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Dr. Lynn Ho Interview – Micropractice Working Towards Meaningful Use

Posted on August 10, 2011 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.

This is the next in a series of EMR and EHR interviews that will be done on EMR and HIPAA and EMR and EHR. The full EMR interview with Dr. Ho can be found on the new EHR and EMR interviews website. The following is a summary of that interview written by Kathy Bongiovi.

After completing a family practice residency at the University of Rochester in 1989, Dr. Ho worked in a variety of settings before making her decision to open her no-staff “micropractice” in 2004. Ho defines micropractice as being “a small, low overhead, no staff, hightech-high touch practice.” Because Ho believes the current financing model of delivering primary care by cranking up the volume of visits in order to meet overhead and salary is broken she wanted to move to a model that would be better for patients and give her more professional satisfaction.

Ho realized that one of the keys to running a successful micropractice is maintaining a low overhead. Her overhead is 25-30% of gross collections instead of the typical 60% that arises from paying staff salaries and for multiple work stations.

Amazing Charts was her choice of EHR and she has found the company very responsive to user requests. All of the software pieces needed to integrate well with her EMR, both via formal interfaces and in her informal workflow.

Ho has been able to make her office completely “paperless.” She accomplished this by having all patients send her their clinical histories using Instant Medical History from her website. She also has all new patients sign a laminated “HIPAA consent, for both billing and emailing, with one signature. Then she scans the page along with a copy of their insurance card to a file. She erases the patient’s information from the laminated sheet and reuses it for the next patient. She uses EDI interfaces for most labs and some x-rays and consults. Most consultants fax her their information electronically.

Dr. Ho had no formal training in using a computer and, in fact, had only used a Mac for accessing her email prior to opening her practice in 2004. She felt that with a laptop, an all-in-one, an internet connection and an EHR as the centerpiece of her technology stable, she was set for life. She was unaware of what her technology configuration would evolve into and she became mindful of just how many of her devices would have to successfully interact to properly implement the EHR system. As of the writing of this article she was in the process of attesting for Meaningful Use and was on course to achieving MU within three months of starting the process.

She updated her EHR to the latest version (Amazing Charts version 6) in order to use the “wizards” that would count the necessary data. Ho commented that it was taking only 2-5 minutes more, per encounter, to include the required documentation. Although she would prefer not to have to spend the extra time filling in the boxes, Ho did admit the MU wizard in her EMR makes it rather simple and not too painful to collect the necessary data.

She had the following thoughts on whether MU certification is proper for any given practice. “If you are already leveraging your EMR to help you in your practice in a meaningful way, then depending on your Medicare/Medicaid revenues/patient mix, it may be worth it to apply”. She felt the questions to be asked “are the monies received – or the penalty that you would incur, worth the time it will take you to: 1)learn about the MU program, 2) learn how to use the MU features of the EMR, and 3) actually do the documentation?” She also feels that a provider needs to consider his or her payor mix and practice volume. However, if a provider doesn’t use the EMR to collect demographic data or to E-prescribe, there will be additional work to adopt these processes into one’s workflow.

Dr. Ho feels that attestation is not proper for everyone. Smaller practices with very tight profit margins which lack breathing room may not be able to succeed because the benefits of certification may be outweighed by the efforts necessary to becoming schooled in MU deployment.

Read the full transcript of Dr. Ho’s EMR and Meaningful Use interview.

Family Practice Clinic Demonstrates Meaningful Use and Receives Maximum Medicare Incentive – EMR and EHR Interview

Posted on June 17, 2011 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.

This is the second in a series of EMR and EHR interviews that will be done on EMR and HIPAA and EMR and EHR. The full EMR interview with Dr. Muir can be found on the new EHR and EMR interviews website. The following is a summary of that interview written by Kathy Bongiovi.

If you’re a doctor, nurse, practice manager, EHR consultant, CEO or executive of an EHR vendor, etc with EMR experience that’s interested in being interviewed, let us know on our http://www.emrandehr.com/contact-us/“>Contact Us page.

Dr. Peter Muir of Springfield Center for Family Medicine was interviewed recently concerning his acquisition of the maximum Medicare Incentive for showing Meaningful Use of a Certified EHR. The Ohio based primary care practice has been using NextGen Ambulatory since 2003 and NextGen Management since 2006.

Dr. Muir stated that their practice chose NextGen EHR because the company focused on clinical offices. Dr. Muir and NextGen EHR share the philosophy of always searching for ways to improve the product. Dr. Muir not only believes in this philosophy but also attended a development think tank along these lines at NextGen’s headquarters. He was also drawn to NextGen because he wanted the capability of customizing his templates.

Having demographics, scheduling, clinical and billing information all on one database has had a huge impact on Muir’s practice. He feels that having a centralized database “makes reporting much easier and more comprehensive than those EHRs with separate databases or separate vendors”. The doctor admitted the conversion from paper charts to EHR was stressful for the first year but well worth it in the long run.

Since Muir’s office has been using EHRs (since 2003), there have been relatively few changes needed for Meaningful Use and any required upgrades to the system came as part of the standard NextGen maintenance fees. There was data that had to be added which was not normally collected by his practice as it had little relevance to his patients but from the patients’ perspective, there was no change in the attention patients received from Springfield Center.

The family practitioner Muir credits the CMS web site and NextGen Healthcare for not only the upgrades to their EHR software but also for their pathway documents and webinars which helped them show meaningful use. He also credits GBS of Youngstown, Ohio (his NextGen vendor for hardware, software) who also helped them implement security upgrades in 2010 in anticipation of the process.

Additionally, being a part of the ONC Meaningful Use Vanguard Program was a benefit to Dr. Muir because “it provides recognition which may allow a greater input in system design and operation.” Muir is concerned, though, that the Program’s flow of information may be difficult if multiple database silos remain in service and a lack of standardization isn’t addressed.

Especially with respect to Meaningful Use Stages 2 and 3, the doctor believes it is critical to have professional health providers utilizing some form of regional system – versus individual systems – in order to have a seamless flow of information. Muir has begun such a system within his own state of Ohio.

The doctor was intricately involved in starting CCHIE (Collaborating Communities Health Information Exchange) in Springfield, Ohio. CCHIE chose HealthBridge as their data engine and together they have partnered with other healthcare providers to provide electronic access to patients’ lab and radiology results as well as to admissions, discharges and transfer information. They have added regions in Southern Indiana and two regions in Northern Kentucky.

Dr. Muir’s advice to fellow doctors is that unless they are planning to retire within the next couple of years they should not delay in the implementation of an EHR. The longer they wait, the more difficult and time consuming the transition will be because, with time, the activities of daily practice will be much broader and more demanding. Additionally, he suggests providers select a system that does not just meet Meaningful Use requirements. His advice is to “select a system that assists you in providing better medical care”.

Read the full transcript of Dr. Muir’s interview.