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EMR Divide Remains Between Larger And Smaller Practices

Posted on January 31, 2014 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study finds that while physicians’ adoption of EMRs has grown substantially between 2009 and 2012, there’s still a big “digital divide” between large and small medical practices, according to a Commonwealth Fund study reported by iHealthBeat.  But it also concluded that there are ways to close the gap, largely through cash incentives and tech help.

According to the study, EMR adoption by primary care physicians increased from 46 percent in 2009 to 69 percent in 2000.  What’s more, Commonwealth Fund found that most doctors are using core health IT functions, including clinical decision support, e-prescribing and electronic ordering of lab tests.  This is clearly a sign that Meaningful Use Stage 1 has had a large impact. (We’re still waiting to see whether doctors continue to drop out and avoid Stage 2’s tougher criteria.)

The study also found that as of 2012, 33 percent of doctors could electronically exchange clinical summaries, and 35 percent could share lab or diagnostic tests with physicians outside their practices electronically.

But these results were not distributed evenly.  Specifically, researchers found that practice size substantially affected EMR adoption.

For example, the research found that 90 percent practices with 20 or more doctors had adopted EMRs, but that just 50 percent of solo physician practices were on board. That being said, the study found higher rates of EMR adoption among small practices that were sharing resources or that took advantage of Meaningful Use incentives.

All told, researchers concluded that technical assistance programs that incentives close the digital divide regarding EMRs between large and small practices.  This just makes sense. If such programs can make it easy and even lucrative to adopt EMRs, we could see the digital gap close soon.

In 2014, Health IT Priorities are Changing

Posted on January 30, 2014 I Written By

The following is a guest blog post by Cliff McClintick, chief operating officer of Doc Halo. Cincinnati-based Doc Halo sets the professional standard for health care communication offering secure messaging for physicians, medical practices, hospitals and healthcare organizations. The Doc Halo secure texting solution is designed to streamline HIPAA-compliant physician and medical clinician sharing of critical patient information within a secure environment.

2014 is a major year for health care, and for more reasons than one.

Of course, some of the most significant reforms of the Affordable Care Act take effect this year, affecting the lives of both patients and providers.

But it’s also a year in which health care institutions will come to grips with IT issues they might have been putting off. Now that many organizations have completed the electronic health record implementations that were consuming their attention and resources, they’re ready to tackle other priorities.

Expect to see issues related to communications, security and the flow of patient information play big in coming months. At Doc Halo, we’re already seeing high interest in these areas.

Here are my predictions for the top health IT trends of 2014:

  • Patient portal adoption. Web-based portals let patients access their health data, such as discharge summaries and lab results, and often allow for communication with the care team. Federal requirements around Meaningful Use Stage 2 are behind this trend, but the opportunity to empower patients is the exciting part. The market for portals will likely approach $900 million by 2017, up from $280 million in 2012, research firm Frost & Sullivan has predicted.
  • Secure text messaging. Doctors often tell us that they send patient information to their colleagues by text message. Unfortunately, this type of data transmission is not HIPAA-compliant, and it can bring large fines. Demand for secure texting solutions will be high in 2014 as health care providers seek communication methods that are quick, convenient and HIPAA-compliant. Doc Halo provides encrypted, HIPAA-compliant secure text messaging that works on iPhone, Android and your desktop computer.
  • Telehealth growth. The use of technology to support long-distance care will increasingly help to compensate for physician shortages in rural and remote areas. The world telehealth market, estimated at just more than $14 billion in 2012, is likely to see 18.5 percent annual growth through 2018, according to research and consultancy firm RNCOS. Technological advances, growing prevalence of chronic diseases and the need to control health care costs are the main drivers.
  • A move to the cloud. The need to share large amounts of data quickly across numerous locations will push more organizations to the cloud. Frost & Sullivan listed growth of cloud computing, used as an enabler of enterprise-wide health care informatics, as one of its top predictions for health care in 2014. The trend could result in more efficient operations and lower costs.
  • Data breaches. Health care is the industry most apt to suffer costly and embarrassing data breaches in 2014. The sector is at risk because of its size — and it’s growing even larger with the influx of patients under the Affordable Care Act — and the introduction of new federal data breach and privacy requirements, according to Experian. This is one prediction that we can all hope doesn’t come true.

To succeed in 2014, health care providers and administrators will need to skillfully evaluate changing conditions, spot opportunities and manage risks. Effective health IT frameworks will include secure communication solutions that suit the way physicians and other clinicians interact today.

Doc Halo, a leading secure physician communication application, is a proud sponsor of the Healthcare Scene Blog Network.

Unlocking The Power of Data Science In Healthcare

Posted on January 29, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

Vinod Khosla, Founder of Sun Microsystems and Khosla Ventures, recently stated that “in the next 10 years, data science and software will do more for medicine than all of the biological sciences together.”

The rise of population health and healthcare analytics companies aligns with Khosla’s claim. There are hordes of companies implementing healthcare analytics and helping providers identify at-risk populations to engage in proactive care. Despite their efforts, most of the analytics companies have been struggling to help providers actually improve outcomes.

Why?

Because data science in and of itself is meaningless. Effective data science can only provide insights. The challenge is in acting on insights provided by data. This is a widely acknowledged problem that every data science / analytics company faces; this problem has been particularly difficult in healthcare where a backwards culture and incentive structure have skewed the system towards complacency and volume rather than proactive care and value.

In healthcare, the actionability and effectiveness of data science hinge on communication between providers and patients, and on patients’ ability to act on those insights. There are a few methods of provider-to-patient communication and actionability:

At the point of care (in person or virtual visit) – providers have been educating patients at the point of care since the dawn of the profession. With advanced data analytics, providers can give more accurate, more customized education during the encounter. But the problem is that patients must act on that information at home when the doctor isn’t looking over the patient’s shoulder. Patients consistently fail to do what providers have asked them to do. The problem here is that the patient education and actionability based on education are intermediated by time and (lack of) context. Patients simply forget or are unwilling to do what their providers ask them to do in order to better care for themselves. Patients aren’t being educated in the right context. Point of care education won’t encourage patients from smoking the next cigarette, taking their meds on time, or skipping cheesecake at the office party.

Patient portals – the federal government has mandated that providers enable patients to engage with providers via patient portals. The basic premise of this mandate is that with access to their own health information, patients will take better care of themselves. Patient portals have some potential to empower patients to learn about their conditions at home and investigate conditions in more depth, but they don’t solve the context problem. Patient portals won’t do anything to help patients order a salad instead of a hamburger.

Messaging and notifications – this is the least explored, least understood, and in my opinion, the most potent communication channel to impact patient behavior. Automated notifications on iOS and Android can be presented contextually provided the device has contextual data to present notifications. Context is king. We live in the age of context. As devices learn more about their owners, devices can present contextual information to help change behavior. If your smartphone (or Google Glass, Jawbone, iWatch, etc) knows that you’re about to smoke a cigarette, it can automatically connect you with your husband/wife so that they can yell at you. If your device knows that you’re out at a steakhouse for dinner with business guests, it can remind you to order grilled chicken instead of a fried steak. The number of opportunities are endless.

To provide a better sense of the power of context, let’s examine Google and Facebook ads. Facebook ads are anything but contextual. When I’m scrolling through my news feed, I don’t care about the latest Hobbit movie, some new workout shake, or Dell’s newest laptop. I logged into Facebook to check out what my friends are up to, not to learn about the Hobbit or a laptop.

But when I Google “flight from Austin to New York January 18th” there’s a huge probability that I’m already committed to spending several hundred dollars to fly to New York, get a hotel, and spend money in NYC. With that search, only relevant advertisers – airlines, taxis, hotels, and local NYC attractions – will bid for my attention; I’m not going to see an ad for The Hobbit when searching for for a trip to NY.

This sense of context is reflected in Facebook and Google’s click through rates (CTR). 1-3% of all Google searches result in the user clicking on an ad. Between .01-.3% of FaceBook ads are clicked on. Google is measurably 10-100x more effective than Facebook. That’s the power of context.

There’s nothing wrong with emailing patients PDFs and interactive digital education tools after an encounter; there’s nothing wrong with patient portals and BlueButton. All of these communication channels fall short in that they don’t take advantage of real-time two way contextual communications. All of these channels are intrinsically one-way and lack context.

Books were the the first few-to-many communication channel. Then newspapers and magazines. Then radios. Then movies and TV. The defining characteristic of the Internet is that it is the first to enable two-way, many-to-many communications. The federal government’s healthcare communication model is fundamentally based on 20th century communication strategies. The power of data science will drive meaningful changes in patient behavior only when communication strategies leverage 21st century communication models.

CCHIT to Leave the ONC Certification Business

Posted on January 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Update: Multiple people sent me the email that was sent to CCHIT certified EHR vendors that details this decision. In the email, along with what’s detailed below, CCHIT suggests a transition to ICSA Labs for EHR certification and talks about a new allegiance with HIMSS to provide new programs and policy guidance including a series of summits and events to support that work. I’m still waiting for an official response from CCHIT and will update the post if they respond.

Update 2: Here is CCHIT and HIMSS press release about the change and also ICSA Labs comments on the change. Drummond Group also issued this response.

I recently got word from a source close to the EHR certification world (yes, that could be just about any EHR vendor or EHR consultant) that CCHIT is about to announce they are leaving the ONC Certification business. I was told that CCHIT will test those that are already in the pipeline, but will not continue as an ONC EHR certifying body. I’d still classify this as a solid rumor for now (I emailed them for comment, but still haven’t gotten a response. I’ll update the post if I do.), but it comes from a reliable source. Plus, CCHIT did just cancel their weekly webinar series. No point in doing the webinar series if you’re not going to be certifying EHR anymore.

Whether the rumor is true or not, it’s worth considering the EHR Certification bodies and what would happen if any of them decide to not go forward with EHR certification. It will likely have a major impact on the meaningful use program.

I don’t think we should be surprised by this decision if indeed it is the case. CCHIT was started years before ARRA and meaningful use. They were created with a cost structure that was higher because they were charging a lot more for their EHR certification when they started. Once ARRA hit, CCHIT was marginalized and as EHR certification was commoditized and codified, CCHIT became irrelevant. Plus, with three new competitors certifying EHR, the prices for EHR certification dropped dramatically.

Furthermore, I think that all of the EHR certifying bodies are finding that 2014 EHR Certification is much more complex and time consuming than the 2011 certification. Yet the price to certify is basically the same. To me, the economics of the EHR certification business were never good.

Think about the business. Let’s say you get paid about $30,000 per EHR certification. There are only 600 customers (at the time we thought it was closer to 300) for your entire business and many of those don’t even pay the full $30k. Enter in 3 competitors and you’re now sharing a market of less than $18 million or $4.5 million per certifying body. Not to mention the stimulus is for only 5 years with many of the EHR vendors likely to consolidate, stop certifying, or go out of business. Plus, EHR certification is not a high margin business and requires expensive government certification. The economics just aren’t that exciting as an entire business.

This rumor is also interesting when paired with the comments I’ve heard that the EHR certification bodies have a backlog of EHR vendors that are trying to get 2014 certified. They’re having to schedule their testing day months out. If CCHIT gets out of the EHR certification business, then that will only increase the delay in 2014 EHR certifications. I wonder if this will lead to another call for a delay in meaningful use stage 2. Can it be delayed now that some have already started MU stage 2?

I’ve never been a fan of EHR certification. I think it represented a lot of cost and very little value to the EHR industry, doctors and patients. I’ll never forget when I asked Marc Probst, Intermountain CIO and member of the ONC committee that worked on EHR certification, why we needed EHR Certification if people had to show meaningful use of the requirements. If you can show meaningful use of a requirement, then the software can certainly do that requirement, no? He answered, “I lost that battle.”

Whether this rumor is true or not, the next couple months are going to be really interesting months for EHR vendors. How many will get across the 2014 EHR Certification line in time? How many will fail in the process? Will the ONC-CHPL be able to keep up? If CCHIT does leave ONC EHR certification behind, what will they do next? Can CCHIT do something to make themselves relevant again?

How Much of Healthcare Business is Healthcare?

Posted on January 27, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

Editor’s Note: We’re excited to welcome Kyle Samani, Founder of Pristine, as a regular blogger here on EMR and HIPAA. I first met Kyle when he was a high school student working at his father’s EHR company. It’s amazing how far we’ve both come since then. You can find all of Kyle’s EMR and HIPAA posts here.

In The Great Re-Bundling of Healthcare, I argued that healthcare will be rebundled along new dimensions because technology will break assumptions that predicated bundling in the analog era of healthcare delivery.

In that post, I noted that a few industries have been completely dismantled and rebundled by technology:

The print publishing industry – newspaper and magazines – thought that their unique value was in their core product – news, editorials, and classifieds. But the unique value they delivered was in printing and distribution. When the Internet reduced the cost of printing and distribution to effectively $0 and free news became the standard, their businesses collapsed. Print publishers are left servicing the paper news market, which is a fraction the size of the overall digital news market.

Taxi companies thought that their local, retail, administrative, and regulatory overhead was necessary to solve the get-from-point-a-to-point-b problem. Using the Internet, Uber, Lyft, and SideCar proved that none of those overhead functions matter, enabling a new era of get-from-point-a-to-point-b solutions. Taxi companies are left servicing the I-haven’t-heard-of-Uber and there-aren’t-enough-Uber-drivers markets, both of which are rapidly shrinking.

Hotels thought constructing buildings and staffing employees was the only way to solve the get-a-place-to-stay-for-the-night problem. Using the Internet, AirBnB proved that anyone can solve the get-a-place-to-sleep-for-the-night problem for anyone else. Hotels are left servicing the high-end, premium service market in the get-a-place-to-stay-for-the-night business.

These examples beg the question: when healthcare is completely rebundled around digital delivery, what businesses will healthcare providers really be in?

In the examples above, the Internet empowered laymen to circumvent legacy establishments. Using the Internet, laymen performed the same tasks more affordably than traditional retail businesses.

With Watson-like self-diagnostics; an army of cheap, connected, sensors; and a wealth of freely available information on the web, laymen will increasingly self-diagnose and self-medicate whenever and however possible. This process will start at the low end – the simple stuff such as common colds, simple bumps and bruises – and increasingly move up market.

Over time, tri-corders (such as Scanadu), smartphone EKGs (such as AliveCor), smartphone ultrasounds, CTs, MRIs, and blood tests will empower patients to gather all of the necessary diagnostic information without ever visiting a retail medical facility. Patients will send data to providers electronically and consult with providers via video conference. The web will obviate the need for most retail overhead, capital expenditure, and labor cost associated with most care delivery.

Medicine will be disrupted from the bottom up. Hospitals won’t completely go away, but they will be left servicing the high-end of the market – ICUs, surgery, labor and delivery, and other high-acuity conditions – just as hotels, print publications, and taxis service the most expensive segments of their respective markets. The vast majority of care will be delivered as virtually and cost effectively as possible.

By circumventing retail establishments, medicine will centralize as geography loses relevance. Just as the hotel and taxi industries consolidated around mega-platforms such as Uber and AirBnB, healthcare will consolidate around provider hubs that service enormous populations. The mega healthcare systems will have the tools to centrally manage populations and interact with them contextually. The major health systems of the analog era that were bounded by geography will battle to become national behemoths as geography becomes irrelevant. Mayo Clinic, Cleveland Clinic, and others are already doing this by establishing virtual clinics across the country.

Why did the publishing industry, taxi industry, hotel industry, and travel agency industries collapse? Why will all of the old practices of medicine collapse? Cost. The most costly aspects of delivering care are labor and retail overhead. As increasingly small, localized, connected computers gather an increasingly large amount of data, computers will help patients self-diagnose and self-medicate without the need for expensive retail or labor overhead. Computers will automate inherently repetitive processes.

So how do I answer the question I posed in the title of this post? I’ll do some high level math. About 15% of the cost of delivering care is associated with billing and administrative overhead. About 40-50% is provider labor. There’s another 5-10% is spent on other miscellaneous expenses. And the remainder of costs are in capital expenditures including retail overhead. I suspect that 50-60% of total healthcare costs could be cut when healthcare is fully digital.

5th Annual New Media Meetup at HIMSS 2014 Sponsored by Stericycle Communication Solutions

Posted on January 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those of you planning to attend the annual HIMSS 2014 conference in Orlando, I’m excited to share the details of the 5th Annual New Media Meetup at HIMSS. Just last week I got a note from someone who attended the first New Meetup at HIMSS Atlanta (2010). It’s amazing the connections you can make at this event and that they’re still in tact 5 years later. No doubt this is why the New Media Meetup is the highlight of HIMSS for me.

We’ve secured a lovely venue for the event at the Tommy Bahama restaurant inside Pointe Orlando a short walk from the convention center. We’ll have the usual food, drinks, and lively conversation. Plus, you’ll get a chance to take multiple selfies with your favorite Health IT social media rock stars.

A heartfelt thanks to Stericycle Communication Solutions for sponsoring the New Media Meeetup and making it possible for those of us in New Media to enjoy a wonderful evening of food and drink together at HIMSS. I hope everyone will check out Stericycle Communication Solutions and thank them for sponsoring the event.

Also, those interested in this event will want to check out the full scale Health IT Marketing and PR Conference that we’re hosting in Las Vegas April 7-8, 2014. It’s going to be a special 2 days devoted to health IT marketing and PR.

Now for the details of the New Media Meetup at HIMSS 2014:

Register Here!

When: Tuesday 2/25 6:00-8:00 PM
Where: Tommy Bahama Pointe Orlando – 9101 International Dr, Orlando, FL 32819 MAP
Who: Anyone who uses or is interested in New Media (Blogs, Twitter, Social Media, etc)
What: Food, Drinks, and Amazing People

Note: We have limited space for the event and so like in past years, we’ll have to close registration once we reach capacity.

Sponsored by Stericycle Communication Solutions
SRCL Communication Solutions
Stericycle Communication Solutions help hospitals and providers acquire and retain patients through outsourced contact center services.

Our focus includes expanding patient access with one call resolution 24/7, identifying providers, scheduling appointments and helping consumers and patients to stay engaged in the health system while also meeting revenue objectives.

We also specialize in patient satisfaction and care compliance, including follow-up solutions after receiving care from physician, hospital, ED or other service provider. Learn more at www.stericyclecommunications.com

A really big thank you also goes out to all the members of Influential Networks and Healthcare Scene that help promote the New Media Meetup. This event was originally brought together through social media and still today is organized using social media.

Let me know if you have any questions and I look forward to seeing many of you in Orlando very soon!

The Guide to HIPAA Compliant Text Messaging

Posted on January 23, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve written regularly about the need to move to HIPAA compliant text messaging, because Texting (SMS) is NOT HIPAA Secure. To add to that, I recently wrote a post on EMR and EHR about Why Secure Text Messaging is Better than SMS. I throw out the whole “fear of HIPAA” component and paint a picture for why every organization should be moving to a secure text message solution instead of using SMS.

While I think a business case can be made for secure text messaging in healthcare over SMS without using HIPAA, the HIPAA implications are important as well. In fact, imprivata has put out The CIO’s Guide to HIPAA Compliant Text Messaging where they make a good case for why HIPAA compliant text messaging is important and how to get there.

The whitepaper suggests that you have to start with Policy, then choose a Product, and then put it into Practice. Sounds like pretty much every health IT project, no? However, the guide also offers a series of really great checklists that can help you make sure you’re covering all of your bases when it comes to implementing a secure text message strategy.

Of course, the biggest challenge to all of this is that everyone is so busy with MU stage 2 and ICD-10. However, when the HIPAA auditors come knocking, I wouldn’t want to be an organization without a secure text message solution. The best way to battle non-HIPAA compliant SMS messaging in your organization is to provide them an alternative.

Full Disclosure: I’m an adviser to HIPAA compliant messaging company docBeat.

Meaningful Use Program a Success…Depending on How You Measure Success

Posted on January 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The new National Coordinator of Health IT, Karen Desalvo, MD, published a blog post on The Health Care blog that proclaims that the “EHR Incentive Program Is on Track.” Of course, many would argue that it’s her job to be a cheerleader for healthcare IT, but I think this post is an important look at the measures that ONC and HHS have of what they consider a success.

If the goal of the EHR incentive money is just to get doctors and hospitals using EHR software, then indeed it’s been a big success. EHR adoption is through the roof at every level (although, I think they’d like it higher in the ambulatory space). This can’t be argued. The $36 billion in EHR incentive money got healthcare on board with EHR software.

If EHR use is your measure of success, then the HITECH act was a success. However, the goal of the HITECH act wasn’t just EHR adoption. If it was, then we wouldn’t have meaningful use. The goal was for doctors to adopt an EHR and then meaningfully use it. Of course, the jury is still out on whether doctors will follow through on meaningful use stage 2. I’m personally predicting a major fall out from those who attested to MU stage 1 and those that choose to sit out MU stage 2. Certainly Dr. Desalvo argues that this won’t be the case.

Either way, let’s assume that the majority of doctors do attest to meaningful use stage 2. Should we call the HITECH act a success? More pointedly, does meaningful use produce the results we want?

As someone who follows the EHR industry day in and day out, I think the jury’s still out on this. I’ve said many times that I fear the EHR incentive money might have incentivized doctors to adopt the wrong EHR software. The current and future EHR switching will likely prove this out. Although, we’ll see if organizations can get it right the second time.

However, choosing the right EHR is only half of the battle. Even the best tool used inappropriately won’t yield the desired results. There’s a strong case to make that meaningful use forces a doctor to use an EHR inappropriately. Every person at ONC calls this blasphemous and every doctor is likely to agree that meaningful use causes more work and does little to improve care.

I recently heard someone argue that they had “no sympathy for doctors having to accurately, legibly, and cohesively document what is happening.” I think it’s a real challenge to say that meaningful use equates the more accurate, legible, and cohesive documentation. In fact, many of the meaningful use hoops serve to make the documentation more illegible and difficult to read. Not to mention the issue of making the physician less efficient and therefore more likely to cut corners.

In this post, I’m not trying to make the case for or against EHR software. I’ve done a whole series on the benefits of EHR and so I believe that they can provide an amazing benefit to healthcare when implemented properly. My point with this post is that if our government is going to spend $36 billion on EHR software, then I wish they’d spend a little more time making sure that it’s not only implemented, but implemented well.

If they did this, then maybe we could call the HITECH act a real success. As it stands now, we’re using the only metrics we have available: EHR incentive spent and meaningful use attestation. I’d suggest there’s so much more value (both gained and lost) in an EHR implementation than either of those two things measures.

How about we track ways EHR use reduced costs, improved patient care, and saved lives? Maybe they don’t want to track that data because if they do, they won’t like the results. What would they do with meaningful use if they found out it raised costs, hurt patient care and did nothing to save lives? Would anyone want to make the case for why meaningful use should be scraped for something better? I wouldn’t want to as the new ONC chair either.

4Med Health IT Courses – HIPAA Training, ICD-10 Training, PQRS Training and More

Posted on January 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most of you know, I’ve been sharing a number of different 4Med approved education courses on this site and throughout my various social media channels. I think 4Med’s done a pretty good job putting together training courses that matter to those of us in Healthcare IT. For example, they have HIPAA courses, EHR Courses, ICD-10 courses and they recently added a course on PQRS which I haven’t seen anywhere else. As a partner, those links and the discount code “healthcare20” will get you a 20% discount off the course price. Plus, many of the courses include CMEs for those that need them.

What’s also been amazing to me is how many people I work with sell the 4Med courses as well. Everyone from health IT service providers to EHR consulting companies are signed up as 4Med affiliates and are suggesting these courses to their clients.

It makes sense why so many people are interested in these training courses. HIPAA Omnibus has led many to take another look at their HIPAA compliance. One of those requirements is to have regular HIPAA training. ICD-10 is bearing down on us and many aren’t ready and so ICD-10 training is going to be huge over the next 6 months. PQRS penalties are coming and many have no idea how the PQRS program even works. Hopefully these training courses can be useful for many of you.

Interview with Barry Haitoff, CEO of Medical Management Corporation of America

Posted on January 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is an interview with Barry Haitoff, CEO of Medical Management Corporation of America.
Barry Haitoff

Tell us about Medical Management Corporation of America (MMCOA).
MMCOA helps physicians and physician groups increase collections, assure compliance, manage overhead and navigate the maze of EMR/EHR, Meaninful Use, PQRS and other Government incentive programs and regulations. With a focus on revenue cycle management, MMCOA helps our clients stay ahead of the curve with things like the transition to ICD-10.

What are the keys to running a good medical billing company?
Like any successful business, I believe the 2 most important assets are people and systems. We hire, retain and cultivate quality individuals and empower them with state of the art systems and technology. We never settle for status quo and continue to look for better ways of doing things. My style of leadership is one of servitude. It is my goal to provide all staff members a great work environment, financial incentives and proper tools to perform their functions.

What’s your take on the economics of outsourcing medical billing? Where’s the ROI for an office that’s considering going with an outside medical billing company like yours?
I tell physicians, “do what you do best and outsource the rest”. Your tax work is handled by a professional accountant, your legal work is handled by a professional attorney, who is handling your billing? Outsourcing your billing can sometimes be more expensive than keeping it in-house, however, the return should far outweigh the added cost.

Most practices do not have adequate resources in their billing department to do the right job. A great deal of money winds up being left on the table. There is a reason that the tallest buildings in most metropolitan cities are owned by insurance companies. A quality billing company will increase your collections at a rate that will far exceed the fee.

In addition, because the typical fee structure is based on a percentage of collections, not only does the billing company have “skin in the game” to do a good job, the billing overhead of the practice is better managed. If one or more physicians are out of the office on vacation resulting in lower charges, that eventually results in lower collections. With billing in-house the practice still pays salaries, benefits, software licenses etc. All the fixed costs remain in place regardless of collections that month. With outsourced billing company, the practice’s cost for billing is directly in proportion to the amount collected that month.

What are some of the biggest changes to medical billing that have happened over the past couple years?
EMR/EHR, PQRS, ePrescribing, HIPAA, Meaningful Use, Accountable Care Organizations, Value/Quality based reimbursement, Bundling, Health Insurance Exchanges, added governmental regulations, OIG compliance and soon…..ICD-10, ICD-10, ICD-10. ICD-10 will prove to be the biggest challenge to date. We’re ready!

How is medical billing going to be impacted by things like ACOs (Accountable Care Organizations) and value based reimbursement?
Someone will still need to make sure that services rendered are reimbursed properly. More challenging, someone will need to distribute funds appropriately to the myriad of providers involved. There will be a greater need for revenue cycle management as payments are bundled.

Is healthcare ready for ICD-10? What are you doing to make sure you’re ready?
Our research to date says no. Providers and staff are not yet trained. Insurance carriers and software vendors have not yet successfully tested.

We have established an ICD-10 committee headed by our Director of Healthcare Informatics. We have begun informing and educating our clients and staff, researching tools, attending training sessions, initiating dialogue with our software vendors and staying up to date.

In what ways has the Accountable Care Act (Obamacare) and the health insurance exchanges impacted your clients?
I’d say that it’s caused a whirlwind of confusion. Providers must take the time to determine which HIX plan networks they’re in, so as not to provide care outside of a contracted relationship with the HIX plans, which predominantly lack out-of-network coverage. We expect our clients to become busier. We expect the additional covered lives to find their way into our clients’ offices. We have helped our clients figure out if they are participants in the Exchanges in their area.

A number of EHR companies have started doing medical billing. How do you differentiate the services you offer versus an EHR vendor?
Most of the EHR vendors that have just started doing medical billing, just started doing medical billing. MMCOA has been in business for 18 years, growing primarily by word of mouth. Some of the EHR vendors are publicly held companies whose most important stake holder is their shareholders. Our most important stakeholder is our clients. We have had clients leave us for those solutions and have since come back. We will continue to provide quality service on a consistent basis and will never sacrifice integrity for growth.

What are the biggest revenue cycle management issues you see in organizations?
Not enough staff. Outdated or inadequate technology. Lack of leadership. Lack of ongoing training. Lack of incentive.

Where do you see revenue cycle management going in the future?
My crystal ball is broken right now. Seriously though, there is a lot of consolidation in our industry and the smaller billing companies will likely go out of business or be acquired. Physicians and physician groups will continue to need assistance with their reimbursements. Unless all healthcare providers wind up employed by an ACO, Hospital System or other Healthcare entity with adequate revenue cycle management expertise, there will be a need for continued navigation of the maze we know as healthcare revenue cycle management.

Medical Management Corporation of America, a leading provider of medical billing services, is a proud sponsor of EMR and HIPAA.