transfer of data takes place,” said John Daniels, vice president of health care organizational services for HIMSS. “Such data integration also improves workflow by saving time for clinical staff, a valuable benefit when looking at nursing shortages in health care.”

The report notes that hospitals are not yet conducting return-on-investment studies on the integration of the monitoring devices to EMRs. But some hospitals have reported that integration has saved time. St. John’s Medical Center in Jackson, Wyo., reports that integration of vital sign monitors to its EMRs has yielded a 60% time savings, because staff do not have to enter the data manually.

The report said a critical factor hospitals face is determining how to connect an intelligent medical device to an EMR.

For those that integrate some devices to an EMR, about half use a wired local area network to provide the connectivity. Only 8% rely solely on wireless LAN connections for the integration.

The report says hospitals will place more importance on integrating medical devices to EMRs when more is known about the stage 2 and stage 3 meaningful use requirements. The Office of the National Coordinator for Health Information Technology is working on stage 2 criteria.

Source : http://www.emrspecialists.com/2011/01/hospitals-integrating-their-medical-devices-and-emrs/

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/

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/

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/

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/

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/

CMS announces $9 million in funding for Medicaid IT

By Joseph Conn

The CMS has announced the awarding of a total of just over $9 million in matching funds to be used by four states to plan for their Medicaid programs to subsidize provider purchases and the use of electronic health-record systems under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.

The states and their grant amounts are: New Jersey, $4.93 million; Louisiana, $1.85 million; Maryland, $1.37 million; and Minnesota, $1.04 million.

Since November 2009, 39 states, Puerto Rico and the U.S. Virgin Islands have shared nearly $67.6 million in planning grants, according to news release information on the CMS website.

The stimulus law provides a 90% federal match to cover the cost of state planning efforts for the Medicaid EHR subsidy programs. According to federal estimates, the government estimates it could spend as much as $27.3 billion on the EHR subsidies under Medicaid, Medicare and Medicare Advantage programs.

Above article publish on http://www.myemrstimulus.com/cms-announces-9-million-funding-medicaid/

Case Western Reserve to help providers adopt EHRs in Ohio

By Mike Miliard

CLEVELAND – Case Western Reserve University (CWRU) School of Medicine has received nearly $8 million in federal stimulus money from the Ohio Health Information Partnership (OHIP), the state designated entity for health information exchange development. That funding will position the school as a regional extension center (REC), allowing it to help 1,765 healthcare providers in Lorain, Cuyahoga, Lake, Geauga and Ashtabula counties advance the use of health IT in their practices.

The CWRU School of Medicine is one of seven RECs in Ohio established by OHIP and made possible by funding from the American Recovery and Reinvestment Act (ARRA). An eighth REC was awarded directly by the federal government to HealthBridge, a not-for-profit health information exchange serving Greater Cincinnati and surrounding areas.

The federal and state initiative is providing smaller primary care practices with an incentive to early adoption of health information technology.

“Electronic health records tend to be financially out of reach for private practitioners and small practices,” said Julie Rehm, senior associate dean of the CWRU School of Medicine and associate vice president of strategic initiatives for CWRU. “If healthcare providers adopt early they are eligible for additional reimbursement from the Centers of Medicare and Medicaid Services until 2011. After that, the reimbursement declines and penalties kick in starting in 2015.”

The REC endeavor, as directed by the federal government, is targeted towards primary care providers, specifically, physicians—MDs or DOs who are family physicians, general internal, pediatric or OB/GYN, and other primary care providers such as nurse practitioners, nurse midwives, or physician assistants with prescriptive privileges and practicing in one of the previously mentioned areas.

The CWRU School of Medicine will provide administration and management to multiple contractors whose roles will vary by expertise but overall will help providers select products and provide training on how to use the technology to its fullest potential in order to improve patient care. This includes providing workforce support, implementation and project management, practice and workflow design, vendor selection, privacy and security best practices, progress towards meaningful use, functional interoperability and health information exchange.

The CWRU REC has a number of stakeholders, including University Hospitals, the Cleveland Clinic and Massachusetts eHealth Collaborative. In addition, the entities likely to participate in the CWRU REC include Kaiser Permanente, Medical Mutual of Ohio and CareSource.

“The School of Medicine is committed to improving the health of our community,” said Pamela B. Davis, MD, dean of the School of Medicine and vice president for medical affairs, CWRU. “We believe that HIT is a key tool in healthcare reform and we look forward to partnering with independent healthcare providers to encourage quick adoption of HIT. Once enabled, HIT provides a two-fold benefit: 1) improving patient care, for example, through electronic alerts that notify healthcare providers of a patient’s need for annual testing e.g., mammograms, and 2) by lowering healthcare costs by reducing redundant testing.”

The Case Western Reserve REC is expected to begin work sometime this month.

“Success for the CWRU REC will be measured in three ways,” said Rehm. “First, we must meet the milestones and metrics that are being asked of us by the federal government. Second, we must enable the earliest adoption possible which will allow primary care providers to pull in the maximum amount of federal dollars from reimbursements. And third, we must improve the quality of care through the utilization of this technology which will ultimately improve the health of Clevelanders.”

http://www.myemrstimulus.com/case-western-reserve-providers-adopt-ehrs-ohio/

56 Organizations Agree on Priorities for “Meaningful Use” Program

According to recommendations from a large collaboration of organizations, the success of the new federal incentives program for health information technology (“HIT”) largely depends on a specific set of health improvement goals, a prioritized set of metrics, and the widespread participation of health care providers and patients.

Health care leaders from 56 different organizations filed a joint public comment on the program, which is part of the economic stimulus in the American Recovery and Reinvestment Act (“ARRA”). The Markle Foundation, the Center for American Progress, and the Engelberg Center for Health Care Reform at Brookings coordinated the collaborative comments on the Centers for Medicare & Medicaid Services’ Notice of Proposed Rulemaking for the Electronic Health Record Incentive Program.

The joint public comment recommends priorities to the U.S. Department of Health and Human Services (“HHS”), which will manage the new Medicare and Medicaid subsidies to doctors and hospitals for “meaningful use” of HIT starting in 2011.

The comment requests that HHS make clear a set of health improvement goals such as improving medication management and reducing readmissions to hospitals, so that everyone can contribute to these priorities.

Peter Basch, MD, senior fellow at the Center for American Progress, said: “As a practicing physician who has gone through the process of implementing health IT, I can say that it’s critical to set a bar that is ambitious but also achievable for the many diverse practices and hospitals that might participate in this program. We point out areas in which HHS can lower burdens on physicians without losing focus on the important goals of using health IT in ways that improve the patient’s experience and outcomes.”

Among other things, the collaborative letter stressed that the HIT program should encourage broad participation of providers by prioritizing the requirements necessary to receive payments and should enhance the ability of patients to obtain electronic copies of their health information.

Above article publish on http://pvwlaw.wordpress.com/2010/03/21/56-organizations-agree-on-priorities-for-%E2%80%9Cmeaningful-use%E2%80%9D-program/