By Rajeev Rajagopal
The healthcare industry is booming like never before. The substantial growth rate has triggered a massive response from BPO companies that offer accurate, affordable medical transcription for group practices. Hospitals, clinics, and healthcare centers strive to find the best transcription service providers in order to get quality service.
Physicians in group practices can’t often find time to manage the great inflow of patients and in addition to this, tight schedules and meetings hardly allow them any time off from work. Failure to manage their medical records properly would make patients lose faith in a medical practice and jeopardize its reputation. To employ staff for undertaking the work would not be practical owing to the huge expenses involved in terms of salary, employee benefits and other factors.
The practical approach to the problem lies in seeking the services of a reputable medical transcription company which would efficiently meet all the requirements regardless of the quantity of work the practice has. Most of the work is outsourced and therefore the cost of service tends to be considerably less. The practice could save as much as about 40%. In the long run, this would prove to be a great financial gain.
To provide accurate, affordable medical transcription for group practices outsourcing companies utilize the latest technology and software and complete the jobs entrusted within minimal turnabout time. Multilevel quality checks by quality analysts and verification of work by proofreaders ensure that transcription work is flawless.
HIPAA compliant companies take adequate safety and security measures. Encryption of data and transfer of files via FTP ensure dedicated and seamless connectivity. Last but not the least, round the clock customer/technical support addresses every issue to ensure customer satisfaction.
Above article publish on http://www.medicaltranscriptionoutsource.com/accurate-affordable-medical-transcription-group-practices/
Thursday, April 22, 2010
Proposed EHR Certification Program Won’t Inhibit Innovation, Says Blumenthal
By Andrea Kraynak
Is your EHR meaningful use-compliant? Healthcare providers may soon be able to find out for sure.
HHS released a proposed rule Tuesday for establishing certification programs for health information technology. The proposed rule describes the creation of a certification program for EHRs, as mandated by the HITECH Act.
EHR certification is designed to “give purchasers and users of EHR technology assurances that the technology and products have the necessary functionality and security to help meet meaningful use criteria,” according to a press release from the Office of the National Coordinator (ONC) for Health Information Technology.
When writing the interim final rule on standards and certification criteria for EHRs, the ONC strived to balance competing agendas, David Blumenthal, MD, MPP, the national coordinator for health information technology, said today at the Healthcare Information and Management Systems Society (HIMSS) 2010 Annual Conference and Exhibition in Atlanta.
For example, it tries to balance the need for uniform standards against the need for interoperability and innovation and the need for an efficient way to exchange information versus patients’ rights to privacy. The agency tried to allow for flexibility, to meet providers “where they are,” and not inhibit “critical innovation,” he said.
Similar to the multi-stage approach proposed for the EHR meaningful use incentive program, the proposed establishment of an EHR certification process would also occur in various phases.
* The first phase would be a temporary certification process whereby the National Coordinator would approve organizations to test and certify EHRs.
* The eventual permanent program would transfer testing and certification fully to private sector organizations and separate the two functions.
The separation of those two functions is an important aspect, Blumenthal said. It allows certification of not only completed EHRs, but also of individual modules, a move designed to allow architectural innovation.
The proposed permanent program also has requirements for accreditation and addresses the potential certification of health information technology (HIT) other than complete EHRs and EHR modules.
HHS anticipates issuing separate final rules for each of the two programs.
The multi-phase system is designed to enable eligible professionals and hospitals to implement certified EHRs in time to qualify for the initial set of meaningful use incentives, which are set to begin as early as October for hospitals, and January 1, 2011 for eligible professionals.
The phased method is a sound way for HHS to work within the regulatory timelines put in place by the HITECH Act, says Frank Ruelas, director of compliance and risk management at Maryvale Hospital and principal of HIPAA Boot Camp in Casa Grande, AZ. “It’s an ambitious program, so this approach works well.”
Because HHS made such a conscious effort to solicit input from so many different parties and such a wide variety of stakeholders, it injected an element of practicality into the rule, according to Ruelas. In addition, the rule takes care to consider the evolving meaningful use criteria and how the adoption of future criteria may affect the certification status of EHR systems or modules, he says.
One element of the program the healthcare community is likely to find particularly helpful is the proposed master “certified HIT products list” that the ONC plans to have publicly available on its Web site.
“This ONC master list will help folks accurately identify genuinely certified products that may help meet their needs, such as in achieving meaningful use,” says Ruelas.
The ONC expects it will add additional features to the Web site over time, such as interactive functions that would allow providers to review combinations of certified EHR modules to verify that they would comprise a certified EHR technology.
Interested parties will have 30 days after the proposed rule’s publication in the Federal Register to comment on the proposed temporary program, and 60 days to comment on the proposed permanent program. You can submit comments electronically at www.regulations.gov.
Blumenthal made it clear that HIT leaders must step forward to provide feedback for the proposed rules; throughout the document, there are questions directed at HIT leaders and requests for feedback. “We want you to continue to be leaders and we will follow your lead,” he said.
With the release of the proposed rule, the focus now shifts from policy to the process of implementation, said Blumenthal, who expects the release of the three related EHR meaningful use final rules later this spring. His soon-to-be expanded office will now begin working on the next iteration of meaningful use.
“That is a huge job. We are going to have to grow considerably to make that happen,” he said.
Above article publish on http://www.ehrexperts.us/proposed-ehr-certification-program-wont-inhibit-innovation-says-blumenthal/
Is your EHR meaningful use-compliant? Healthcare providers may soon be able to find out for sure.
HHS released a proposed rule Tuesday for establishing certification programs for health information technology. The proposed rule describes the creation of a certification program for EHRs, as mandated by the HITECH Act.
EHR certification is designed to “give purchasers and users of EHR technology assurances that the technology and products have the necessary functionality and security to help meet meaningful use criteria,” according to a press release from the Office of the National Coordinator (ONC) for Health Information Technology.
When writing the interim final rule on standards and certification criteria for EHRs, the ONC strived to balance competing agendas, David Blumenthal, MD, MPP, the national coordinator for health information technology, said today at the Healthcare Information and Management Systems Society (HIMSS) 2010 Annual Conference and Exhibition in Atlanta.
For example, it tries to balance the need for uniform standards against the need for interoperability and innovation and the need for an efficient way to exchange information versus patients’ rights to privacy. The agency tried to allow for flexibility, to meet providers “where they are,” and not inhibit “critical innovation,” he said.
Similar to the multi-stage approach proposed for the EHR meaningful use incentive program, the proposed establishment of an EHR certification process would also occur in various phases.
* The first phase would be a temporary certification process whereby the National Coordinator would approve organizations to test and certify EHRs.
* The eventual permanent program would transfer testing and certification fully to private sector organizations and separate the two functions.
The separation of those two functions is an important aspect, Blumenthal said. It allows certification of not only completed EHRs, but also of individual modules, a move designed to allow architectural innovation.
The proposed permanent program also has requirements for accreditation and addresses the potential certification of health information technology (HIT) other than complete EHRs and EHR modules.
HHS anticipates issuing separate final rules for each of the two programs.
The multi-phase system is designed to enable eligible professionals and hospitals to implement certified EHRs in time to qualify for the initial set of meaningful use incentives, which are set to begin as early as October for hospitals, and January 1, 2011 for eligible professionals.
The phased method is a sound way for HHS to work within the regulatory timelines put in place by the HITECH Act, says Frank Ruelas, director of compliance and risk management at Maryvale Hospital and principal of HIPAA Boot Camp in Casa Grande, AZ. “It’s an ambitious program, so this approach works well.”
Because HHS made such a conscious effort to solicit input from so many different parties and such a wide variety of stakeholders, it injected an element of practicality into the rule, according to Ruelas. In addition, the rule takes care to consider the evolving meaningful use criteria and how the adoption of future criteria may affect the certification status of EHR systems or modules, he says.
One element of the program the healthcare community is likely to find particularly helpful is the proposed master “certified HIT products list” that the ONC plans to have publicly available on its Web site.
“This ONC master list will help folks accurately identify genuinely certified products that may help meet their needs, such as in achieving meaningful use,” says Ruelas.
The ONC expects it will add additional features to the Web site over time, such as interactive functions that would allow providers to review combinations of certified EHR modules to verify that they would comprise a certified EHR technology.
Interested parties will have 30 days after the proposed rule’s publication in the Federal Register to comment on the proposed temporary program, and 60 days to comment on the proposed permanent program. You can submit comments electronically at www.regulations.gov.
Blumenthal made it clear that HIT leaders must step forward to provide feedback for the proposed rules; throughout the document, there are questions directed at HIT leaders and requests for feedback. “We want you to continue to be leaders and we will follow your lead,” he said.
With the release of the proposed rule, the focus now shifts from policy to the process of implementation, said Blumenthal, who expects the release of the three related EHR meaningful use final rules later this spring. His soon-to-be expanded office will now begin working on the next iteration of meaningful use.
“That is a huge job. We are going to have to grow considerably to make that happen,” he said.
Above article publish on http://www.ehrexperts.us/proposed-ehr-certification-program-wont-inhibit-innovation-says-blumenthal/
Medical Billing – Electronic Or Paper Claims
By: Michael Russell
Sometimes there are things in life that are very obvious. In the medical billing world, this isn’t always the case. Many on the outside would automatically think that electronic billing of claims is the sure pick over sending paper claims via the United States Post Office. And while electronic billing certainly does have its advantages, is it really the be all and end all of medical billing? In this article, we’re going to take a good look at each method of sending claims. Sometimes the grass is greener but sometimes it isn’t.
Let’s take a look at the facts of each type of billing. With paper claims, you have to either manually fill out the claims by hand, especially if you’re a small office and can’t afford expensive software, or at best you need the software to fill out the claims as they are printed off your dot matrix or laser printer. Most software products for this industry don’t support Inkjet printing. For that matter, most carriers won’t accept anything but laser quality anyway.
With paper claims, you also have the wait. Because insurance carriers are desperately trying to move on over to electronic billing, they process paper claims at a snails pace. It could be anywhere from 30 to 60 days to get paid on your paper claim. This is not a maybe. This is indeed a fact. Paper claims get paid slower.
Another fact of paper claims is that they carry the additional cost of having to keep forms in inventory. These forms are not cheap. Even if you get them included in your software package, the cost of billing a paper claim, at least on a per claim basis, is much higher than electronic transmissions.
Another fact of paper claims is that they have to be mailed. This adds the cost of postage to the already high cost of paper claim billing. Plus, with paper claim billing, there is always the chance that a claim can be lost in the mail. While this is not necessarily a given that it will happen, it is a definite possibility.
Now, let’s look at the facts of electronic billing. For starters, electronic medical billing is faster. The claims are literally transmitted to the insurance carrier in a matter of seconds, depending on how big the claim file is. Larger files do take longer, but for the most part, this is a much quicker process.
Electronically billed claims get paid faster. There is no question about this. Insurance carriers do this as an incentive for medical billing agencies to use electronic billing methods.
Electronic billing requires software and transmission hardware such as a modem or an Internet connection. This adds an expense to electronic billing that you don’t have with paper claims. This is a fact. There is no way to send claims electronically without some kind of software and transmission device.
Those are the facts of each. On the surface, it appears that electronic billing is the hands down choice. But before you make that decision, you must realize that unless you have a large enough client base to justify electronic billing, the cost of the software alone might make it unprofitable. Plus, with electronic billing, you’re going to have technical issues that you won’t have with paper claims, meaning you’re going to have to hire a networking staff and other technical persons.
Above article publish on http://www.mymedicalbillingoutsourcing.com/medical-billing-electronic-paper-claims/
Sometimes there are things in life that are very obvious. In the medical billing world, this isn’t always the case. Many on the outside would automatically think that electronic billing of claims is the sure pick over sending paper claims via the United States Post Office. And while electronic billing certainly does have its advantages, is it really the be all and end all of medical billing? In this article, we’re going to take a good look at each method of sending claims. Sometimes the grass is greener but sometimes it isn’t.
Let’s take a look at the facts of each type of billing. With paper claims, you have to either manually fill out the claims by hand, especially if you’re a small office and can’t afford expensive software, or at best you need the software to fill out the claims as they are printed off your dot matrix or laser printer. Most software products for this industry don’t support Inkjet printing. For that matter, most carriers won’t accept anything but laser quality anyway.
With paper claims, you also have the wait. Because insurance carriers are desperately trying to move on over to electronic billing, they process paper claims at a snails pace. It could be anywhere from 30 to 60 days to get paid on your paper claim. This is not a maybe. This is indeed a fact. Paper claims get paid slower.
Another fact of paper claims is that they carry the additional cost of having to keep forms in inventory. These forms are not cheap. Even if you get them included in your software package, the cost of billing a paper claim, at least on a per claim basis, is much higher than electronic transmissions.
Another fact of paper claims is that they have to be mailed. This adds the cost of postage to the already high cost of paper claim billing. Plus, with paper claim billing, there is always the chance that a claim can be lost in the mail. While this is not necessarily a given that it will happen, it is a definite possibility.
Now, let’s look at the facts of electronic billing. For starters, electronic medical billing is faster. The claims are literally transmitted to the insurance carrier in a matter of seconds, depending on how big the claim file is. Larger files do take longer, but for the most part, this is a much quicker process.
Electronically billed claims get paid faster. There is no question about this. Insurance carriers do this as an incentive for medical billing agencies to use electronic billing methods.
Electronic billing requires software and transmission hardware such as a modem or an Internet connection. This adds an expense to electronic billing that you don’t have with paper claims. This is a fact. There is no way to send claims electronically without some kind of software and transmission device.
Those are the facts of each. On the surface, it appears that electronic billing is the hands down choice. But before you make that decision, you must realize that unless you have a large enough client base to justify electronic billing, the cost of the software alone might make it unprofitable. Plus, with electronic billing, you’re going to have technical issues that you won’t have with paper claims, meaning you’re going to have to hire a networking staff and other technical persons.
Above article publish on http://www.mymedicalbillingoutsourcing.com/medical-billing-electronic-paper-claims/
Wednesday, April 21, 2010
Relaxing Meaningful Use Key to EMR Industry Growth, Kalorama Notes
By Chip Means
Relaxing the meaningful use standards, as some physician organizations and members of Congress are urging HHS to do, would be a boon to the EMR industry, according to market research firm Kalorama Information, which completed its market research report “EMR 2010 (Market Analysis, ARRA Incentives, Key Players, and Important Trends)” earlier this year. The report predicts a $13.8 billion market that if properly driven by incentives and encouragement of health systems, could grow in double digits.
“Requiring physicians to undergo 25 mandates by next year may not be effective given the kind of real-world usage among physicians we see today,” said Bruce Carlson, publisher of Kalorama Information. “Getting physicians used to these systems is the challenge to a totally paperless healthcare system in the United States and we think gradual, achievable goals would be preferable.”
Kalorama notes that the objectives of the HSS meaningful use requirements, in order for physicians to receive incentives in 2011, include some that would be expected, such as a requirement that physicians must submit a percentage of claims electronically, use an established diagnostic list such as ICD-9, and have common medications entered for each patient. The firm notes that some sort of requirement for computerized physician order entry (CPOE) on a percentage of orders should also be expected to increase EMR use. But Kalorama believes that requiring 80% of orders via CPOE by 2011, or that half of patients get auto-reminders through an EMR system, is a possible limiter to sales of EMR systems.
Thirty-seven U.S. Senators, led by Senate Finance Committee Chairman Max Baucus, D-Montana, and Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, D-Iowa, wrote a letter requesting improvements in a proposed rule for distributing stimulus funds for health IT that was published by the Centers for Medicare & Medicaid Services which would increase flexibility and encourage participation among providers. 235 members of the U.S. House of Representatives urged CMS to modify its proposed definition and requirements for hospitals to qualify for the meaningful use of health IT incentive payments.
Kalorama’s market research study was conducted before the release of ‘meaningful use’ standards by HHS, but it did note that the largest barrier to EMR use in the United States is physician compliance. Kalorama has also noted that for EMR to grow in the way the federal government envisions, healthcare systems will have to develop incentives of their own, something that might be in jeopardy if standards are not easier to follow.
“It’s not just about encouraging physicians directly, though that’s part of it,” notes Carlson. “It’s about encouraging healthcare systems to develop ‘matching’ programs to encourage EMR among their affiliated physicians. Unless there’s a clear road to incentive money they won’t do that.”
Above article publish on http://www.emrspecialists.com/2010/04/relaxing-meaningful-key-emr-industry-growth-kalorama-notes/
Relaxing the meaningful use standards, as some physician organizations and members of Congress are urging HHS to do, would be a boon to the EMR industry, according to market research firm Kalorama Information, which completed its market research report “EMR 2010 (Market Analysis, ARRA Incentives, Key Players, and Important Trends)” earlier this year. The report predicts a $13.8 billion market that if properly driven by incentives and encouragement of health systems, could grow in double digits.
“Requiring physicians to undergo 25 mandates by next year may not be effective given the kind of real-world usage among physicians we see today,” said Bruce Carlson, publisher of Kalorama Information. “Getting physicians used to these systems is the challenge to a totally paperless healthcare system in the United States and we think gradual, achievable goals would be preferable.”
Kalorama notes that the objectives of the HSS meaningful use requirements, in order for physicians to receive incentives in 2011, include some that would be expected, such as a requirement that physicians must submit a percentage of claims electronically, use an established diagnostic list such as ICD-9, and have common medications entered for each patient. The firm notes that some sort of requirement for computerized physician order entry (CPOE) on a percentage of orders should also be expected to increase EMR use. But Kalorama believes that requiring 80% of orders via CPOE by 2011, or that half of patients get auto-reminders through an EMR system, is a possible limiter to sales of EMR systems.
Thirty-seven U.S. Senators, led by Senate Finance Committee Chairman Max Baucus, D-Montana, and Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, D-Iowa, wrote a letter requesting improvements in a proposed rule for distributing stimulus funds for health IT that was published by the Centers for Medicare & Medicaid Services which would increase flexibility and encourage participation among providers. 235 members of the U.S. House of Representatives urged CMS to modify its proposed definition and requirements for hospitals to qualify for the meaningful use of health IT incentive payments.
Kalorama’s market research study was conducted before the release of ‘meaningful use’ standards by HHS, but it did note that the largest barrier to EMR use in the United States is physician compliance. Kalorama has also noted that for EMR to grow in the way the federal government envisions, healthcare systems will have to develop incentives of their own, something that might be in jeopardy if standards are not easier to follow.
“It’s not just about encouraging physicians directly, though that’s part of it,” notes Carlson. “It’s about encouraging healthcare systems to develop ‘matching’ programs to encourage EMR among their affiliated physicians. Unless there’s a clear road to incentive money they won’t do that.”
Above article publish on http://www.emrspecialists.com/2010/04/relaxing-meaningful-key-emr-industry-growth-kalorama-notes/
More Doctors Are Prescribing Medicines Online
By Timothy W. Martin
Doctors are increasingly prescribing medications electronically, abandoning the traditional paper scripts that can result in drug errors due to hard-to-read writing or coverage denials by a patient’s insurer.
The number of e-prescriptions nearly tripled last year to 191 million from the previous year’s 68 million, representing about 12% of the 1.63 billion original prescriptions, excluding refills, according to Surescripts LLC, whose online network handles the bulk of the electronic communications. The growth has accelerated. For the first three months of this year, nearly one in five prescriptions was filed electronically, Surescripts says. About 25% of all office-based doctors currently have the technology to e-prescribe, more than twice as many as at the end of 2008, Surescripts says.
Industry officials expect the growth in e-prescribing to continue, helped in part by a regulatory ruling last month that will soon allow doctors to start prescribing controlled medications such as narcotics and anti-depressants electronically. Under Drug Enforcement Administration rules, doctors previously had to hand out paper prescriptions for controlled drugs, even while other drugs could be e-prescribed.
The recent DEA ruling “is what we’ve all been waiting for,” says John Halamka, an emergency-room physician at Beth Israel Deaconess Medical Center in Boston, who has used e-prescribing for three years. Being able to digitally zap some prescriptions to a pharmacy, while having to use a pad and paper for other medicines has disrupted work flow at the hospital, he says. “Now we can write prescriptions for [cholesterol drug] Lipitor and Valium [a controlled anti-anxiety medication] on the same program,” he says.
Doctors transmit e-prescriptions via a secured Internet network directly to pharmacies from their computers or hand-held devices. Nearly all chain drug stores and 62% of independent pharmacies now accept e-prescriptions that are uploaded directly to their computers. For medical practices, the cost of e-prescribing software and hardware, such as laptops, as well as training can range from about $1,000 to $1,750 per physician, according to software makers.
Displayed on the doctor’s e-prescribing screen are an array of drugs and their prices. Doctors select among different doses and either generic or name-brand medications. Also listed are which medications are covered, and which are not, by a patient’s insurance company. For some e-prescribing programs, symbols in the form of small faces appear on the screen: A green smiley face means the medication will be the cheapest for a patient, or that it’s the preferred drug based on other medications the patient is taking. Yellow and red faces indicate less desirable options.
Major pharmaceutical chains say about one in four prescriptions they receive aren’t filled because they are not covered under a patient’s insurance plan. That usually prompts calls from the pharmacy to the doctor seeking alternative medication, they say. Insurance information is also available without e-prescribing, but usually requires a doctor or his staff poring through binders of information.
Ali Tural, a pediatrician from Fall River, Mass., who started e-prescribing last fall, says the new system has meant he spends less time on the phone with pharmacists and patients wrangling, for instance, over prescriptions not covered by insurance or the cost of the medications. “In the past, patients would complain to me about the little eye drops that cost them $80 or $100,” Dr. Tural says. “Now I can go to a patient and show them the real-life prices and compare the costs.”
A study by researchers at Weill Cornell Medical College in New York, published in February in the Journal of General Internal Medicine, found that e-prescribing significantly reduced errors that occurred with paper prescriptions, including patients receiving medications of the wrong dose or incorrect usage instructions. The researchers examined some 7,500 prescriptions from 12 medical practices. Practices that used electronic prescribing for a year cut their error rate to 6.6% on average from 42.5% before they began e-prescribing, the researchers found. The error rate at medical practices that continued to use paper prescriptions rose slightly to 38% on average from 37%.
Electronic prescriptions can also lead to errors, for instance if a doctor hits the wrong computer key. Dr. Tural says that in e-prescribing for his young patients he has inadvertently selected the pill version of a drug instead of the liquid form.
Michael Cohen, president of the Institute for Safe Medication Practices, a nonprofit that analyzes medication errors, supports e-prescribing. Still, he recommends that patients getting electronic prescriptions also ask for verbal instructions from the doctor for taking the medication and request a printout of the e-prescription.
Debbie Kenney, 59, of Philadelphia, says her doctor last spring wrote her a prescription for a hypertension medication that had recently come on the market. Unknown to both of them, however, the new medication could interfere with her asthma. Side effects flared up in December when she had trouble breathing after catching a cold, she says.
After her doctor began e-prescribing in January, Ms. Kenney says the new system clearly indicated that she shouldn’t be taking that hypertension drug. Instead, she says, her doctor switched her to another medication for hypertension that was compatible with her asthma.
“I do feel more confident now,” Ms. Kenney says. “When other drugs are prescribed, I can say to my doctor, ‘Show me the side effects.’ “
Helping to win doctors over to e-prescribing are incentives by the Center for Medicare and Medicaid Services, the federal agency that oversees the big federal insurance programs. CMS last year began paying doctors a bonus for e-prescribing. And beginning in 2012, CMS will begin penalizing doctors who haven’t adopted the electronic system for issuing prescriptions.
E-prescribing also is expected to encourage broader use of electronic medical records, which includes such features as storage of full medical histories, lab reports and programs that let doctors send alerts and reminders to patients. The cost of the technology to maintain full electronic medical records is roughly $25,000 to $45,000 per physician. An e-prescribing system typically can later be incorporated into a medical records system.
President Barack Obama has touted broader adoption of e-prescriptions and electronic medical records as integral parts of health-care reform. Government stimulus money has been earmarked for helping doctors pay for electronic medical records systems.
Pharmacy chains, including Walgreen Co. and CVS Caremark Corp., say they like e-prescribing because it means their staff spend less time on the phone sorting out problems with doctors. “E-prescribing gives the pharmacist more time to spend with the patient, to really have those meaningful discussions,” says Don Huonker, Walgreen senior vice president of health care innovation.
Above Article Publish on http://www.eprescriptionservices.com/doctors-prescribing-medicines-online/
Doctors are increasingly prescribing medications electronically, abandoning the traditional paper scripts that can result in drug errors due to hard-to-read writing or coverage denials by a patient’s insurer.
The number of e-prescriptions nearly tripled last year to 191 million from the previous year’s 68 million, representing about 12% of the 1.63 billion original prescriptions, excluding refills, according to Surescripts LLC, whose online network handles the bulk of the electronic communications. The growth has accelerated. For the first three months of this year, nearly one in five prescriptions was filed electronically, Surescripts says. About 25% of all office-based doctors currently have the technology to e-prescribe, more than twice as many as at the end of 2008, Surescripts says.
Industry officials expect the growth in e-prescribing to continue, helped in part by a regulatory ruling last month that will soon allow doctors to start prescribing controlled medications such as narcotics and anti-depressants electronically. Under Drug Enforcement Administration rules, doctors previously had to hand out paper prescriptions for controlled drugs, even while other drugs could be e-prescribed.
The recent DEA ruling “is what we’ve all been waiting for,” says John Halamka, an emergency-room physician at Beth Israel Deaconess Medical Center in Boston, who has used e-prescribing for three years. Being able to digitally zap some prescriptions to a pharmacy, while having to use a pad and paper for other medicines has disrupted work flow at the hospital, he says. “Now we can write prescriptions for [cholesterol drug] Lipitor and Valium [a controlled anti-anxiety medication] on the same program,” he says.
Doctors transmit e-prescriptions via a secured Internet network directly to pharmacies from their computers or hand-held devices. Nearly all chain drug stores and 62% of independent pharmacies now accept e-prescriptions that are uploaded directly to their computers. For medical practices, the cost of e-prescribing software and hardware, such as laptops, as well as training can range from about $1,000 to $1,750 per physician, according to software makers.
Displayed on the doctor’s e-prescribing screen are an array of drugs and their prices. Doctors select among different doses and either generic or name-brand medications. Also listed are which medications are covered, and which are not, by a patient’s insurance company. For some e-prescribing programs, symbols in the form of small faces appear on the screen: A green smiley face means the medication will be the cheapest for a patient, or that it’s the preferred drug based on other medications the patient is taking. Yellow and red faces indicate less desirable options.
Major pharmaceutical chains say about one in four prescriptions they receive aren’t filled because they are not covered under a patient’s insurance plan. That usually prompts calls from the pharmacy to the doctor seeking alternative medication, they say. Insurance information is also available without e-prescribing, but usually requires a doctor or his staff poring through binders of information.
Ali Tural, a pediatrician from Fall River, Mass., who started e-prescribing last fall, says the new system has meant he spends less time on the phone with pharmacists and patients wrangling, for instance, over prescriptions not covered by insurance or the cost of the medications. “In the past, patients would complain to me about the little eye drops that cost them $80 or $100,” Dr. Tural says. “Now I can go to a patient and show them the real-life prices and compare the costs.”
A study by researchers at Weill Cornell Medical College in New York, published in February in the Journal of General Internal Medicine, found that e-prescribing significantly reduced errors that occurred with paper prescriptions, including patients receiving medications of the wrong dose or incorrect usage instructions. The researchers examined some 7,500 prescriptions from 12 medical practices. Practices that used electronic prescribing for a year cut their error rate to 6.6% on average from 42.5% before they began e-prescribing, the researchers found. The error rate at medical practices that continued to use paper prescriptions rose slightly to 38% on average from 37%.
Electronic prescriptions can also lead to errors, for instance if a doctor hits the wrong computer key. Dr. Tural says that in e-prescribing for his young patients he has inadvertently selected the pill version of a drug instead of the liquid form.
Michael Cohen, president of the Institute for Safe Medication Practices, a nonprofit that analyzes medication errors, supports e-prescribing. Still, he recommends that patients getting electronic prescriptions also ask for verbal instructions from the doctor for taking the medication and request a printout of the e-prescription.
Debbie Kenney, 59, of Philadelphia, says her doctor last spring wrote her a prescription for a hypertension medication that had recently come on the market. Unknown to both of them, however, the new medication could interfere with her asthma. Side effects flared up in December when she had trouble breathing after catching a cold, she says.
After her doctor began e-prescribing in January, Ms. Kenney says the new system clearly indicated that she shouldn’t be taking that hypertension drug. Instead, she says, her doctor switched her to another medication for hypertension that was compatible with her asthma.
“I do feel more confident now,” Ms. Kenney says. “When other drugs are prescribed, I can say to my doctor, ‘Show me the side effects.’ “
Helping to win doctors over to e-prescribing are incentives by the Center for Medicare and Medicaid Services, the federal agency that oversees the big federal insurance programs. CMS last year began paying doctors a bonus for e-prescribing. And beginning in 2012, CMS will begin penalizing doctors who haven’t adopted the electronic system for issuing prescriptions.
E-prescribing also is expected to encourage broader use of electronic medical records, which includes such features as storage of full medical histories, lab reports and programs that let doctors send alerts and reminders to patients. The cost of the technology to maintain full electronic medical records is roughly $25,000 to $45,000 per physician. An e-prescribing system typically can later be incorporated into a medical records system.
President Barack Obama has touted broader adoption of e-prescriptions and electronic medical records as integral parts of health-care reform. Government stimulus money has been earmarked for helping doctors pay for electronic medical records systems.
Pharmacy chains, including Walgreen Co. and CVS Caremark Corp., say they like e-prescribing because it means their staff spend less time on the phone sorting out problems with doctors. “E-prescribing gives the pharmacist more time to spend with the patient, to really have those meaningful discussions,” says Don Huonker, Walgreen senior vice president of health care innovation.
Above Article Publish on http://www.eprescriptionservices.com/doctors-prescribing-medicines-online/
Bill Would Expand Eligibility for ‘Meaningful Use’ Incentives
Yesterday, Reps. Patrick Kennedy (D-R.I.) and Tim Murphy (R-Pa.) introduced a bill (HR 5025) that would allow behavioral, mental health and substance abuse treatment providers to qualify for incentive payments for the “meaningful use” of electronic health records, Healthcare IT News reports.
Under the 2009 federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs can qualify for incentive payments through Medicaid and Medicare.
The new Health Information Technology Extension for Behavioral Health Services Act of 2010 would extend eligibility for the incentive payments to:
* Behavioral and mental health professionals and clinics;
* Substance abuse professionals and treatment facilities;
* Psychiatric hospitals; and
* Licensed psychologists and clinical social workers (Merrill, Healthcare IT News, 4/16).
Above article publish on http://www.myemrstimulus.com/bill-expand-eligibility-meaningful-use-incentives/
Under the 2009 federal economic stimulus package, hospitals and physicians who demonstrate meaningful use of EHRs can qualify for incentive payments through Medicaid and Medicare.
The new Health Information Technology Extension for Behavioral Health Services Act of 2010 would extend eligibility for the incentive payments to:
* Behavioral and mental health professionals and clinics;
* Substance abuse professionals and treatment facilities;
* Psychiatric hospitals; and
* Licensed psychologists and clinical social workers (Merrill, Healthcare IT News, 4/16).
Above article publish on http://www.myemrstimulus.com/bill-expand-eligibility-meaningful-use-incentives/
Monday, April 19, 2010
A New Study: Easing the Adoption and Use of Electronic Health Records in Small Practices
A new study identifies lessons learned by organizations that help small physician practices adopt and use electronic health records (EHRs).
The authors surveyed 29 initiatives that help smaller medical practices adopt and use EHR technology, including some regional extension centers. They obtained information from program leaders, Web sites, and published reports.
Key Findings
* Current programs providing health IT assistance form one-on-one relationships with practice clinicians and staff to overcome implementation barriers—such as lack of technical expertise, isolation, and practice disruption—and to increase odds of successful practice transformation.
* Practice consultants need direct experience with small practices, the technical expertise to manage relationships with vendors, knowledge of software implementation, and know-how around work-flow change and quality improvement methods. Program leaders warned of a shortage of such individuals and remain concerned about finding sufficient qualified staff.
* A significant barrier to successful implementation and use of health IT is underestimating the effort and upheaval that accompany implementation.
* Most assistance programs can provide only limited help with selecting software and hardware, yet this is a critical decision for practices.
* Practice redesign and quality improvement methods are integral to using health IT to its full capabilities. Program leaders stressed addressing practice redesign prior to, or simultaneously with, health IT implementation.
Above article publish on http://www.ehrexperts.us/a-new-study-easing-the-adoption-and-use-of-electronic-health-records-in-small-practices/
The authors surveyed 29 initiatives that help smaller medical practices adopt and use EHR technology, including some regional extension centers. They obtained information from program leaders, Web sites, and published reports.
Key Findings
* Current programs providing health IT assistance form one-on-one relationships with practice clinicians and staff to overcome implementation barriers—such as lack of technical expertise, isolation, and practice disruption—and to increase odds of successful practice transformation.
* Practice consultants need direct experience with small practices, the technical expertise to manage relationships with vendors, knowledge of software implementation, and know-how around work-flow change and quality improvement methods. Program leaders warned of a shortage of such individuals and remain concerned about finding sufficient qualified staff.
* A significant barrier to successful implementation and use of health IT is underestimating the effort and upheaval that accompany implementation.
* Most assistance programs can provide only limited help with selecting software and hardware, yet this is a critical decision for practices.
* Practice redesign and quality improvement methods are integral to using health IT to its full capabilities. Program leaders stressed addressing practice redesign prior to, or simultaneously with, health IT implementation.
Above article publish on http://www.ehrexperts.us/a-new-study-easing-the-adoption-and-use-of-electronic-health-records-in-small-practices/
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