MGMA concerned about success of EHR incentive program

I just read the attached article about the MGMA’s concerns with respect to the government’s incentive program for electronic health records.

“This is a historic opportunity for the industry to improve the clinical care physicians deliver to their patients and to streamline healthcare administration,” said William F. Jessee, MD, the MGMA’s president and CEO. “If constructed effectively, this program has the potential of transforming the nation’s healthcare system.”

I agree with DR. Jessee. The program needs to be structured in a way to facilitate wide spread adoption, instead of erecting huge barriers for physicians. I plan to follow this posting up with an additional posting detailing what is known about the program so far.

In the mean time, I’ve included a link to Kyle Hardy’s article, MGMA concerned about success of EHR program.

Selecting an Electronic Medical Records System: Choose Wisely

Choosing the right Electronic Medical Records System (EMR) for a particular medical practice can feel like a daunting task. There are hundreds of options in the marketplace making it difficult for an organization to sift through all the available systems and then make a selection. A further complication is the process of selecting the perfect information technology for a specific medical practice. This complex process requires a real examination of the workflow for one’s particular office.

Software companies continually promote through marketing campaigns the idea that marketplace consumers simply need to purchase software, insert the disk, press OK and begin using the software. When a small business is attempting to apply technology to their workflow, the process can become significantly more complex and involved.

Industries such as accounting, legal and financial services typically staff a full-time employee to manage the implementation of their business software. Some private medical practices may have the resources for this approach but without this dedicated position it is risk as most physicians are not familiar with the technologies involved.

To help get your medical practice started, I have outlined a phased approach to evaluate, select, deploy, and continuously improve an implementation of an EMR. This is by no means an all-inclusive “how-to guide” but rather a guide to begin the process of EMR implementation.

Phase 1: Identify the Need

Identify the people in your organization that will be responsible for the success of the EMR implementation. In a smaller practice this is typically a doctor and the office manager.

Once the team has been selected, start to create the criteria that you will use to review and evaluate potential EMR solutions. This is an important step to take if the plan includes the evaluation of multiple software platforms. It is much easier to compare options with a predetermined set of criteria.

Investigate the U.S. Government Economic Stimulus Program to ensure that you are a qualifying practitioner. For information click here to view our FAQ.

Ask yourself this question. What are my expectations of EMR in streamlining the daily business routines in my office?  There are a whole host of features available as part of any qualifying EMR platform, i.e., e-prescription , faxing, referral letters just to list a few. It is important to first determine what features will most benefit your specific practice and what features fall into the “nice to have but not necessary” category. Completion of phase one will frame your requirements and establish a budget for this project. The number of “beneficial” features is directly proportionate to the cost and budget requirements.

Phase 2: Examine the Workflow 

Once you have an idea of the features you would like to apply to your medical practice the next step is to determine those features that will be used on a daily basis. The best way to accomplish this is to examine the current workflow in the office.

Take a close look at how you run the practice today in the paper world and ask these questions:

• What are the steps taken with each patient?
• What parts of your paper notes do you really like?
• What’s really challenging?
• What efficiencies or limitations do you have in your practice?
• What do you hope to accomplish with an EMR?
• Is time wasted looking for misfiled patient charts?
• Is phone tag with patients an ongoing occurrence because access to the information is not always available?
• Do lab reports take forever to get into a patient chart?
• Does printing appropriate patient education materials with the push of a button seem appealing?
• Do decision support tools matter?

Performing this exercise should help identify how to gain tangible benefits from an EMR system.  A sample list of criteria was created to help your office get started. Please email me to request a copy.

Phase 3: Solicit Proposals

Begin meeting with potential vendors now that you are armed with a list of selection criteria. It’s a good idea to exclude software options that are not CCHIT certified. EMR that meet the 2008 CCHIT certification standards already adhere to rigorous standards for interoperability and e-prescription. These and a host of other items will likely be requirements for your practice to qualify for federal stimulus funding.

Keep in mind when interviewing potential vendors that not all offers are the same. Some companies will offer software only, services only or some will offer both. It is always a good idea to have the same vendor that sells you the solution also be the one required to support your EMR. Proposals should include a description of how the vendor intends to move from paper to electronic data files and the one time cost to accomplish the change over. The proposal should also include an exact description of the vendor support program for your practice in the future and the ongoing costs to provide this service.

Phase 4: Implementation of EMR

Following the completion of vendor selection it is time to start the implementation of your electronic medical records system. The selected vendor should have outlined a phased approach to include:

• Purchasing, configuring and deploying the new hardware and software
• Examining your existing workflow and paper charts
• Applying lessons and insight from that examination to the business workflow of your EMR software
• Training everyone in your office to use the new software
• Repeated training if needed in your office to ensure competency with the new software
• Periodic follow up with everyone in the office to make sure they know how to use the software
• Follow up to make the necessary adjustments

Both the vendor and the practice need to adopt a “whatever it takes” attitude when it comes to making the transition work. The best vendor in the world will be unsuccessful if there is a lot of resistance from team members in the practice. Likewise, a rigid vendor that is more focused on the number of hours worked than actually getting the job done will likely contribute to a failed implementation.

Phase 5: Support is Critical

A well-designed and well-implemented EMR system is a great foundation, but it is not the end of the process. Software can be temperamental and sometimes users forget how to do something that they learned in training. EMR requires consistent practice for members who use the software to achieve the real benefits. Additionally, consistent use will likely be a key requirement to meeting the government’s “meaningful use” definition. That means that the software and the network that the system resides on must work reliably which is why it’s important to ensure that you’ve selected a vendor who has the ability and intention to support your practice long term. It’s important to understand when reviewing the vendor proposal, exactly how the company intends to support your medical staff users, your network and your data after the system has been deployed.

• Who will be called when there is a problem?
• What is the average turn-around time for support?
• How will systems and data be backed up for your office?
• What countermeasures and processes has the vendor put in place to ensure that your practice meets and stays current with the industry regulatory requirements i.e., HIPPA?

When making the important decision on the selection of a long lasting EMR system and vendor relationship, it is necessary and critical to take time. The failure rate for EMR implementations undertaken is 30% to 40%. An impulsive purchase of an EMR system is therefore ill advised. It is important to have everyone on-board at the practice with the decision, as it is vital to the success of this project. Using a selection process that’s methodical, critical and inquisitive will go a long way to help your practice succeed with electronic medical records.

Endsight works in partnership with gloStream and can help with the complexity of this process. Endsight provides an inclusive solution designed to help busy physicians like you through the change of migrating to electronic medical records. The process is called gloDNA and it stands for Detailed Needs Analysis.  Included is a slide show that provides more detail about this approach. Click here to learn more and to schedule a practice consultation.

More than 140,000 physicians on growing list of e-prescribers

The number of physicians using electronic prescribing will have more than doubled in 2009, executives of the e-prescribing network Surescripts said.

More than 140,000 – 23 percent of all office-based physicians, nurse practitioners and physician assistants in the United States – are e-prescribing today, officials said.  At this current pace, Surescripts projects that its active e-prescribers in 2009 will more than double the 74,000 that were e-prescribing at the end of 2008.  by Bernie Monegain (Re-posted) More than 140,000 physicians on growing list of e-prescribers

Because I am fairly young and in good health, I have long stretches of time between office visits to my doctor.  The last time I was in the doctor’s office he prescribed medication for me by scratching an order out on a prescription pad.  The next time I pay him a visit, I don’t expect to see my prescription written on a piece of paper. 

EMR systems that will qualify for the federal stimulus program will be required to include the capability to process  prescriptions electronically.  gloEMR from gloStream already has this written into its software.  Without leaving the EMR interface, physicians can prescribe medication and transmit those prescriptions electronically using an integration into Surescripts.

In addition to being one of the requirements to qualify for the $44,000 stimulus incentive payments, e-prescribers also qualify for an additional 2% back.  For more information about electronic prescribing incentives, click here.

To learn more about gloEMR, click here.

To learn more about Endsight, click here

To schedule an in-person meeting to discuss electronic medical records and how this technology might be applied to your practice, click here

Healthcare IT chief takes on meaning of ‘meaningful’

In an open letter, National Coordinator for Health Information Technology David Blumenthal discusses what the government means when it refers to the “meaningful use of electronic health records.”

David Blumenthal, National Coordinator for Health Information Technology, recently sent an open email discussing “meaningful use.” (To read it click here)

In his email, Blumenthal states that infact, a great deal of work has been done to define  “meaningful use.” So far the process has included involvement from hundreds of stake holders and constituents and has resulted in a revised set of recommendations.

As the National Coordinator for Health Information Technology (ONC), Blumenthal  is charged with coordinating nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. ONC is working with the Centers for Medicare & Medicaid Services (CMS), through an open and transparent process, on efforts to officially designate what constitutes “meaningful use.”  The issue  is being carefully considered from many different angles and perspective and CMS has a sizable collection of recomendations to synthesize as it firms up its official definition.

CMS is expected to publish a formal definition of meaningful use, for the purposes of receiving the Medicare and Medicaid incentive payments, by December 31, 2009. At that time, the public will be able to comment on the definition, and such comments will be considered in reaching any final definition of the term.

Blumenthal also points out that even in the absence of a formal definition, physicians can still a begin evaluating the capabilities and benefits of an electronic medical record system.  EMR providers are happy to demonstrate their software and these demonstrations can serve as a way to help physicians to begin thinking about how they will apply EMR software to their specific workflow. 

For years, Endsight has been helping clients apply technology to thier business in a meaningful way.  To accomplish this, Endsight provides an upfront, detailed needs analysis that places the emphasis on the medical practices requirements and then maps those requirements to the software’s features. 

To learn more about Endsight’s approach, click here.

To schedule an in-person meeting to discuss your specific needs, click here. 

You can also watch a short web video that introduces Endsight by clicking here.

gloEMR Version 5.0 Receives 08 CCHIT Certification

On September 15^th,  gloStream announced in a press release that the Certification Commission for Health Information Technology (CCHIT) awarded their company’s  latest EMR product, gloEMR version 5.0., its 2008 Certification.  

 

When meeting with doctors, one of the big questions that freqently gets asked is, “Will this system communicate with the hospital’s system?” Interoperability, Is one of the key reasons incentive payments for physicians was included in ARRA (American Recovery and Reinvestment Act). It makes sense that the 2008 CCHIT Certification would include further definition around an EMR’s ability to exchange patient information with other systems.

The additional criteria added to the 2007 certification further demonstrates an “evolving” standard that will need to be continually monitored.

What is CCHIT?

According to its website, CCHIT stands for Certification Commission for Health Information Technology.  This organization is an independent, 501(c)3 nonprofit which  is  recognized as a certification body for electronic health records.

CCHIT’s goals are widespread adoption of health information technology (health IT) that can foster improvements in quality, safety, efficiency and access – key goals in today’s national dialog on health reform. For more information about CCHIT, Click here.

Is the 2008 CCHIT Certification the same thing as “meaningful use”?

No, selecting a product that meets 2008 CCHIT Certification will have an impact on meaningful use, but this does not guarantee that a medical practice will receive stimulus funding.   The Health and Human Services Commission has yet to issue an official standard for EMR systems to qualify for stimulus funding.

The criteria that will be used to gauge meaningful use has already been written into ARRA.  In his article entitled “Meaningful use no Mystery, Experts Contend,” Jack Beaudoin further discusses the broad strokes to this topic.  I’ve included a link to that article here.

What’s so important about this announcement?

gloStream’s  announcement  provides further evidence that the company is committed to doing whatever it takes to ensure that their products meet the Federal Government’s requirements for funding under ARRA. Endsight is also committed to providing guidance and support that will allow local Bay Area physicians to successfully deploy electronic medical records in a manner that will allow them to qualify for funding under ARRA.

If you think your practice is ready to start exploring electronic medical records, I invite you to click here to schedule an in person discussion.

HIT policy committee holds privacy hearing

Quote from: http://www.healthcareitnews.com/news/hit-policy-committee-holds-privacy-hearing-today “The success of health information technology and exchange rests on consumer and provider confidence in privacy and security protections,” Jodi Daniel, Director of the office of Policy and Research at the Office of the National Coordinator for Health IT.

Selecting an EMR system is just one step in the overall evaluation and deployment process. Security, privacy, and regulatory compliance will be key issues to wrestle with as Bay Area physicians evaluate their electronic medical records options. Diana Manos authored the included report about the HRT policy committee last week. I think her article sheds some light on the complexity of deploying an EMR system. Many challenging questions must be answered and addressed to assure the system is integrated in a way that protects the practice from an information/data breach.

I believe that this issue lends further weight to the idea of working with a local computer networking partner to navigate the selection and implementation process. Endsight has been helping clients deploy “hardened” networks that meet their clients regulatory requirements for quite some time. If you’re ready to begin evaluating your options for electronic medical records we’d be happy to share what we know with you. Click here to schedule an appointment with us.  

UnitedHealth: e-payments could save billions, help pay for health

It uses Microsoft Word as its form editor.  This allows doctors to re-create their paper-based charts in a Microsoft Word file, maintaining the format and look and feel of the original paper-based document.

It’s embedded with voice recognition software, allowing doctors to dictate directly into the Microsoft Word formatted note.  This feature saves time and eliminates the monthly cost for dictation services.

Glostream only sells their software through local dealers.  Moving from paper charts to electronic medical records is a huge undertaking.  Having a local partner help you through this process and maintain your systems moving forward is a much safer approach than simply buying software, trying to implement it yourself.

About Jason:  Originally from the great state of Ohio Jason Clause relocated to the Bay Area to work in high-tech.  A veteran of the dot com boom and bust, Jason has more than 10 years experience helping small businesses apply information technology to improve business process and increase revenue.  Jason lives in Dublin, California with his wife Jennifer and enjoys hiking, cooking and quiet time at home.  His hobbies include golf, snowboarding, creative writing and performing amateur stand up comedy. 

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